Inspection on 03/10/06 for Longbridge Deverill House

This inspection was carried out on 3rd October 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

Longbridge Deverill House 01/10/08

Longbridge Deverill House 19/01/06

Longbridge Deverill House 12/07/05

Longbridge Deverill House 16/12/04

Longbridge Deverill House 24/08/04

Similar services:

2 Perhaver Park

The Vicarage

Fairfields Country Rest Home

St George`s

5 Seafield Road

Credence House

Poldhu

Queensmount

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

CARE HOMES FOR OLDER PEOPLE Longbridge Deverill House Church Street Longbridge Deverill Warminster Wiltshire BA12 7DJ Lead Inspector Thomas Webber Unannounced Inspection 09:30 3 October 2006 rd 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 Longbridge Deverill House DS0000057131.V308087.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. Longbridge Deverill House DS0000057131.V308087.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Longbridge Deverill House Address Church Street Longbridge Deverill Warminster Wiltshire BA12 7DJ 01985 214040 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) Equality Care Ltd Jean Proctor Care Home 27 Category(ies) of Dementia - over 65 years of age (3), Learning registration, with number disability over 65 years of age (2), Old age, not of places falling within any other category (27), Physical disability over 65 years of age (1) Longbridge Deverill House DS0000057131.V308087.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The maximum number of service users who may be accommodated in the home at any one time is 27 Not more than 1 service user aged 65 years and over with a physical disability may be accommodated at any one time No more than 2 service users aged 65 years and over with a learning disability may be accommodated at any one time No more than 3 service users aged 65 years and over with dementia may be accommodated at any one time 19th January 2006 Date of last inspection Brief Description of the Service: Longbridge Deverill is a private residential home offering accommodation and personal care to a total of 27 residents over the age of 65 who require care primarily through old age. The home is also registered to accommodate 3 service users with dementia, 2 with leaning disabilities and 1 with a physical disability within the overall total. The home is a detached 300 year old listed building, which has been extended several times and is situated on the busy A350 in the village of Longbridge Deverill between Warminster and Shaftesbury. There is a railway station in Warminster and the A303 is about a ten minute drive to the south of the village. The home is located close to limited local amenities. There is a bus stop immediately outside the entrance to the home and car parking facilities are available to the front of the property. The home provides all single bedrooms for residents use. However, there are two shared bedrooms, which would only be used for married couples or relatives who wish to share. Apart from one single bedroom, all are provided with en-suite facilities. Residents bedrooms are located on the ground and first floor levels. The home’s fees charged to residents for the care and accommodation range from £400 to £650 per week. The home is registered under Equality Care Limited and the registered manager is Ms Jean Proctor. Information about the services provided is available in the home in written form by way of its service users’ guide. CSCI inspection reports can also be seen in the home and interested people can download these directly from the CSCI website. Longbridge Deverill House DS0000057131.V308087.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection conducted over a period of two days on 3rd and 4th October 2006 from 09:30 to 15:35 and 09:35 to 14:50 respectively. The judgements contained in this report have been made from evidence gathered before and during the inspection, which included a tour of the premises and takes into account the views and experiences of eleven of the twenty four residents, which were sought on an individual basis. The comments of one of the resident’s relatives, who was visiting during the inspection, were also sought. The records of four residents were also checked in greater detail during the inspection to ensure that the records are appropriately maintained and that their care needs are being suitably met. Twenty seven of the thirty eight Standards were also assessed on this occasion which included the examination of records, staffing, care practices, systems, policies and procedures. Feedback was provided throughout the inspection. What the service does well: The home is run and managed by persons who are appropriately qualified and have sufficient experience within the care setting. The home continues to provide sufficient numbers of staff on duty at all times to meet the needs of the residents and are working towards achieving a fully trained workforce. Staff were observed undertaking their duties in a caring and attentive manner. Residents who were spoken with commented very positively about the care provided by the staff. A visiting relative of one of the residents who was met during the course of the inspection supported these comments. Residents described the staff as being excellent, kind, helpful and caring. All residents are assessed, normally prior to admission, to ensure that the home can meet their