Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 11/11/08 for Moorlands Nursing Home

Also see our care home review for Moorlands Nursing Home for more information

This inspection was carried out on 11th November 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

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

What the care home does well

Service users have access to health care and remedial services. Staff makes sure that those who are fit and well enough are encouraged to be independent, have regular appointment and visit local health care services. The health care needs of service users unable to leave the home are managed by visits from local health care services. Service users have the aids and equipment they need and these are well maintained to support them and staff in daily living. The home provides a wide range of activities based on the agreed needs of the service user. Those service users who are nursed mostly in their bedrooms do not loose out on activities. It was noted in the records and in discussion with one such service user, that they have activities suitable to their needs in their bedroom on a one to one basis with the activities co-ordinator. Observations of care staff interaction with service users indicated that most times service users are treated with respect and dignity. it was also observed that great care was taken in respect of the service users` personal belongings.

What has improved since the last inspection?

The last key inspection resulted in a number of Statutory Requirements and recommendations for good practise and these were dealt with satisfactorily and within the agreed time scale. The Chef informed us the food budget has been increased and service users told us the quality of meals are much improved. The home is currently undergoing intensive re-decoration and should improve the look of the home when it is completed. The new manager plans to take service users who would like to go out on trips on a regular basis starting this Christmas to see the Christmas lights.

What the care home could do better:

