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Inspection on 03/10/08 for Jennifer`s Lodge

Also see our care home review for Jennifer`s Lodge for more information

This inspection was carried out on 3rd October 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home is laid out in a domestic style and residents have use of the ground floor as well as access to a large and attractive garden. Bedrooms have been converted to be en-suite. The home is welcoming of visitors and the atmosphere is relaxed and friendly. Contact with family and friends is encouraged and a most residents have regular visits at the home and go to their relatives for short visits. Residents say that the staff are friendly and helpful, and the manager is at the home almost every day, and listens whenever they have any problems. The staff and manager are quick to involve relevant health professionals and social services whenever their support is needed. This was observed to be the case during the inspection. Health care needs are well met and residents commented that the food is good and they are generally happy that they get food they like. The registered manager is experienced and is open about areas where the home needs to improvements. There is a commitment shown by the manager and owner to act on requirements and recommendations made by other professionals and by the residents.

What has improved since the last inspection?

The registered provider has included information in residents contracts to show the fees being charged and reasons for any residents who are levied higher charges for the care provided. All residents have been asked about their wishes regarding end of life care and these wishes have been included in care plans for the residents who have agreed to do so. The home`s policy regarding protection of vulnerable adults has been reviewed and is now in line with the local authorities policy. Staff have had update training and understand their responsibilities in protecting residents and in recording information. Recruitment procedures have much improved and information is available regarding all staff to show that they have been properly CRB checked before starting work at the home. The home has improved training plans for staff and all staff have an individual training plan and records which show that they have appropriate training to provide a good service. This training also includes end of life care and learning disability support. The homes quality assurance system is now of a good standard and shows that residents are being consulted about how the home is run.

What the care home could do better:

The home should include a statement regarding mental health support and learning disability support in the home`s Statement of Purpose so that prospective residents willknow they can expect this support. Exercise routines available to residents should be more clearly clarified in the care plans, and formal exercise routines must be available to residents. Damaged flooring in the ground floor rest area must be replaced, and a video recorder in the dining area should be stored in a safer place, in order to ensure everyone is safe. Staff should receive more training regarding end of life care, and the care of dementia, in order to improve their skills and knowledge in these areas. Residents meetings should be revived so that residents can regularly be able to say how they feel about living at the home, and to sort out any practical problems they may have. The home should publish results of any resident surveys in writing so that residents can see the results of these surveys, and any plans for improvement.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Jennifer`s Lodge 105 Wellmeadow Road Catford London SE6 1HN     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: Sean Healy     Date: 1 0 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 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 30 Information about the care home Name of care home: Address: Jennifer`s Lodge 105 Wellmeadow Road Catford London SE6 1HN 02084612516 02084611944 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Jennifer Blackwood,Mr Eric Blackwood Name of registered manager (if applicable) Mrs Jennifer Blackwood Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: up to 3 persons aged 65 years and above, one of whom may be suffering from dementia to include one person aged 55 years or above Date of last inspection Brief description of the care home Jennifers Lodge is a small, privately owned care home providing support and accommodation for four older people. Mr and Mrs Blackwood are the proprietors, and Mrs Jennifer Blackwood is the registered care manager. The home is located on a residential road with direct access to public transport and a short distance from the main shopping area of Catford. There is on street parking available but no off road parking. The home is laid out on the ground floor and first floor of a detached house, and provides a service to four older people. Each resident has their own bedroom, which has been adapted to have en-suite toilet facilities. The provider?s email Care Homes for Older People Page 4 of 30 care home 4 Over 65 0 4 4 0 Brief description of the care home address is: jenniferbp@hotmail.co.uk Information about the service provided is made available to current and potential service users in the homes Statement of Purpose, Service Users Guide and in the homes brochure. The recent CSCI report is given to service users with the Statement of Purpose at the time of admission, and a copy is kept in the main entrance hall. At 5/10/07 the homes fees range from *380- per week to #400- per week, which covers all of the homes charges including food. Residents have to pay for other personal expenses such as hairdressing, transport and personal shopping. The reasons given by the manager for the difference in fees are that one resident has a larger bedroom and has higher support needs Care Homes for Older People Page 5 of 30 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: This inspection took place on the 3rd October 2008, and was concluded on the 10th October 2008, having received information requested regarding residents and relatives views. The Registered Manager and two care staff were involved in the inspection, and four residents gave their views of their experience of living in the home. I examined a range of documents regarding residents assessments and care plans, staff recruitments training and supervision and health and safety and I toured the building to look at the accomodation and facilities provided. Four residents information files were examined