needs. The home also writes to the residents’ families or representative confirming that the home can meet the residents’ needs based on their assessment. Opportunities are available for prospective residents and their families to visit the home, prior to admission, to assess the quality of the facilities and suitability of the home. Residents are provided with a copy of the home’s written contract or placing authority’s terms and conditions. Residents’ care plans and accompanying risk assessments have been established for all residents. Residents live in a safe and well-maintained environment where they have access to safe and comfortable indoor and outdoor communal facilities, which meets the residents’ individual and collective needs. Residents are provided with their own bedroom which they have personalised to their individual wishes. All residents’ bedrooms, apart from one single bedroom, are provided with en-suite facilities, consisting of at least a toilet and wash hand basin. Longbridge Deverill House DS0000057131.V308087.R01.S.doc Version 5.2 Page 6 Residents have access to a suitable number of toilet and bathroom facilities. The home is maintained to a good standard being clean, tidy and comfortable and offers appropriate laundry facilities for the benefit of the residents. Residents who were spoken with commented positively about the standard and cleanliness of their accommodation, confirming that their bedrooms are kept clean and tidy. Residents also commented very favourably about the laundry arrangements, stating that their clothing is returned in good condition. Residents’ health care needs are being suitably met and staff have a good understanding of their responsibility when administering medication. Opportunities are available for residents to pursue social, religious and recreational activities. Residents are supported to maintain contact with their families and friends. Residents, within their capabilities, exercise their personal autonomy and choice and residents’ privacy and dignity are respected at all times. Residents receive a varied, appealing and balanced diet and meals are eaten in a relaxed and congenial setting. Residents who were spoken with commented very favourably about the quality and quantity of food provided, confirming that they receive plenty and alternatives are available to meet their individual preferences. Residents’ financial interests are being suitably maintained. The health, safety and welfare of the residents and staff are, in the main, being promoted and protected. Information is provided to residents on how to complain and they are confident that any complaints/concerns would be listened to, taken seriously and acted upon. Appropriate procedures are in place to protect residents from abuse with staff having been provided with a copy of the procedures and have undertaken appropriate training. What has improved since the last inspection? What they could do better: Evidence must be obtained to show that all aspects of the staff recruitment practices are being appropriately followed for the better protection of the residents. Residents would also benefit from staff being supervised on a more Longbridge Deverill House DS0000057131.V308087.R01.S.doc Version 5.2 Page 7 frequent basis to ensure that the standard of care provided to them is being consistently maintained. A full audit needs to be undertaken for all rooms located on the first floor and window restrictors must be fitted to these unless individual risk assessments indicate otherwise for the safety of the residents. 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. Longbridge Deverill House DS0000057131.V308087.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 Longbridge Deverill House DS0000057131.V308087.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 5 and 6 This judgement has been made from evidence gathered both during and before the visit to this service. Residents are provided with a copy of the home’s written contract or placing authority’s terms and conditions so that they are aware of the services being provided to them. All residents are assessed to ensure that the home can meet their needs. Opportunities are available for prospective residents and their families to visit the home prior to admission. The home does not provide intermediate care. Quality in this outcome area is good. EVIDENCE: Residents who are privately funded are provided with a copy of the home’s contract. However, where residents are funded by social services, they would also be provided with a copy of the relevant local authority’s statement of terms and conditions and a copy of the home’s supplementary agreement. Evidence was available to confirm that signed contracts have been established for all but one of the four residents recently admitted. The outstanding contract is currently with the resident’s solicitor, waiting to be signed and returned. The home’s contract also confirms that residents are given a fourweek trial period, although this timescale can be extended. Longbridge Deverill House DS0000057131.V308087.R01.S.doc Version 5.2 Page 10 The home’s pre-assessment and assessment tools have been completed regardless of whether residents are funded privately or by social services. This is normally achieved prior to admission and is undertaken wherever the resident is accommodated at the time. In addition, the home would normally obtain a copy of the community care