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Inspection on 23/01/09 for Leolyn Care Home

Also see our care home review for Leolyn Care Home for more information

This inspection was carried out on 23rd January 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

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 atmosphere at the home was relaxed with communication between staff and residents being positive open and friendly. There is clear information available to prospective residents regarding the services provided and the costs involved. The home is well maintained with good quality furnishings and fixtures. The lifestyle experienced meets residents expectations and preferences at this time and residents are involved in the running of the home. The training for staff is good and covers a wide variety of resident related conditions, which give the staff an understanding of the residents needs. All residents and visiting professionals contacted as part of the inspection process confirmed a satisfaction with the home and its services one resident saying, ` couldn`t ask for better care`. There is a robust recruitment process that protects the service users.

What has improved since the last inspection?

From the information received during the site visit the requirements set at the last key inspection had been actioned. The home were able to evidence that they record all complaints received and the action taken.

What the care home could do better:

The home needs to develop the Service Users Guide and Statement of Purpose to ensure it includes the training and qualifications the staff have undertaken, so that prospective residents are reassured that staff have the knowledge and skills to meet their needs. The pre-admission assessment needs to be more informative so the home can be assured that they can meet the prospective residents needs in full. The care documentation including individualised care plans and risk assessments need to be improved to ensure residents receive appropriate and person centred care that meets their assessed needs and to minimise any risks. The medication practices need to be reviewed and improved to ensure that the residents health and well being are protected and promoted. The staff structure for the dementia unit needs to be reviewed to ensure that there is a dedicated head of unit to supervise and advise staff.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Leolyn Care Home 63 Pevensey Road St Leonards On Sea East Sussex TN38 0LE     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: Deborah Calveley     Date: 2 3 0 1 2 0 0 9 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 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 31 Information about the care home Name of care home: Address: Leolyn Care Home 63 Pevensey Road St Leonards On Sea East Sussex TN38 0LE 01424422063 01424457000 leolyn@new-meronden.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): New Century Care (Leolyn) Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 34 Number of places (if applicable): Under 65 Over 65 0 34 0 dementia old age, not falling within any other category physical disability Additional conditions: 34 0 34 The maximum number of service users to be accommodated is 34. The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) Dementia (DE) - Maximum number of places 7 Physical disability (PD) Date of last inspection Brief description of the care home Leolyn is a large detached property, situated in a residential area of St. Leonards-OnSea. It is owned by New Century Care Ltd. and provides 24 hour nursing and personal care for up to 34 residents aged 50 years or older. In november 2007, a dedicated Dementia Care Unit The Castle Wing for seven people was registered on the second Care Homes for Older People Page 4 of 31 Brief description of the care home floor, and includes lounge and dining facilities, activity area and communal bathrooms. All seven bedrooms have an ensuite facility. Leolyn is set out over four floors with both a chair lift and a passenger lift to provide access to all floors. Road parking enables easy access for visitors to the Home. Care Homes for Older People Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term service user to describe those living in care home settings. For the purpose of this report those living at Leolyn will be referred to as residents. This was a key inspection that included an unannounced visit to the home and follow up contact with residents representatives and visiting health and social care professionals. This unannounced inspection was carried out over 6 hours on the 23 January 2009. There were 25 residents living in the home on the day of which six were case tracked Care Homes for Older People Page 6 of 31 and spoken with. During the tour of the premises four other residents both male and female were also spoken with. The purpose of the inspection was to check that the requirements of previous inspections had been met and inspect all other key standards. A tour of the premises was undertaken and a range of documentation was viewed including: the Service Users Guide, Statement of Purpose, care plans, medication records and recruitment files. Four members of care and housekeeping staff were spoken with in addition to discussion with the appointed manager, area manager, cook and head of housekeeping. Telephone contact was made with visiting professionals following the visit and their views and comments are incorporated into the report along with the information received verbally during the site visit. An Annual Quality Assurance Assessment was received from the Manager completed in full prior to this key inspection. Fees charged as from 1 January 2009 range from 513 pounds per week to 719 pounds, which does not include toiletries. Additional charges are made for hairdressing, chiropody, newspapers and outside activities. What the care home does well: What has improved since the last inspection? What they could do better: The home needs to develop the Service Users Guide and Statement of Purpose to ensure it includes the training and qualifications the staff have undertaken, so that prospective residents are reassured that staff have the knowledge and skills to meet their needs. The pre-admission assessment needs to be more informative so