Inspection on 18/11/08 for Hollywood Rest Home

This inspection was carried out on 18th November 2008.

CSCI found this care home to be providing an Good 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

Hollywood Rest Home 11/12/07

Hollywood Rest Home 02/08/06

Hollywood Rest Home 12/01/06

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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: Hollywood Rest Home 791 Chester Road Erdington Birmingham West Midlands B24 0BX     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Brenda ONeill     Date: 1 8 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (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 31 Information about the care home Name of care home: Address: Hollywood Rest Home 791 Chester Road Erdington Birmingham West Midlands B24 0BX 01213506278 F/P01213506278 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Hollywood Rest Home Ltd Type of registration: Number of places registered: care home 27 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 26 The maximum number of service users who can be accommodated is: 27 The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 26 Date of last inspection Brief description of the care home Hollywood rest home is situated on the corner of Chester Road and Orphanage Road in a mainly residential area of Erdington. It is close to local shops, public houses and other community facilities. The home is within easy access of public transport and on the main bus route for convenient access to Erdington. Formerly a family home with an attached coach house, the property has been converted and extended to provide Care Homes for Older People Page 4 of 31 Over 65 26 0 Brief description of the care home accommodation for 26 elderly people. Bedrooms are provided over two floors consisting of seventeen single and four double bedrooms several of which have ensuite facilities. Communal facilities are all on the ground floor and comprise of two comfortable lounges and a large dining room. Bathrooms and toilets are located throughout the home and there is a shaft lift to the first floor ensuring people with mobility difficulties have easy access. Two of the bedrooms are accessed either by stairs or a stair lift for those with mobility difficulties. The registration for the home also includes a one bedroom flat next door to the main home. This was not occupied at the time of this inspection. There is some off road parking to the side of the home. The range of fees charged at the home was not detailed in the service user guide for the home. Care Homes for Older People Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The last key inspection at the home was carried out on December 11th 2007. This inspection was carried out by one inspector over one day in November 2008. During the course of the inspection a tour of the home was carried out, the care for two of the people living in the home was tracked. Two staff files were sampled as well as other staff training records, care, health and safety documentation. We spoke with the manager, the proprietors, two staff members and five of the people who live in the home. Prior to the inspection the manager had completed an Annual Quality Assurance Assessment (AQAA) which gave some additional information about the home. Eleven surveys were sent out to the people living in the home. Four of these were returned. Care Homes for Older People Page 6 of 31 An anonymous complaint had been raised with the Commission about the amount and variety of food available, the attitude of some of the staff and the availability of the manager and owner of the home. The complaint was referred back to the owner of the home and the issues were looked into as well as documents in relation to food being sent to us. No evidence was found to support the concerns at the time or during the course of this inspection. No adult protection issues had been raised in relation to the home since the last inspection. What the care home does well: What has improved since the last inspection? The systems in place for care planning and risk assessments had improved ensuring they were individualised and staff knew how to meet the majority of the needs of the people living in the home and minimise any risks. The requirements made following the last inspection in relation to the management of medicines had been met, for example, balances of medicines held in the home at the end of the 28 day cycle were carried forward to the next medication administration chart. Care Homes for Older People Page 8 of 31 The safety of the people living in the home had improved with COSHH items being stored securely and personal toiletries being returned to peoples bedrooms after use. The home had introduced a formal quality monitoring system to ensure the service was improved on an ongoing basis. There had been further improvements to the environment. All bedrooms had been fitted with locks, accessible to staff in an emergency, so that the people living in the home were able to lock their rooms if they wished. All bedrooms had been provided with bedside lighting and there had been some further decoration. The registration application for the manager had been forwarded to the Commission. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 31 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There was adequate information available for people wanting to move into the home to help them decide if the home could meet their needs. The pre admission assessment procedures ensured that the needs of all the people being admitted to the home were known by the staff. People were able to visit the home prior to admission to see if the home could meet their needs. Evidence: The statement of purpose and service user guide for the home were combined into one document. It had been updated since the last inspection and included the vast majority of information that people would need to help them decide if the home could meet their needs. The range of fees charged at the home was not included. This was discussed with the owners and they felt they would rather negotiate fees with individuals when they were considering moving into the home. It was recommended that the range of fees be included in the service user guide to give people some idea of Care Homes for Older People Page 11 of 31 Evidence: the lowest and highest charges. The satisfaction surveys that were returned to us prior to the inspection indicated that people thought