assessment or the equivalent in relation to those residents funded by social services. Documentary evidence was available to confirm that the home’s pre-assessment and assessment tools had been completed in relation to the four most recent admissions to the home who were case tracked by the Commission. Copies of the community care assessment and information from other relevant professions had also been received, where appropriate. In addition evidence was available to show that the home had written to the residents’ families or representative confirming that the home can meet the residents’ needs based on the assessment. As part of the introductory process, opportunities are available for prospective residents and their families to visit the home as many times as they wish prior to admission. The manager reported that a niece accompanied one prospective resident, whereas the niece and daughter of another two prospective residents made pre-admission visits to the home on their behalf. All members of residents’ immediate families are provided with a copy of the home’s service users’ guide and residents are also provided with a copy of this document, which is placed in the bedroom on arrival. The home does not provide intermediate care, therefore this Standard is not applicable. Longbridge Deverill House DS0000057131.V308087.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 This judgement has been made from evidence gathered both during and before the visit to this service. Care plans and accompanying risk assessments have been established for all residents to ensure that their care needs are being appropriately met. Residents’ health care needs are being suitably met. Residents’ privacy and dignity are respected at all times. Quality in this outcome area is good. EVIDENCE: Care plans have been established for all residents and these have been redesigned since the last inspection. The level of content in residents’ care plans has significantly improved and describes the objectives to be achieved, along with residents’ strengths and needs and how these are to be met. Evidence was available to confirm that residents’ care plans are well written, informative, personalised and being reviewed on a monthly basis by the home and with the involvement of residents. Residents’ placements are being reviewed initially after four weeks and then yearly unless changes occur. Residents’ reviews involve all interested parties, including the residents themselves. A range of assessments has been established for residents which include: Waterlow for pressure areas, manual handling, nutritional, patient moving and handling risk assessments, garden and risk assessments. These Longbridge Deverill House DS0000057131.V308087.R01.S.doc Version 5.2 Page 12 documents are reviewed periodically and discussion was held with the manager about ways of improving and merging some of these documents. Residents are registered with either of the two practices within the Warminster area and residents, who are able, tend to visit the surgeries for any appointments with the support of staff. Transport, by way of taxis, is provided for this purpose by the home. The district nurse visits twice a week and sees and provides any treatment to residents in the privacy of their bedrooms. The manager re-affirmed that an excellent rapport exists between the home and the district nurses. Documentary evidence of all health care visits are suitably recorded on an individual form established for each resident and are cross referenced within their daily case notes. Residents also access other health care services such as dental, opticians and chiropody as and when required. Domiciliary visits are made to the home by the optician and chiropodist, although residents would normally make visits to the dental practice for any appointments, unless unable to do so. Appropriate aids are provided for those residents who require them for continence and mobility. Appropriate systems have been established for the receipt, storage, administration and return of unwanted medicines. The home uses the Nomad monitored dosage system for the administration of medication and evidence was available to confirm that residents’ drug sheets are being appropriately initialled for medication administered. A pharmacist last visited the home on 30th August 2006 to check the storage, receipt, administration and return of unwanted medicines. The report produced from this visit identified no concerns. Appropriate policies and procedures have been established for residents, who are deemed capable following a risk assessment, to maintain control over their own medication. Suitable storage facilities have been provided for this purpose. On the day of inspection none of the residents were self-medicating, although one resident maintains control over her medication which is administered by staff. Staff only administer residents’ medication once they have received full training from the manager. Some staff have also received external training in this area. Residents are provided with their own single bedroom where they can conduct all their personal affairs in complete privacy, including the receipt of medical examinations and any treatment. Residents can access the home’s office phone or cordless phone to make and receive calls in private. Alternatively, residents can have a telephone installed in their bedrooms and some of them have availed themselves of this facility. Residents’ mail is given directly to them unopened unless they are unable to deal with it themselves. In these circumstances, their relatives or the home would deal with residents’ mail. Suitable locks are provided on the various toilets and bathrooms to aid privacy when using these facilities. Staff also knock on residents’ bedroom doors before entering and this practice was observed during the course of the inspection. Longbridge Deverill House DS0000057131.V308087.