the home can be assured that they can meet the prospective residents needs in full. The care documentation including individualised care plans and risk assessments need to be improved to ensure residents receive appropriate and person centred care that meets their assessed needs and to minimise any risks. The medication practices need to be reviewed and improved to ensure that the residents health and well being are protected and promoted. The staff structure for the dementia unit needs to be reviewed to ensure that there is a dedicated head of unit to supervise and advise staff. Care Homes for Older People Page 8 of 31 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 31 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides prospective residents and relatives with a good level of information about the home, its facilities, services and the costs involved.Further information in respect of staff qualifications would be beneficial. The admission procedures allow for the needs of prospective residents to be assessed by a competent person before admission. Evidence: There is an informative Statement of Purpose and Service Users Guide in place, which contains information about the home and the services it provides along with some information regarding the qualifications of staff. In order to reassure prospective residents that the staff have the knowledge and competency to meet their needs, more information regarding the training and updates they receive would be beneficial. It was confirmed whilst talking to residents that the contract arrangements were clear Care Homes for Older People Page 11 of 31 Evidence: and understood. There is a copy of the terms and conditions of residency included in the homes information documents. A review of the care documentation confirmed that pre admission assessments are completed by the appointed manager or a manager from a sister home within the organisation. The last three admissions to the home were identified and the records relating to the admission procedures followed were reviewed. This confirmed that pre admission assessments are completed and in the main provide a clear assessment of prospective residents care needs. As discussed, one pre admission viewed was brief and little information recorded and this did not give the evidence that the home had collated enough information to make a decision whether they could meet the prospective needs of that individual. Prospective residents are seen either in their home or hospital before admission and the input from relatives and other professionals is used whenever possible. This approach could be more clearly recorded on the assessment documentation to demonstrate the procedure followed. It was confirmed that the home confirms in writing that having regard to the assessment that the home can meet the assessed needs of the prospective resident. The agreement letter was not viewed at this time. The appointed manager was able to verbally demonstrate his knowledge and awareness of the different specialities required in the home and will ensure that the carers employed have attended relevant courses to deal with the needs of the elderly and also specialised courses for certain diseases such as dementia. Trial visits to the home can be arranged. The appointed manager confirmed that residents are invited to a trial period to ensure suitability of the home. This is also clearly stated in the Statement of Purpose and in the statement of terms and conditions in place. Intermediate or rehabilitative care is not provided at Leolyn. Care Homes for Older People Page 12 of 31 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although care documentation provides a framework for the delivery of care it needs to be developed to provide clear guidance to care staff on all the care needs of the residents along with robust systems for risk assessment to ensure individual person centred care is delivered. The homes practice at this time do not ensures residents medicines are ordered, stored and administered safely thus placing residents at potential risk. Residents are treated with respect and have their privacy and dignity maintained. Evidence: The care documentation pertaining to six residents were reviewed in depth as part of the inspection process. The residents were found in the main to have care plans specific to their needs and all evidenced regular review. However it was identified that not all care plans had a care plan in place for communication and mental health needs and this needs to be developed further. This was acknowledged by the appointed manager and will be reviewed and developed, therefore a requirement was not made at this time but will be followed up closely at the next key inspection. Individual risk Care Homes for Older People Page 13 of 31 Evidence: assessments for health needs are included in the care planning format used by the home and all risk assessments were found to be completed, but not all followed through with an appropriate plan of action when identified as required. This pertains to nutritional tools and identified weight loss. It was discussed that staff need to be documenting more accurately the fluids offered and taken by those on a 24 hour recording. There are tools in place for skin integrity and moving and handling and it was discussed that to ensure the continued safety and well being of the residents that the type of hoist and sling used should be clearly documented and the settings for the pressure relieving equipment included in the risk assessment. This will inform all staff involved in the care of the residents. Two health care professionals were contacted following the site visit and their comments concerning Leolyn were: Conscientious and knowledgeable staff Always polite and courteous. Staff spoken with confirmed that they received a full report on each resident daily and the daily notes viewed and were informative, highlighting changes to individual residents, some information would be more effective if cross referenced with the specific care plan. The clinical room is well organised and kept clean and tidy and there are suitable storage facilities for medication stocks and dressings. A medicine trolley is stored in the room and the staff keep it clean and organised. There is a small fridge and temperatures of the