for information about assessments, care planning, risk assessments and complaints. Three staff files were examined for Care Homes for Older People Page 6 of 30 information about employment training and supervision. Discussion also took place with CSCI Regional Team regarding the registration status of the home, and whether there was a need to have a variation to registration included to reflect one resident having a mental health support need and another having a Learning Disability. It was decided that the primary care need of old age and dementia was sufficient and that a variation is not necessary. What the care home does well: What has improved since the last inspection? What they could do better: The home should include a statement regarding mental health support and learning disability support in the homes Statement of Purpose so that prospective residents will Care Homes for Older People Page 8 of 30 know they can expect this support. Exercise routines available to residents should be more clearly clarified in the care plans, and formal exercise routines must be available to residents. Damaged flooring in the ground floor rest area must be replaced, and a video recorder in the dining area should be stored in a safer place, in order to ensure everyone is safe. Staff should receive more training regarding end of life care, and the care of dementia, in order to improve their skills and knowledge in these areas. Residents meetings should be revived so that residents can regularly be able to say how they feel about living at the home, and to sort out any practical problems they may have. The home should publish results of any resident surveys in writing so that residents can see the results of these surveys, and any plans for improvement. 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 30 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 30 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have the information they need to make a decision about whether to live at the home. Residents contracts do adequately explain their rights and responsibilities and the service to be provided. All residents care needs are properly assessed before moving in to the home. Intermediate care is not provided. Evidence: There was a recommendation made at the last inspection for the home to include more information in how provides support for mental health and learning disability care needs, in the home Statement of Purpose and Service User Guide. While the home has clarified in residents care plans how it will provide support individually for each resident in these areas of need, this information has not yet been transferred in a general way into the homes Statement of Purpose and Service User Guide, as was Care Homes for Older People Page 11 of 30 Evidence: recommended the last inspection. Given that it is important for prospective residents to be able to judge how the home provides for these care needs, before making a decision to live at the home, it remains important for the home to include these aspects of care in these documents. Therefore this recommendation is repeated. (Refer to Recommendation OP1) Two of the residents were placed at the home by Lewisham local authority, one by Bromley local authority, and one resident is privately funded. There was a requirement made at the last inspection for the home to include in the residents contracts, or statement of terms and conditions, information about the reasons for any higher charges being made to any individual resident. This has now been done and this requirement is met. All four residents have a contract, or statement of terms and conditions provided to them, outlining their rights and responsibilities, and outlining the service to be provided by the home. The four residents range in age from 80 years old to 99 years old and all have a full assessment of care needs in place which has been provided for the home by Lewisham or Bromley social services. The homes manager has also carried out as separate care needs assessment before making a decision to provide a service. This assessment is very detailed in health and social care needs and ensures that up-to-date information is available to help to decide whether the home can provide for the residents care needs. Care Homes for Older People Page 12 of 30 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. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Health and personal care needs are well set out in care plans. Health care needs are being met, and medication is well managed. Residents are treated in a respectful manner ensuring their privacy is respected. Evidence: I examined three residents care plans and health and medication records and spoke with all four residents. There is clear and substantial health care information included in all residents care plans. This includes details of GPs, physiotherapist, chiropodist, noting support provided and involvement from the district nurse and tissue viability nurse when needed. At the last inspection one resident had been supported by the home through a difficult period having undergone surgery, and the homes records and care plans showed good detail about how this person should be supported throughout the recuperation. Today this resident confirmed that her care plan and the care provided by staff continued to support her well. Discussion with this resident revealed that she may benefit from the use of a swivel pad to enable her to get in and out of Care Homes for Older People Page 13 of 30 Evidence: cars. This should be considered and included in her care plan if appropriate. (Refer to Recommendation OP7) There was a requirement at the last inspection for the home to ensure residents are asked about their wishes regarding end of life care and that these be included in their care plans with each residents permission. This has now been done and all files examined assured clearly written, signed statement, from each resident, outlining their wishes. Each residents care plans are also include a good level of detail about their leisure and social care interests, and about their desired relationships with family and friends. The care needs outlined in residents care plans include: pain control, wound healing, mobility support, personal care guidance for staff, mental health support, constipation, activities, and social networking. All files showed that risk assessments were fully taken into account and all reviewed monthly. One resident had recently moved into the home within the previous three months, and a detailed care plan and risk assessment was in place, which he confirmed he had been consulted about. There is an