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Inspection on 25/06/08 for Linford Park Nursing Home

Also see our care home review for Linford Park Nursing Home for more information

This inspection was carried out on 25th June 2008.

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

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

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

What the care home does well

An effective assesment procedure that includes the provision of good information about the home means people move into the home confident they will receive the support and care they need and with an understanding about the running of the home. People living at the home have the opportunity to take part in meaningful activities and to maintain contact with their family and friends.

What has improved since the last inspection?

The care planning process has been improved. Care plans contain clear details about the action to be taken to meet the individuals assessed needs. The care plans are regularly updated and reviewed. Care plans are in place for people who have wounds; these deltas the type of dressing and treatment required and provided information about progress of the healing of the wound. The management of medications has improved since the last key inspection. This was evidenced at the random pharmacy inspection carried out by one of our pharmacy inspectors in March 2008 and the improvements continue to be maintained. People living at the home have a choice of food at meal times and records are kept of the food provided to people living at the home. A record is kept of complaints received by the home that details what the complaint is and the action taken to resolve the complaint. The manager audit`s these complaints and uses the results to feed into the improvement plans for the service. Recruitment practices have improved. Records evidence that all recruitment checks including references, CRB and POVA first if necessary and evidence that the person is entitled to work in the country are obtained before a person commences employment at the home. This helps to ensure people living at the home are receiving care and support from people who are suitable to work as carers. The home is clean and tidy ; there are sufficient cleaning staff on duty at any one time to keep the home clean and tidy. A staff rota is displayed that details what staff are on duty and in what capacity and at what time. All items that are hazardous to health are stored in a secure area to reduce the risk of people living at the home having access to them and harming themselves. The registered providers have employed a manager. He is in the process of submitting his application to be registered as the manager of the home to us.

CARE HOMES FOR OLDER PEOPLE Linford Park Nursing Home Linford Road Linford Ringwood Hampshire BH24 3HX Lead Inspector Gina Pickering Unannounced Inspection 25th June 2008 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 Linford Park Nursing Home DS0000011430.V365425.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. Linford Park Nursing Home DS0000011430.V365425.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Linford Park Nursing Home Address Linford Road Linford Ringwood Hampshire BH24 3HX 01425 471305 01425 471306 linfordpark@googlemail.com 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) Northdown Estates Limited To Be Confirmed Care Home 107 Category(ies) of Dementia (12), Dementia - over 65 years of age registration, with number (64), Old age, not falling within any other of places category (80), Physical disability (10), Physical disability over 65 years of age (80) Linford Park Nursing Home DS0000011430.V365425.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. All service users must be over the age of 60. A maximum of 80 service users can be accommodated. This is subject to review on or after 21st August 2006. 26th March 2008 Date of last inspection Brief Description of the Service: Linford Park nursing home is situated in Linford, a rural area of the New Forest, around three miles from the market town of Ringwood. The home is registered to accept up to 107 service users over 60 years of age. There is currently a condition that only allows up to 80 service users to be admitted. The home is registered to provide care to people in the older person category with mental health needs, dementia, and physical disability. Accommodation is offered over two floors, a passenger lift is provided. The current fee charged is £543-£750 Linford Park Nursing Home DS0000011430.V365425.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Quality rating for this service is one star. This means that the people who use this service experience adequate quality outcomes. The inspection considered information received by the Commission about the service since the last key inspection in January 2008. Information provided to the Commission in the form of the home’s Annual Quality Audit Assessment form in which the registered provider or manager tells the Commission how the service has developed over the past twelve months and how they propose to continue to improve was considered during the inspection process. But because this document had been received in 2007 prior to the last key inspection in January 2008 some of the information was out of date. We surveyed people who use the service, relatives, staff and health care professionals who have input into the service. Information received from these surveys has been used to inform the inspection process. A visit was made to the service on 25th June 2008. We looked at documentation relating to six people using the service. We had conversations with the manager, registered providers, ten staff members, seven people who live at the home and one visitor as well as looking at various documentation as part of the inspection process. What the service does well: An effective assesment procedure that includes the provision of good information about the home means people move into the home confident they will receive the support and care they need and with an understanding about the running of the home. People living at the home have the opportunity to take part in meaningful activities and to maintain contact with their family and friends. Linford Park Nursing Home DS0000011430.V365425.