room and fridge are recorded daily. There are policies and procedures in place for staff to refer to regarding the safe administration storage disposal and recording of medication including insulin administration. There are systems for recording and checking controlled drugs. The Medication Administration Charts (MAR) were viewed and no gaps identified. The MAR sheets include the codes use by staff for the non administration of prescribed medicines and staff are to be reminded that the reasons for non administration need to be documented clearly on the reverse of the administration charts. From viewing the records it was identified there has been a number of medications out of stock from 2 days to 12 days. As discussed this needs to be taken up with the pharmacy provider as it impacts on the health needs of the residents and needs to be cross referenced in the the specific care plan. The appointed manager was able to provide documentation to evidence that staff had ordered them before running out but the systems for following up need to be more pro active. This information has also been passed on to the CSCI pharmacist. The controlled medication book was seen and a recommendation of good practice is that the index is used for audit purposes and all controlled medications no longer in use are correctly checked out in the controlled ledger. The comparison signatures of staff able to administer medication were Care Homes for Older People Page 14 of 31 Evidence: available and current. Feedback from a health professional was positive regarding care practices in the home and confirmed that advice was sought as and when required. Staff were seen to be respectful and considerate to all residents whilst attending to their needs. The relationships between staff of all nominations and residents was positive and inclusive. The home has a friendly and positive atmosphere which is appreciated by the residents living in the home and people visiting. Each of the residents were addressed by their preferred term and dressed appropriately in welllaundered clothing. The home have policies and procedures in place to guide staff when caring for their residents in the last stage of their life and the home staff spoken with demonstrated an empathy and understanding of these. The AQAA states that the home are planning to investigate and implement the Liverpool Care Pathway Care Homes for Older People Page 15 of 31 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social activities and meals continue to be creative and provide daily variation and interest for people living in the home. Residents are able to make a range of choices about their lives as well as maintaining links with friends and relatives. Evidence: There is an activity co-ordinator in the home who takes responsibility for organising activities, outings and visiting entertainers within the home. The activity programme is displayed in the entrance area of the home and evidenced a range of activities. There is a book of photographs showing residents and staff enjoying various festivities. From discussion with the activity co-ordinator the exercise classes are also popular with some residents. She is dedicated to her role and is continuously looking at new ideas to meet the residents interests and hobbies and is taking guidance from the National Association for providers of Activities for Older People (NAPA) training programme. Care plans evidenced some residents past histories and social preferences, and work is being undertaken at present on improving the content of the care plans for each resident. Care Homes for Older People Page 16 of 31 Evidence: The AQAA states that there are plans to explore links with local community based organisations to expand the activities, encourage staff to develop individual activity programmes and continue to take guidance from the National Association for providers of Activities for Older people (NAPA) training programme. The home have a small library area with a computer with internet access for residents to access. It was confirmed by staff that the residents are supported and enabled to join local events held in the vicinity and attend the Church Services at nearby churches. Residents are facilitated to maintain their independence for as long as they are able. There are no restrictions on visiting times as long as consideration is shown to all the residents. There are communal areas throughout the home that are available to residents and their visitors for private meetings if required. The tour of the home evidenced that many of the residents have individualised their bedroom with items from home and residents and relatives spoken with confirmed that they are encouraged to make it homely, one resident proudly showed her ornament collection and photographs that hold many memories of her life. It was observed during the inspection that the routines at the home are flexible residents spoken with confirmed that they were consulted about all aspects of their lives. The home has an advocacy policy in place and the information regarding this is available to all residents. Breakfast and the mid day meal was observed and was seen to be organised and well managed ensuring that those residents needing assistance were given time and able to have the assistance that they needed in an unrushed manner. It was confirmed that residents had a choice at lunchtime which included a vegetarian choice. Those residents saying they did not like the main choice were seen to have alternatives provided that they did want. Menus are used and circulated the day prior to the meals being provided, there are no records kept on what food is eaten by each resident unless there is a problem and it was discussed that records are beneficial in identifying appetite traits early. It was mentioned that communication between the staff and kitchen could be improved. All feedback about the food was complimentary and comments included: nice food I have choices in what eat and the meals are good. The dining area in both units of the home are pleasant and well furnished with natural light. Care Homes for Older People Page 17 of 31 Evidence: The meals provided looked appetising and were served in a manner that ensured it looked attractive. Fresh fruit is provided, and assessable to the residents The chef