Inspection on 16/09/08 for Loose Valley Nursing Home

This inspection was carried out on 16th September 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Loose Valley Nursing Home 16/10/06

Loose Valley Nursing Home 15/11/05

Loose Valley Nursing Home 29/06/05

Loose Valley Nursing Home 09/03/05

Loose Valley Nursing Home 26/08/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Loose Valley Nursing Home 15 Linton Road Loose Maidstone Kent ME15 0AG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Susan Hall     Date: 1 6 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 31 Information about the care home Name of care home: Address: Loose Valley Nursing Home 15 Linton Road Loose Maidstone Kent ME15 0AG 01622745959 01622747627 loose.valley@nellsar.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Janet Ann Poole Type of registration: Number of places registered: Nellsar Ltd care home 39 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registration is restricted to caring for older people which can include up to five people with a terminal illness. Date of last inspection Brief description of the care home Loose Valley Nursing Home is owned by Nellsar Ltd, who are a family owned independent company, providing care homes in the Home Counties. They currently run twelve care homes for older people, including homes for people with nursing needs and homes for people with dementia. Loose Valley is situated approximately two miles from the centre of Maidstone, and is on a main transport route with a good bus service. The home consists of an original Victorian house, with a large purpose built wing added about ten years ago. It is set in extensive grounds overlooking the Loose valley. Some bedrooms have views of the grounds and surrounding countryside. The home is registered to provide nursing care for up to thirty nine older people. Most bedrooms Care Homes for Older People Page 4 of 31 Over 65 39 0 Brief description of the care home are for single use, but shared rooms are available. Accommodation is provided on two floors, with a passenger lift providing easy access between floors. As the home provides nursing care, there are registered nurses on duty at all times. Current fees can be obtained from the manager. Care Homes for Older People Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This home has been assessed as having a rating of 2 stars, good. The fee levels currently range from 450.00 - 777.00 per week, depending on the assessed needs of each individual resident, and the room being used. This was a key inspection, which includes all information gained about the home since the last inspection, as well as a visit to the home. CSCI survey forms were sent out to residents, health professionals and staff, and nine were received back. These contained mostly positive information, indicating that residents are happy with the care they receive, and are confident that their views are Care Homes for Older People Page 6 of 31 listened to and taken into account. Comments included: The standard of nursing care is very good; the staff are respectful, cheerful and helpful; and my mother receives first rate care. The inspection visit was carried out by one inspector and lasted for over seven hours. During this time, we (i.e. CSCI) chatted with seven residents, two relatives, one health professional, and four staff, as well as the manager, who was present throughout the day. The companys operations director was also present in the home during the afternoon, and feedback was given to the manager, deputy manager, and operations director together. The home consists of an original Victorian house, with a large purpose built wing added about ten years ago. The company have been carrying out a refurbishment of the new wing during the past year, and have made some considerable improvements. The older part of the building is badly in need of refurbishment, and this process has just been commenced. The company are having a new passenger lift fitted first, prior to redecoration and some inside structural alterations. All residents and relatives have been informed about this work, and the renovation will be carried out with minimal disruption to residents. The company have also applied for planning permission to add another wing to the home, to provide additional bedrooms and residents facilities, and a new kitchen. CSCI have not received any complaints or concerns about the home since the previous inspection, and there have been no referrals to the Social Services Safeguarding Adults team. What the care home does well: What has improved since the last inspection? What they could do better: Some care planning documentation could be improved, in respect of showing how decisions are made on behalf of residents, who no longer have the mental capacity to Care Homes for Older People Page 8 of 31 make certain decisions for themselves. The external grounds have been allowed to fall into a sad state of untidiness and are overgrown. There are three acres of grounds, which could be maintained/designed far more attractively for the benefit of residents. The companys application form needs to be amended, so that applicants are asked to provide a full employment history (i.e. from the time of leaving full time education). New staff must provide the home with a recent photograph. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 31 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a good range of information to enable enquirers to make a decision about coming into the home. Evidence: The statement of purpose has been amended since the last visit, and contains all the required information. This document is included in a welcome pack for the home, which also contains the service users guide, and a colour brochure with photographs. The service users guide is clearly set out, and includes relevant information about the day to day running of the home, such as: meal times, visiting, use of telephone, activities, complaints procedure and additional payments. Each new resident is given a copy of the service users guide on admission to the home. Prospective residents are invited to view the home, and to meet staff. Many are too unwell to view the home for themselves and rely on relatives or care managers to Care Homes for Older People Page 11 of 31 Evidence: decide for them. Each resident has a pre-admission assessment carried out by the manager or deputy manager, who are both level one nurses. Three of these were viewed, and they contained sufficient information for an informed decision to be made about the homes ability to meet residents needs. The manager said that she checks details such as if any specific equipment is needed, to ensure that this is in place prior to admission. All admissions are for a trial period of four weeks, with a review at the end of this time to check that the placement is suitable. Residents are provided with a contract which is clearly set out, and includes the terms and conditions of residency. Residents who are funded by Local Authority are also required to agree to the terms and conditions of the home. Additional payments are required for items such as hairdressing, chiropody, newspapers, and dry cleaning. Care Homes for Older People Page 12 of 31 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal care is given by a team of caring and reliable staff; and health care needs are well met in the home. Evidence: The care plans are set out with an index, so that it is easy to find the required information. Each resident has their care plan stored discreetly in their own room, with their agreement. This means that staff have to go to the room to write in the care plans, and the information is always available to the person concerned. The staff need to continue to ensure that these folders are stored in such a way as to protect the residents confidentiality, and that sensitive material is not available for others to view. Admission details are stored in separate folders, which are kept at the nurses station. Detailed assessments are carried out on admission, and these are reviewed each month, and form the basis for the care planning. Four care plans were inspected, and these contained assessments for items such as use of bed rails, moving and handling, falls risk, skin integrity, continence, nutrition and pain management. The assessments Care Homes for Older People Page 13 of 31 Evidence: are well completed – for example, moving and handling assessments include details for the resident for standing, sitting, turning in bed etc, with details of use of frame or hoist, and if one or two care staff are needed. Residents (or their next of kin/representative) are requested to sign consent forms for specific items, such as having their photograph taken for medication identification. A personal profile is completed for each resident as soon as possible after admission, so that staff can become familiar with their likes and dislikes, previous family history and occupation, and preferences in regards to hobbies and activities. Each care plan is drawn up in a typed format, and is evaluated each month. The care plans cover all aspects of daily living, such as personal hygiene needs, nutrition, social needs, and wound care. They include good details, enabling specific care to be given – such as preference of bath or shower, preferred time for getting up/going to bed, and choices about meal times and socialising. Wound care is carried out well, with clear directions for the dressing to be applied, and a written evaluation for each dressing change. Most residents choose to be registered with a GP surgery nearby, and two GPs from this surgery take it in turns to visit the home each week. The company employ a physiotherapist who comes into the home once per week, and enables residents to improve and maintain their mobility and dexterity. Residents find this input very helpful and encouraging. The home also has good access to other health professionals, such as a tissue viability nurse, dietician, speech and language therapist, and wheelchair services. Medication is stored in a clinical room, which is of sufficient size and provides adequate storage. Most medication is administered via the Boots monitored dosage system. The medication trolley and storage cupboards are kept in good order, and there is evidence of stock rotation. The deputy manager oversees all the ordering and medication management; and the deputy manager and the manager carry out auditing. Controlled drugs are stored according to requirements, and the controlled drugs register is well maintained. All Medication Administration Records (MAR charts) were viewed, and are well completed. Handwritten entries are signed for by two nurses. Eye drops are dated on opening. The deputy manager agreed that it would be good practice to date all liquid medicines on opening as well. If residents wish to self medicate, an assessment is carried out and reviewed regularly, to ensure that the resident is familiar with the medication and can manage it properly. The manager and deputy manager both have many years experience in caring for older people, and have had training in end of life care. Discussions are held with the resident (when possible) or their next of kin, about their preferences if they are dying. Care Homes for Older People Page 14 of 31 Evidence: For example, do they prefer to stay in the home, or to go to hospital and to continue to have active treatment. The staff ensure that residents who are dying are kept comfortable and as pain free as possible, and have friends or family to visit as wanted. The manager clearly identified the importance of applying the Mental Capacity Act 2005 for residents who no longer have the mental capacity to make some decisions for themselves. It is recommended that any such decisions taken on behalf of a resident are more clearly documented to show how the decision has been reached, and with a signed format showing who has made those decisions. Residents and relatives said that the nursing and