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 This judgement has been made from evidence gathered both during and before the visit to this service. Opportunities are available for residents to pursue social, religious and recreational activities. Residents are supported to maintain contact with their families and friends. Residents can exercise personal autonomy and choice and they receive a varied, appealing and balanced diet with meals being eaten in a congenial setting. Quality in this outcome area is good. EVIDENCE: From observations and discussions with residents, it is apparent that they can choose where and how to spend their time, including rising and going to bed. Residents have the opportunity to pursue their own individual interests as well as being able to participate in the various activities arranged by the home should they so wish. Visiting entertainers occasionally come in to provide sessions for the residents. Staff complete an activity form for each resident, which records the types of activities they attend. Staff will occasionally take residents to town when they show a wish to go and some residents are taken out by their relatives. A few residents also attend various clubs/centres. A hairdresser visits weekly. A Church of England service is held monthly and another resident is transported by friends to attend a Catholic service. Longbridge Deverill House DS0000057131.V308087.R01.S.doc Version 5.2 Page 14 The home supports and encourages residents to maintain contact with their families, friends and representatives and an open policy has been established by the home with regard to visiting times. Residents can choose who to see and where to see any visitors, either in the privacy and comfort of their own bedrooms or in the communal rooms available. One relative who was spoken with confirmed that she is always made welcome when she visits. Observations and discussions with some residents confirmed that they can exercise personal autonomy and choice within their individual capabilities. Residents are supported and encouraged to maintain their independence. Residents can bring items of furniture and personal possessions to make their bedrooms more homely and several of them have done so. Residents can choose what time to get up and go to bed, how and where to spend their time, what to wear, where to eat, and what activities to participate in. A satisfactory and varied four weekly menu is in operation, which provides a choice at breakfast time with set meals at lunch and teatime. However, alternatives are provided for these meals if required to meet the preferences of the residents. Residents’ special diets are suitably catered for and their dislikes are well known and recorded by the home. Drinks and snacks are also available at other set times of the day, including high tea in the afternoon. Residents can choose where to eat all their meals, although they are encouraged to use the dining room for their main meal as part of socialisation. Residents who were spoken with commented very favourably about the quality and quantity of food provided, confirming that they receive plenty and alternatives are available to meet their individual preferences. The main meal of the day was observed on the second day of the inspection where residents ate their meal in a relaxed and congenial setting. Longbridge Deverill House DS0000057131.V308087.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 This judgement has been made from evidence gathered both during and before the visit to this service. Residents are confident that any complaints/concerns raised by them will be suitably dealt with. Appropriate procedures are in place to protect residents from abuse. Quality in this outcome area is excellent. EVIDENCE: A satisfactory complaints procedure has been established by the home and residents have been provided with a copy of this procedure with a further copy being displayed on the home’s notice board. The home records and responds promptly to any complaints and concerns and this was evident during the course of the inspection. The home operates an open and transparent policy and as a result all complaints/concerns are treated in the same way regardless of whether they are minor or more serious. Residents commented that they had no concerns/complaints, although they felt confident in discussing any issues of concern with the manager or staff. The home has appropriate procedures for responding to suspicion or evidence of abuse and has obtained a copy of the Department of Health Guidance “No Secrets”. In addition, copies of the shortened version of the Wiltshire and Swindon Vulnerable Adults procedures, which are in line with the Department of Health guidance document, have been obtained and been distributed to all staff. New staff employed cover abuse awareness as part of their induction programme with some staff having attended external abuse training. Staff also cover abuse training when completing the National Vocational Qualification. Longbridge Deverill House DS0000057131.V308087.