confirmed that she meets with residents to discuss their dietary requirements when required. The safer cooking better business book is completed on a daily basis. The Environmental Health Organisation have not visited the home in the past year. Care Homes for Older People Page 18 of 31 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Practice in the home ensures that complaints are responded to, with residents and representatives being confident that they are listened to. Practice in the home ensures that adult protection issues are responded to when identified. Evidence: The complaint policy and procedure is clear and uncomplicated and a copy of this is readily available in the home and the Service Users Guide. A system of recording complaints was demonstrated to the inspector during her visit to the home. The home has received three complaints since the last inspection. Residents spoken with confirmed that they were confident that any complaints or concerns that they had would be listened to and responded to. The home has relevant guidelines on the protection of vulnerable adults and staff have all received appropriate training. The management team has a clear understanding of adult protection guidelines and are aware of how to initiate an investigation if required. There have been two safeguarding alerts in the past year which have been investigated and any action required undertaken. Care Homes for Older People Page 19 of 31 Care Homes for Older People Page 20 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a comfortable clean and safe environment for those living in the home and visiting Residents are enabled and encouraged to personalise their room and rooms are homely and reflect the residents personalities and interests Evidence: A tour of the home confirmed that the home is well maintained and bedrooms are attractive with some being very personalised and all bedrooms have an ensuite facility. Residents spoken to said that they liked their rooms one saying that the home Its very comfortable. There is an attractive patio area and gardens with seating areas for residents to use in the warm weather, the residents also plant bulbs in the tubs and look after them with support from the staff. The home have a choice of various communal areas which are attractive and allow for different uses ensuring residents have choice and how they spend their time. There are adequate communal bathrooms and shower rooms in the home, with specialist equipment to ensure all residents can have a bath or shower. The home has specialised equipment available throughout the home to promote independence. During the inspection it was noted that staff were using lifting and supporting equipment appropriately. Call bells are provided in all areas and staff were seen to be Care Homes for Older People Page 21 of 31 Evidence: attentive and ensured residents had access to these. The home has a range of special mattresses and seat cushions, which are used on an assessed needs basis to prevent tissue damage. The lighting in the home is of domestic quality and there are above bed lights as well as the main ceiling lights. Water temperatures are controlled and monitored monthly and a record kept. Random temperatures were taken and were of the recommended level. There are systems in place for monitoring safety issues such as fire checks, fire drills, PAT testing, electrical tests and gas and boiler checks and all the rooms are routinely checked for safety and maintenance issues. The records in the home confirmed they were up to date. The tour of the home confirmed that staff are aware of the fire safety policies, no doors were found inappropriately wedged open. Polices and procedures for infection control are in place and are updated regularly. The home was clean and free from offensive odours on the day of the inspection. Sluice facilities were clean and hygienic, laundry areas were found to be clean and safe. In the main good practice in respect of infection control by staff was observed during the inspection visit, soiled linen was appropriately put in red bags and all areas of the home were clean. Whilst there were gloves and aprons freely available in the home, staff are to be reminded regarding the appropriate use of gloves. Residents were very complimentary about the laundry service indicating clothes are generally returned the same day. Care Homes for Older People Page 22 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Robust recruitment procedures are in place to protect residents and there are sufficient staff on duty to meet residents needs. The training records evidenced that staff are receiving the necessary training to perform their job competently and thus protecting their residents Evidence: There were twenty five residents living in the home on the day of the inspection the staffing levels have been reduced due to vacancies. The staffing rota was viewed and the staffing levels were seen to be sufficient to meet the needs of the residents at this time. It was confirmed by the manager that there is flexibility of the staffing levels and they are adjusted according to the changing needs of the residents. Care staff spoken with said that the levels of staff on duty were sufficient to give the care required they also said that the senior staff always helped out. This was also observed during the site visit. Residents also confirmed that they had no complaints regarding the amount of staff. A roster is held giving names and designations of staff on duty. It was discussed that when the dementia unit was registered 01/11/07, it was a condition That a nurse-in-charge is appointed to head-up the new EMI unit and that all staff employed to work there are suitably trained in dementia care. The concerns discussed are that what cover is in place from 5 pm untill 9 am and weekends and who Care Homes for Older People Page 23 of 31 Evidence: is taking responsibility for ensuring that the needs of people suffering from dementia are met and reflected in the individual care plans. Separate staff are employed for kitchen and cleaning laundry maintenance and gardening. A selection of staff recruitment files were viewed and demonstrate that a robust recruitment process has been introduced to protect residents and contained all the relevant information required. There