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? The care planning process has been improved. Care plans contain clear details about the action to be taken to meet the individuals assessed needs. The care plans are regularly updated and reviewed. Care plans are in place for people who have wounds; these deltas the type of dressing and treatment required and provided information about progress of the healing of the wound. The management of medications has improved since the last key inspection. This was evidenced at the random pharmacy inspection carried out by one of our pharmacy inspectors in March 2008 and the improvements continue to be maintained. People living at the home have a choice of food at meal times and records are kept of the food provided to people living at the home. A record is kept of complaints received by the home that details what the complaint is and the action taken to resolve the complaint. The manager audit’s these complaints and uses the results to feed into the improvement plans for the service. Recruitment practices have improved. Records evidence that all recruitment checks including references, CRB and POVA first if necessary and evidence that the person is entitled to work in the country are obtained before a person commences employment at the home. This helps to ensure people living at the home are receiving care and support from people who are suitable to work as carers. The home is clean and tidy ; there are sufficient cleaning staff on duty at any one time to keep the home clean and tidy. A staff rota is displayed that details what staff are on duty and in what capacity and at what time. All items that are hazardous to health are stored in a secure area to reduce the risk of people living at the home having access to them and harming themselves. The registered providers have employed a manager. He is in the process of submitting his application to be registered as the manager of the home to us. Linford Park Nursing Home DS0000011430.V365425.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Linford Park Nursing Home DS0000011430.V365425.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 Linford Park Nursing Home DS0000011430.V365425.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Effective assesment procedures that include the provision of good information about the home mean people move into the home confident they will receive the support and care they need and with an understanding about the running of the home. The home does not provide intermediate care. EVIDENCE: Comprehensive details about the service provided by the home are included in the statement of purpose and the service users guide. Both these documents were reviewed in June 2008 and updated to detail the current service provided at the home. The statement of purpose details that for every body wishing to move into Linford Park an assesment of their needs is carried out by staff at the home and a copy of social services assessments and care plans are requested. Once the decision has been made that the home can meet the Linford Park Nursing Home DS0000011430.V365425.R01.S.doc Version 5.2 Page 10 persons needs and a place is offered the service user guide is provided which gives further information about the home, a copy of the terms and conditions of residency at the home and if relevant a local authority contract is supplied to the person planning to move into the home. We looked at documents belonging to six people living at the home. They all contained an assessment made of the persons needs before they moved into the home. The more recent admissions had more detailed assesment that resulted in a basic outline of the support that persons would need when they move into the home. All files contained social service care management assessments and care plans for the time the person moved into the home. Of the people living at the home that we had conversations not all of them were able to remember the processes that took place when they moved into the home. Others were able to tell us that their relatives had visited the home and had then told them what to expect at the home. One visitor confirmed that he had visited the home to make the decision about its suitability for his wife. Several of the people who could remember moving into the home confirmed that they had written information about the home before they moved in. Linford Park Nursing Home DS0000011430.V365425.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Improved care planning processes mean that people living at the home receive the support and care they need in the way they like. People living at the home have their health care needs met by a work force that has a good understanding of health care issues, by effective monitoring and assessments and by prompt referral to health care professionals when needed. Improved medication practices and effective monitoring of these mean that people using the service have their wellbeing protected. Good care practices means that a person’s privacy and dignity is protected. . EVIDENCE: Following the key unannounced inspection in January 2008 the service was required to make improvements to the care plans ensuring that the plans Linford Park Nursing Home DS0000011430.V365425.R01.S.doc Version 5.2 Page 12 accurately reflect the current assessed needs of the persons and that they are updated and reviewed to reflect changes in peoples needs. We were informed by the service that this requirement had been met. The evidence that we gathered during the inspection process confirms that this requirement has been met. We looked at care plans belonging to six people living at the home, three living in Woodlands wing and three living in the Linford wing. Care plans are well ordered and organised making it easy for staff to access the information they need. Care plans incorporate personal