Inspection on 31/08/06 for Lakeview House

This inspection was carried out on 31st August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Lakeview House 10/10/08

Lakeview House 20/10/05

Lakeview House 03/05/05

Lakeview House 23/08/04

Lakeview House 19/05/04

Lakeview House 28/01/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Lakeview House 88 Churchill Avenue Northampton Northants NN3 6PG Lead Inspector Mrs Pat Harte Unannounced Inspection 31st August 2006 10:00 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 DS0000035736.V308832.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. DS0000035736.V308832.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lakeview House Address 88 Churchill Avenue Northampton Northants NN3 6PG 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) 01604 678810 01604 642307 www.northamptonshire.gov.uk Northamptonshire County Council Miss Michelle Kathy Mullen Care Home 41 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (41), of places Physical disability over 65 years of age (3) DS0000035736.V308832.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. No person falling within the OP category can be admitted where there are already 41 people of OP category already in the Home. No person falling within the DE (E) category can be admitted where there are already 20 people of DE (E) category already in the Home. No person falling within the PD (E) category can be admitted where there are already 3 people of PD (E) category already in the Home. To be able to accommodate one named service user who has needs within the LD (E) category. Total number of service users in the home must not exceed 41 Date of last inspection 20th October 2005 Brief Description of the Service: Lakeview House is a residential care home providing personal care for up to 41 Elderly Residents, including 20 people with Dementia and 3 people with Physical Disabilities. The Home has a specific condition to provide care for 1 existing named Resident with Learning Disabilities. The Home provides permanent care only. Northamptonshire County Council owns the Home. The Manager is Mrs. M. Mullen. The Home is situated in a residential suburb of Northampton adjacent to nearby shops and easily accessible by public transport. The Premises consist of a 2-storey building providing lounge/dinning, bathing and toileting facilities and bedroom areas on both floors. The first floor is accessible by a lift. Single bedrooms are provided for all Residents. The County Council carries through a financial assessment to determine the fees to be paid by Residents. These are variable according to means and go to a maximum of £327 per week. Residents are responsible for paying extra charges for external services such as Chiropody and Hairdressing and items such as toiletries and newspapers. DS0000035736.V308832.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for Service Users and their views of the service provided. Inspection planning took half a day and consisted of a full review of the inspection record, the Homes service history record including notifications of complaints, accidents, events and incidents, the pre inspection information submitted by the Home and correspondence and contacts between the Commission and the Home. At the time of the inspection Residents and Relatives questionnaires had not been received back by the Commission. The information was collated and analysed to form the plan of inspection focusing on the outcomes for Residents. The primary method of inspection used was ‘case tracking’ which involved selecting two Residents and tracking the care they receive through review of their records, talking with them and the care staff. In addition five Residents, six staff and two Relatives were spoken with. Observations were made on routines and care practices. Selected areas of the premises were viewed and a selection of records was inspected. Discussions were held with the Registered Manager. The Inspection took place during the morning and afternoon over a period of 6 hours and was carried out on an unannounced basis What the service does well: Lakeview House continues to have a stable staff group who demonstrated their commitment to the well being of their Residents. Staff turnover was low and the deployment of regular staff to each unit means that familiar staff are on hand to provide consistency and continuity of care for their Residents. Residents spoke very highly of the staff group commenting that they were very caring, helpful and on hand to quickly respond to their needs. Residents commented and observations confirmed that relationships between themselves and the staff were very good. Comments included “the staff are so kind,” “They can’t do enough for me,” “They respect my wishes and allow me to do what I can for myself,” “I can choose where I want to spend my time,” “They help me find my way about the home,” “The food is very good and they know what you like and don’t like to eat,” “They always find you an alterative if you DS0000035736.V308832.R01.S.doc Version 5.2 Page 6 don’t fancy the main course,” and “They know when I feel down and give me support,” and “They get my Doctor in quickly if I am feeling poorly.” The records showed that the assessment process is thorough and ensures that only People whose needs can be