care staff work to consistently high standards, ensuring that residents individual needs and preferences are met, and that their privacy and dignity are always upheld. Comments included phrases such as the staff are wonderful and always cheerful; the staff are committed to providing good care, and are sensitive and compassionate; and the staff are brilliant! Care Homes for Older People Page 15 of 31 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a good range of activities, and suitable entertainment. Visitors are always made welcome in the home. The residents benefit from having high standards of food with a good choice of menus. Evidence: The home has an activities co-ordinator who works five days per week. She has a developed a programme to include one to one time for residents (especially those who stay in their own rooms) on Mondays and Fridays; and group activities on Tuesdays, Wednesdays and Thursdays. Residents said that they enjoy having different things to join in with, and generally felt that there are sufficient activities. The activities coordinator is comparatively new, and has spent time with each resident asking them about the things they would most like to do. This has formed the basis of the weekly programme. Items include activities such as scrabble, dominoes, bingo, quizzes and games (e.g. snakes and ladders). Residents also enjoy being taken out for walks in the grounds, and there is wheelchair access all round the building. Residents said that they look forward to exercise classes held twice each week by a fitness trainer, and this is well attended. There used to be an additional charge for this, but now the home pays for this and there is no extra charge. Care Homes for Older People Page 16 of 31 Evidence: In-house entertainment is organised from time to time, and outings to places of interest such as Leeds Castle. Outings are usually arranged with a few at a time, so that sufficient attention can be paid to each one. The home currently uses wheelchair taxis for transportation. The company have just purchased two mini buses, so these will also be available for use in the future. Residents may also be taken out in small groups for shopping, or visits to the pantomime or theatre. The manager ensures that there is opportunity for residents spiritual needs to be met. Several local ministers visit the home, including Church of England vicars and a Roman Catholic priest, and also give communion. A church service is held in the home each month, and residents are also enabled to go out to the church of their choice if they wish to do so. The local Baptist church provides special services for Easter, Harvest, and Christmas. Visitors are welcomed into the home at any time, and are offered hot drinks, and can stay for meals with their relative if they wish to do so. Residents are able to bring in personal items from home, including some furniture items - in agreement with the manager, and according to each individual bedroom. Residents are enabled to manage their own financial affairs for as long as they are able or wish to do so, and the home will provide information about advocacy services if needed. Residents and relatives said that the food is very good – well cooked, sufficient choice, and plenty of it. Residents can suggest new ideas for the menus, and these are altered to accommodate seasonal changes. Residents can have a cooked breakfast if they wish, and can have snacks at any time, including during the night. Hot drinks are served with biscuits mid-morning and mid-afternoon, and with biscuits or sandwiches (on request) during the evenings. There is a choice of main meal at lunch times and for supper. The dessert trolley at lunch times is a highlight of the day, and residents look forward to making their choice from this. Meals can be taken in residents own rooms in the lounges, or in the small dining area. There is a strong adherence to ensuring that personal preferences will be met. For example, some residents prefer their meals later in the day than the usual set times, and the manager and chef ensure that their preferences are adhered to (e.g. one resident has her supper at 7pm, and another likes breakfast later in the morning than others). The chef has completed intermediate training, and is familiar with different dietary needs. The kitchen is well equipped, and was seen to be spotlessly clean. The fitments are old and many cupboard doors are missing, so this creates additional cleaning. The Care Homes for Older People Page 17 of 31 Evidence: company are hoping to build an additional wing, which will incorporate a new kitchen (planning permission is currently being sought). The Environmental Health Officer is satisfied with the current state of the kitchen and the high standard of cleanliness. Care Homes for Older People Page 18 of 31 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Any concerns or complaints are taken seriously and are properly investigated. Residents are protected from abuse. Evidence: The complaints procedure was on display and is included in the service users guide, and the policies and procedures. It is written differently in different places, and needs some slight amendments, and clarification. The manager and operations director confirmed that this would be done. There are sufficient details for writing to the manager, or to the company, and the procedure includes Social Services details as well as CSCI details in the copy in the service users guide. Complainants are sent a written acknowledgment (for a written complaint) within three working days; and are given a response outlining any investigation, and the outcome, within twenty-eight days. Residents feel able to voice their opinions freely, and have access to the manager or deputy manager nearly every day. There are also residents meetings, where residents can share any concerns in a group setting. The home has only had one complaint during the last year, and records show that complaints are taken seriously and are properly