up-to-date medication policy, which was last reviewed in July 2007. All the residents are supported by the home to administer and store their medication. There is a signed agreement in place for all residents showing that they have agreed for the home to do this for them. Medication is stored in a locked cabinet in the lounge area and all residents medication is supplied by the local pharmacy on a monthly basis. The home collects prescriptions from the GP on behalf of the residents. None of the current residents self medicate, and all have been assessed as to their abilities and wishes to do so. Each resident has a file, which contains information about their prescribed medication, which includes a photograph to help avoid mistakes being made. Good records of medication administered are kept in a separate book and records showed medication received and returned. At the last inspection it was recommended that the system for recording when and why medication is refused be reviewed and improved. This has now been done and this is recommendation is met. All of the care staff have been trained in the administration of medication and a manager commented that she is very pleased that they are consistently competent in doing this task. All residents have a personal care support plan included in the care plans. These are clearly written and kept up-to-date. All residents currently residing at the home need support with bathing and dressing, and some higher-levels of support are required for one resident. There are good details in the care plan describing how this is to be done. Personal care plans are reviewed monthly, with a more in-depth reviews every six months, and an annual review with social services. Residents said that the staff are helpful and sensitive when helping them in personal care. Care Homes for Older People Page 14 of 30 Care Homes for Older People Page 15 of 30 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents find the lifestyle in the home support they needs well, and contact with family and friends is welcomed and supported. Residents are given choices and are supported to make informed decisions about their lives. Good food is provided in a comfortable dining area. Evidence: Daily activity routines for residents are a clearly written in their care plans. Each resident has a description of activities that they most like to do and there is a system used for writing down activities people have taken part in to help ensure they are given good opportunities to do things. This system enables the manager to more easily oversee the activities are happening. Some residents attend a day centre, a social club, have outings to parks and shops, and attend their local church with the support of the homes manager staff, who also provide transport for them when they need it. Church representatives also visit the home regularly to visit some residents. Care plans for residents showed activities to Care Homes for Older People Page 16 of 30 Evidence: include: enjoying music, going to church, library visits, weekly visits for some residents the day centre, reading, colouring in painting, missing, and the using a video club for accessing tapes of their own personal taste. There was a recommendation made at the last inspection for the home to explore options for one resident to develop relationships and friendships other than those with staff. This resident no longer lives at the home but the staff had done some work to achieve this recommendation. There is now a new system for planning and recording residents activities so that a manager can easily monitor activities to ensure residents planned activities actually happen. Three of the residents said that staff are very helpful and try hard to make life interesting, and to help them with activities. Discussion with the manager and with some residents suggested that it would be beneficial for the home to include more regular structured opportunities for residents to have exercise appropriate to their needs and to explore whether residents would like to have more games and puzzles included in their activities. (Refer to Recommendation OP12) All residents can have visitors any time of the day and night and the homes policy does not restrict visitors in any way. Two residents said that they have family visit very regularly and they are made to feel welcome by staff. One resident does not have any family involvement at all, and attends the day centre three days a week. The residents manage their own financial affairs with support from either family or social services or the Court of protection. Information is available in the home regarding how to contact external professionals such as CSCI, social services, and advocacy services should they need to. Residents have their personal possessions in their rooms and their rooms were seen to be well maintained and well decorated. I met with one resident in her room and she confirmed that staff are respectful when entering her room and leave her to spend time on her own when she chooses to. All four residents have their own rooms and said that the staff respect their privacy. The home provides food, which is nutritious and fresh, and which is cooked daily in the home. All staff have food hygiene training and health and safety in the kitchen is well managed. Residents said that the food is generally good and is hot and freshly made. The staff and manager said that daily food choices are offered and care plans do clearly show each residents preferred meals. Two of the residents said that the food is excellent, and others said it was good. Care Homes for Older People Page 17 of 30 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. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives are confident that their complaints will be listened to and acted upon, and are protected from negligence and abuse by the homes safeguarding adults policy and practices. Evidence: The home has a clear and up to date complaints policy which all residents have a copy of in their rooms, and there were no complaints made since the last inspection. Residents confirmed that they have been informed how to complain if they need to and that the manager is always available to discuss problems with. There was a requirement at the last inspection for the home to ensure that the safeguarding policy be updated to reflect the Lewisham local authoritys policy. This requirement was met and policy has been updated and staff have been advised and trained in recognising and reporting suspicions or allegations of abuse. Two staff were able to describe the proceedures for recording and reporting if necessary. The home now has a copy of the local authorities revised policy and the staff have been briefed on its content. There have been no referrals to the adult protection team or to the POVA register since Care Homes for Older People Page 18 of 30 Evidence: the last inspection. Care Homes for Older People Page 19 of 30 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained and is clean pleasant and hygienic. Evidence: There were four recommendations made at the last inspection regarding the homes environment. These were: 1. To provide comfortable furniture in the dining room area so that residents can comfortably watch the television that is situated there. 