Inspection on 06/12/06 for Little Haven Nursing & Residential Home

This inspection was carried out on 6th December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Little Haven Nursing &... 28/12/05

Little Haven Nursing &... 30/08/05

Little Haven Nursing &... 07/12/04

Little Haven Nursing &... 28/07/04

Little Haven Nursing &... 17/02/04

Little Haven Nursing &... 18/08/03

Little Haven Nursing &... 09/12/02

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

CARE HOMES FOR OLDER PEOPLE Little Haven Nursing & Residential Home Beaulieu Road Dibden Purlieu Southampton Hampshire SO45 4JF Lead Inspector Tracey Box Unannounced Inspection 6th December 2006 09:00 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 Little Haven Nursing & Residential Home DS0000011432.V319159.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. Little Haven Nursing & Residential Home DS0000011432.V319159.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Little Haven Nursing & Residential Home Address Beaulieu Road Dibden Purlieu Southampton Hampshire SO45 4JF 02380 847222 02380 847585 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) The Wilverley Association Limited Mrs Adele Roberts Care Home 43 Category(ies) of Old age, not falling within any other category registration, with number (43) of places Little Haven Nursing & Residential Home DS0000011432.V319159.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th December 2005 Brief Description of the Service: Little Haven is a registered care home that accommodates forty-three service users over the age of 65 years. The home is the sister home to Forest Oaks and is administrated by the Wilverley Association Ltd, which is a charitable trust, and as such, all members of the governing committee are volunteers. The home was purpose built some years ago located on three floors in pleasant gardens and is situated in a semi-rural area close to the New Forest. The home is close to shops and other local amenities. Service users are able to go out into the community independently where possible. All 43 rooms are single occupancy with en-suite facilities and have extra facilities within them for storage. The service users who receive personal care furnish those rooms and supply all soft furnishings making each room very individual. The home has two passenger lifts installed. The grounds surrounding the home are well maintained. Little Haven Nursing & Residential Home DS0000011432.V319159.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The people living at Little Haven prefer to be referred to as residents, therefore the rest of this report will reflect this. The opportunity was taken to look around the home, view records, procedures and talk with residents and staff. The inspector also had the opportunity to observe the interaction between residents and staff. The staff on duty during this visit felt they were supported to do their job. Two relatives spoke very highly of the care and support their relative receives, and they are made to feel very welcome at the home whenever they visit. The inspector received a pre inspection questionnaire from the manager prior to this visit, which provided further evidence of how the home is meeting the National Minimum Standards. The manager confirmed the fees for the home range between £360.00 £468.00 per week for residential care and £673.00 per week for nursing care. What the service does well: The home is very good at assessing if it can meet the needs of residents before they come to the home and maintains good records. The residents and relative spoken with stated they had useful information about the home when making the decision to stay. The home was very clean and had a relaxed, homely atmosphere and residents spoken with all said that the staff were caring and friendly. Comments included ‘ I can’t fault them, I have wonderful care’ and ‘the staff are lovely’. Residents also said that staff were polite and treated them with respect at all times. The home offers various activities with external entertainers visiting regularly. Four residents said they usually attend activities, they enjoy the singers, and are looking forward to a group who visit to sing Christmas Carols. The home has an open and efficient process in place for dealing with complaints, concerns and compliments. The staff team at the home are skilled and receive regular training to be able to care for the residents. The home has a logical and detailed process for recruiting new staff. Little Haven Nursing & Residential Home DS0000011432.V319159.R01.S.doc Version 5.2 Page 6 Residents said that they felt enough staff were on duty for each shift, with one resident saying ‘ I don’t have to wait if I want help, staff are always very attentive’. Staff said that they were supported and encouraged to obtain qualifications. Just over 50 of staff have completed an National Vocational Qualifications (NVQ) level 2 or above award. Staff also receive training in mandatory subjects and specialist training to ensure they are able to meet individual’s needs. One resident said they feel safe and comfortable at the home and their opinions are sought. The registered manager has a good rapport with residents and runs the home in their best interests. What has improved since the last inspection? What they could do better: One requirement was made as a result of this visit, the manager must ensure that all staff receive regular, formal supervisions. Some en-suite toilets have been replaced have been replaced, but others are difficult to flush. The manager confirmed the home has a maintenance programme in place to replace all toilets as soon as possible. The stair carpet in the ‘Garden wing’ needs replacing, it was faded and worn in places, the manager said this too is part of the maintenance programme and will be replaced. The manager is aware of the areas in which improvements should and could be made and is keen to improve the standards within the home further. Little Haven Nursing & Residential Home DS0000011432.V319159.R01.S.doc Version 5.2 Page 7 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. Little Haven Nursing & Residential Home DS0000011432.V319159.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 Little Haven Nursing & Residential Home DS0000011432.V319159.