Inspection on 24/09/08 for Howards

This inspection was carried out on 24th September 2008.

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

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

Other inspections for this house

Howards 27/09/07

Howards 05/03/07

Howards 08/12/05

Howards 16/08/05

Howards 20/12/04

Howards 13/08/04

Similar services:

Old Hastings House

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Extracts from inspection reports are licensed from CQC, this page was updated on 19/12/2008.

CARE HOMES FOR OLDER PEOPLE Howards Howards 24 Rowtown Addlestone Surrey KT15 1EY Lead Inspector Pat Collins Unannounced Inspection 24th September 2008 09:30 X10015.doc Version 1.40 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Howards DS0000013683.V372300.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Howards DS0000013683.V372300.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Howards Address Howards 24 Rowtown Addlestone Surrey KT15 1EY 01932 856665 01932 856665 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Greydales Limited Nicola Crossley Care Home 21 Category(ies) of Dementia - over 65 years of age (0), Old age, registration, with number not falling within any other category (0), of places Sensory impairment (0) Howards DS0000013683.V372300.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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 needs on admission to the home are within the following categories: Old age, not falling within any other category - (OP) Dementia (DE) maximum number of places 10 2. 3. Sensory Impairment (SI) 4 The maximum number of service users to be accommodated is 21 The age/range of persons to be accommodated will be 60 years and over 27th September 2007 Date of last inspection Brief Description of the Service: Howards is a care home providing personal care and accommodation for up to twenty-one people of mixed gender aged from 60 years. Service provision includes dementia care. The home is situated in a quiet residential area on the outskirts of Addlestone village and is a few minutes walk from a small parade of local shops. It is within 2 miles of the M25 and readily accessible from Central London and the Home Counties. The building is detached with off road parking at the front. Bedroom accommodation is arranged on two floors, served by a full size passenger lift. Nineteen bedrooms are for single occupancy, fifteen with ensuite facilities and there is one twin bedroom. Communal facilities comprise of assisted bathrooms, a shower room and toilet facilities, also two lounges and a conservatory, which is also the dining room. The conservatory overlooks a wellmaintained garden with two fishponds. The current level of fees range from £550.00 to £650.00 per week. Additional charges apply for personal items, hairdressing, chiropody and newspapers. Howards DS0000013683.V372300.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this care home is: two star good service. The unannounced inspection visit formed part of the key inspection process using the ‘Inspecting for Better Lives’ (IBL) methodology. It took place over six hours and was undertaken by one regulation inspector. The report will say what ‘we’ found as it is written on behalf of the Commission for Social Care Inspection (CSCI). The responsible individual on behalf of the organisation was present for part of the inspection and for the feedback. The registered manager and deputy manager were present throughout the visit. Judgements about how well the home meets the national minimum standards for older people have been formed on the basis of the cumulative assessment, knowledge and experience of the home since the last inspection. The Annual Quality Assurance Assessment (AQAA), which is a self-assessment and dataset completed annually by management, also informed the inspection outcomes. We have taken into account information gained through discussions with people using the homes services, with management and staff. Additionally, comments of relatives and friends of people using services in response to the homes latest quality assurance survey. We toured the premises and garden, inspecting all rooms. Records, policies and procedures were sampled and practice observations carried out. These included administration of medication, arrangements for serving breakfast and lunch and a group social activity. We wish to thank all who contributed information to the inspection process. Also people using the home’s services and staff for their time, hospitality and assistance throughout the inspection visit. What the service does well: The staff team help people using services with communication skills, enabling their participation in activities of daily living. Best practice observations included the warm and frequent interaction between staff and people using services; also use of orientation boards in bedrooms of people with short term memory loss. These were being used in a positive, age appropriate manner, promoting independence and wellbeing. They provided prompts and information significant and meaningful to each individual. Recognition of equality and diversity is embedded in the homes culture, underpinning its policies, procedures, recruitement and care practice and staff training. A comprehensive needs assessment process ensures people using services can be confident the home can meet their needs. Howards DS0000013683.V372300.R01.S.doc Version 5.2 Page 6 People using the homes services can make choices in their lifestyles. They have opportunity to engage in a social activities programme coordinated by the activities organiser. There is some opportunity to access community facilities and they are supported in maintaining contact with family and friends. A balanced and varied diet is