2. Make a video or DVD player available in the lounge area so that residents can watch films of their choice 3. To provide a more user-friendly remote control for the TV of a larger size so the residents could more easily use it 4. To make the groundfloor bathroom door more easily openable by residents as it had been sticking on the lino of the bathroom floor Recommendations 1,2, and 3 have been addressed by the home, and there is now a couch in the dining area, and a video player available in the lounge. However groundfloor bathroom door continues to stick on the floor when being opened, and prevents some residents from independently opening this door. This recommendation is repeated. (Refer to Repeated recommendation OP19) Care Homes for Older People Page 20 of 30 Evidence: New easy chairs have been purchased for three of the four bedrooms, and for the livingroom area, and this has improved the comfort for residents. The home is an older building and adequately meet the needs of the residents. All of the older residents reside and sleep on the ground floor of the premises. The home is kept in a good state of repair and furniture is now of a good standard. The home is adequately equipped with toilet and bathroom facilities for the existing residents use. There is a bathroom and toilet on each floor and each residents has their own seperate ensuite tiolet. However the toilet door on the ground floor is still sticking and could not be independently used by some residents. This should be rectified as soon as possible. (Refer to Repeated Recommendation OP19) All of the electrical in gas equipment is maintained and has up-to-date maintenance certificates. The fire equipment is consistently serviced and well maintained. The portable appliance tests are now also up to date The home is maintained to a good level of cleanliness, and a cleaner visits the home and number of times a week to ensure bathrooms and kitchens and hallways are kept clean. Laundry facilities are separate from the kitchen and there are no incontinence issues and the home. The homes owners have drawn up plans for a proposed extension to include a relaxation area for residents. These plans have not yet been approved but they demonstrate that the owner are has in mind development plans for improvement the home. There is a video player in an inappropriate place in the dining area, sitting on the top of the TV, which could be a hazard for residents. This needs to be placed in a safer place such as in the cupboard. (Refer to Recommendation OP19) The current rest area of the home has flooring which has a hole in it, and could cause residents to trip. This floor covering must be replaced with adequate safe flooring covering. (Refer to Requirement OP19) Care Homes for Older People Page 21 of 30 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. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents needs are met by the numbers and skill mix of staff and staff are qualified to the appropriate NVQ level. Improvements have been made to ensure that residents are protected by the homes recruitment practices and these practices now fully protect them. The staff training provided by the home is appropriate to residents support needs and staff development. Evidence: The home is staffed by a full time manager, and a staff team of five part time support staff, who are experienced in the care support necessary to provide support to the current residents. The manager/owners family are resident on the premises and provide night support and some day support. The manager is almost always available at the home and residents and some health care and social care professionals commented that the manager and staff are good at providing the support the residents need and are good at speaking with other professionals outside of the home when professional, help is needed. There is a rota showing that there are always two staff available to provide support to four residents. Sometimes the manager fills one of the two support staff roles and there is a rota for the manager and the owner to provide sleep-in and emergency support if needed. Care Homes for Older People Page 22 of 30 Evidence: Three of the five staff are qualified to NVQ level 2/3 and this meets the 50 qualified staff requirement. Three staff files were examined and were seen to be largely complete and in order regarding recruitment and employment information. The files are well organised and all staff were recruited and inducted in a fair and methodical manner. All had two references and two a completed induction checklist, which is in keeping with Skills for Care requirements. Two staff confirmed that they had been fairly interviewed and inducted over three days. The files showed that all members of staff had an up to date CRB checks done which included a an enhanced POVA check. There was a requirement at the last inspection for the home to ensure that all staff had an up to date enhanced CRB on file and this has now been met. There was also a requirement made for the staff training plans to include training in areas regarding learning disabilities and end of life care. This has now been included in staff training and this requirement is also met. There is a staff training and development programme in place, which meets the National Training Organisation workforce training targets. The system for staff to access training includes local authority training and NVQ qualifications. All staff receive an induction over a three-day period and are subsequently schedules for NVQ training if they do not already have this qualification. All staff are receiving more than three days training per year and have an individual training plan. Current training plans include: COSSH, food hygiene, first aid, POVA /adult protection training, fire safety and medication, learning disabilities support and end of life care. Care Homes for Older People Page 23 of 30 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. Quality in this outcome area is now