Inspection on 04/12/08 for Maple Lodge Nursing Home

This inspection was carried out on 4th December 2008.

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

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

Other inspections for this house

Maple Lodge Nursing Home 18/12/06

Maple Lodge Nursing Home 22/02/06

Maple Lodge Nursing Home 07/09/05

Maple Lodge Nursing Home 24/02/05

Maple Lodge Nursing Home 09/09/04

Maple Lodge Nursing Home 23/03/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Maple Lodge Nursing Home Woolwich Road Witherwack Sunderland SR5 5SF     The quality rating for this care home is:   three star excellent 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: Sam Doku     Date: 0 4 1 2 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 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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 30 Information about the care home Name of care home: Address: Maple Lodge Nursing Home Woolwich Road Witherwack Sunderland SR5 5SF 01915493672 01915493687 maple.lodge@fshc.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Anthony Duggan Type of registration: Number of places registered: Tamaris Healthcare (England) Ltd care home 54 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: Service users within the category of MD/MD(E) may only be accommodated on the first floor Date of last inspection Brief description of the care home Maple Lodge is a two storey care home which was purpose built in 1995 and offers accommodation to a maximum of 54 older people. The home provides both personal and nursing care to those living there, some of whom may have dementia, mental health needs or general nursing care needs. The service users who require general nursing are accommodated on the ground floor and those with dementia and mental health needs are accommodated on the first floor. The property is located in a residential area of Witherwack and is within walking distance of a small range of local Care Homes for Older People Page 4 of 30 Over 65 30 15 24 30 15 0 Brief description of the care home amenities, including shops, a post office, and a pub and bus station to the city centre of Sunderland. Local churches are accessible by car or public transport. A mini-bus is available to the home for use by service users but this must be pre-booked. Accommodation is provided on two floors, each with self-contained facilities including lounges, dining areas, WCs and bathrooms. All bedrooms are single rooms, of good size and are provided with en-suite WC facilities. Entry to the home is accessible with lift access to the first floor. Externally, generous car parking space is provided to the front of the building, and extensive grounds surround the home. This area is enclosed with fencing for security but would benefit from landscaping. The scale of charges per week for living in the home is between 505.80 Pounds to 525.80 Pounds. The Providers website address is: www.fshc.co.uk Care Homes for Older People Page 5 of 30 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: three star excellent 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: The quality rating of this service is 3 Star. This means the people who use the service experience excellent quality outcomes. The inspection was unannounced and commenced on 4 December 2008 and completed on the same day. Before the visit the inspector looked at: Information we have received since the last inspection visit on 19 December 2006. How the home dealt with any complaints and concerns since the last inspection. Any changes to how the home is run. The providers view of how well they care for people, as highlighted in the details provided in the Annual Quality Assurance Assessment (AQAA). The views of the people who use the service. The comments made by the Care Homes for Older People Page 6 of 30 residents in the four residents and relatives surveys that we received. The comments made by the staff in the five staff surveys that we received. During the visit the inspector did the following. Talked to the people who use the service, the manager and the staff. Looked at information about the people who use the service and how well their needs are met. Looked at other records which must be kept. Checked that staff have the knowledge, skills and training to meet the needs of the people they care for. Looked around the home to make sure it is safe and secure. Checked what improvements have been made since the last inspection. The inspector told the manager what he found. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use the services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: The residents enjoy good social and recreational activities. The activities organiser ensures that at least there is an organised trip once every two weeks. The activities coordinator provides group and individual activities for the residents. As part of the Christmas festivities, the home had booked for the residents to attend a pantomime at the local theatre. Also a visit by the children from the local primary school had been arranged for them to come and sing Christmas carols for the residents. The residents commented that they were looking forward to seeing the school children. Daily records show good examples of how the home works with other healthcare professionals in meeting the needs of the residents. There were examples of prompt referrals to GPs, Psychiatrist and tissue viability nurse when the condition of a resident requires such a specialised healthcare input. The care plans are regularly reviewed and updated to reflect the current care needs of the residents. Staff of all grades receive regular one-to-one supervision and records of these are kept in individual files. There is also a record of annual appraisal for all the staff. The home is good at making good links with the local primary school, where the school pays regular visits to the home, and the children were actively involved when the home was creating a garden for the residents. The home has a good system in place for carrying out regular audits of the residents accounts. This system proved effective in the most recent audit of the accounts when some discrepancies were noticed. The company took immediate action to rectify the situation, including a disciplinary