Inspection on 25/07/08 for Linfield Care Home

This inspection was carried out on 25th July 2008.

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

Linfield Care Home 05/04/06

Similar services:

Wingham Court

Old Hastings House

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Linfield Care Home 18 - 22 Wykeham Road Worthing West Sussex BN11 4JD Lead Inspector Jan Aston Unannounced Inspection 25th July 2008 09:30 25/07/08 09:30am 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 Linfield Care Home DS0000065278.V367552.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. Linfield Care Home DS0000065278.V367552.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Linfield Care Home Address 18 - 22 Wykeham Road Worthing West Sussex BN11 4JD 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) 01903 529629 01903 529634 linfield@guildcare.org www.guildcare.org Guild Care Manager post vacant Care Home 54 Category(ies) of Dementia (0), Old age, not falling within any registration, with number other category (0), Physical disability (0) of places Linfield Care Home DS0000065278.V367552.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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: Dementia (DE) Old age, not falling within any other category (OP) 2. Physical disability (PD). The maximum number of service users to be accommodated is 54. Date of last inspection 5th April 2006 Brief Description of the Service: Linfield Care Home, registered for 54 people, is a large newly built, welldesigned Care Home operating under the Guild Care group of homes and provides specialist care for people with nursing needs; physical disabilities and dementia care needs. It is situated in the centre of Worthing approximately ½ a mile from the town centre and all its amenities and the sea front. A park gives an open aspect to the rear of the building and parking facilities are available in the grounds for visitors. The gardens are of an open aspect with a secure well-planned garden for those receiving care in the ground floor dementia unit. A roof garden provides as additional space for residents to enjoy. The building operates on three floors with a lift providing access between the floors. There are four cluster areas with each having an open-plan lounge and kitchen, giving the home a friendly homely aspect. There are two separate communal dining rooms on the ground and first floors and a large communal lounge that can be extended into the spacious hall when needed. All rooms are single rooms with en-suite facilities including level access shower. Linfield Care Home DS0000065278.V367552.R01.S.doc Version 5.2 Page 5 The Responsible Individual operating on behalf of the organisation is Antonia Bunnin. The registered manager’s post is currently vacant. The current fees for the service range from £597 - £862 Linfield Care Home DS0000065278.V367552.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 Star. This means that people who use this service experience good quality outcomes. This inspection assessed the key standards as laid down by the Commission. The visit to the service took place on Friday 25th July 2008 and seven hours were spent in the home. The Inspector looked around the home, examined a sample of records in relation to the needs of six people living in the home, records relating to the recruitment and training of staff, complaints, accidents and Health and safety checks. Seven members of staff were spoken with privately during the visit. An expert by experience accompanied the Inspector for part of the visit and spent two hours in the home speaking with people living in the home and their relatives. An expert by experience is a person who, because of their shared experience of using services, and/or ways of communicating, assists an Inspector by visiting a service to help them get a picture of what it is like to use the service. The expert by experience looked around the home, spoke with four people living in the home and two relatives who were visiting. Prior to the inspection surveys were sent to people living in the home, and to members of staff. There were no surveys received from people living in the home and eleven from members of staff. An Annual Quality Assurance Assessment form (AQAA) was completed and sent to the Commission prior to the inspection. Information from the surveys and the AQAA will be referred to in this report. What the service does well: The accommodation and outside areas are of an excellent standard and the home is comfortable and homely. The atmosphere in the home was relaxed and members of staff were cheerful and very helpful. People are supported and encouraged to maintain their independence and to be as active as possible. Activities in the home provide opportunities for people to go out a couple of times a week, go on holiday and to keep occupied within the home. Staffing levels allow members of staff to have sufficient time to spend with each person. Linfield Care Home DS0000065278.V367552.R01.S.doc Version 5.2 Page 7 The Richmond Suite has been specifically designed to cater for people with dementia and follows current guidelines and recommendations about how to decorate and furnish this area. This has been done very well. The support provided by members of staff to those living in this suite was observed to be very positive, calming and sensitive to their needs. The way in which meals are provided at Linfield promotes a person living in the home to have a choice about what and where they eat. The food is of a good standard and the dining room is attractively laid out so that people have