met in full are admitted to the Home. Care was taken to identify any risk areas, such as falling, and put plans in place to eliminate the risks as much as possible. Prospective Residents and their Relatives are invited to view the Home, discuss their needs with staff and meet with other Residents, a process that Residents felt helped them to make decisions on their placement. Staff showed that they involved all their Residents in the planning of their care, including those Residents with Dementia. Residents’ commented that staff treated them as individuals and respected their individual wishes and preferences on how the care was to be provided. The care planning process took account of any cultural or religious needs paying respect to Peoples’ differing backgrounds and lifestyles. Arrangements were made to support the Residents, uphold their wishes and enable them to pursue their religious observances. Local Clergy visit individuals in the Home and hold services. Health care needs were carefully monitored and Residents confirmed they were enabled to see their relevant medical professionals promptly and in private. Records showed that specialist professionals such as the Continence and Falls Advisers were called in to give staff advice on how best to support their Residents. Residents confirmed that they were aware of the home’s complaints procedure and felt confident to raise any issues or concerns with staff or the Manager. There have been no complaints since the last inspection. Routines were observed to be relaxed and flexible and Residents stated that their personal lifestyles preferences such as rising and going to bed times were respected. They felt they had freedom of choice in how and where they wished to spend their time. Observations confirmed that staff took care to protect Residents’ dignity and privacy by ensuring personal care tasks were carried out in private. Residents commented that staff took care to ease any embarrassment and make them comfortable when intimate tasks such as bathing were carried out. Residents’ comments and the review of records showed that they were encouraged to remain as independent as possible and do things for themselves. The Activity programme was viewed as excellent. Residents were encouraged to pursue their interests and hobbies and to develop new ones. There were opportunities for individual as well as group activities. Meaningful activities DS0000035736.V308832.R01.S.doc Version 5.2 Page 7 were provided for Residents with Dementia. Residents are supported to go for walks and visit the local shops. Residents’ comments on the food provision were very positive. They felt that they were provided with a good range of meals, choices were available and staff went out of their way to “tempt” their appetites. The catering staff were fully aware of their dietary needs and likes and dislikes. Records showed that staff monitored Residents’ weight and their appetites to ensure any problems were quickly identified and action taken, for example the introduction of food supplements. Residents were provided with a safe and comfortable environment including access to safe garden areas. The Home offers additional sitting areas by the bar, the entrance and the offices. Some Residents said they preferred to sit in these areas as they could see what was going on and enjoyed meeting people visiting the Home. What has improved since the last inspection? What they could do better: 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. DS0000035736.V308832.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 DS0000035736.V308832.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 5 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Good information is made available to prospective Residents on the Home’s services and facilities and the assessment process is thorough and effective ensuring that the needs of Residents admitted to the Home can be met in full. EVIDENCE: We looked at the information given to prospective Residents on the Home’s services and the process of assessment to see that this was thorough in identifying Peoples’ needs and ensured that those needs could be met. Residents confirmed that they had been given the Home’s Service User Guide, they felt this contained accurate and good information on the services and facilities and how to raise any issues or concerns. The Statement of Purpose, which describes the aims and objectives, was reviewed and updated in December 2005. Copies of both the Guide and Statement are available in the main foyer so that anyone visiting the Home may access them together with DS0000035736.V308832.R01.S.doc Version 5.2 Page 10 other information such as Independent Advocacy, the last Inspection report and the results of satisfaction surveys. The assessment process ensured that the Manager or senior staff visit all prospective Residents to carry through a needs assessment. Where at all possible prospective Residents and their Relatives are encouraged to visit the Home to view the facilities, meet with staff and other Residents and discuss further their care needs before coming to their decisions on admission. On the day of Inspection two Relatives were visiting the Home on behalf of a prospective Resident. They said that the member of staff showing them around had made them most welcome and