preferences with regard to sleeping and rising routines, daily routines, whether they prefer to be cared for by a female, male staff or do not mind and other personal preferences such as one person does not like to be alone in a room or hobbies they like to take part in. Details about how a person likes to be supported in their personal and health care is found in the plans. Discussion with people living at the home, staff members and a visitor indicated that people’s wishes as documented in care plans are adhered to. Nutritional assessments are made using a professionally recognised tool and a care plan is developed if nutritional risks are identified. Professionally recognised tools for pain assessment, moving and handling and dependency are used and a plan of care developed accordingly if a risk or a need is identified. There was some documentary evidence in the care plans to indicate the involvement of people living at the home or their representatives in the development and review of care plans. For example one person had clearly indicated his wishes in writing regarding diet expressing his understating of how his choice of diet could affect his medical condition. Conversation with a visitor indicated that he has a good understanding about the care his wife receives and any changes to his wife’s care are discussed with him and his wife. Care staff and nurses told us about how the care plans are used and developed. The nurses write the care plans but information to develop the care plans is provided by care staff, people living at the home and relatives. Care staff told us they use the care plans to ensure they are supporting and caring in the way the person likes, ensuring they are meeting the individuals needs and their choices are being respected. A requirement had been made following the previous inspection that for all people who have a pressure ulcer or wound of any description a plan of care must be in place that details the treatment needed to promote the healing of the wound. We were told that no one at the home has a pressure ulcer. But staff showed the care plans for people who have wounds, several of them being leg ulcers that had been experienced by the person for a long time. The plans detailed the treatment needed, how often and gave an indication of the healing progress of the wound. There was documentary evidence of the involvement of health specialists in wound care. The evidence gained confirms that the home has complied with this requirement. Linford Park Nursing Home DS0000011430.V365425.R01.S.doc Version 5.2 Page 13 The team of trained nurses working at the home facilitate the health care of people living at the home. Documentation evidences the contact people have with doctors and other health care professionals. Instructions from doctors about a person’s health care are recorded in the doctor’s notes of the care planning documentation as well as being incorporated into the care plan and medication administration record sheet if needed. A procedure is in place and used to refer people to the GP if there any concerns about their wellbeing. This procedure means that non-urgent health care needs are attended to when one of the GP’s from the local surgery visits the home twice a week and for urgent health care needs GP’s are called out, as they would be if someone was living in their own private home. We received comments from one of the GP surgery concerned regarding the home’s practice of calling out GP’s which indicated that sometimes these call outs were inappropriate. These comments were discussed with the manager who told us he has visited the surgery’s to introduce himself to the practice manager to try to improve working relationships. Throughout the inspection process information was obtained evidencing the privacy and dignity of people living at the home is promoted and protected. Care plans detail people’s wishes about personal care and their wish to have either a male or female carer supporting them with their personal care. Staff members were observed talking with and assisting people at the home in a friendly and pleasant manner. No breaches of privacy were observed throughout our visit to the home; staff were always seen to knock on a persons bedroom door and wait for a response before entering the room. A pharmacy inspection had been carried out by one of our specialist pharmacy inspectors following the last inspection. The pharmacy inspection confirmed requirements made about ensuring that prescribed medications are kept in a locked area and that arrangements are in place for the safe administration, handling, recording of medications at all times had been complied with. As part of this inspection we sampled records to evidence that this compliance is being maintained. We looked at six medication administration record charts and checked the details on the chart against the supply that was in the home. A clear audit tail is available for medications ordered, delivered and administered to people living at the home. All nurses have undertaken a three-day course about the safe handling and management of medications. We conclude that the home continues to comply with the regulations about the management of medications. We had a look at the storage of controlled medications on the Linford wing. It was observed that the CD cupboard, although secured in the main medication cabinet, is not secured to the wall in the required manner as detailed in the Misuse of Drugs (Safe Custody) Regulations 1973. Linford Park Nursing Home DS0000011430.V365425.R01.S.doc Version 5.2 Page 14 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): 12, 13, 14 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home have the opportunity to take part in meaningful activities and to maintain contact with their family and friends. People living at the home are able to exercise choice and control over their life. People living at the home benefit from a varied and healthy diet. EVIDENCE: A full time activity coordinator is employed by the home. She explained that it is an ongoing process to obtain information about the