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): 1,2,3 & 6. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents received comprehensive information about the home, which enabled them to make an informed choice. Each resident had a written contract with the home, however the fee included was not always correct. A full care assessment is undertaken for everyone wishing to live in the home to ensure the home can meet their care needs. The home have the provisions to provide intermediate care to residents who have been assessed as receiving short term nursing or residential care. Little Haven Nursing & Residential Home DS0000011432.V319159.R01.S.doc Version 5.2 Page 10 EVIDENCE: The pre inspection questionnaire stated the home has an up to date statement of purpose and a service users guide, which includes a summary of the statement of purpose and refers to the latest CSCI inspection report. Three residents confirmed they have their own copy, one resident showed the inspector theirs, which included all relevant information. Two residents said it provided them and their relatives with information which made them want to visit the home to see If they would like to live there. One resident said he had a relative who used to live at the home, and visited the home on their behalf before they moved in, and now he lives at the home. The manager said she receives telephone calls from social services, hospitals and relatives asking if the home has any vacancies for residential and nursing places available on a regular basis, they are sent literature about the home. The manager completes a comprehensive assessment with the resident, their families/representatives to find out as much information as possible, to ensure the home can meet their needs. The assessments seen included information about general health, diagnosis, mobility, equipment needed, personal care, skin/pressure area care, elimination, sensory aids nutrition, past medical history, sleep, current medication, allergies, orientation, ability to make decisions, temperament, social care support and spiritual/cultural needs. If the home can meet the individual’s needs, they are invited, with their relatives or representative to visit the home. The home also requests financial assessments and medical form completed by a doctor. One resident recalled spending the day at the home prior to them moving in, which gave them an idea of a typical day, they were involved in activities, ate lunch and tea, met other residents and staff and had a tour of the home. Once a prospective resident has decided to live at the home, the manager sends out a ‘welcome’ letter to all new residents or their families, the inspector read a copy of one which was sent to a resident who was due to move into the home a few days after this visit, which included information about fire safety, routines for daily newspapers and post, reporting odd jobs, activities (mobile library, hairdresser etc) laundry facilities, where the information notice boards are and what they display, no smoking policy, receiving visitors, local information, complaints procedure, and the ‘house committee’ for residents and their relatives. The manager also sends written confirmation that the home will keep the room vacant until the resident can move in, this letter also confirms the fee which will be paid. Little Haven Nursing & Residential Home DS0000011432.V319159.R01.S.doc Version 5.2 Page 11 Once the resident is admitted to the home staff use a checklist to ensure they have informed the resident of relevant information, staff said they find this useful to make sure they haven’t missed anything. The inspector saw five residents contracts with the home, three were for residents who have moved to the home since the last visit, two were for people had lived at the home for some time. Three most recent contracts included the correct fee that the home charge, however two contracts included a fee which the home charged when the resident moved into the home, and subsequently there have been increases in the fees, which had not been included. The manager showed the inspector a spreadsheet stating the fees charged for each resident, and said that the home write to the resident or their relative to inform them of increases in fees, one resident and a relative confirmed this practice. One resident who had recently moved in said the staff are very friendly and always speak, and what he likes is they remembered his name, one thing he thinks is very important. The manager confirmed the home does provide intermediate care to residents who require short tern stay, the manager completes the assessments and ensures staff receive training to meet the individual’s needs. The home has appropriate accommodation to enable this. Little Haven Nursing & Residential Home DS0000011432.V319159.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): 7,8,9 & 10. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are involved in the development and review of their care plans, their health care needs are met and they are protected by staff following the home’s clear procedures for handling medication. Residents feel that they are treated with respect at all times, and their independence is supported. EVIDENCE: The inspector looked at four care plans. The plans were very comprehensive and contained the information gathered during the pre admission assessment. Staff said the care plans provide them with the information they need in order to provide the exact care and support the resident needs. Staff said they review the care plans with the resident on a monthly basis, records seen confirmed this. Three residents said that they knew what was written in their care plans, as staff had discussed it with them and that they agreed with the Little Haven Nursing & Residential Home DS0000011432.V319159.R01.S.doc Version 5.2 Page 13 information in their plans. All care plans have been signed and dated by the resident or their representative and by staff. Risk assessments were included in the care plans including those for mobility, falls and nutritional risks, the inspector saw records of monthly nutritional and pressure area assessments being completed for residents. All risk assessments were specific to individual