offered. The homes atmosphere is warm and friendly and good relationships evidently exist between staff and people using services. One person commented, I am very happy living here, they look after me very well, I love the staff and enjoy my meals. My room is very homely and I do what I want, when I want. It is very informal and relaxed here. I sometimes visit my friend who also lives in a care home. It is very posh but that doesnt necessarily mean better. I think this home is the best. The homes management is efficient and based on openness and respect, ensuring it runs in the best interest of people using services. The manager speaks with them daily, continuously seeking feedback to improve the homes services and address any issues as they arise. People using services have access to healthcare and remedial services. The home receives good support from a general practitioner and district nursing service. The environment is clean and hygienic, domestic in character, welcoming and overall nicely decorated and comfortably furnished. What has improved since the last inspection? What they could do better: Staff vetting procedures must ensure evidence obtained of prospective staffs physical and mental fitness or, where this is impracticable, for prospective staff to provide a signed declaration that they are fit. There is management recognition of the importance of staff training and development. Effort is being made to deliver staff training that meets statutory and service specific requirements. The manager is aware that there are still Howards DS0000013683.V372300.R01.S.doc Version 5.2 Page 7 gaps in staffs training and is working hard to address shortfalls. The in-house staff induction programme must incorporate safeguarding adults awareness. The expectation for care homes to cover the Common Induction Standards in their staff induction programme was discussed with the manager. A formal system for practice assessment of staffs competence in the administration of medication needs to be in place. A record must be kept of medication given to people using services who self medicate. Existing and prospective people using services might benefit from the provision of accessible information about the home. The service users guide and complaint procedure should be available in a range of formats, including large print, tailored to the individual needs of people who use the service. The social activities programme should be displayed, to offer people using services an informed choice of whether to participate. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Howards DS0000013683.V372300.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Howards DS0000013683.V372300.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards: 1, 3, 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Services are centred on the needs, wishes and views of people using services. Information produced to help them choose a home that meets their needs and aspirations should be available in a range of accessible formats, suitable to meet the communication needs of people using services. Comprehensive pre-admission assessment procedures ensure the home can meet the needs of people using services. Service provision does not include intermediate care. EVIDENCE: The home has an up-to-date combined Statement of Purpose and Service Users Guide, produced in a concise information document. The manager stated that this is given to people using services or their representative at the time of receiving enquiries about the home. It sets out the service aims and objective and philosophy of care, to provide a happy, safe environment and congenial surroundings for every resident. Our core philosophy is to recognise each Howards DS0000013683.V372300.R01.S.doc Version 5.2 Page 10 person as an individual and to provide care and attention to meet each specific physical and emotional needs. It provides a brief description of the home also information about its services and facilities, terms and conditions, about staff and the complaint procedure. It was suggested this be produced in other formats, including large print, suitable for the needs of people for whom the home is intended. We sampled the files of three people using services, focusing on pre-admission practice and procedures. Admissions do not take place until a full needs assessment is carried out by the manager, to be confident needs can be met by the home. The manager endeavours to carry out her own assessment, irrespective of whether the person already has a care management (health and social services) assessment. She is efficient at obtaining a copy of care managers assessments, where these exist. The three files examined all had comprehensive assessments carried out prior to admission. The process included a two and three day assessment with overnight stays for two people who planned to relocate to Surrey to be nearer their families. A person admitted as an emergency was assessed and referred by her general practitioner. The home manager undertook a home visit with the general practitioner to ensure the home could meet her needs. The assessment format enables diverse needs to be identified. Intermediate care is not provided by this home. Howards DS0000013683.V372300.