addressed. There have been no complaints made directly to CSCI since the last inspection visit. Care Homes for Older People Page 19 of 31 Evidence: Staff receive initial training about the protection of vulnerable adults (POVA) during their induction; and then attend yearly training. The records show that all staff are kept up to date with this training. The manager is familiar with the Local Authorities policies and procedures for safeguarding adults, and has copies of these available. The home has a whistle-blowing policy and procedure in place, and staff are familiar with this. There have been no Safeguarding issues raised about the home. Care Homes for Older People Page 20 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The company is in the process of refurbishing the premises to bring it up to a good standard. More attention is needed for maintaining the surrounding gardens. Evidence: The home comprises an old Victorian building (which used to be a vicarage), with a large purpose built wing at one side. The new wing has had most areas refurbished during the past year. This includes redecoration of the bedrooms, corridors, and the conservatory/dining room; and re-carpeting for many areas. Other new carpets have been purchased and are due to be fitted soon. The original building is generally shabby and run-down inside, and a complete refurbishment of this part of the building is just being commenced. There is a phased approach to this work. The refurbishment includes fitting a new passenger lift in place of the current small lift, and this will take approximately two months to carry out. Before work is commenced on the passenger lift, a stairlift is being fitted to enable some residents to move between the ground and first floors. There are several residents with rooms on the first floor who will be unable to use the stairlift, and a separate sitting room has been created on the first floor for their benefit, during the time of refurbishment. Residents and relatives are being kept fully informed about the ongoing changes and the work being done. The refurbishment includes some shared rooms being altered to rooms for single use. Care Homes for Older People Page 21 of 31 Evidence: The company are also hoping to build a second wing on to the building, which will include a new kitchen and some additional bedrooms. The home is currently let down by the poor maintenance of the grounds, including the driveway and front garden. There are three acres of gardens which are overgrown and are unattractive. This does not encourage residents to go out in the grounds, and is not pleasant for them to view. Even during a time of refurbishment, these gardens could be made much more welcoming and attractive for residents, and there is a requirement to see that the grounds are put into order, and have an ongoing maintenance and gardening plan, so that they do not fall into such a state of disrepair again. A new mower has just been purchased, and the manager is recruiting a gardener. Toilets and bathrooms are fitted with suitable hand and grab rails to assist residents, and there are toilet surrounds and raised seats available. The home has specialist baths, and baths with integral hoisting facilities. One bathroom in the new wing has been redesigned during the last year into a shower room, and residents appreciate having a choice of shower. There are plans to alter another bathroom on the ground floor into a shower room, and this would make better use of this facility. All bedrooms in the new building have en-suite toilets. There are commodes available for residents who find it difficult to use these, and for residents in the original building where rooms are not en-suite. The home has three sluices, and two of these have been fitted with new sluicing disinfectors during the past year. Residents are invited to choose the décor for their bedrooms when redecoration is being carried out, and one resident was very keen for me to see the colour she had chosen. The home has four mobile hoists, and staff find that these are sufficient for demand. The beds are suitable for nursing use, but some residents would benefit from having newer profiling beds. There are pressure-relieving mattresses on most beds, and additional pressure-relieving equipment is purchased as needed. Water temperatures are checked each month, and there is a yearly legionella check. The home has window restrictors fitted for safety as needed. Radiators are fitted with guards or have low surface temperatures. The laundry is equipped with two commercial sized washing machines and one tumble dryer, which is suitable for the current number of residents. There is a laundry assistant on duty six days per week, and the nursing and care staff assist with laundry at other times. There is a separate area for clean laundry. The home usually has three Care Homes for Older People Page 22 of 31 Evidence: domestic staff on duty each day, and this is very important at this time as the home requires ongoing cleaning while refurbishment work is carried out. The older part of the building is particularly difficult to keep clean, and the domestic staff do an excellent job in maintaining the cleanliness to a good standard. There is a faint smell of urine in some areas which appears to be due to old carpeting which no longer responds well to frequent cleaning. These carpets are due to be replaced as part of the refurbishment. Care Homes for Older People Page 23 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home maintains good staffing levels; and staff training is well managed. Evidence: Staffing levels usually consist of two nurses and four care staff on duty in the mornings; one nurse and four care staff in the afternoons; one nurse and five carers in the evenings; and one nurse and three careers at night (if occupancy is full). These numbers are currently sufficient to cover dependency levels. In addition to these staff there is a chef/cook on duty from 8am – 5pm, and two kitchen assistants who serve