residents, one risk assessment included the identified risks to a resident who may be physically violent to others of property, another assessed the risk of self-harm/neglect. Records showed that residents received visits from GPs and other health professionals such as the district nurses. Records show residents were offered the choice of receiving an influenza vaccination. A resident said that she had received the vaccination, and this was recorded documented in her medical records. A trained nurse was observed administering medication appropriately and there is a good medication policy and procedure in place. The home administers from ‘single blister pack system’ provided by the local pharmacist and is stored appropriately, in sufficient quantities. At the time of the inspection six residents administered their own medicines, this was included in their care plan and risk assessments had been completed. One resident chooses to collect his own prescriptions on a monthly basis from his chosen pharmacist. Trained nurses order and check all medicine received at the home recording name, quantity and sign for them. The records were seen and found to be satisfactory. The home uses the ‘Medicine Administration Record Sheets (MARS) system for recording the administration of medication. Residents who administer their own mediation sign for their monthly supply, staff complete a six monthly audit of all medication. Medication that is in need of disposal is returned to the local pharmacy and a record is kept by the home that is signed on receipt by the pharmacist. The inspector observed the staff interacting with the residents and found them attentive, caring, respectful and have a good understanding of individual’s needs. Staff induction records showed that privacy and dignity and the provision of personal care are covered during the induction process, and the response from residents indicated that the carers treat them with dignity and respect and that they are trustworthy. Four resident told the inspector that staff respected their choice and privacy at all times. Throughout the visit, staff were seen to knock on doors and wait before entering rooms and they spoke to residents in their preferred manner, as Little Haven Nursing & Residential Home DS0000011432.V319159.R01.S.doc Version 5.2 Page 14 stated in their care plans, and were friendly but respectful. Staff said they are aware of the importance of dignity and respect, one staff said, “ I treat people as I wish to be treated”. Little Haven Nursing & Residential Home DS0000011432.V319159.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): 12,13,14 & 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are able to exercise control over their lives, participate in social activities, receive visits from friends and relatives as they wish and enjoy a choice of meals served in a relaxed atmosphere. EVIDENCE: Residents are able to exercise choice by participating in social activities if they wish, one resident said ‘we have an person who comes and does a quiz with us, which I really enjoy.’ All residents spoken with thought the activities matched their needs, and that staff respected their wishes to spend time on their own. Two residents said they enjoyed the weekly ‘movement to music’ exercises. Residents feel they are supported to lead active lives as they prefer. One of the display boards advertised the mobile library visiting, the hairdresser has an appointment book for residents to write in their preferred date and time, the local Brownie group were visiting to help residents put up Christmas decorations, and every other month a coffee morning is held and residents Little Haven Nursing & Residential Home DS0000011432.V319159.R01.S.doc Version 5.2 Page 16 prefer to have meetings twice a year, as one resident said staff and the manager work closely with residents, and talk a lot, so there is no need for meetings. The manager said residents are invited to attend the provider’s annual accounts meeting if they want to. The home has two designated drivers to provide transport for residents when needed, One resident has his own car that he enjoys driving. The manager said that there were no residents from an ethnic minority at present but that if a resident had cultural or religious interests every effort is made to accommodate this. The home has an open visiting policy. This was evidenced by records of visitors to the home and confirmed by four residents who said their relatives visit the home at different times of the day on a regular basis and are always welcomed. The home employs one cook who prepares and cooks meals, she said some of the meals are prepared freshly, some are frozen. The inspector noticed the lunch was being served onto plates mid morning and were covered and stored in a hot plate until lunch twhich of the two dishes on offer, and that they receive that choice at lunch time. The residents spoken with said they enjoyed the food, it is nicely presented and hot. Some residents choose to eat their meals in their bedrooms, others enjoy socialising in the dining room. Little Haven Nursing & Residential Home DS0000011432.V319159.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 excellent. This judgement has been made using available evidence including a visit to this service. Residents and staff are confident that their complaints will be listened to, taken seriously and acted upon. Staff have a good understanding of Adult Protection issues that protects residents from potential abuse. EVIDENCE: Residents’ spoken with said that they were very aware of the complaints procedure, even though they have not had to use it, they said they would go straight to the manager if they had a concern or complaint and were confident that the manager would take their concerns seriously. Residents confirmed that the staff are very good and listen to them, no one has felt the need to complain, only compliment. Staff spoken with were aware of the home’s complaint procedure which includes the address for the CSCI and states that all complaints will be dealt within 28 days. A copy of the home’s complaint procedure is included in each service users guide and welcome letter for new residents. Little Haven Nursing & Residential Home DS0000011432.V319159.R01.S.doc