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards: 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care received by people using the homes services is based on their individual needs. The principles of respect and dignity are put into practice. People using services are protected by the homes policies and procedures for the management of medication. EVIDENCE: Observations of practice confirmed personal support is responsive to the varied and individual needs and preferences of people using services. They are encouraged and enabled to be independent, as far as they can be. Staff respect their privacy and dignity. Intimate care is delivered in private and staff practice was observed to be discreet in the promotion of continence. Staff knocked on bedroom doors and waited for a response before entering occupied rooms. The care plans sampled stated the reason why bedroom doors were not fitted with privacy locks. The personal appearance of people using services was of a good standard, appropriate to their age and culture. Howards DS0000013683.V372300.R01.S.doc Version 5.2 Page 12 Care plans had been further developed and improved since the last inspection. They give a comprehensive overview of the health and personal care needs of each individual, acting as an indicator of change in health requirements. They are supported by detailed risk assessments, including falls risk assessment. The care planning process is inclusive and care plans are subject to regular review. People using services have access to healthcare and remedial services. The home receives good support from a general practitioner and the district nursing service. There are aids and equipment provided, which are well maintained, to support people using services in daily activities of living. The district nurse was currently providing treatment to one person with a small pressure sore, acquired in hospital. The managers attention was drawn to the criteria for notification of pressure sores, though not necessary in this instance. The home has an efficient medication policy supported by procedures and practice guidance, which staff understand and follow. The storage, recording and disposal of medication was compliant with regulations and ensured safe practice. No controlled drugs were prescribed at the time of this inspection, however the home has correct storage facilities for Schedule 2 controlled drugs should they be necessary. Staff designated responsibility for administering medication receive relevant training through a college. The manager stated that their practice is assessed at the home, to ensure competence. The needs to formalise and evidence these practice assessments was discussed. The homes management respects and understands the rights of people using services in the area of health care and medication. People who wish to continue administering their own medication receive the support they need to do so. Self - administration of medication is subject to a robust risk assessment that is reviewed at regular intervals and when there is any change in the persons circumstances. Since the last inspection a person who is self – medicating had been supplied with a lockable facility in her room, for the safe storage of her medication. This persons medication is ordered by the home and properly receipted. The manager was informed of the need to maintain a record of when medication is given to this person for self - administration. Howards DS0000013683.V372300.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards: 12,13,14,15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the homes services can make choices about their lifestyle. They have opportunity to engage in a social activities programme, to access their local community and maintain contact with family and friends. A balanced and varied diet is offered. EVIDENCE: The staff team help with communication skills, enabling the participation of people using services in daily living activities. Best practice observations included the warm and frequent interaction between staff and people using services; also the use of orientation boards in bedrooms of individuals with poor short - term memory. These were used in a positive, age appropriate manner, promoting independence and wellbeing, with prompts and information significant and meaningful to each individual. Organised activities are provided at the home by an activities organiser. A group activity was observed taking place in the afternoon at the time of the visit. The activities coordinator had received training in use of reminiscence techniques, to enhance communication. The importance of ensuring provision of visual prompts in the environment relating to the days social events was Howards DS0000013683.V372300.R01.S.doc Version 5.2 Page 14 discussed with the manager. She confirmed speaking with the activities organiser very recently and she had agreed to produce an activities programme for display in the home. The homes quality assurance survey carried out since the last inspection had demonstrated that some visitors were unaware that the home employs an activities organiser and there is an activities programme in operation. Evidence was seen of a range of activities provided, though it is acknowledged that only a small number of people using services are interested in joining in group activities. People using services said that various entertainment and outings are organised throughout the year. Last year some people enjoyed going to see a Christmas pantomime and a trip to London to see the Christmas decorations and lights. There had also been an outing this year to Brighton. A number of social occasions had taken place since the last inspection. The home also has a person who comes in once a month providing musical activities and a music for health session. People have opportunity to go out locally and sometimes visit the pub, a few doors down from the home. People using services benefit from open visiting times and can meet with visitors in the communal areas or if preferred, in their bedrooms. They were observed to freely move around the home, making choices in where they sat, including use of their rooms, and how they spent their time. Meal times were observed to be a positive and social experience. People have a choice of having their breakfasts in their rooms or in the dining room or lounge. Dining tables in the light, spacious dining room were attractively laid for lunch. The two-course roast meal appeared appetising and was nicely presented, portions sizes individualised according to personal preferences. Conversations with some people using services confirmed overall satisfaction with the standard of catering. Though there is not an alternative choice on the menu, they said if they wished to have something different then the cook would prepare it for them. The cook has worked many years at the home, at one time in the capacity of manager until her retirement. She was well aware of the individual likes and preferences of people using services and tried to meet individual requirements when planning menus. Howards DS0000013683.V372300.