Good. This judgement has been made using available evidence including a visit to this service. The home is managed by a person who is fit to be in charge, and who provides adequate leadership for the staff who work there. The home is run in the best interests of the residents, and has improved the formal annual quality audit system and does consult with residents. Residents financial interests are safeguarded, and staff are now consistently supervised about their work. Health and safety is well managed and the safety of residents and staff are protected. Evidence: The home is managed by and experienced and qualified person who is registered with the Commission for Social Care and Inspection, and who holds the required NVQ 4 qualification in Care and Management. The manager has made improvements in how the home communicates with staff and Care Homes for Older People Page 24 of 30 Evidence: residents, and there is now a better system in place for staff training and development, and for holding team meetings and supervision of staff. The staff and residents records are now well organised and contain the majority of information needed. Comments from residents and staff about the management are good and the manager and owner are available in the home on a daily basis. The home now has a system for surveying residents, families and healthcare professionals views about how the home is managed, and the most recent survey was done in July/August 2008. Questions in the survey include: views on food, staff attitude, staff ability to do their job, activities and communication. The home has not yet published results of these surveys for residents and families to read and it is recommended that they do so as soon as is possible. (Refer to Recommendation OP33) The manager and owner are available in the home daily and provide hands on support to residents. There was a requirement made at the last inspection for the home to put in place an effective quality assurance system, in order to monitor performance and plan for any necessary improvements. This has now been sucessfully done and this requirement is now met. There is now a formal quality assurance audit system in place, and there is now a quality assurance checklist being used by the manager to check that a range of important management activities within the home have been consistently carried out. A partial audit took place in January and again in July 2008. Findings from this included: policy and procedures updates required, the homes water temperatures were being effectively checked, and medication reviews with pharmacists were taking place. Findings from these audits and are being included in the homes annual development plan. The home had been facilitating regular or residents meetings, but these have not been happening consistently. Discussion with the manager and some of the residents suggest that it would be beneficial for residents to revive these meetings, and to document discussion and action from these meetings for residents information. (Refer to Recommendation OP33) All residents are supported in their financial affairs by either family or solicitors and not by the home. The home only looks after small amounts of money, up to 40 Pounds usually, which they have now ensured is properly recorded and receipted for as a response to a request at the last inspection. Two residents confirmed that this is how their financial affairs are managed and said that they are confident in the systems for consulting and supporting them in any areas needed. Examination of three staff files, and discussion with two members of staff showed that Care Homes for Older People Page 25 of 30 Evidence: the home is consistently providing formal supervision, for care staff every two to three months. Annual performance appraisal is now consistently happening for staff, and training and personal development is included in this process. Health and safety is now well managed in the home, and there is a fire alarm system and fire risk assessment to protect against the risk of fire. Residents files have a range of personal risk assessments, which take account of personal care support needs and risk of falls. All certification regarding electrical appliances and the electrical wiring and gas are up to date. The annual quality assurance audit form returned to CSCI showed that the home does not currently use the Department of Health Essential steps for assessment of management of infection control guidance, and given the level of personal care support provided it is recommended that the home get a copy for reference purposes. (Refer to Recommendation OP38) Care Homes for Older People Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 The registered provider should include more information about a mental health support and learning disability support provided by the home, in the homes Statement of Purpose and Service User Guide. The registered provider and manager should consider the use of a swivel pad in one residents care plan to enable her to more easily get in and out of cars. The registered manager should explore with residents whether they would like to have more board games and puzzles included in the homes actvities routines. The registered manager should include more regualr opportunities for residents to have more structured exercise appropriate to their needs and abilities included in the homes weekly riutines. The Registered provider should make the ground floor bathroom door more easily openable by residents The registered provider should move the video player, currently situated in the dining area, from its current position and place it in a safer place, to avoid risk to residents and staff 2 7 3 12 4 12 5 6 19 19 Care Homes for Older People Page 28 of 30 7 8 19 33 The Registered provider should make the ground floor bathroom door more easily openable by residents The registered provider and manager should re-establish the practice of facilitating regular residents meetings to enable them to voice their opinions on issues affecting them in the home. Minutes of these meetings should be kept and made available to residents The registered provider and manager should provide a written outcome for residents regarding surveys conducted in the home, so that residents will understand findings and plans for the development. The Registered provider should secure a copy of the DOH Essential Steps for Assessment of Management of Infection Control as a reference for the home in preventing cross infection 9 33 10 38 Care Homes for Older People Page 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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