a pleasant place to eat. The Provider has ensured that members of staff are trained to do the work and have supported 70 of the staff team to achieve National Vocational Qualifications. Members of staff who responded to the inspection through surveys said that “the service looked after residents well and keep the home clean”, “Guild Care as a whole works very hard to maintain a high standard and is always finding ways to improve the service to it’s clients”, “good training and open door policy to management”, “there is no discrimination they treat us as individuals”. A person living in the home said that they enjoyed the activities and “one of the drivers is my favourite he is so good and always cheerful and he’ll take you to the shops or anywhere you like’. A relative said, “‘I can now sleep at night knowing my wife is being well cared for.’ What has improved since the last inspection? What they could do better: All the necessary information is recorded about the individual need of each person however it is recommended that the care planning system be reviewed as to achieve a comprehensive up to date picture of the needs of each individual it required looking in at least six files. A clear, brief but concise picture of a person’s needs is not therefore easily obtained and this could make it difficult for new staff and the monitoring of needs. Linfield Care Home DS0000065278.V367552.R01.S.doc Version 5.2 Page 8 It is recommended that the Registered Manager take steps to further consult relatives about their needs and wishes in respect of how they wish the service to communicate with them to ensure they receive information about their relative when appropriate and at suitable intervals. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Linfield Care Home DS0000065278.V367552.R01.S.doc Version 5.2 Page 9 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 Linfield Care Home DS0000065278.V367552.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 3 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are supported to make an informed decision about where to live as they have sufficient written information about the service and their needs are assessed prior to admission to the home. People also have the opportunity to visit the home before they make a decision to move in. Intermediate care is not provided in the home. EVIDENCE: Whilst looking around the home it was noted that the homes brochure pack was available in people’s rooms. This compiled of a summary of the Statement of Purpose, a Service User Guide and complaints procedure. The AQAA completed by the Provider stated, “We send out brochures, enquiry forms and welcome packs. We provide a Service User Guide on admission and our Statement of Purpose is made available to all residents, potential and existing.” Linfield Care Home DS0000065278.V367552.R01.S.doc Version 5.2 Page 11 Information provided from a person wishing to move into the home or their relative during an initial enquiry is recorded. Prior to admission an appropriately qualified person assesses the needs of the person and the person is offered the opportunity to visit the home or stay on a trial basis. A trained nurse who was spoken with during the inspection confirmed that he is involved with undertaking pre-admission assessments with the Deputy Manager. From the sample of six care plans examined it was noted that an enquiry form had been completed and all had a basic information sheet that recorded personal information along with medical history and medical checks on admission. An assessment that obtained information about all aspects of a person’s needs had been undertaken and the information recorded. Other information had also been obtained from previous placements, Care Management assessments and Continuing health care assessments. During the visit to the home it was observed that a relative of a person needing residential care visited the home and asked to look around. The person was made welcome and there was no hesitation in arranging for a member of staff to show the person around the home. The AQAA completed by the Provider stated, “We invite people in for a taster, to have lunch, afternoon tea and chat to residents and staff.” Intermediate care is not provided in this setting. Linfield Care Home DS0000065278.V367552.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A person’s health, personal and social care needs are set out in an individual plan of care that demonstrates the health and personal care that people receive is based on their individual needs. Medication is administered according to recommended guidelines. The principles of respect, dignity and privacy are put into practice. EVIDENCE: From examining a sample of records relating to six people living in the home it could be seen that information about all aspects of a person’s needs had been obtained and how a person is to be supported recorded on an agreed care plan. The agreed care plan recorded a person’s preferred daily pattern, personal hygiene needs, and pressure area management, nutritional needs, nutritional screening, and night care plan. The plan had been signed either by the person or their representative. A copy of the care plan is also placed in each person’s room for members of staff to refer to. Linfield Care Home DS0000065278.V367552.R01.S.doc Version 5.2 Page 13 Other information had also been obtained from the person or their relatives and recorded on a lifestyle summary. This recorded the person’s preferred name, how the person communicates, important things to the person, items that mean a lot to them and information