they received enough information about the home before they moved. The files for two people who had moved into the home since the last inspection were sampled. They showed that the manager of the home had undertaken assessments of the individuals needs prior to them being admitted to the home. The assessments were quite comprehensive and covered areas such as, personal care, family contact, mobility, nutrition and communication. Any needs that were identified during the assessment were detailed. Both files also included copies of the assessments undertaken by social workers who had been involved in the admission process. These documents gave the staff at the home additional information about the individuals. One of the pre admission assessments undertaken by the manager had been done at a hospital. The other had been undertaken when the individual visited the home prior to admission to see if they liked it. Care Homes for Older People Page 12 of 31 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The systems in place for care planning and risk assessments had improved ensuring they were individualised and staff knew how to meet the majority of the needs of the people living in the home and minimise any risks. Some minor improvements were needed to the management of medicines to ensure people received their medicines as prescribed. The staff respected the privacy and dignity of the people living in the home. Evidence: At the time of the last key inspection concerns were raised about the lack of comprehensive risk assessments and some of the care plans being generic. At the time of this inspection there had been a significant improvement. The care plans and risk assessments for two people who had been admitted to the home since the last inspection were sampled. The care plans were much more personalised and detailed how staff were to meet the Care Homes for Older People Page 13 of 31 Evidence: needs of the individuals. For example, for one person whose first language was not English there were details of how staff were to communicate with the individual. The same person had a very good management plan in place for when she became agitated which was usually when staff were trying to assist with personal care. This detailed how staff were to explain everything they were doing and how they were to divert the persons attention. It also acknowledged that the behaviour could alarm other people living in the home and how this was to be addressed. The other persons care plan included a very comprehensive management plan for staff to follow for an ongoing health concern. Only one of the files included a care plan for personal care needs. This was well detailed and included details of the individuals, preferences, what she was able to do for herself and how staff were to ensure her privacy and dignity. Clearly from the daily records the other person was receiving a lot of support with her personal care and needed to have a care plan in place for this. The files also included a brief over view of the daily routines of the individuals. These included such things as preferred rising and retiring times and preferred drinks when going to bed and getting up. One of the care plans stated that the individual was to see a continence adviser. This had not happened but when speaking to staff we were informed the person was not incontinent and did not require this service. Another care plan detailed the wound care for one of the individuals, when the district nurse was to visit and so on. Although this was a very comprehensive plan the records indicated the wound was healed and the nurse had discharged the individual. The manager was advised that the care plans needed to be reviewed on at least a monthly basis and any care plans no longer applicable should be removed and where any of the needs of the individuals had changed these should be updated in the care plans. Both files sample included quite comprehensive manual handling risk assessments. These detailed what moves people were able to undertake on their own and any moves that were to be undertaken by staff. Both files included nutritional and tissue viability assessments. It was not clear on the tissue viability assessments if the individuals were at risk or not as there was no indication as to what the score meant. However in both cases their skin care had been detailed in their care plans, for example, one had a care plan for dry skin and the application of cream and what staff were to be aware of. Other risks had management plans in place with the care plans, for example, for challenging behaviour. However it was noted that one person had had some falls since being in the home. Information received prior to admission suggested the person was prone to falls also. There was no specific risk assessment in place for this. The majority of the falls were happening when the person was in their bedroom and although there were some safeguards in place, for example, regular staff checks there was no specific plan in place stating how the risk was to be minimised by staff. A risk Care Homes for Older People Page 14 of 31 Evidence: assessment was forwarded to us after the inspection. This was well detailed and instructed staff on how they were to minimise the risk of the individual falling. There was some evidence of personal care needs being met in daily records and key worker reports. All the people living in the home that were seen were very well presented many having jewelery and make up on and nicely manicured nails. There was ample evidence that peoples health care needs were being met. Records had been improved making it easier to track the visits that had taken place by health care professionals. They detailed visits from G.Ps, district nurses, dentists and chiropodists, hospital appointments being kept as necessary and emergency treatment being sought when needed. The people living in the home that were spoken with were very satisfied that their health care needs were met. They told us that if they requested to see the doctor staff arranged this. One person told us she had not been well during the night and staff had asked her did she want to see a doctor, if she did they would call one and it was 2am. One doctor visited while we were there and he was very positive in his comments about the home saying it was very well run. The vast majority of the medication in the home continued to be administered via a 28 day monitored dosage system, boxed medication