action. The home has put further checks in place to ensure that the residents monies are safe at all times. The home takes safeguarding issues and complaints very seriously. Records show that where there was an incident which could be seen as a potential safeguarding issue, the home took immediate action to instigate safeguarding procedure. In all the cases, the home has been extremely proactive in any investigations and cooperated with other agencies in making sure that the residents are safe and their welfare is safeguarded at all times. The complaints procudure is available in audio version on CD and also in large print. The provider also confirmed that the procedure is being printed in 2 different languages, initially this will be Urdu and Mandarin. There will also be a facility to be able to provide a translation of the Complaints Procedure in other languages on request. Comments from residents and relatives include: The staff go beyond what is expected of them. The activities coordinator is a gem. She is really dedicated to her work. Care Homes for Older People Page 8 of 30 There is always something for us to do. Plenty of activities. The carers are wonderful, they will do anything for you. There is always plenty to eat. The food is really good here. This place is really very clean and there is never a smell in the home. Staff who were spoken with were also very complimentary about the improvements in the home and the efficient way in which the registered manager manages the home. All the staff said they have seen great improvements in the quality of the care that is given and attributed this to the excellent ways in which the manager and the senior staff manage the place. There are excellent infection control measures in place. The laundry assistant is very knowledgeable about how to prevent the spread of infection. She showed the inspector how cloths that belonged to one person with MRSA is managed. She has followed the infection control procedures in ensuring that the cloths are bagged in a recognisable plastic bags and washed separately to prevent cross contamination. There are also alcohol-base hand lotions throughout the home for staff and visitors to use to ensure that the risks of cross infection or cross contamination are reduced. What has improved since the last inspection? What they could do better: 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 Care Homes for Older People Page 9 of 30 240 7535. Care Homes for Older People Page 10 of 30 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 11 of 30 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. Prospective residents have their needs assessed before they are admitted to the home. This ensures that the needs of the prospective residents have been identified and arrangements can be made to provide the care that the person needs when they are admitted. The home provides information about the service, including invitation for prospective residents to visit the home, which enable them to make informed decisions about whether to live there. Evidence: Four residents files were examined as part of the case tracking exercise. The files contained pre-admission assessments carried out by the home and also by the social worker or nurse assessor. The manager confirmed that it is the homes policy and also the policy of the company for the nursing staff to carry out such assessments or obtain Care Homes for Older People Page 12 of 30 Evidence: a copy of the assessment from the nurse assessor or a social worker before admission is arranged. The manager explained that this is to make sure that they have the necessary skills and facilities to meet the needs of the person. These assessments are then used to prepare the initial care plans for the person so that all staff would know what care and support the person needs when they arrive in the home. The inspector spoke to three residents on the ground floor unit and one gentleman on the dementia care unit about their experience of the pre-admissions arrangements. They all confirmed that they were visited in their homes or in hospital by the nurses from the home and they were asked several questions about their health. One lady said that her daughter was with her and she asked the nurse a lot of questions about the home and the staff. The inspector asked two staff members to describe the admission process. Staff described the process including the opportunity for prospective residents come and visit the home and to find out more about the home before making up their minds about coming to live at Maple Lodge. The manager confirmed that all residents have copies of the service user guide which provides information about the home and the service that the home provides. Copies of these were found in some of the bedrooms that were viewed. Residents are aware of the copies in their rooms and said that although they dont read it, they know they have copies which they could read if there is the need to do so. Care Homes for Older People Page 13 of 30 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. The residents receive care that is consistent with their personal and healthcare needs. Furthermore, the home has good procedures in place for administration and safe handling of medication, thus promoting the health of the residents. The residents are treated with dignity and their right to privacy is upheld. Evidence: The inspector spoke with a number of residents and he used the opportunity to talk to them about the arrangements that are in place to make sure that their healthcare needs are met. They all said that they have access to healthcare facilities including visits from their GPs and other healthcare professionals. Some gave instances where the nursing staff arranged for their GPs to visit. The residents files provide details of the healthcare support that each individual resident receives. The care notes show entries of visits to or from healthcare professionals. At the time of the inspection, a physiotherapist had called to see one residents who needed her services. Care Homes for Older People Page 14 of 30 Evidence: The records , belonging to one of the residents who was case tracked, showed that the staff had taken prompt action when they were concerned about her weight loss. This was brought to the