devoted time to answering their questions and discussing their concerns. They found the process invaluable as it helped them to judge whether their Relative would feel comfortable in and like the Home. Two Residents assessment records were reviewed. The assessments were thorough and took account of all areas of need including Residents’ emotional and psychological care needs. Historical information had been gathered from Residents, Families and relevant professionals to broaden the understanding of the needs. Care had been taken to establish the Residents’ wishes in relation to routines, food likes and dislikes and dietary needs, their hobbies and interests and their preferences for their support as well as any cultural or religious needs. Arrangements were in place to ensure visits from local Clergy to enable Residents to pursue their religious observances. The approach showed that the diversity of Residents is recognised and respected. The Manager also demonstrated that she considered the needs of each prospective Resident carefully and balanced these with the dependency levels of People already living in the Home. Admissions are not made where there is any doubt that the needs can be met or where it is felt that the staffing levels would not be sufficient to manage additional high dependency needs. Recognised assessment tools were used to assess any risk areas such as falls, movement and handling, skin and nutritional needs. Where Residents were suffering from Dementia an additional assessment of their mental abilities, awareness and understanding had been carried through. Assessments of physical care needs identify any aids or equipment that may be needed for individual Residents. Resident’s records showed that they had been given contracts detailing the terms and conditions of their placement, details of the fees to be charged are DS0000035736.V308832.R01.S.doc Version 5.2 Page 11 provided direct from the County Council following a financial assessment. The Service User Guide provides information on areas not covered by the fees, for example toiletries, newspapers and services provided by external professionals, such as Chiropodists and Hairdressers. Residents spoken with felt that staff were well briefed on their needs in readiness for their admission. Staff spoken with felt that they were provided with good information on their Residents needs, routines and wishes. DS0000035736.V308832.R01.S.doc Version 5.2 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 & 11 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are supported to take acceptable risks, make decisions about their lives and are assured that the staff group know their needs, aspirations and goals. EVIDENCE: We looked at the Home’s care planning processes to ensure that staff were given instruction and guidance on how to meet Service Users’ needs. Two Residents care plans were inspected. The plans showed a holistic approach to recording the Residents’ needs and provided staff with good levels of instruction and guidance on how the care is to be carried through. It was clear that Residents were involved in the development of their plans and agreement reached on how the care was to be provided. DS0000035736.V308832.R01.S.doc Version 5.2 Page 13 The plans showed Residents were enabled to maintain their individual preferred lifestyle routines, for example preferred rising and going to bed times were clearly stated. The care plans gave step-by-step guidance to staff on the areas where they needed assistance. For example personal care routines such as bathing were thoroughly documented giving detailed instructions to staff on the timings, the equipment needed and how the task was to be carried through. The plans detailed the areas that the Residents could safely undertake for themselves showing they were encouraged to maintain as much control over their lives and be as independence as possible. Reminders were incorporated into the plans for staff to routinely monitor skin and nail conditions, which meant that any changes were quickly picked up and the necessary action taken. Risk assessments were carefully undertaken and plans were in place to eliminate the risks as much as possible. For example the risk of falls was carefully considered and instructions were given to staff to remind Residents to use their mobility aids, to call for assistance when they wished to get up or to escort them when they moved about the Home. Night routines were clearly detailed and instructions were given to staff where checks were needed. Residents confirmed that the night checks had been discussed and agreed with them. They stated that they felt reassured and had peace of mind that staff were popping in to make sure they were all right. Records showed that good use if made of historical information to help staff understand and provide support for Resident’s with Dementia. For example information on past interests, events and people of importance to individual Residents are documented to help staff understand and respond to their Residents in their confusion. Strategies were in place to help Residents manage their confusion and frustrations. For example staff were instructed to monitor a Resident’s emotional well being as she often became upset and distressed in her confusion, the plan stated that one to