Version 5.2 Page 18 The complaint log was available which included sufficient detail to monitor complaints successfully, the manager confirmed one complaint had been received since the date of the last inspection, records showed it had been dealt with appropriately and that the complainant was satisfied with the outcome. Two residents said that they see the owner on a regular basis when they carry out a monthly unannounced visit to the home, understood they monitor the home and ensure the well being of the residents. Two staff members spoken with said that they are aware of the correct procedures to follow if a disclosure of abuse was reported to them, and they had received formal training in abuse awareness, certificates confirmed this. The home has procedures for staff to follow should abuse be suspected, including Hampshire County Council’s Protection of Vulnerable Adults, the Department Of Health’s ‘No Secrets’ guidelines and Whistle Blowing. The manager confirmed that policies and procedures are reviewed and available for staff to access regarding complaints and protection, staff confirmed this. The manager is proactive in following the correct procedures and confirmed she referred one incident to social services to investigate under the Protection Of Vulnerable Adults procedures. Records showed the home acted promptly and appropriately to minimise further incidents, drawing a close to the investigation. Little Haven Nursing & Residential Home DS0000011432.V319159.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. The environment provides residents with a warm and comfortable home. There is a good infection control procedure at the home to safeguard the welfare of residents. EVIDENCE: The home was warm, clean and welcoming, all parts of the home seen ware tastefully decorated. The home has an ongoing maintenance programme which has resulted in areas being redecorated, as referred to at the beginning of this report. Prior to this visit the home identified that the flushing mechanism of the toilets were difficult for residents to use and some have been replaced, however it is recommended that all are replaced, the manager confirmed this would be done. Little Haven Nursing & Residential Home DS0000011432.V319159.R01.S.doc Version 5.2 Page 20 One relative said the home is always clean, the manager explained the home employs domestic staff who work every day. Accommodation is provided over two floors. Access to the first floor is by two flights of stairs and a passenger lift. There is adequate communal space, the home has two lounges and a a dining room. Resident’s bedrooms looked comfortable and contained many personal items such as pictures and ornaments. Two residents spoke of their satisfaction with their rooms with comments of ‘it’s comfy’ and ‘I have everything I need’. Keys are provided for residents who wish to lock their doors. Access to the garden has been improved to enable residents to visit the garden which is on a slope, one resident said she likes to watch the birds who eat food from the bird table. The garden was well maintained. The home has a well equipped laundry. Infection control procedures were in place. Staff were observed to follow the guidance, equipment such as gloves and aprons were available. Staff said they had received infection control training, certificates were in place to support this. Little Haven Nursing & Residential Home DS0000011432.V319159.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. Residents feel that a sufficient number of staff are on duty to meet their individual and group needs. There is sufficient skill mix within the team and to meet the residents needs. The homes comprehensive recruitment practices ensure resident’s safety. Staff receive mandatory and specialist training and are supported to obtain NVQ level 2 or above. EVIDENCE: Residents spoken with said there are always enough staff on duty who know how they like to be cared for, staff said they felt there are enough staff on duty on each shift. The inspector spoke with two staff who said there are ample staff on duty at all times, there is always at least one trained nurse, the manager works during the day as well. It was evident from practices and interactions observed that staff had developed good relationship between themselves and residents. Comment Little Haven Nursing & Residential Home DS0000011432.V319159.R01.S.doc Version 5.2 Page 22 from residents included that staff were very kind and always helpful and that they were a “good team”. One resident praised the domestic staff for their hard work in keeping their bedrooms clean and tidy. Records seen indicated that 56.25 of staff have achieved an NVQ level 2 or above, which exceeds the standard of 50 . The home employs a training officer to co-ordinate staff training when required. The staff confirmed that they undertake training regularly and the inspector viewed copies of individual staff training certificates and other records of instructions. The staff have received training in the necessary health and safety subjects such as fire safety, first aid, moving and handling, health and safety, infection control and food hygiene. Other training courses attended by staff include abuse training, pressure area care, wound care, diabetes, and catheter management. The home employ a cook and domestic staff, both said they receive ample training to carry out their jobs effectively, certificates confirmed this. The staff spoken with felt that the recruitment process within the home is thorough. The inspector was able to see three different staff records and found that they were detailed with the necessary checks taken to ensure staff are fit to work at the home. Other records seen on file included criminal record bureau and protection of vulnerable adults register checks, registered nurse identification pin numbers as well as signed declarations from staff that they have read and understand the General Social Care Code of Conduct. The manager said that all staff job descriptions are being revised and will be included with staff’s next pay. The staff spoken with stated that the induction programme run by the home was useful and detailed. The files seen held records of the individual staff induction training covering the key areas with the signatures of the staff member and trainer. The manager confirmed that the home’s induction programme meets the recently amended Skill For Care standards for induction. Little Haven Nursing & Residential Home DS0000011432.V319159.