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards: 16,18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using services are protected by the homes complaints and safeguarding procedures. EVIDENCE: The complaint procedure had been updated but was not accessible in that it was kept in a folder and not displayed or issued to people using services and their representatives. It was suggested this be displayed prominently in a communal area or made available in each bedroom. Discussion took place with the manager about the need to reword the complaint procedure and the combined Statement of Purpose and Service Users Guide, which also refer to the complaint procedure. This is important so as not to raise expectations outside the remit of the Commission of Social Care Inspection specific to the investigation of complaints. Consultation with some people using services confirmed they would raise any concerns with their family or representatives or with care staff. We have not received any complaints about the home since the last inspection. The home had not received any complaints in the past twelve months. There is a copy of Surreys multi-agency safeguarding procedure, though not the latest edition, which the manager was advised to obtain. There has not been any safeguarding referrals regarding people using the homes services in the past twelve months. The manager is clear when an incident must be referred to the Local Authority as part of the local safeguarding adults Howards DS0000013683.V372300.R01.S.doc Version 5.2 Page 16 procedure. The staff member consulted was aware of indicators of abuse and stated she would not hesitate to report any allegations or suspicions of abuse to the manager. The home has a whistle blowing policy. Some staff had not received safeguarding training and others needed refresher training. The manager confirmed this training was planned. The need to ensure safeguarding adults awareness is included in the staff induction programme was discussed. Individual people living in the home confirmed they felt safe and that staff treated them well. A shortfall in staff recruitment practices must be addressed to fully ensure the safety of people using services. Howards DS0000013683.V372300.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards: 19, 25, 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the homes services live in a safe, hygienic, well - maintained and comfortable environment that encourages independence. EVIDENCE: The exterior of the home was tidy and the garden well maintained. Since the last inspection the home has had a new stainless steel fitted kitchen. This was observed to be clean and hygienic on the day of the inspection visit. The two sitting rooms were nicely decorated and comfortably furnished, in keeping with the traditional style of the building. The dining room was light and spacious. All communal areas were accessible to people using services and grab rails are provided to maintain independence. Bathrooms were fitted with power - assisted baths and facilities include a wheelchair accessible shower room. Bathrooms and toilets were clean and hygienic and supplied with liquid soap and paper hand towels, promoting best practice infection control Howards DS0000013683.V372300.R01.S.doc Version 5.2 Page 18 procedures. Bedrooms were comfortable and personalised. The shared bedroom was noted to have a privacy screen. All bedrooms had washbasins, emergency call bells and TV points as standard. An ongoing upgrading, redecoration and maintenance programme was evident. The home was clean and hygienic throughout and odour was well managed. Full compliance with requirements made at the time of the last inspection was evidenced. This had enhanced the environment, improving standards of cleanliness, décor, safety and ensuring all people using services have a hot water supply to washbasins in bedrooms. A boiler was not working at the time of the visit, affecting the temperature to one side of the building. An urgent call out had taken place to an engineer and a new boiler on order, due to be fitted in 48 hours. Howards DS0000013683.V372300.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards: 27,28,29,30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A shortfall in staff recruitment practice was identified and remedial action agreed with management, to ensure the protection of people using services. The number and skill mix of staff meets their needs. Management is aware of gaps in staff training and the training and development programme is ongoing, to ensure staff have the necessary skills and competencies. EVIDENCE: The homes staffing structure is based around the delivery of outcomes for people using services. Since the last inspection staffing levels had been reviewed. Staffing levels were now supplemented at peak periods. The rota demonstrated consistent staffing levels of two care staff and a senior or deputy manager on duty during the waking day, with a third care assistant at peak