one time was to be provide to enable her to discuss her fears and frustrations. Discussions with the Manager and staff and observations of practice showed that attention has been paid to developing effective communication methods. Care plans detailed the need for staff speak clearly, explain carefully and give time for Residents respond. Staff showed that they were sensitive and took care and time to work at their Residents’ pace. Care was taken to ensure that Residents with dementia care needs were enabled to express choice and make their wishes and opinions known. DS0000035736.V308832.R01.S.doc Version 5.2 Page 14 The care plan records showed that changes in need were noted and new instructions were provided for staff where necessary. Where no changes have occurred there is a system for reviewing the plans on a monthly basis. Health care records were detailed and showed that staff were quick to respond to any changes and request visits from the relevant medical practitioners. For example in one instance a significant change in a Resident’s behaviour had occurred and arrangements were immediately made for a medical and psychiatric assessment. The care plan indicated that one to one staffing had been introduced to provide constant monitoring and support for the Resident concerned and to ensure the behaviour exhibited did not affect other Residents. Residents’ felt that staff kept a close eye on their health care needs and quickly arranged for Doctors visits. They stated that staff always ensured they saw their Doctors in private. Procedures were in place for the management of medication. Assessments are carried out to determine whether Residents wishing to manage their own medication have the ability and are safe to do so. Where this can be achieved Residents are provided with safe storage arrangements. The required records for incoming, administration and disposal of medication were in good order. Observations confirmed that Medication was safely and appropriately administered. Medication, including controlled drugs, was safely stored. Records showed that care is taken to check the use of any household remedies with Residents’ General Practitioners. Observations confirmed that staff ensured the protection of Residents privacy and dignity by carrying through personal care tasks in private. Residents felt that staff knew their care needs very well and provided them with good support and encouragement. Several Residents spoke of staff helping them to find their way about as they were forgetful and easily got lost. Other Residents commented that staff allowed them to do things for themselves and only supported where necessary, they saw this as being very important as it allowed them to continue to be independent. Residents’ records showed that staff made every effort to secure their wishes on arrangements to be made following death. The Home can provide care for DS0000035736.V308832.R01.S.doc Version 5.2 Page 15 Residents who are ill or dying so long as their needs can be met with the support of community medical professionals. DS0000035736.V308832.R01.S.doc Version 5.2 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service Residents are enabled to exercise control and choice in the way they wish to lead their lives and are provided with good activity programmes in keeping with their interests. EVIDENCE: We looked at the routines of the Home and the activities programmes to ensure that Residents were able to live relaxed and fulfilled lives reflecting their personal preferences. Residents stated that routines were relaxed and flexible. They commented, and observations confirmed, that they were free to decide on how and where they wished to spend their time. They said that timings such as getting up and going to bed were wholly in accordance with their wishes. Staff are allocated to each of the units within the Home bringing consistency and continuity of care and ensuring that Residents with Dementia become familiar with their staff group. DS0000035736.V308832.R01.S.doc Version 5.2 Page 17 Unit staff are responsible for providing Residents activities. The range of activities was viewed as excellent and weekly programmes were in place for each of the units taking account of Residents wishes and abilities. There are opportunities for games, regular Bingo sessions and opportunities to participate in the weekly National Lottery and exercise sessions. Residents are taken for walks and visit the local shops. There are opportunities to visit the Mobile Library and to enjoy externally provided entertainment. Staff take care to gather historical information on Residents hobbies and interests, particularly those Residents with dementia care needs. For example staff showed that they were carefully considering how a Resident could be safely supported to pursue his interest in carpentry and be creative. Games and books are used to stimulate and promote interaction and help Residents recall past ways of life and there are opportunities for activities such as regular cookery sessions, which prove to be very popular and give Residents a real sense of achievement. Residents stated they were very satisfied with the activity programme, there was always something to do but they could chose whether or not they wished to join in. Many Residents commented that they enjoyed