was kept to a minimum. All medication was being acknowledged when it was received into the home and copies of prescriptions were kept so that they could be cross referenced to medication received. Any balances of medication held in the home at the end of the 28 day cycle were being carried forward to the next MAR (medication administration record) chart. A random audit was undertaken of the boxed medication being kept in the home. Some minor discrepancies were found between the amounts that had been received into the home, the amounts that had been administered and what was remaining for some medication. The manager and senior care were advised they should randomly audit the medication before and after drug rounds to identify where the errors were occurring. This will ensure that all medication is being administered as prescribed. The staff were administering some controlled medication and the records for these were appropriate. No issues were raised in relation to the privacy and dignity of the people living in the home. Where there were care plans in place for personal care how staff were to ensure peoples privacy was detailed. People living in the home were able to have private time in their bedrooms if they wished. They could meet with their visitors in the privacy of their bedrooms or one of the quieter areas of the home. All bedrooms had been fitted with locks and keys were available to the people living in the home if they wanted them. As bedrooms are being refurnished a piece of lockable furniture is being purchased to enable people to store any private items. Care Homes for Older People Page 15 of 31 Care Homes for Older People Page 16 of 31 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in the home were afforded a lifestyle that appeared to meet their needs, maintained contact with family and friends and were provided choices and nutritious food at mealtimes. Evidence: The files sampled during the inspection did not include any care plans detailing the social needs of the people living in the home making it difficult to know to if peoples needs were being met. It was strongly recommended that care plans were put in place detailing the social needs of the people living in the home and how these were to be met or enabled by staff. No rigid rules or routines were observed in the home. People were seen to wander freely around the home, spend time quietly in their rooms, sit talking in small groups and taking part in activities such as sing a longs and knitting. One of the satisfaction surveys that was returned to us was a little critical of the activities available in the home and described them as ad hoc and not stimulating. Other surveys indicated there were always activities arranged that people could take Care Homes for Older People Page 17 of 31 Evidence: part in. The surveys were discussed with the manager and home owner and they disagreed that activities were not stimulating and they were ad hoc. The home did not have a set activities programme as this could mean that if staff were not available the people living in the home would be disappointed and also they wanted people to be able to decide on an ongoing basis what they would like to do. We spoke to some of the people living in the home and they said there were activities if they wished to take part. Activity records indicated that staff facilitated activities twice a day whenever possible. These included such things as knitting, carpet bowls, films, card games, board games, dance and exercises, cake making, reading newspapers and coffee mornings. The people we spoke to appeared satisfied with the activities available. There was evidence that there were organised events throughout the year at the home many of which relatives were invited to these included, a garden party, easter celebrations, Halloween party and firework displays. There were also occasional trips out to such places as a local pub for lunch, the sea life centre and shopping. Two people went out to a luncheon club and another went out to church twice a week. There was also a church service in the home every Sunday. People were encouraged to do small tasks around the home, for example, laying tables. One person spoke to us about helping the hairdresser which she very much enjoyed and doing things such as folding serviettes. Visitors were made welcome at the home and there were no set visiting times. Daily records and key worker diaries showed that people living in the home had visitors at varying times. One person we spoke to told us she had been to visit her husband in hospital which had stopped her worrying quite so much. The people living in the home were free to go out with their relatives when they wished. The people living in the home were enabled to make choices in their everyday lives. For example, when to go to bed and get up, what to wear, how they spent their time and what and where they ate. They were able to take personal possessions into the home and these were seen in bedrooms. The people living in the home that we spoke with were very satisfied with the meals saying they had choices at meal times and food was plentiful. the satisfaction surveys we received also indicated people were satisfied with the meals. The menus were varied and nutritious and were displayed on the dining room tables. The menus were discussed with the people living in the home at meetings with them. The records for these showed that people had requested such things as croissants for breakfast and these had been put on the menu. Care Homes for Older People Page 18 of 31 Evidence: A complaint had been lodged with us earlier in the year which raised some issues about the food being served in the home. For example, not enough food, no snacks and jam sandwiches for lunch. This was referred back to the owner of the home and copies of the menus and food records were sent to us. No specific issues were raised by the documents and the owner did not uphold the complaint. No issues were raised at this inspection about the variety or amounts of food available. The records of food being served to the people living in the home needed to be further developed to ensure they included all the foods served and any special diets catered for. They also needed to include some indication of the amounts eaten by individuals. Care Homes for Older People Page 19 of 31 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in the home were satisfied that they were listened to and their views acted