attention of her GP and also the Consultant Psychiatrist. The staff continued to monitor her weight and while she is receiving appropriate treatment from the GP. The care plans are well written and provide good information for staff to follow when carrying out specific care tasks. The care plans provided details of how staff should support the residents and these are regularly reviewed and changes made to them to reflect the current care needs of the individuals. The inspector spoke to staff about specific care plans and they were aware of how the person should be cared for. Care staff said that they often read the care plans but are regularly informed by the nursing staff when changes are made to any of the care plans. However, in two of the four care plans that were examined, some of the care plans needed more information to help staff manage behaviours that were proving to be challenging to the staff. In one of those cases the triggers that staff have been asked to look for should have been stated in the care plans so that the care staff know exactly what to look for. The home has detailed written policies on the storage and administration of medicines. The manager confirmed that the nursing staff who are responsible for the administration of medicines have received up to date training on safe handling of medicines, and they follow the homes medication policies. A random check of the medicines administration system was undertaken by the inspector in the presence of the registered manager. There were no discrepancies noted, and the administration sheets have been signed and dated as required. The manager pointed out that the treatment room can be very warm at times, particularly in the summer months as there is no suitable ventilation system in place to keep the room cool. The manager was aware that this could affect the effectiveness of some of the medicines that are kept there. The company should consider installing a suitable cooling system in the room to keep medicines at the right temperature. The interaction between staff and residents was good. Staff showed respect to the residents and this was commented on by a number of residents. The service user surveys that were received indicated that the residents are treated with respect and dignity. The inspector observed that the staff were polite, courteous, friendly and professional in the way they related to the residents. There was a happy and friendly atmosphere in the home. This was particularly more noticeable during small group activities which the activities coordinator had organised for the residents. Care Homes for Older People Page 15 of 30 Care Homes for Older People Page 16 of 30 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents have the benefit of meaningful and fulfilling social and recreational activities which enhance their wellbeing. The residents are provided with good variety of wholesome and nutritious meals, which promotes their health and wellbeing. Evidence: The dining areas on the ground and first floors have recently been redecorated and furnished to a good standard. The table cloths beautifully match the curtains, providing a pleasant environment for the residents. Dining tables were appropriately set and residents had their meals in pleasant and comfortable environment. A four-week rotational menu remains is operation in the home. Examination of past menus show that the home provides choice of menu for the residents. Those residents with special dietary needs are catered for. The residents were given plenty of time to enjoy their lunch and people who require help from staff with the meals were given that support in ways that preserved their dignity. Residents said they like the food and that there is always plenty to eat. They Care Homes for Older People Page 17 of 30 Evidence: described the food and the choice that is available to them as excellent. The home has an activities coordinator who organises social and recreational activities for the residents. She maintains a record of all the activities that individuals take part in. She also ensures that individuals who are not able to join in organised activities receive one-to-one attention from her. The activities that are organised for the residents include bingo, card games, sing along, films and outings. The manager confirmed that at least there is an organised trip once every two weeks. As part of the Christmas festivities, the home had booked for the residents to attend a pantomime at the local theatre, and also a visit from the local primary school to sing Christmas carols for the residents. At the time of the inspection, a small group of residents were engaged art work and knitting. Residents confirmed that they get up and go to bed when they want. One lady said that no one is made to go to bed at a set time. She said people go to bed when they have had enough and tired. Residents said that they are provided with cups of tea when they first get up in the morning. A few of the residents said that they prefer to have a lie-in in the morning and the home has no problems in allowing them to enjoy their lie-in. The dining areas on the ground and first floors have recently been redecorated and furnished to a good standard. The table cloths beautifully match the curtains, providing a pleasant environment for the residents. Dining tables were appropriately set and residents had their meals in pleasant and comfortable environment. A four-week rotational menu remains is operation in the home. Examination of past menus show that the home provides choice of menu for the residents. Those residents with special dietary needs are catered for. Care Homes for Older People Page 18 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and relatives have information about how to make a complaint and are confident that any concerns raised would be acted on by the home, thus promoting their right to express their views about the service. Staff are aware of safeguarding adults procedures and have received suitable training which safeguard the welfare of the residents. Evidence: The comments in the service user surveys show that the residents and their relatives are aware of the complaints procedure and would know how to complain. The complaints record shows that relatives have on occasions raised concerns