the Home’s bar facilities where they could have their “favourite tipple” and socialise with other Residents. There is an open visiting policy. Residents confirmed that they were enabled to receive their visitors in private if they wished. Residents were fully satisfied with the food provision. They felt that staff respected their individual likes and dislikes and that were provided with a good range of choice and alternatives. One Resident commented, “They give you more than enough, seconds are always available.” Other Residents stated that staff went out of their way to tempt their appetites. Records showed that care is taken to identify any nutritional, dietary or cultural needs. Care was taken to routinely monitor Residents weight and appetites. This ensured that any nutritional concerns are quickly identified so that action can be taken. For example food and fluid charts may used to ensure sufficient intake and the advice of the Dietician or Doctors is sought to determine any need for additional supplements. DS0000035736.V308832.R01.S.doc Version 5.2 Page 18 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Home has effective systems in place to ensure complaints are listened to, investigated and acted upon and to ensure that Residents are protected from abuse. EVIDENCE: We looked at the systems in place to ensure that any concerns and complaints are listened to and acted upon and that Residents are protected from abuse. Residents confirmed that they had been given the Home’s complaints procedure which is also displayed in the Home. Those spoken with felt confident and able to raise any issues or concerns with staff. A complaints record is maintained. No complaints have been made to the Manager or to the Commission since the last inspection. Residents are registered on the Electoral roll and are given assistance to exercise their voting rights by postal votes or visiting the local polling stations. Robust procedures for the Protection of Vulnerable Adults are in place. Staff records showed that staff receive training in recognising abuse and in the reporting procedures to the relevant Authorities. No allegations have been reported since the last inspection. Discussions with staff showed they were DS0000035736.V308832.R01.S.doc Version 5.2 Page 19 fully familiar with the procedures and were committed to ensuring the protection of their Residents. DS0000035736.V308832.R01.S.doc Version 5.2 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are provided with a warm, safe and comfortable environment however there has been a slow response by the County Council to address an urgent refurbishment issue. EVIDENCE: We looked at the premises to ensure that they were suitable for the Residents needs and offered them a comfortable and safe environment. The premises were in good order, warm, safe, comfortable and well maintained. Residents stated that cleaning routines were carefully organised to ensure no disruption to their preferred routines. Standards of domestic and hygiene maintenance were overall viewed as very good. DS0000035736.V308832.R01.S.doc Version 5.2 Page 21 The Manager showed that she had requested the Provider to replace a carpet in a Resident’s bedroom with suitable flooring due to an unacceptable odour. She demonstrated that every effort had been made by the domestic staff and external industrial cleaners to eradicate the odour. This had not been possible and the odour had become offensive and permeated the corridor area outside the bedroom. Suitable replacement flooring should be provided as a matter of urgency. Residents’ bedrooms viewed were comfortable and safely maintained and observations confirmed that they were able to have their furniture and belongings around them and personalise their rooms as they wished. They confirmed their satisfaction with the communal facilities and felt that they were comfortable and homely. Several Residents make good use of additional seating areas such as the foyer, by the bar and in the hallway by the Offices. Residents with Dementia have the use of a pleasant, secure and safe garden area adjacent to the main, well-maintained open front garden. Several Residents spoke of making good use of the gardens during the recent fine weather. The Care plans and observations confirmed that specialist equipment is provided for Residents with physical disabilities. Examples are mobility aids and hoists to safely carry through movement and handling practices. Equipment such as pressure relieving mattresses and cushions may also be obtained where needed to promote Residents comfort and promote tissue viability. DS0000035736.V308832.R01.S.doc Version 5.2 Page 22 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Recruitment procedures are robust and sufficient numbers of competent care staff are deployed to meet the Residents needs. EVIDENCE: We looked at staff recruitment procedures and staff training to ensure Residents were in safe and competent hands. Residents spoken with said that the all the staff, including ancillary staff, were very kind, committed and caring. They felt that care needs were promptly attended to. Observations showed that staff constantly monitored their Residents, responded promptly to their needs and relationships were excellent. The rotas showed that minimums of six care staff are