about family and friends. There was evidence that a relative had been consulted and the file contained “notes for Mum’s care plan”. The care plan for a person with dementia living on the Richmond suite was examined. This contained a “whole person picture, a strengths assessment and evidence of an assessment undertaken by a Consultant Psychiatrist. All care plans contained risk assessments in respect of falls, moving and handling, the use of bedsides where necessary and skin condition and risks of pressure areas. There was evidence of monthly evaluations of the agreed care plan and night care plan. Monthly observations of medical checks, temperature, blood pressure, weight and pulse were also recorded. Recording of daily events, care provided and visits or advice by professionals were not contained within individual care plans/folders but in a communal unit files that contained this information for all people on that particular unit. Communal files and recording was also kept for, frequency of bowel movements and urine, weight records, shower/bath records and treatment of pressure areas or dressings. Whilst it could be seen that the necessary information had been obtained and recorded about each individual in order to get a true up to date picture of the needs of each individual it required looking in at least six files. The communal files for each unit do not support person centred planning and does not respect confidentiality of information. A clear, brief but concise picture of a person’s needs is not therefore easily obtained and this could make it difficult for new staff and the monitoring of needs. It is recommended that the care planning system be reviewed. There was evidence from the sample of care plans examined that the health needs of each individual are being assessed and monitored and visits by professionals such as district nurses where appropriate, G.P, chiropodist are noted and any advice or treatment recorded. From the sample of care plans it could not be determined however when an individual had last had their hearing or sight tested or received a dental or mouth check. Chiropody visits were recorded for only two people in the sample. Only one person in the sample had received a sight test. From observations made during the visit it could be seen that people living in the home looked clean, comfortable and well cared for. The expert by experience spoke with a relative who showed her the level of observation chart Linfield Care Home DS0000065278.V367552.R01.S.doc Version 5.2 Page 14 showing that his wife is checked every 30 minutes day and night, the activity which took place; changing pads, what and how much she ate and drank. All the equipment his wife uses is supplied by the Home. His wife is always dressed in her own clothes. He said, ‘I can now sleep at night knowing my wife is being well cared for.’ The home uses a monitored dosage system for medication. All medication is supplied and pre-packed in blister packs by the Pharmacy. It was noted from looking around the home that a separate medication trolley that can be locked is used for each unit. The administration of the lunchtime medication was observed. This was administered by the trained nurse on duty and was done appropriately and safely. The records of medication given were organised and up to date. There was evidence that a person is supported to take their own medication where they have been assessed as having the capacity to do this safely. The Skills for Care induction training programme used by the home for new members of staff provides training and guidance of how staff should support people with personal care needs and respecting a person’s privacy and dignity. It was noted whilst in the home that members of staff spoke with people living in the home and relatives in a respectful manner and were helpful. Members of staff also knocked on people’s doors before walking in. Linfield Care Home DS0000065278.V367552.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who use the service are supported to make choices and decisions in their lives. A varied programme of activities ensures that people have opportunities to satisfy their social, cultural, religious and recreational interests and needs. People have nutritious and attractive meals and snacks, at a time and place to suit them. EVIDENCE: Activities are organised on a daily basis by an activities co-ordinator and an activity programme was seen for the next two months. Copies of this were available in the reception area. Activities include bingo, mini bus trip, music and movement, pottery party, shopping trip, poster painting, residents meeting, tea and film, residents meeting and individual time with staff. On the morning of the inspection people living in the home joined in the residents meeting. The AQAA completed by the Provider told us that, “we took a group of residents on holiday and this was a huge success and enhanced their social life immensely.” Linfield Care Home DS0000065278.V367552.R01.S.doc Version 5.2 Page 16 The expert by experience spoke with people living in the home who told the expert that some people are able to go on their own for walks around the block and Victoria Park that backs on to the home. There is also a mini bus with drivers to take them for excursions and they can either chose where they want to go or the driver will suggest somewhere. A person said, ‘One of the drivers is my favourite he is so good and always cheerful and he’ll take you to the shops or anywhere you like’. There are different activities on some days; musical movement appears to be a favourite. There is