interests and life history of people living in the home so she can organise activities that will appeal to people living in he home. Records are kept of activities that people take part in and the response they had to the activity. A two-week activity programme is displayed in the entrance hall along with leaflets detailing the activities planned for the two-week periods being available for people to take. Information is portrayed in large print and pictorial formats allowing people who have difficulties understanding the written word to be able to have some understanding of the activities available. Activities planned for the week we visited the home included cross word club, reminiscence sessions, exercise to Linford Park Nursing Home DS0000011430.V365425.R01.S.doc Version 5.2 Page 15 music, as visit from a hand bell group, a quiz afternoon as well as visits and one to one sessions with people. The activity coordinator told us that for people who are unable to take part in group activities or do not want to she spends time with them on a one to one basis, chatting, listening to music or manicuring their hands. Observation throughout the inspection evidenced that people living at the home responded to her in a positive manner indicating that people living at the home are able to have meaningful interactions with her. Staff were observed throughout our visit interacting well with people living at the home, giving them reassurance and encouraging them to join in individual activities such as jigsaws, music, discussing pastimes and the newspapers. The statement of purpose details there are no limitations on visiting times; people at the home can choose when to receive their visitors. One visitor we spoke to during our visit to the home confirmed that he can visit at anytime of the day and he is always made to feel welcome by the staff. People living at the home that we were able to hold conversations with told us they are able to have visitors at any time. Throughout the inspection process evidence was gathered confirming that people living at the home are able to make choices in their daily lives. Examples of these include being able to make choices about involvement in activities, where and when to take their meals and their wishes regarding care support being included within the care planning process. People were observed being able to move freely or with assistance around the home, choosing whether to use the communal areas or sit in their bedrooms. People living at the home told us they choose what they want to do. Discussion with staff at the home evidenced that they believe the people living at Linford House must be supported to make choices about their daily lives. Concerns were raised at the previous inspection that people were not having any choice of food at mealtimes and that a record of food taken by people living at the home was not being kept. Menus were on display in the dining rooms detailing the choices available for meals that day. There were also photographs of the various meals provided at the home to aid people visually with meal choices. Conversations with people living on Linford wing confirmed that choices at meal times are made available to people living at the home. Observation on Woodlands wing confirmed that people living there are given the opportunity to make choices about their meals. People living at the home can make choices where they take their meals. A large dining area in the Linford wing is available for people living on that wing to take their meals or they can take them in the privacy of their own bedrooms. Smaller dining areas are available on the Woodlands wing for people living there. But both staff and people living at the home told us that people living in Woodlands wing can chose to take their meals in the Linford dining room if they wish, though this does not happen frequently. Care plans details the assistance people need at Linford Park Nursing Home DS0000011430.V365425.R01.S.doc Version 5.2 Page 16 meal times, whether they need assistance with feeding or they need their food prepared in a certain way that enables them to eat their meals independently. Staff were observed to be assisting people with their meals with sensitivity. Documents were seen in the kitchen evidencing that records are kept of the meals provided to people living at the home. No concerns were raised by any person we talked to about the quality and quantity of the meals provided at Linford Park. Linford Park Nursing Home DS0000011430.V365425.R01.S.doc Version 5.2 Page 17 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): 16 & 18. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who live at the home are confident that complaints will be taken seriously and responded to promptly. Because some staff do not have a complete understanding about safeguarding procedures people living at the home might not be fully protected from the effects of abusive practices. EVIDENCE: A complaints procedure is displayed in the entrance hallway to the home and information about the complaints process is detailed in the statement of purpose and service user guide that is supplied to all people moving into the home. People living at the home and their relatives told us that they know who to express complaints and concerns to and they are confident that concerns and complaints will managed effectively. Relatives and people living at the home told us the new manager responds promptly to any concerns raised so they do not develop into formal complaints. Staff we spoke understand the complaint process at the home The complaints log book detailed two complaints received by the home since the last inspection, the action taken to resolve the complaint and when a response was provided to the complainant. This means the home has complied with a requirement made about the documentation of complaints made following the last inspection. The manager, to ensure the procedure is being followed correctly and to identify any common concerns that need to be addressed, audits the record of complaints monthly. Linford Park Nursing Home