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23, 24 and 26 This judgement has been made from evidence gathered both during and before the visit to this service. Residents live in a safe and well-maintained environment. They have access to safe and comfortable communal facilities. Residents are provided with their own bedrooms which they have personalised to their individual wishes. Residents have access to a suitable number of toilet and bathroom facilities. The home is maintained to a good standard which offers appropriate laundry facilities for the benefit of the residents. Quality in this outcome area is good. EVIDENCE: The home has an ongoing programme of maintenance to enhance the residents’ living environment and a number of improvements continue to be carried out since the last inspection. These include the refurbishment and redecoration to some residents’ bedrooms and the repair and repainting to some windows. The hairdressing salon is also in the process of being redecorated. Due to the layout of the premises, the home provides two passenger lifts and a stair lift to enable residents to access all parts of the building. A call bell system is installed in each room, which can be used by Longbridge Deverill House DS0000057131.V308087.R01.S.doc Version 5.2 Page 17 residents to call for staff assistance. There is a spacious, safe, well maintained and accessible rear garden, which is used and appreciated by the residents, weather permitting. The home provides sufficient communal space to meet the needs of the residents. These consist of two large lounges and a separate dining room. The range of facilities provide the option for a variety of activities to take place as well as providing residents with a choice of where to sit. The communal rooms are suitably furnished, providing a combination of domestic and natural lighting. The home provides sufficient bathroom and toilet facilities, which meet the needs of the residents. These facilities include a hydrotherapy bath which the current group of residents choose not to use. The home provides all single bedrooms for residents’ use. However, there are two shared bedrooms, which would only be used for married couples or relatives who wish to share. Apart from one single bedroom, en-suite facilities are provided to all other bedrooms which consist of at least a toilet and wash hand basin. Residents’ bedrooms are suitably furnished and equipped to ensure comfort, privacy and to meet their assessed needs. Residents can bring items of furniture and personal possessions to make them more homely and several of them have done so. Residents’ bedrooms are normally redecorated and refurbished where there is a change of occupancy. Locks have been fitted to residents’ bedroom doors where this has been requested and is based on a risk assessment. In addition all residents’ bedrooms have been or are in the process of being provided with a lockable storage space, which consists of either a safe or a lockable cupboard. Residents spoken to commented positively about the standard and cleanliness of their accommodation. The home continues to be maintained to a good standard being clean, tidy and comfortable. However, an unpleasant odour was noticed in one bedroom despite regular shampooing of the carpet. The laundry room provides suitable facilities to meet the needs of the home. Residents’ clothing is labelled to ensure that garments are appropriately returned and residents commented very favourably about the laundry arrangements, stating that their clothing is returned in good condition. Longbridge Deverill House DS0000057131.V308087.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 This judgement has been made from evidence gathered both during and before the visit to this service. The home continues to provide sufficient numbers of staff on duty at all times to meet the needs of the residents. Residents benefit from an appropriately trained workforce. Residents are not always supported and protected by the home’s recruitment practices. Quality in this outcome area is adequate. EVIDENCE: The home ensures that there are sufficient staff deployed by providing between four to five members of care staff on duty in the mornings with three on in the afternoons and evenings. There are two waking night staff on duty each night together with a member of staff sleeping in. The above staffing levels exclude the number of ancillary staff employed. Staff were observed undertaking their duties in a caring and attentive manner. Residents who were spoken with commented very positively about the care provided by the staff and a visiting relative of one of the residents who was met during the course of the inspection supported these comments. Residents described the staff as being excellent, kind, helpful and caring. Evidence was available to confirm that the home is using the induction booklets, known as the ‘Training Record of Induction and Competence in Care’, for all new staff employed. The home continues to support staff in either obtaining or working towards achieving training in the National Vocational Qualifications at various levels in order to achieve a trained workforce. At the time of the inspection, the home had achieved approximately 67 . In Longbridge Deverill House DS0000057131.V308087.R01.S.doc Version 5.2 Page 19 