a room with hairdryers and washbasins and the hairdresser comes in twice a week. The chiropodist also calls on a regular basis. People living in the Richmond suite have a small West Highland Terrier called Rabbi living with them and a budgie. There are no restrictions on visitors or visiting times. People spoken with said that usually people respect meal times and don’t visit then. It was seen that people living in the home had individual telephones in their rooms that they pay for, so they speak with relatives or friends in private. The expert by experience spoke with a relative who said, that he is made most welcome at whatever time he chooses to visit and receives a cup of coffee and biscuits. Care plans record some information about people’s choices and likes and dislikes. People living in the home confirmed that they have opportunities to suggest changes or ask for improvements through regular residents meetings. They said that they are listened to and any suggestions acted upon. A residents meeting was taking place during the visit. There are two dining areas in the home that are both attractive and provide a pleasant place to eat. People living in the home are encouraged to eat in the dining room but they are free to eat in their rooms if they wish. The menu for the day is displayed in each dining room. Breakfast in the dining rooms is laid out in a buffet style so people can help themselves and there is a choice of a cooked breakfast. There is a four-week menu plan but people are offered an alternative meal everyday. There is always a choice of a hot or cold supper. Within each suite there is an open plan lounge and kitchen area where drinks and snacks can be made so food and drink is always available. It was observed on the Richmond suite that people were offered snacks of cheese, biscuits and fruit with their morning coffee. There is a full time chef employed and two assistant chefs. One of the assistant chefs was spoken with, he confirmed that there is a good cleaning regime and they comply with the food safety regulations. The last EHO inspection report of November 2006 stated, “Very pleased with the practices and procedures and high standard of hygiene in kitchen.” The kitchen looked clean and storage of food appropriate and labelled. Linfield Care Home DS0000065278.V367552.R01.S.doc Version 5.2 Page 17 The assistant Chef confirmed that he completed an update in food hygiene procedures the day before the inspection. He also said that people are informed of what meals are available each day and they are asked what they would like. People are supported to choose what they would like to eat by a sample of each meal available being shown to them. There was evidence that people living in the home are consulted about the food and their choices and relatives are included in this consultation where necessary. The Chef regularly speaks with people living on each unit about the quality of food provided and their choices. The expert by experience said I observed members of staff bringing round to the tables two plates, one with fish, chips and peas and the other with quiche and vegetables for the residents to chose from. Both appear to be well presented and nutritious. The menus for both lunch and dinner are displayed in large print and those sitting around the tables all agree the food is good. The kitchen is visible from the dining room and is of excellent standard. The Inspector sampled the meal of the day and found it to be cooked well, tasty and presented well. A fan in the kitchen used during hot weather is not working appropriately and blows cooler air from outside into the kitchen. This has the potential risk of blowing matter into food being prepared. This was raised with the Manager after the inspection and will be addressed. Linfield Care Home DS0000065278.V367552.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home and their relatives can be confident that their concerns and complaints will be listened to and acted upon. There are measures in place to ensure that people are protected from abuse. EVIDENCE: The complaints policy and procedure is provided in the Statement of Purpose and service user guide and is given to people living in the home and their relatives. The complaints procedure is displayed in the entrance hall. There is a system for recording complaints to show the detail of the complaint, the timescales of the response and the outcome. The organisations head office is also informed of the complaint and a regular audit of complaints is undertaken. It was noted that four complaints had been received since January 08 and they had been responded to appropriately. The Commission has not received any complaints about this service. A relative told the expert by experience that he chats regularly with the care workers on his wife’s floor and with the Manager and attends most of the residents’ regular meetings. He is aware of the complaints procedure but has had no cause to use it. Linfield Care Home DS0000065278.V367552.R01.S.doc Version 5.2 Page 19 There has been a recent safeguarding adult allegation. This was reported to West Sussex Social & Caring Services and an investigation took place. The outcome of the investigation was inconclusive and there were no concerns about the health and welfare of people living in the home. Members of staff spoken with were aware of how to recognise signs of abuse and to report any allegations in line with the West Sussex Social and Caring Services Safeguarding Adults Procedures and of the local contact details. All newly appointed members of staff receive information about safeguarding procedures as part of their induction and there is an ongoing programme of training in recognising and reporting signs of abuse. Members of staff spoken with confirmed they have received this training. From the sample of six staff records examined it could be seen that only three had received this training. The Manager should ensure that all members of staff have received training in awareness of abuse and the reporting procedures under the safeguarding adult procedures. Linfield Care Home DS0000065278.V367552.