on. There were policies and procedures in place to ensure the people living in the home were safeguarded. Evidence: The home had an appropriate complaints procedure. A copy of this was issued to the people living in the home in the service user guide. The home had not logged any formal complaints since the last inspection. One complaint had been lodged with us. The issues raised included the amount and variety of food available, the attitude of staff and the availability of the owner of the home and the manager. The complaint was referred back to the owner of the home and the issues were looked into as well as documents in relation to food being sent to us. No evidence was found to support the concerns at the time or during the course of this inspection. The satisfaction surveys returned to us indicated that the people living in the home knew who to speak to if they were unhappy and how to make a complaint. The relationships between the staff and the people living in the home were good and this would give people the confidence to raise any issues they may have. As at the last inspection it was recommended that the staff record any minor grumbles made by the Care Homes for Older People Page 20 of 31 Evidence: people living in the home and how these were resolved as further evidence that they listen to the people living in the home. No adult protection issues had been raised about the home since the last inspection. We knew from the last inspection that the home had appropriate policies and procedures on site in relation to adult protection issues. These included a very comprehensive step by step guide for staff to follow in the event or suspicion of abuse. It was difficult to ascertain how many staff had received training in adult protection issues as the home did not have a training matrix although a copy of training dates given to us indicated that some training had taken place at the end of last year. Care Homes for Older People Page 21 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provided the people living there with a safe, well maintained and very comfortable place in which to live. Evidence: A tour of the home was undertaken. It was found to be safe, well maintained and comfortable with a good standard of furnishings and fittings. The communal areas comprised of two lounges and a large dining room. All were well furnished and decorated and the people living in the home were clearly very comfortable. The home did have a library area but as this was not used very often it was in the process of being made into another bedroom. The owners said they were intending to extend the home in the near future and this would incorporate some further communal space. There were adequate numbers of toilets and bathing facilities throughout the home. It was strongly recommended that the plans to have a floor level shower installed in the home were followed through. This would ensure the people living in the home had a choice of having either a bath or a shower. Some bedrooms were seen. There had been some further decoration and Care Homes for Older People Page 22 of 31 Evidence: refurbishment of bedrooms since the last inspection. All the bedrooms had had locks fitted that were accessible to staff in an emergency. The issue raised at the last inspection in relation to the people living in the home having access to bedside lighting had been addressed. Bedrooms had been personalised to the occupants choosing. All the people we spoke to were very satisfied with their bedrooms. The home had a variety of aids and adaptations including shaft lift, stair lift to two bedrooms, assisted bathing and toilet facilities, hand and grab rails and an emergency call system. The home was clean and odour free. The issues raised at the last inspection in relation to the storage of COSHH substances and personal toiletries being left in bathrooms had been addressed. The laundry was appropriately located and equipped. The kitchen was not inspected however the environmental health officer had recently visited the home. The report for the visit was very favourable with only minor issues being raised. Care Homes for Older People Page 23 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels and competencies were such that the needs of the people living in the home could be safely met. The recruitment procedures were robust and ensured the people living in the home were safeguarded. Evidence: Staff turnover at the home remained relatively low. Some of the staff had worked at the home for a considerable amount of time which was very good for the continuity of care of the people living there. The rotas indicated staffing levels were good. The minimum staffing was four care staff during the waking day and two waking night staff. The managers hours were not included in the care rota. The home also employed catering and domestic staff. Throughout the course of the inspection it was clear that the relationships between the staff and the people living in the home were good. The people we spoke with were very positive about the staff team saying they are marvellous, they could do no more and we have a laugh. The recruitment files for two staff that had been employed since the last inspection were sampled. All the required documents were available and all the required checks had been undertaken before the individuals had started work at the home, for Care Homes for Older People Page 24 of 31 Evidence: example, two written references and POVA first checks. Records indicated that new staff were having the appropriate induction when they started work at the home. As at the time of the last inspection it was difficult to assess the training undertaken by the staff team, as the home did not have a training matrix. We were shown a list of training that had been scheduled since the last inspection and were told this had all taken place. Topics included manual handling, infection control, first aid, food hygiene and adult protection. We were also told that some staff were undertaking dementia care training as a distance training course with a local college. It was strongly recommended that the manager had a training matrix for the staff team detailing when and what training had been undertaken so that it was easy to identify any shortfalls. The information received on the AQAA indicated that fifteen of nineteen staff employed at the home had an NVQ level 2 or above. At the time of the inspection we were told there were now sixteen staff with an