The AQAA which is a legal document needs to be completed fully answering the questions asked. The new manager has shared with us her vision for moving the running of the home into a more up-to-date style and some of her ideas are recorded in minutes of staff and relatives meeting.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Moorlands Nursing Home Macdonald Road Lightwater Surrey GU18 5US     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: Mavis Clahar     Date: 1 1 1 1 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 29 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 29 Information about the care home Name of care home: Address: Moorlands Nursing Home Macdonald Road Lightwater Surrey GU18 5US 01276473140 01206828291 moorlands@caringhomes.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Kathleen Henrietta Buckley Type of registration: Number of places registered: Moorlands (Lightwater) Ltd care home 41 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 41 The registered person may provide the following category of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Dementia - DE Old age, not falling within any other category - OP Date of last inspection Brief description of the care home Moorlands is an attractive house built in the early 1900s. The home is set in its own grounds, situated 1 mile from Lightwater village centre, 2 miles from Camberley town centre and within reach of the major towns in North West Surrey. The home provides nursing care and accommodation on two floors for 41 older people. Twenty-five of the bedrooms have en-suite facilities. The home has a lift and stair access to the upper floor. The home is tastefully decorated and furnished, with lounges and quiet areas Care Homes for Older People Page 4 of 29 Over 65 0 41 41 0 Brief description of the care home overlooking well-kept gardens. The home is staffed by Registered Nurses and health care assistants, and is supported by the Primary Health Care Team and specialists nurses. The range of fees for the rooms is from 570 - 785 pounds per week and includes physiotherapy assessment. There is an additional cost for hairdressing, chiropody service and any personal toiletries, newspapers and magazines. Care Homes for Older People Page 5 of 29 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: The last Key Inspection for this service was completed on 11th March 2008. Fees at this home are in the range of 570 - 785 pounds per week and includes physiotherapy assessment. There is an additional cost for hairdressing, chiropody service and any personal toiletries, news papers and magazines. This unannounced site visit which forms part of the key inspection to be undertaken by the Commission for Social Care inspection (CSCI) was undertaken by Mrs Mavis Clahar on the 11th November 2008 and lasted for six hours and forty five minutes; commencing at 08:45 hours and concluding at 15:30 hours. Also assisting on this inspection visit was an Expert by Experience. This is a person who either has a shared Care Homes for Older People Page 6 of 29 experience of using services or understands how people in this service communicate. They visit the home with us to help us get a picture of what it is like to live in or use the service. This is important because the views and experiences of the people who use the service are central to helping us make a judgement about the quality of the care being delivered in the home. The recently appointed manager of the home assisted on this site visit. The CSCI Inspecting for Better Lives (IBL) involves an Annual Quality Assurance Assessment (AQAA) to be completed by the service, which includes information from a variety of sources. This initially helps us to prioritise the order of the inspection and identify areas that require more attention during the inspection process. This document was received by CSCI (us) and is referred to throughout the report. The current manager of the home is new in post following the retirement of the original manager in October 2008. The new manager of the home is a Registered nurse with many years experience in nursing and managing care of older people. She articulates her responsibility for the clinical guidance and supervision of all trained nursing staff and carers and for the Pre assessment of proposed service users wishing to enter the home. The majority of the service users spoken to were able to express their thoughts and feelings about the care they receive. The information contained in this report was gathered mainly from observation by the inspectors, speaking with a number of service users, information obtained from the Pre inspection questionnaires completed by service users, relatives, and staff, and from information contained within the AQAA. Further information was gathered from records kept at the home. The first part of the inspection was spent discussing and agreeing the inspection process with the manager followed by a tour of the home, which included time spent in discussion with service users, care workers, activities co-ordinator, and the Chef. The manager and staff are aware of the Laws regarding equality and diversity and Equal opportunities and this was reflected in the staff mix. All service users in this home are Caucasian and reflect the population of the area in which the home is situated. All records sampled were up to date with care plans being signed by the service users or by relatives. One Statutory Requirement and one recommendation of good practise was issued on this visit. Please see Environment outcomes for full disclosure. The final part of the inspection was spent giving feedback to the manager about the findings of this visit. The inspector would like to thank all the service users, visitors to the home and care staff that, made the visit so productive and pleasant on the day. What the care home does well: 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 240 7535. Care Homes for Older People Page 8 of 29 Care Homes for Older People Page 9 of 29 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 29 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 service users and their relatives have the information needed to choose a home, which will meet their needs and service users are being assessed to ensure the home is capable to meet the needs of the service users prior to being admitted into the home. Evidence: Review of service users documents and identified policies demonstrated the home has a policy and procedure on admission and discharge of service users. Within the admission policy all service users must have an assessment prior to being admitted into the home. We were told the manager of the home who is trained in the principles of assessment of service users needs based on what the care the home says it will provide carries out all pre admission assessments of service users prior to them being admitted into the home. In the managers absence the deputy manager carries out the assessments. Care Homes for Older People Page 11 of 29 Evidence: Review of a random sample of service users files including one recently admitted service user, demonstrated that pre admission assessments are being carried out and relatives were being involved in the assessment process. Care Homes for Older People Page 12 of 29 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 home has a good and clear care plan in place for service users and this includes appropriate risks assessments. This forms the basis for care based on the agreed care needs of the service users and demonstrated that trained staff met service users health and personal care needs. The homes medication policy on receiving, storing and administering of medication was in place and being adhered to thereby ensuring the safety and protection of the service users. Care workers treated service users with respect and maintain their dignity and privacy when delivering personal care. Evidence: The randomly selected care plans were clear and easy to read, identifying risks to service users and detailing how these risks would be managed. The daily worksheets demonstrate service users needs were being met according to the agreed care plans. The new manager has initiated a system that requires staff to sign, whereby all service Care Homes for Older People Page 13 of 29 Evidence: users are checked regularly to ensure their safety and wellbeing are maintained and that no service user is left or forgotten. In discussion with service users and care workers it was demonstrated that