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The accommodation provided at Linfield is homely, clean, safe and well maintained and is of an excellent standard. EVIDENCE: A tour of the premises was undertaken. All areas of the home looked well maintained and furnished to a high standard. The garden areas looked well kept and attractive and well equipped with garden chairs. The outside area to the Richmond suite is particularly attractive and provides a safe, secure and stimulating area for people living in that unit. The Richmond Suite has been specifically designed to cater for people with dementia and follows current guidelines and recommendations about how to decorate and furnish this area. This has been done very well. Linfield Care Home DS0000065278.V367552.R01.S.doc Version 5.2 Page 21 People living in the home have personalised their rooms and all rooms look different. The doors to peoples’ rooms are fitted with automatic door guards that are linked to the fire alarm so they can leave their doors open but still be safe in the event of a fire. It was observed that lockable drawers have been provided in all rooms to secure valuable items. All rooms have en-facilities. All areas of the home were clean and hygienic. Infection control is part of the mandatory training programme provided a number of times a year and is open to all staff. Members of staff confirmed that they had received training in the prevention of infection. Members of staff confirmed that they have good hand hygiene routines and they have antiseptic hand gel placed in areas of the home. A number of people particularly mentioned the efficiency of the laundry and at most times clothes are washed and ironed the same day. There are sufficient numbers of domestic staff to keep the home clean and to assist in the kitchen. The expert by experience made the following comments about the environment; the home is new and softly decorated with muted colours, a different colour for each floor to make it easier for residents to identify. The interior is very light and air-conditioned. All the rooms are a good size, single and en suite. In addition there are larger bathrooms on each floor with specialised equipment. Each floor is split into nursing and residential with an intimate lounge area. The top floor also has a breakfast room, for those residents preferring not to take their breakfast in their rooms, leading out onto a roof garden. The rooms visited were personalised with pictures, ornaments, some with cards on display and in some fruit and biscuits. The rooms and corridors are well lit and softly decorated giving a feeling of calm. All areas are clean with no smell and fresh flowers, paintings and ornaments on display in the public areas. The building has been designed to allow easy access to all areas for people living in the home. A loop system has been installed to assist people with hearing difficulties. The documentation relating to the safety of the building, utilities and equipment was examined. This provided evidence that safety inspections on utilities, equipment, lift and fire alarms are undertaken at appropriate intervals. Radiators within the home are guarded and hot water outlets fitted with a thermostatic valve to prevent scalding. The service has developed a fire risk assessment and an evacuation plan. There is a current Public Liability Insurance cover in place. Potential risks to people living or working in the home and visitors have been assessed and information recorded on a risk assessment. The risk assessments had been reviewed. Linfield Care Home DS0000065278.V367552.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The numbers and skill mix of staff meets the needs of people living in the home. People are safeguarded by the home’s recruitment policy and practices. Members of staff are trained and competent to do their jobs. EVIDENCE: Members of staff spoken with confirmed that the staffing levels on each unit allows them to support people with personal care in a way they prefer with sufficient time to do this well. Two members of staff are allocated on each unit plus one person who floats between suites. The extra person floating was introduced about six months ago and members of staff said that this was working well. Two trained nurses and a Senior Care Assistant also work on each shift. With the employment of domestic, laundry, kitchen assistants and an activities person care staff are able to concentrate on providing personal care. In the Richmond suite there is a dedicated staff team and usually staffing levels allow three members of staff plus the manager on each shift and three plus a senior care assistant at the weekends. Linfield Care Home DS0000065278.V367552.R01.S.doc Version 5.2 Page 23 From observations made during the visit to the home and from information obtained from people living in the home and from members of staff the staffing levels are appropriate for the level of support required by people living in the home. A sample of records relating to the recruitment and training of members of staff was examined. The