DS0000011430.V365425.R01.S.doc Version 5.2 Page 18 Policies and procedures about safeguarding adults are in place. The training matrix developed by the manager indicates that 61 of staff members have received training about the protection of vulnerable adults. The manager told us he has identified this area as a training need and is making plans to ensure training about the protection of people is delivered to all staff members. But at the time of our visit there was not a date for when this training is being provided. Discussion with staff evidenced that they have a good understanding about different types of abuse and how to recognise abuse if it is happening. All staff acknowledged that abusive practices are unacceptable and they would inform the manager if they suspected abusive practices were occurring but some were unclear about the exact procedures that would take place in the case of suspected abuse being reported. For example some staff members were not clear about the fact that social services take the lead role in investigating suspected abuse. We looked at the home’s records of incidents with the manager. For one incident concerning the interactions between two people living at the home the manager decided during the course of the inspection that he will contact social services to seek advice as to whether it necessitates a safeguarding referral. It must be noted that despite the manager having not previously referred this issue to adult social services, appropriate action was taken by the home in respect of the incident to protect the individuals involved. Linford Park Nursing Home DS0000011430.V365425.R01.S.doc Version 5.2 Page 19 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): 19 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service benefit from living in a safe and comfortable environment, which is suitably furnished and maintained. EVIDENCE: As part of the inspection a tour was made of the environment looking at a sample of bedrooms, bathing facilities, communal areas, the kitchen and the laundry. Bedrooms were to varying degrees personalised with the person’s own belongings such as ornaments, pictures and small items of furniture. There are a variety of communal areas for the use of people living at the home including separate lounge areas on Linford and Woodlands wing of the home, a large dining area service the people living on the Linford wing. This area is Linford Park Nursing Home DS0000011430.V365425.R01.S.doc Version 5.2 Page 20 also used as a recreation/activity area. Separate dining areas in the Woodlands wing are for the use of people living in those wings. Staff told us that despite there being separate dining areas in Woodlands people living there are able to eat their meals in the large dining area if they wish. We observed people who use the service moving freely with or without support from the staff between the communal areas and their bedrooms making the choice about where to sit and how to occupy themselves. The fact that people are able to choose where to spend their time was confirmed in conversations that we had with people living at the home. There are sufficient bathing and toileting facilities for people who live at the home. Policies and procedures are in place about hygiene practices and the control of infection. A team of housekeepers are responsible for the cleaning of the home. During our visit the home was observed to be clean and tidy with no offensive odours. People who live at the home told us the home is always clean and fresh. This indicates that there are sufficient housekeeping staff on duty at any one time to ensure the cleanliness and hygiene of the home. The home’s laundering facilities are on the ground floor. The position of laundry and good laundry practices reduce the risks of cross infection from dirty laundry. The laundry floors and walls are easily cleanable and were clean and tidy on the day our visit. Linford Park Nursing Home DS0000011430.V365425.R01.S.doc Version 5.2 Page 21 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): 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. Improving staff development and training provision is ensuring people living at then home are cared and supported by a skilled and knowledgeable work force in suitable numbers. Robust recruitment procedures mean that people living at Linford Park are supported and cared for by staff suitable to work in the caring profession. EVIDENCE: A staff rota displayed in the home details who and in what capacity, such housekeeping, kitchen or care staff, is on duty at any one time. Staff and people living at the home told us they believe there is generally sufficient staff in numbers on duty to meet their needs. Observation during our visit to the home showed that staff members have time to sit and talk with people living at the home and call bells were answered promptly indicating that there were sufficient numbers of staff on duty at that time. We observed housekeeping staff were busy at their duties and the home was clean and tidy indicating there are sufficient housekeeping staff on duty at any one time to ensure the cleanliness of the home. Linford Park Nursing Home DS0000011430.V365425.R01.S.doc Version 5.2 Page 22 We looked at a sample of staff records. These evidence that good recruitment practices are followed ensuring that no one commences employment at the home prior to two written references being received, CRB and POVA information being obtained, and documentation being obtained to confirm that a person from overseas is eligible to work in this country. These processes protect the welfare of those living at the home. The manager has developed a training matrix that details what training each staff member has undertaken. By developing this tool is able to plan training for the staff team ensuring they all receive mandatory training and training specific to the needs for people living at the home. The manager has identified areas that required additional training. Examples of these include safeguarding adults and food hygiene and he conformed that this training is being put in