breakfast, assist the chef, and serve drinks and snacks and lay tables etc. This system works well, and provides additional staff members to help with feeding residents who need assistance. There are also laundry and domestic staff, and a maintenance man. The home has made good progress with improving the numbers of care staff with NVQ levels 2 or 3. This has risen from 28.5 at the last inspection to 60 who have now completed training. Another two care staff have nearly completed NVQ level 2, and this will then bring the percentage up to 70 which is excellent. Recruitment procedures are generally well carried out. These include a POVA first Care Homes for Older People Page 24 of 31 Evidence: check and Criminal Record Bureau (CRB) check; two written references; proof of ID; health questionnaire, and an interview record. However, there were no staff photographs on file and there is a requirement for this, as photocopies of passports or driving licences are not clear enough for photographic evidence. The application forms need to be amended, as they currently ask for ten years of employment history; whereas applicants must be asked to provide a full employment history – i.e. from the time of leaving full time education. All staff members are provided with a job description, a GSCC code of conduct, and a contract. The home has a detailed induction programme in place, which incorporates mandatory staff training. The manager and the deputy manager mentor new staff through this process. The training matrix confirms that staff training is kept up to date in these subjects e.g. health and safety, moving and handling, fire safety and infection control. Not all care staff have completed basic food hygiene, but this is being dealt with. The chef has recently completed a trainers course, and is now qualified to teach the staff, which will make it easier to provide this training. Nursing and care staff are enabled to carry out additional training to help them to develop their knowledge and skills. These include subjects such as wound care, diabetes, and strokes. Care Homes for Older People Page 25 of 31 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home benefits from having a competent manager, who runs the home smoothly and efficiently. She also provides a good lead to staff, ensuring that they deliver care with sensitivity and compassion. Evidence: The manager has worked in the home for many years as the head of care, but has only been in post as manager for a year. She is assisted by the head of care, who is also the deputy manager. They have clearly defined roles, and work well together, providing a clear lead for other staff. The manager has an open door policy and speaks with most residents on most days, so that they know her well and can easily raise any concerns. Staff were seen to interact well with residents and with each other, and there is a good sense of team work in the home. Residents all spoke highly of the staff, with no exceptions. The home has staff meetings as well as individual one to one staff Care Homes for Older People Page 26 of 31 Evidence: supervision, so there is plenty of opportunity for staff to share concerns or ideas. The manager carries out most staff supervision, so that she keeps up to date with individual staff changes and training needs. A yearly questionnaire is sent out to residents, relatives, and health professionals; and the results of this are analysed by the company, and are made available for people to view. The results from last years questionnaires showed that most residents are very satisfied with the levels of care, food, staffing and activities. Any comments made have been taken into account and acted on. The companys operations director visits the home each month to carry out regulatory visits, and the company have recently appointed a quality assurance manager as well. The home does not manage any private money for residents. Any costs incurred are included in a monthly invoice to them or their representative. Records and documentation are well managed by the home, with items appropriately filed and kept up to date. The manager ensures that health and safety is observed throughout the home, and all staff are trained in this. Servicing records were viewed for hoist servicing, fire equipment, gas certificate and water (legionella) checks, and are all up to date. The home has a comprehensive fire risk assessment, which was updated in August 2007, and complies with the fire regulation requirements. The company carries out auditing for accidents, incidents and complaints, which highlights if there are any patterns to these, so that issues can be addressed. Care Homes for Older People Page 27 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 28 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 19 23 To improve the external grounds of the home, and provide adequate ongoing maintenance for these. So that the external grounds of the home are suitable for, and safe for use, by the residents; and are appropriately maintained. 16/11/2008 2 29 19 To ensure that the company have a photograph on file for each staff member. To alter the application form so that applicants are requested to provide a full employment history (i.e. since the time of leaving full time education). To comply with all aspects of recruitment as outlined in Schedule 2 of the Care Homes Regulations. 31/10/2008 Recommendations Care Homes for Older People Page 29 of 31 These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 8 To improve documentation in care planning, so that it clearly shows how decisions have been made on behalf of residents, who no longer have the mental capacity to make these decisions for themselves (in accordance with the Mental Capacity Act 2005). To ensure that the complaints procedure is amended, so that it shows a clear pathway for complainants to follow. 2 16 Care Homes for Older People Page 30 of 31 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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