service users care needs are met. The service user or relative signed the care plans to indicate their involvement in deciding what care they received. It was evidenced that care staff undertaking the development and monthly review of the care plans also signed and dated them. In discussions with service users on the day of the visit they confirmed they were involved in the planning of their daily care. Information contained in the homes Annual Quality Assurance Assessment (AQAA) was minimal and did not address the issues requested. However, in discussion with the new manager we were told service users benefit from the involvement of our specialist health professionals who supports us in meeting the needs of our service users. All service users are registered with a local General Practitioner (GP) of their choice and visits are recorded, with access to specialist healthcare professionals through their GP practice as required such as sight and hearing tests which are carried out on a regular basis; and these visits are also recorded in the service users folder. Service users are offered access to chiropody service and weekly hairdressing facilities are available at a cost to the service users. In discussion with the registered nurse and care workers they were extremely proud of the high standard of care they provided to all service users in the home. However, we observed one incidence where a service user who was obviously in a very distressed condition was being wheeled too fast by a carer who took no notice of the service users tears. Fortunately, the manager stopped the carer, consoled the service user before she allowed the carer to move his charge. We were told on the day of the visit that no service user at present was risked assess as capable to self medicate. However, the home had a policy on self-medication should it becomes necessary. The AQAA gave no information regarding what the home does with this aspect of care. We were told by the new manager Qualified and senior care staff have all received training in the receipt, recording, storage handling and administration and disposal of medicines. All medicines are administered from a lockable drugs trolley, which is stored in a locked medication room when not in use. In discussion with the Registered Nurse we were told, we keep a controlled drugs register and record fridge and medication room temperatures daily. We evidenced this as correct during a tour of the home. Care staff identified as capable to administer medication are requested to leave a dated sample of their signature, which is kept in the medication trolley. We also observed all service users case tracked had a recent photograph included in their personal folder and medication record, to reduce the risk of mistakes happening during medication administration. We observed that care workers wore name badges to enable visitors and service users Care Homes for Older People Page 14 of 29 Evidence: with memory impairment to be sure of whom they are speaking with; and we also observed Service users being treated in a friendly but respectful manner by care workers. In discussion with one visitor on the day of the inspection and review of the pre inspection questionnaires indicted service users are treated with respect and dignity, and that they are able to make their own choice. A relative told us My relative is very happy here, everything is so nice he has his own room, and can have as much privacy as he wants. The only problem is the staff never seems to have time to talk with him. They do their task and have to go on to the next person. We observed the staff to be mainly task driven with very little interaction with the service users. The language barrier of the staff does not help with good communication. We observed that they were doing their tasks by rote and not really concentrating on what they were doing. An example of this observation is when carers left service users in front of the TV in lounge 3, they had not noticed that the TV was mistuned and that it would be very difficult for the service users to view the programme behind the snow. It was obvious to us that two service users wanted to watch the programme but were unable to communicate this to the staff. The TV problem was reported to the manager and it was immediately fixed. We experienced considerable language problems with some of the staff and it was not possible to communicate with them. However, those staff we could communicate with was cheerful and helpful. Care Homes for Older People Page 15 of 29 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. Service users lifestyles matched their needs and preferences and where possible they are able to maintain contact with family, friends and the local community. Service users are able to make choices in accordance with their abilities and were provided with a balanced diet in mostly pleasant surroundings and in an unhurried way. Evidence: The home employs a full time activity-co-ordinator who provides a range of activities based on the individual assessed and agreed needs, including their preferences, cultural beliefs and customs. We were told that wherever possible relatives are encouraged to participate in the planning and of service users activities. The AQAA did not give suitable information regarding this outcome area. In discussion with the new manager we were told that she has had a meeting with the activity coordinator and agreed that she should concentrate on providing service users with a varied activities programme that includes exercise, sing-a-longs, dominoes and quizzes for example. They are planning to take service users out on outings when the weather gets better. We observed the activities programme displayed in the reception area of the home, in Care Homes for Older People Page 16 of 29 Evidence: all the dining room and lounges used by the service users. We were told the C/E Vicar holds regular services at the home, and those service users who are able attends. We were told by service users that they are able to have their friends and relatives visit any time it is convenient for them to visit. We spoke with one visitor to the home who expressed their satisfaction with the level of care their relatives were receiving, and they also spoke highly of the dedication and caring attitude of some of the staff towards them. However the relative was concerned about the robot way some staff members perform their task not bothering or not able to see the individual beyond the task. He observed that carers had no time to chat with service users, as they always seem to be in a rush to finish their task. They also told us the senior staff keeps them informed of any changes in the condition of their relatives. Two of the service users spoken to said they had choice in their clothing and sometimes they receive help from their key worker. On the day of inspection all service users were dressed appropriately for the weather. We were told all the meals at Moorlands are prepared fresh on site. Service users have a choice daily and can eat in either the dining room or their bedrooms. We were told they have ordered linen tablecloths with matching napkins to created a very attractive and welcoming dinning room where the tables being dressed with freshly laundered and colour coordinated table linen. We were told service users choose their food from daily displayed menus that include two alternative choices to the main courses. We observed fruit was not readily available to service users but staff were seen offering drinks to service users. We observed a marked improvement in the décor of the dining area, and in discussion with service users they said they were very pleased with the redecorations. One inspector sampled the lunch and agreed with the comments of the service users who said the food was very good, tasty and the right amount. The inspector observed the presentation of the food was done in a way to stimulate appetite. Some service users had supplements as ordered by their GP or dietician, to maintain body weight or increase appetite. We observed that where the Chef pleasantly presented a pureed meal, the carers tend to mix it all together before serving it to the service users. Fruit juices and squash were served with lunch, which was served in the dinning room unless a service user requested to have their meals in their bedrooms. We observed care workers interacting in a friendly but dignified manner with service users during the lunch time, sitting down on the newly purchased