home uses the Skills for Care Common Induction Standards programme that provides a comprehensive training programme. A copy of this induction programme was seen completed in a staff file. There is an ongoing programme for mandatory training that includes; fire, first aid, food hygiene, moving & handling, infection control, safeguarding adults, COSHH and dementia. Members of staff confirmed that this training is available and any other course they may wish to go on is supported and accessed. From information provided on the AQAA thirty-two members of staff have achieved National Vocational (NVQ) level 2 and six are working towards this. Members of staff said that the organisation encourages and supports this training. A sample of recruitment records was examined for six members of staff. Three had been employed since January 2008. Records demonstrated that a full recruitment procedure had been followed including application, interview, proof of identity, references taken up and Criminal Record Checks in place before the person started working in the home. Linfield Care Home DS0000065278.V367552.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The quality monitoring systems ensure that all areas of the home are run in the best interests of people living there. People’s financial interests are safeguarded. The health, safety and welfare of people living in the home and staff are promoted and protected. EVIDENCE: The Registered Manager’s post is currently vacant. A new manager has been appointed and will commence working in the home on the 4th August 2008. The new manager is an experienced manager and has for the Guild Care organisation for over nine years. Linfield Care Home DS0000065278.V367552.R01.S.doc Version 5.2 Page 25 People living in the home said that meetings with them are held regularly and they feel confidant that they can say anything and will be listened to and action taken. Meetings are also held with relatives or representatives. External auditors from Dementia Care Matters have audited the Richmond suite. The last audit was undertaken in January 2008. This report was seen and noted that it sated that the Richmond Suite was “providing an exceptional level of person centred dementia care and high levels of positive social interaction. Members of staff always turn positive person care into a positive social interaction” A relative who spoke with the expert by experience said that he felt that the communication between the home and relatives could be improved. He said he is kept informed but not given enough advance warning. He has brought up the lack of communication over key workers and care plans at meetings with relatives and has found that “some of the other attendees in the meeting had never heard of either”. He feels there is a lack of structure in supporting and reviewing them. The care plan kept in his Mother’s room has not been updated with the name of her new Key worker. He said, ‘this is what I mean. When I come to see my mother there is no one person I can talk to, say, on a monthly basis to find out how my mother is progressing. Her short term memory is failing and I worry about her.’ It is recommended therefore that the Manager of the service considers these comments and takes action to improve the service in these areas. People living in the home are encouraged to manage their own finances and where they lack capacity to do this relatives or legal advisors assist with financial matters. The Provider and Manager do not act as Appointee’s or hold Power of Attorney for anyone living in the home. The Manager and administrator assist two people with small amounts of money for additional services and personal expenses; all transactions are recorded and moneys accounted for. Members of staff spoken with confirmed that they meet with the manager regularly through staff meetings and supervision meetings. From the records examined it could be seen that all staff in the sample had received supervision. The Manager is in the process of ensuring that all staff receives an annual appraisal. Members of staff confirmed that a person was always available on call in the evening and weekends. The documentation relating to the Health and Safety of the premises was in good order and up to date. Risk assessments had been undertaken in respect of all aspects of health & safety risks within the home and all had been reviewed in January of this year. There was evidence that the fire alarm and equipment had been inspected in April 2008. Members of staff receive ongoing training in fire safety. Training sessions had been undertaken on and another Linfield Care Home DS0000065278.V367552.R01.S.doc Version 5.2 Page 26 booked for Annual safety inspections had been undertaken on electric portable appliances, lift, hoists, gas, electricity and heating. There is an ongoing training programme in the health and safety topics such as first aid, moving and handling, infection control, fire and health and safety to ensure that members of staff receive an annual update in this training. Linfield Care Home DS0000065278.V367552.R01.S.doc Version 5.2 Page 27 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 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 N/A X 3 X 3 X X 3 Linfield Care Home DS0000065278.V367552.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Linfield Care Home DS0000065278.V367552.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Linfield Care Home DS0000065278.V367552.R01.S.doc Version 5.2 Page 30 - 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. 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