with the manager and these have been addressed to the satisfaction of the complainants. The complaints procedure is posted in the reception area and a summary of the procedure is in the service user guide. The residents on the ground floor unit said that they are aware of the complaints procedure. A number of them said that they have no problems but would know what to do if they had the need to complain about something that they are not happy with. One lady said you will hard pressed to find something to complain about. Because of the memory problems that most of the residents on the dementia unit Care Homes for Older People Page 19 of 30 Evidence: have, it was difficult to get a view from them about the complaints procedure. However, a staff member commented that the relatives are closely in touch with the residents and they would complain on their behalf if they were unhappy about anything. The complaints procudure is available in audio version on CD and also in large print. The provider also confirmed that the procedure is being printed in 2 different languages, initially this will be Urdu and Mandarin. There will also be a facility to be able to provide a translation of the Complaints Procedure in other languages on request. Details in the complaints records and other relevant safeguarding records show that the home takes safeguarding issues and complaints very seriously. Records show that where there were incidents which could be seen as potential safeguarding issues, the home took immediate action to instigate safeguarding procedures. In all the cases, the home had been extremely proactive in any investigations, and cooperated with other agencies in making sure that the residents are safe and their welfare is safeguarded. Staff commented that the registered manager has an excellent reputation for safeguarding the residents from any form of abuse. One such comment was he lives no stone unturned when it comes to safeguarding matters. Since the last key inspection, there had been a number of safeguarding issues and complaints, and the way the manager and the area manager handled these matters can only be described as very professional and effective. The registered manager and the line manager have been at the forefront of a number of safeguarding investigations and have fully cooperated with other care agencies. Where the home was asked to carry out specific investigations relating to safeguarding matters, these were carried out within the expected timescales and reported to the safeguarding team as required. Investigations carried by the home were thorough and timely. The manager and the area manager do not shy away from identifying the homes shortcomings in certain safeguarding matters and where this is the case, they would prepare and implement an action plan and in ensure that appropriate systems are put in place to make sure the homes shotcomings are addressed. The home has a good system in place for carrying out regular audit of the residents accounts. This system proved effective in the most recent audit of the accounts when some discrepancies were noticed. The company took immediate action to rectify the situation, including a disciplinary action. The manager immediately advised the Commission and the local social services department of the discrepancies involving the finances of a resident. The home, immediately put further checks in place to ensure Care Homes for Older People Page 20 of 30 Evidence: that the residents monies are safe at all times. The speed with which the manager acted and the subsequent actions taken by the manager and the area manager is an indication of how seriously they take safeguarding issues. The manager stated that all the staff have had training in safeguarding adults. Staff who were spoken with were familiar with the homes policy on safeguarding vulnerable people. The staff showed understanding of the POVA procedures and also showed an awareness of the need to protect the residents from all forms of abuse. Care Homes for Older People Page 21 of 30 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 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 safe, secure, clean, warm and pleasant environment for the residents to live in. Evidence: The home is clean and maintained to a good standard. The bedrooms that were viewed were clean and personalised, reflecting individual tastes and preferences. Residents have been encouraged to furnish their rooms with personal items, including families photographs, pictures and small items of furniture which enhanced the homeliness of their rooms. All rooms are single occupancy with en-suite facility. Individual rooms have good ventilation and natural lighting. The two dinning rooms have recently been decorated and furnished to a good standard. Window restrictors have been fixed to all windows for safety, and all radiators have suitable covering to prevent any accidents to the residents. Checks of hot water at randomly selected bathing outlets confirmed that hot water did not exceed the safety level of 43 degrees centigrade. There are good arrangements in place for regular maintenance work in the home. Care Homes for Older People Page 22 of 30 Evidence: The maintenance book shows that the handyman has kept on top of any maintenance and safety work that is needed to maintain a safe environment. These include fire safety checks and fire drills. The home has suitable infection control policies in place. Staff have had training in infection control and records show that the home has adhered to effective infection control procedures. The kitchen was noted to be clean and maintained to a good standard. There is a cleaning rota showing how the domestic staff keep up with the cleaning activities in the kitchen. Records relating to daily food temperatures and other food hygiene measures are maintained. These are records that need to be maintained to ensure that proper food hygiene methods are being maintained. The laundry was found to be well ordered, and appropriate COSSH notices are in place. The laundry machines are suitable for cleaning foul linen. There are excellent infection control measures in place. The laundry assistant is very knowledgeable about how to prevent the spread of infection. She showed the inspector how cloths belonging to one person