was evidence of health questionnaires, Criminal Record Bureau checks, two references, a resume of previous employment and work permits where necessary. All the paperwork is kept within a locked room. There is an induction programme in place and has been introduced for all staff. Files seen confirmed this. New staff are required to complete an initial induction programme and undertake mandatory training including fire and health and safety. This leads into foundation training in preparation of NVQ training. The AQAA states that 100 per cent of staff have an NVQ qualification. The induction and foundation training is in line with the Skills for Care guidance. The provider facilitates regular training sessions and recent ones have included safe cleaning, food hygiene, nutrition, infection control and moving and handling. There is a rolling programme of training which will ensure that staff receive the training necessary to meet the residents needs. Staff spoken with said that training opportunities at the home are good and they are well supported by the senior staff and the manager Care Homes for Older People Page 24 of 31 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed in an open and friendly manner with suitable quality monitoring systems. Residents financial interests are safeguarded The health safety and welfare of residents and staff are generally well promoted and protected. Evidence: Since the last inspection the previous manager has resigned and an appointed manager took up the post in August 2008. He has the necessary experience and knowledge to manage the home. He has been the registered manager and general manager in other homes throughout his 40 year career in the nursing profession. He has a qualification in both general (RN)and mental health nursing (RMN) and has management qualifications as well as ensuring that he continues with his own learning portfolio and updating his knowledge. During the inspection visit there was no doubt that the manager had a good working relationship with everyone in the home and Care Homes for Older People Page 25 of 31 Evidence: everyone spoken to said that he was approachable fair and responded to issues raised quickly. From discussions with the appointed manager there was no doubt that he is committed to adressing any shortfalls discussed and is already adressing areas that were identified. There are systems in place to monitor the quality in the home and include the use of questionnaires. It was confirmed that these are audited, reported on and responded to. It was recommended that the use of questionnaires is expanded to staff and visiting professionals and that the results of the questionnaires are displayed in the home. There are resident/relative meetings and staff meetings, which are documented. The home does manage the personal monies for a number of their residents The AQAA stated residents monies are not pooled and are individualised and appropriate records held. It was confirmed that the system used provides an audit trail of how transactions are managed on behalf of residents. Staff supervision has been commenced, at present all staff have receive supervision, senior staff will undertake training and then the manager will delegate out the supervisions of staff. Leolyn looked well maintained and systems are in place to report any problems to the maintenance team that need attention. Certificates relating to Health and Safety in the home were reviewed and found on the whole to be full. Full records of hot water checking are kept there are measures in place to prevent Legionnaires disease and the health and safety policy is up to date. It was however noted that environmental risk assessments are not fully recorded, this was discussed in full on the inspection visit. The accident book was viewed along with the actions taken to prevent a reoccurrence. It was discussed that recurrent falls and incidents are cross referenced and reflected in individual care plans. A requirement was made under risk assessments. The first aid boxes need to be spread out throughout the home and they need to be regularly checked and topped up. The kitchen first aid box would benefit from including a burns treatment and an eye wash for immediate first aid. This was discussed and will be reviewed and therefore a requirement was not made at this time. Good practice was observed throughout the inspection in respect of promoting the safety and well being of the residents. Care Homes for Older People Page 26 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 1 4 That the registered person ensures that the Statement of Purpose and Service Users Guide is further developed to include the staff qualifications, and service users views of the home. To allow prospective service users the information so as to reassure them the home and staff can meet their health needs. 02/04/2009 2 3 14 That the Registered Provider 02/04/2009 ensures that the pre admission assessment has sufficient detail to ensure the home has the necessary facilities and skills to meet the prospective need. To ensure the health and well being of the admissions to the home. 3 8 14 That the registered provider ensures that all risk assessments are based on 02/04/2009 Care Homes for Older People Page 28 of 31 clear criteria and include an action plan for staff to follow. That accurate records pertaining to fluid intake, nutrition, pressure relieving equipment and communication are further developed and accurately reflect the service users changing needs. To ensure the health, safety and well being of the service users. 4 9 13 That the registered person 02/04/2009 shall make arrangements for the recording, handling, safe keeping and disposal of medicines. To ensure the health, safety and well being of the service users. 5 26 13 That the registered provider ensures that all staff follow the homes policies and procedures in infection control measures: The correct use of gloves and aprons whilst giving personal care. To ensure the health and well being of the service users. 02/04/2009 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. Care Homes for Older People Page 29 of 31 No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 30 of 31 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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