addition evidence was available to confirm that staff attend other relevant training as well as the required various mandatory courses. A sample of four newly appointed staff files showed that most of the recruitment practices are being followed. This included completed application forms with a full employment history, two satisfactory written references and medical clearance. Although there was some documentation to show that the home had sent for enhanced Criminal Record Bureau checks, there was no evidence to show that these had been received in respect of three of the most recent staff employed. Even though these checks had been obtained by the home from other organisations these were deemed as unacceptable practice. The provider has agreed to ensure that appropriate checks are obtained. Longbridge Deverill House DS0000057131.V308087.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 35, 36 and 38 This judgement has been made from evidence gathered both during and before the visit to this service. The home is run and managed by persons who are appropriately qualified and have sufficient experience. Residents’ financial interests are being suitably maintained. Staff are not being supervised at an acceptable frequency to ensure that they are providing appropriate care to the residents. The health, safety and welfare of the residents and staff are being promoted and protected. Quality in this outcome area is good. EVIDENCE: The manager has a First Level Nurse qualification and has subsequently obtained the NVQ 4 and Registered Managers’ Award. She also has appropriate management and supervisory experience in the relevant care setting to the client group she manages. The manager continues to undertake periodic training to update her knowledge, skills and competence whilst managing the home. The management team are clear about their roles and responsibilities. The manager is complemented and supported by one of the Longbridge Deverill House DS0000057131.V308087.R01.S.doc Version 5.2 Page 21 co-proprietors of the company whose main role is the overall administration of the company. The co-proprietor has also achieved the NVQ 4, City and Guilds Advanced Management in Care qualification and also has appropriate management and supervisory experience. The home has secure facilities for the safe storage of residents’ monies. However, a spot check carried out of the system and money held by the manager showed some deficiencies in respect to three of them whereby the monies did not tally with the balance sheet. A full audit was carried out during the inspection and all deficiencies were rectified. However, greater care should be taken when dealing with residents’ monies to ensure that accuracy is maintained with regard to each transaction. There are a range of mechanisms in place for the manager to both brief and receive feedback from staff in order to monitor the standard of care and services provided to the residents. These include daily handover meetings, quarterly staff meetings, informal and formal staff supervision. Written evidence was available to confirm that staff are being formally supervised, however the level of frequency needs to be improved to ensure that the home achieves the recommended frequency of at least six times a year. Safe working practices have been established within the home, which complies with the relevant legislation. Policies and procedures are in place to ensure a safe working environment. Staff continue to receive ongoing training in relation to health and safety. Risk assessments have been completed in respect to the residents and the building. Radiator covers have been fitted to all radiators for the protection of the residents. Examination of the fire log book showed that appropriate servicing, tests, checks, drills and instruction to staff are being carried out at the appropriate frequencies. A tour of the premises did not identify any major health and safety issues. However, it was noticed that there were no restrictors fitted to one of the resident’s bedroom window located on the first floor. The manager intends to carry out a full audit of window restrictors to all rooms on the first floor and will fit appropriate window restrictors, where these are not in place, for the safety of the residents unless individual risk assessments indicate otherwise. Longbridge Deverill House DS0000057131.V308087.R01.S.doc Version 5.2 Page 22 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 3 4 X 3 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 4 3 3 3 X 4 3 X 3 STAFFING Standard No Score 27 3 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X X X 3 2 X 3 Longbridge Deverill House DS0000057131.V308087.R01.S.doc Version 5.2 Page 23 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 OP29 Regulation 19(1)(b) Timescale for action The registered individuals must 30/11/06 ensure that appropriate recruitment practices are followed in respect of all members of staff employed. Requirement RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP36 Good Practice Recommendations The registered individuals should ensure that all members of staff receive formal supervision at least six times a year. Longbridge Deverill House DS0000057131.V308087.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Longbridge Deverill House DS0000057131.V308087.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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