periods. Housekeeping staff, a cook and two waking night staff are also included in the rota each day. The manager is supernumerary to staffing levels. The home has a stable workforce, a number of staff having worked there for many years. There was a sense of good teamwork and a happy atmosphere. Recruitment practice almost meets statutory requirements. The need to ensure vetting procedures include obtaining evidence of prospective staffs physical and mental fitness or, where this is impracticable for a signed declaration to be Howards DS0000013683.V372300.R01.S.doc Version 5.2 Page 20 obtained from them, was discussed with the responsible individual and the manager. It was agreed this shortfall would be addressed. As at the time of the last inspection, further discussion took place regarding the need to ensure the recording, storage and disposal of CRB records is in accordance with CRB guidance. These were currently filed on personnel files. The induction programme is an in-house format that did not incorporate safeguarding adults awareness. The expectation for homes to cover the Common Induction Standards in their staff induction programme was also discussed. Staff files were sampled to assess the homes training programme. There was evidence that the service recognises the importance of staff training and development and is trying to deliver a programme that meets statutory and service specific requirements. The manager is aware that there are some gaps in staffs training and plans to deal with this. Twelve staff had recently undertaken first aid training. The manager was aware of the need to ensure all staff had moving and handling training. The company has a trainer and this is planned. At the time of the inspection four staff had care qualifications at NVQ level 2 or above and four were working towards this qualification. Howards DS0000013683.V372300.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards: 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is effectively managed and run in the best interest of people using services. The management and administration of the service is based on openness and respect and effective quality assurance systems are in place. EVIDENCE: The AQAA was received on time. The requirements made at the time of the last inspection were met or in the process of being met. The inspection outcomes demonstrated continuous improvement in services. Though gaps remain in individual staffs training there is an ongoing training programme to address the same. Care practice, based on all available information, provides a good quality of life for people using the homes services. There is a focus on equality and diversity issues and a person centred approach to the delivery of care and support. Howards DS0000013683.V372300.R01.S.doc Version 5.2 Page 22 The homes management structure has changed and one deputy manager is employed, not two, as at the time of the last inspection. The registered manager was perceived to have a positive, professional relationship with the responsible individual. He visits the home on a very regular basis as well as undertaking statutory monthly visits. Observations confirmed the homes management and administration was overall efficient and effective. The manager continues to study for the Registered Managers Award qualification (RMA). The home retains the services of a care consultant who sometimes undertakes the statutory visit on behalf of the responsible individual. He used to visit the home monthly but his input is now reduced to every two to three months. He undertook the homes latest quality survey in which some people using services and their representatives took part. The survey questionnaires sampled were completed anonymously. Comments included, Very friendly and caring staff, always on the go but have time to answer questions. It was suggested that the home generates an action plan from future quality surveys. This should demonstrate changes or improvements as a result of survey feedback. There also should be a system for sharing the results of surveys with current and prospective people using services and other interested stakeholders. People using services are supported to manage their money where possible, though mostly this responsibility is with their families. The home held money on behalf of two individuals whose financial records we sampled. Their money was securely stored and financial transactions were recorded and receipted. The balance of their money was accurate. Health and safety hazards identified at the time of the last inspection had been addressed. It was suggested to the manager that personal risk assessments for people using services include assessment of the potential trip hazard posed by the barrier around the pond in the garden, for individuals who use the garden unsupervised. Staff work to a clear health and safety policy. Safety records sampled included moving and handling risk assessments, records demonstrating regular monitoring of hot water temperatures to baths, showers and washbasins, the homes fire risk assessment and electrical certificate. Discussion took place with the manager regarding the homes cramped office facility and limited storage to ensure confidentiality of records. At the time of the inspection access to the office was restricted to senior staff for this reason. Howards DS0000013683.V372300.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x 3 3 STAFFING Standard No Score 27 3 28 1 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Howards DS0000013683.V372300.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Howards DS0000013683.V372300.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Howards DS0000013683.V372300.R01.S.doc Version 5.2 Page 26 - 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!