place. Staff records also contained copies of certificates for courses attended and qualifications obtained by staff members. Staff told us that the home provides them with good opportunities for training. They told us in the past six months they have received training about fire safety, moving and handling, food hygiene, and dementia and for the trained nurses management of medications. The home continues to work towards achieving 50 of it care work force with NVQ level 2 in care or above. Care staff on duty during our visit to the home confirmed that they had completed NVQ level 2. Staff told us their induction programme covered what they needed to know to begin supporting and caring for people at the home. The manager confirmed that induction programmes follow Skills for Care common induction standards. We saw a copy of the induction programme used by the home to confirm this. Linford Park Nursing Home DS0000011430.V365425.R01.S.doc Version 5.2 Page 23 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): 31, 33, 35 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a home that is now being effectively managed and is seeking the views of those using the service to influence the development of the home. Robust procedures ensure that the finances of people using the service are protected. Good health and safety practices protect all people at the home. EVIDENCE: Since the last inspection the registered providers have appointed a manager for the home who is a qualified nurse and has a Foundation degree in Care Home management. At the time of our visit he had been in position for six weeks and had already made significant improvements to the service. He told Linford Park Nursing Home DS0000011430.V365425.R01.S.doc Version 5.2 Page 24 us he is the process of submitting an application to us to be registered as the manager of Linford Park. But to this date we have not yet received a application for registration from him. Staff, visitors and people who live at the home spoke highly of the manager. They told us he shows empathy with both people living at the home and staff members working at the home, understating the needs of both these groups and putting practices in place to meet their needs. Both staff, people living at the home and visitors told us that they feel able to approach the manager with any concerns they might have, they are listened to and their thoughts and views will be considered and will influence the running o f the home. The manager spoke of his developing working relationship with the registered providers evidencing that they work together to improve the service at the home and consequently outcomes for those living at the home. For example he is developing a business plan that included the development of staff, improvement of the environment and the plan for increasing the number of people living at the home to included recruitment and training of extra staff. The manager told us about the several tools he intends to be used to quality monitor the service being provided at Linford House. Some of these have already been implemented such as regular auditing of care plans, medication records, accident records and complaints records. He also plans to hold staff meetings, ‘residents’ meetings, and to survey people living at the home and their representatives about the service provided by the home. Some of the people living at the home told us that there had been meetings held previously but no action seemed to be taken as result of any of their comments, but they already believe the new manager will respond to their comments. They believe they will have some influence over the running of the home. The manager told us that one of his long term plans is to apply for the investors in people accreditation to assist and evidence the auditing of staff development. Procedures are in place about the handling of money for people who live at the home. People can make use of a safekeeping facility if they wish. Records are kept of monies held for people including details of income and expenditure and people can access their money whenever they wish. Health and safety procedures are in place. The training matrix evidences that staff have received training about various aspects of health and safety, for example 100 staff have undertaken training about fire safety, 100 about infection control and 98 about the control of substances hazardous to health. Suitable moving and handling equipment is available. The fire logbook evidences that fire safety checks are carried out in accordance with the Fire and Rescue Services guidelines. The home has a policy for the control of substances hazardous to health known to staff. Chemicals and other items are securely stored in locked cupboards. Linford Park Nursing Home DS0000011430.V365425.R01.S.doc Version 5.2 Page 25 A food hygiene inspection was carried out in June 2008. There was one requirement following this inspection that the home has complied with. We looked at a sample of service certificates evidencing that services and equipment are maintained at manufacturers recommended intervals. This protects the wellbeing of all at the home. Linford Park Nursing Home DS0000011430.V365425.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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 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 2 X 3 X 3 X X 3 Linford Park Nursing Home DS0000011430.V365425.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. 1 Standard OP9 Regulation 13(2) Requirement Controlled medication cabinets must be secured to the wall in the manner as described in the Misuse of Drugs (Safe Custody) Regulations 1973. All staff must receive training about safeguarding of adults. Timescale for action 25/09/08 2 OP18 13(6) 25/08/08 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 Linford Park Nursing Home DS0000011430.V365425.R01.S.doc Version 5.2 Page 28 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 Linford Park Nursing Home DS0000011430.V365425.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. 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