deployed on daytime shifts and 3 night carers provide night care. In addition a Residential Care Supervisor is on duty on all daytime shifts to oversee the sunning of the shifts and provide guidance and support for staff. The Manager demonstrated that staffing levels are adjusted according to the needs of the Residents. For example an additional carer has recently been DS0000035736.V308832.R01.S.doc Version 5.2 Page 23 deployed to provide one to one support for an individual Resident with high dependency needs. The overall staff team includes Catering, Domestic and Laundry Staff and a Handyman. The ancillary staff provision ensures that care staff are not diverted from their care duties. The Manager mainly works office hours. Staff stated that they were always able to contact her or other County Council representatives in an emergency out of office hours. Two staff members’ records were viewed and showed that the recruitment practice was good and afforded Residents protection. The necessary Criminal Records Bureau Checks had been undertaken and references obtained. Records showed that new staff were provided with an induction programme linked to the Sector Skill Council’s recommended guidelines and timeframes. There is also a process of induction for Agency staff should they be needed to replace regular staff due to sickness or holidays. Discussions with the Manager showed that she keeps the annual staff training plan under review and accesses core and specialised training on an on going basis. Staff spoken with felt that they had good access to training in general and were encouraged and enabled to update their skills and develop new ones. They were encouraged to undertake National Vocational Qualifications and currently 55 of the care staff group have obtained a qualification, which is above the expected standard of 50 . DS0000035736.V308832.R01.S.doc Version 5.2 Page 24 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 37 & 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The Management of the Home is effective and in the best interests of the Residents. Safe systems are in place for the management of Residents monies and items held for safekeeping. EVIDENCE: We looked at the overall management of the Home and Health and Safety to ensure that the Home was effectively managed and Service Users were not at risk. The Manager demonstrated her ongoing commitment to maintaining the required Regulations and Standards and ensuring the Home is run in the best interests of her Residents. This is demonstrated by the fact that no requirements within her remit have been made in this report. DS0000035736.V308832.R01.S.doc Version 5.2 Page 25 She closely involves her Residents in the running of their home. Residents said that she was readily available to them and was in contact with them on a daily basis. They confirmed and records showed that regular Residents meetings are held. It was clear from Residents comments are sought and their opinions, views and wishes are listened to and acted upon. The Manager has undertaken surveys with the Residents, Relatives and stakeholders, such as Doctors, Nurses and other visiting professionals, to gain their opinions of the services. The results have been collated and published and have been made available to all in the information area at the entrance to the Home. Staff spoken with felt that the Manager was easily accessible to them and was willing to discuss any issues, guide them in practice and offer support. Records showed that formal staff supervision is undertaken bi monthly. The Home’s policies and procedures were all revised last year by the County Council and are in place to guide and instruct staff. The systems for the safekeeping, where necessary, of Residents moneys were in good order. Two records inspected showed that receipts were carefully maintained for any purchases made by staff on a Resident’s behalf or charges incurred for services such as Hairdressing and Chiropody. There is an internal auditing and reconciliation system to ensure the accuracy of the individual accounts and balances. The approach to general health and safety was assessed as good. The premises were safely maintained and no hazards were observed. Staff training records showed regular updates in Health and Safety, Fire training and Movement and Handling. Accident/Incident records were well maintained and showed that every accident or incident was analysed and action was taken to prevent similar occurrences. Staff records confirmed training is provided in Health and Safety. DS0000035736.V308832.R01.S.doc Version 5.2 Page 26 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 3 3 4 3 4 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 3 3 X 3 3 3 3 DS0000035736.V308832.R01.S.doc Version 5.2 Page 27 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. 1 Refer to Standard OP19 Good Practice Recommendations The carpet in Bedroom 7 should be replaced with suitable flooring to meet the Residents needs urgently. DS0000035736.V308832.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB National Enquiry Line: 0845 015 0120 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 DS0000035736.V308832.R01.S.doc Version 5.2 Page 29 - 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. 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