with MRSA is managed. The cloths are bagged in recognisable plastic bags and washed separately to prevent cross contamination. There are also alcohol-base antiseptic hand lotions throughout the home for staff and visitors to use in order to minimise the potential spread of infection or contamination in the home. Care Homes for Older People Page 23 of 30 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 staffing numbers are satisfactory and promote the safety and welfare of the residents. The registered manager follows the company policy on staff recruitment, supervision and training procedures, which promote the welfare of the service users. Evidence: The home employs sufficient number of staff to meet the needs of the residents. There is a registered nurse on duty at all times including night duties. Staff were spoken to about the staffing levels in the home. They all said that the staffing levels are always adequate. On the day of the inspection, the manager had to work on the floor because the nurse who would be in charge of the ground floor unit went on the sick. Staff were on the whole happy with the staffing levels in the home but some commented that occasionally they experience reduced staffing levels due to sickness or holiday commitments. One staff member did say that sometimes when there is staff shortage the registered manager would step in and work on the floor to complement the care hours. Staff records show that the staff have received training in moving and handling, first aid, protection of vulnerable adults, fire safety, food hygiene and health and safety Care Homes for Older People Page 24 of 30 Evidence: training. The nursing staff continue to receive refresher training to update them on nursing practices. Staff also receive regular supervision and appraisals and the details are kept on individual files. The files for the most recently employed staff were examined to check on the recruitment process by the manager. The files show that the home has been following good recruitment procedures. All the files contain completed job applications, copy of job description, appropriate references, evidence of CRB checks and record of induction and training. Information in the AQAA shows that nine of the sixteen care staff have NVQ Level II or above. Care Homes for Older People Page 25 of 30 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 is managed by a qualified and experienced person, and runs the home for the benefit of the residents. The home has procedures in place to provide supervision for staff of all grades. This promotes the quality of the service that the residents receive. The safety and welfare of the residents are protected by the regular servicing of electrical and mechanical equipments and the safety arrangements that are in place. Further more, the residents finances are protected by regular auditing of the accounts. Evidence: The registered manager has long experience of managing a residential care home. Staff commented positively on his management qualities as being excellent. Staff commented that the manager does not tolerate bad practices and he would come down heavily on anyone who is not performing well. One staff member said he sticks Care Homes for Older People Page 26 of 30 Evidence: by the rules and some staff dont like it, but his priority is to the welfare of the residents. There is a quality assurance system in place for seeking the views of the residents and visitors to the home. Quality audits are carried out on a monthly basis to make sure that the service is delivered in a consistent manner and that the views of the people who use the service are taken into consideration. The inspector spoke with the manager and the temporary administrative officer about the system for managing the residents monies. The manager confirmed that checking the financial system is part of the regular audit that he carries out. Receipts are available for all transactions that have been made on behalf of residents. The manager described to the inspector a recent audit which highlighted some discrepancies in the amount of monies held in the home. The discrepancies were immediately investigated and appropriate actions were taken to protect the residents from any financial abuse. There are suitable arrangements for care staff and other ancillary staff to receive oneto-one supervision from the manager and the trained nurses. Staff records show that the manager and the nurses have provided individual supervision to care and ancillary staff on a regular basis. The company Health and Safety policies remain in place. These cover policy areas such as fire prevention and Care of Substances Hazardous to Health (COSHH), protection of vulnerable adults, infection control, dealing with violence, disposal of clinical waste and record keeping. There is evidence that staff adhere to the policies as set by the company. Servicing records confirm that all portable appliances have been tested. A record is maintained of regular water temperature tests in the home. Regular servicing of fire equipment, passenger lift, bath lifts and hoists, gas and electrical appliances have been carried out by the contracted companies. All the servicing records that were examined were up to date. These included servicing of passenger lift, hoists, water treatment, electrical installation and gas servicing. Care Homes for Older People Page 27 of 30 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 30 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 Recommendations 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 7 The care plans should be better organised to provide more information to staff about the specific care needs of the residents. One of the care plans for a gentleman on the dementia care unit require specific instructions to staff on handling his challenging behaviour. The treatement room can be very warm as there is no suitable ventilation system in place to keep the room cooler. The provider should consider installing a suitable cooling system in the room to keep medicines at the right temperature. 2 9 Care Homes for Older People Page 29 of 30 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 © (2009) 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. 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