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): 31,33,35,36 & 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The manager is experienced and competent to run the home. Management and administration of the home is based on openness and respect. An effective quality assurance system is in place. Safeguards are in place to protect the interests of the residents. The home is not involved in monitoring or handling residents’ money. Staff would benefit from formal supervision by an appropriately trained line manager. The residents’ health, safety and welfare are well promoted by the home with systems that ensure everyone is protected within the home. Little Haven Nursing & Residential Home DS0000011432.V319159.R01.S.doc Version 5.2 Page 24 EVIDENCE: The manager is registered with the Commission. She has the required experience and is competent to run the home. The manager is a level Registered General Nurse (RGN) and has completed her Registered Mangers Award (RMA) and keeps up to date with her professional development by attending training such as age discrimination law, abuse training for managers and receives various monthly publications such as care management, caring times and healthcare magazines. The manager is keen to maintain standards, and continues to improve the service. There is a strong ethos of being open and transparent in all areas of running of the home. Discussions with staff and observations showed there are clear lines of accountability within the home. Also the management approach of the home creates an open, positive and inclusive atmosphere. The staff felt they were included in the day-to-day decision making within the home, stating that changes and or issues are discussed and actions agreed at regular staff meetings that are minuted. The minutes were available from the offices for reference. Residents said that they felt able to give their views, which they feel are valued, on the quality of care provided at the home to the manager and feel involved in issues affecting the home. Residents spoken with commented that management and staff are very approachable, always make themselves available and readily help with any problems. They also had nothing but positive comments to say about staff which included – “They really care”, “They don’t rush you” and “Staff like a laugh”. The inspector saw three compliment letters from relatives, all since November ’06. A quality assurance and monitoring system based on seeking the views of residents, relatives and professional is in place and will be circulated in December ‘06. As well as completing questionnaires, residents told the inspector that management are always asking how things are and if they would like anything different. The manager said some residents prefer the home to safeguard small amounts of money for them, the inspector saw the money and records for two residents Little Haven Nursing & Residential Home DS0000011432.V319159.R01.S.doc Version 5.2 Page 25 money, both were found to be correct. Each resident has lockable storage in their bedrooms to safeguard their valuables. Records showed that since January 2006, none of the staff have received more than one supervision, therefore a requirement was made for the manager to ensure that all staff receive regular, formal supervisions. The manager said staff receive supervision from the trained staff during the shift, however this is not sufficient one to one formal time. The training officer will devise a supervision programme and ensure staff who will be line managers receive appropriate training. No unsafe practices were observed during the inspection. Certificates were available for required checks of systems and equipment. Risk assessments where necessary have been completed and are reviewed regularly. Staff have received training in health and safety, first aid, fire safety, care of substances hazardous to health and moving and handling. All the residents and relatives spoken with stated that they felt safe at the home and some confirmed that the fire alarms are regularly tested. The manager explained the recording system for fires safety maintenance, training, evacuation and visual checks. The visual checks of all fire safety equipment has been recorded and undertaken at appropriate intervals to ensure the safety of the residents. The home has a satisfactory reference file for the Control of Substances Hazardous to Health (COSHH) information leaflets for each chemical being used within the home. The home has a policy, procedures and information on health and safety. A sample of policies and procedures was seen and it showed that these are reviewed regularly. There is an ongoing system in place that ensures that all appliances are serviced, records and certificates seen indicated that the systems such as the electrics and specialist equipment including bath aides and hoists received regular servicing and maintenance. The employer’s insurance liability certificate was displayed and current. Little Haven Nursing & Residential Home DS0000011432.V319159.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 4 3 4 X X 4 HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 4 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 4 2 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 4 X 4 X 4 2 X 4 Little Haven Nursing & Residential Home DS0000011432.V319159.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 OP36 Regulation 18 (2) Requirement Staff must receive formal supervision at least six times a year. Timescale for action 06/02/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP19 OP19 Good Practice Recommendations Residents would benefit from the home replacing their toilet flushing mechanisms. Residents, staff and visitors would benefit from the stair carpet being replaced in the ‘Garden wing’. Little Haven Nursing & Residential Home DS0000011432.V319159.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Little Haven Nursing & Residential Home DS0000011432.V319159.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!