NVQ which well above the required fifty percent. Care Homes for Older People Page 25 of 31 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager ensured the smooth running of the home in a competent manner with the full support of the owners. The health and safety of the people living in the home were generally well managed. The home has a formal quality monitoring system in place based on seeking the views of the people living in the home with a view to continuous improvement. Evidence: The manager had worked at the home for a considerable amount of time and had all the relevant qualifications. He had several years experience of caring for older people and was well versed in the running of a residential home. He demonstrated a good knowledge of the needs of the people living in the home at the time. We were told that the application for the registration of the manager had been forwarded to the Commission. This is the first home owned by the current owners and they remained very committed Care Homes for Older People Page 26 of 31 Evidence: to ensuring the home was run in the best interests of the people living there. One of the owners worked at the home virtually every day and offered support to the manager. The home had purchased a quality monitoring system and were working through this. The system audited the home against the National Minimum Standards. We were told that where the standards were not met an action plan was put in place stating what improvements were needed. To contribute to the system there were meetings with the people living in the home to get their views and opinions. Satisfaction surveys were completed on a regular basis with the people living in the home, their relatives and visiting professionals. The owner of the home was also conducting Regulation 26 visits to oversee the conduct of the home. During these visits she spoke one to one with different people living in the home and made records of the discussions. There were also regular staff meetings. There was a system in place at the home for managing money on behalf of the people living there where this was necessary. The records for this were sampled and found to be appropriate. All income and expenditure was documented and receipts were available for any expenditure made on behalf of people. The health and safety of the people living in the home and the staff were well managed. Staff received training in safe practices and had access to such things as protective clothing where necessary. The AQAA received by us prior to the inspection indicated that the equipment in the home was regularly serviced. The inhouse checks on the fire system were up to date and staff were receiving fire training and undertaking fire drills as required. It was recommended at the last inspection that the owners explored if the water system in the home needed to be checked for the prevention of legionella. They had addressed this and an outside contractor had undertaken all the required checks. This will now be done on a regular basis. We received very few Regulation 37 notifications form the home. Daily records and accident records showed that there had been some accidents in the home that we should have been notified about. Although there were no indications that accidents or incidents were not being managed appropriately the notifications are needed so that we can be assured through that all incidents are well managed on an ongoing basis. Care Homes for Older People Page 27 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 28 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 13 Where people living in the home are prone to falling a risk assessment must be undertaken and a management plan put in place detailing how the risk will be minimised. This requirement had been met for the individual concerned prior to the publishing of this report. This will ensure the people living in the home are safeguarded. 30/12/2008 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 1 1 It is recommended that the service user guide includes the range of fees charged at the home so that people have some idea of the the costs. Care plans should be reviewed at least monthly and where the needs of the people living in the home have changed the care should be updated. Any care plans no longer Page 29 of 31 2 7 Care Homes for Older People applicable should be removed from the working files. This will ensure staff have all the current information they need to care for the people living in the home. 3 7 It is recommended that care plans are drawn up for all the needs of the people living in the home and they detail how the identified needs are to be met by staff. This will ensure the people living in the home receive person centred care. Tissue viability assessments should be clear about what the score indicates. This will ensure staff are aware of whether people are at risk or not. It is recommended that the medication is randomly audited before and after drug rounds. This will ensure medication is being administered as prescribed. It is recommended that the people living in the home have care plans for their social needs to ensure they receive person centred care. The records of food being served to the people living in the home needed to be improved to ensure they detailed all the meals served and whether any special diets were being catered for. It was recommended that the staff record any minor grumbles made by the people living in the home and how these were resolved as further evidence that they listen to the people living in the home. It is strongly recommended that the plans to have a floor level shower installed in the home were followed through. This will ensure the people living in the home had a choice of having either a bath or a shower. It is strongly recommended that the manager has a training matrix for the staff team detailing when and what training has been undertaken so that it is easy to identify any shortfalls. The manager should ensure the Commission is notified of any events that affect the well being of the people living in the home. This will assure the Commission that any incidents in the home are being managed appropriately and in the best of interests of the people living in the home. 4 8 5 9 6 12 7 15 8 16 9 21 10 30 11 38 Care Homes for Older People Page 30 of 31 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (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. 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