stools beside service users and speaking to them whilst helping them with their lunches. Care Homes for Older People Page 17 of 29 Care Homes for Older People Page 18 of 29 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. The home has a satisfactory complaints policy and procedure and training in place that evidenced that service users and relatives concerns are listened to and acted upon. Robust Safeguarding adults policies are in place to protect the service users from abuse. Evidence: The AQAA informs that two Safeguarding concerns were investigated by Surrey Adults Safeguarding Team and records kept by the home on the day of the visit, revealed that they have been investigated and suitable actions were put into pace to prevent a repeat of the concern. The manager told us that since her appointment she has kept in touch with service users on a daily basis and issues raised are dealt with immediately; this reduces the incidents of formal complaints. Service users spoken to said they knew how to complain and will do so if they are not happy. Their complaint is always dealt with immediately and they were satisfied with the outcomes. The pre inspection questionnaire demonstrated that the majority of service users said they knew how to complain. The AQAA informs us that the home received eighteen complaints since the last key inspection and thirteen were upheld and responded to within the twenty-eight days as per the home’s policy. In total 88 of complaints received were resolved Care Homes for Older People Page 19 of 29 Evidence: within twenty-eight days in line with the homes policy on managing complaints. The manager told us she has completed the Safeguarding Adults training in her previous role, but is conscious of the fact that Surrey is different and that she has made initial contact with Surrey County Council, asking for a place on the Surrey Multi-agency Safeguarding course as soon as a place is available. It was noted that the home received a number of compliments from relatives of service users commending the staff on their kindness and understanding and for the high quality of work they perform. A copy of the most recent CSCI report was not made available in reception for visitors to the home. An immediate requirement was made to rectify this and it was immediately complied with. In discussion with care workers, it was apparent they are aware of the homes policy and procedure on Safeguarding Adults and felt secure in the knowledge that if they had to use the whistle blowing procedure the manager and the Owners of the home would support them. During discussion with care workers it became apparent they had a good knowledge on Equality and Diversity issues relating to the service users they were responsible for. A random sample of care workers training record demonstrated that care workers are being trained to undertake the duties of meeting the service users assessed needs, thereby protecting them from abuse. Care Homes for Older People Page 20 of 29 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 physical design and layout of the home enables service users to live in a comfortable environment, which encourages independence, and protect their privacy and dignity. Evidence: We observed that decorators were working on the ground floor of the home on the day of the visit and we were told they plan to have the complete home re-decorated. The manager, who is very new in post, told us that the management and staff encourage service users to see the home as their own home. It presents as a comfortable but in need of refurbishment and updating home, which has the specialist adaptations needed to meet the service users needs and were serviced and records kept verifying this. Some service users told us in the pre inspection questionnaires recently the cleaning of the home has been spasmodic and not regular enough. At times dust is visible on furniture surfaces. In discussion with the manager she acknowledged that this could well be true as records show for a short period they encountered lack of domestic staff due to illness and annual leave. However, this was remedied as soon as possible and that she apologised to service users for this shortcoming even though this happened prior to her taking the post as manager for the home. Care Homes for Older People Page 21 of 29 Evidence: The home has attractive gardens, which are well maintained and there is good access to the gardens from various parts of the home. It was noted that service users were able to personalise their bedrooms with small items of furniture, paintings on the wall and many family photographs. We observed that a number of toilets on the ground were left dirty for the cleaners to make clean. In discussion with the manager we emphasised the need for all staff to work together as a team and to ensure that toilets in particular are left in a satisfactory state for the use of the next service user. Generally, the home presents as clean, safe, worn and tiried, mostly hygienic, tidy and free from offensive odours except in one sluice. Random review of care workers training record demonstrated they have had training in infection control and this was evident in the storage of waste. In discussion with the manager we were told she has had meetings with heads of all department to ensure the home works to one goal that is to maintain the health and safety of all service users. A recommendation of good practice was made for this outcome group. Care Homes for Older People Page 22 of 29 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. Staff in the home are trained, skilled and in sufficient numbers to fulfil the aims of the home and meet the changing needs of the service users. Service users are well supported by a staff team that recognises and responds appropriately to their diverse needs. Evidence: Review of the staff rota demonstrated the number and grade of staff on duty to provide care and attention to service users for any twenty-four period was sufficient to meet the assessed care needs of the service users. Where staffing levels are low other staff members or agency staff covered shifts. The home has a programme of planned training in place and we were told all members of staff have an individual training record this was verified by the randomly reviewed staff folders audited. The AQAA informs over 20 of care workers have obtained the National Vocation Qualification at Level 2 (NVQ L2) and in discussion with care workers on the day of the visit some told us they had NVQ L2 qualification or were in the process of doing the course and this was evidenced in the random sample of files reviewed. We were told both Registered Nurses and Care workers are encouraged and enabled to Care Homes for Older People Page 23 of 29 Evidence: undertake developmental training as well as the mandatory training and according to the AQAA, constant review of the homes training matrix ensures staff receive up to date training and this was verified during review of the homes training records and care workers files reviewed. All newly appointed staff undertakes an induction programme as recorded and documented in their personal files. The home ensures that staff undertakes the mandatory training with yearly updates as necessary to maintain their competency to fulfil their duties. This was evidenced through discussion with the manager and care workers and from review of care workers training records Random sampling of care workers file demonstrated the homes recruitment processes are in line with the Care Homes Regulations 2001 Schedule 2 whereby all care workers are Criminal Records Bureau, (CRB) and Protection of Vulnerable Adults (POVA) checked prior to commencing employment, and two written satisfactory references are obtained. Staff files sampled contained the required work history. Care workers are in receipt of terms and conditions of employment as evidenced in their randomly selected files. A review of randomly selected Registered Nurses Personal Identification Numbers (PIN) verified current registration with the Nursing and Midwifery council. We were told that supervision records were up to date and this was verified during random sampling of care workers files. In discussion with care workers some were able to give examples of how the home applied equality and diversity to the different needs and wishes of the service users in their care, and also within the diverse staff group. Staff files contained their up to date training records and it was noted that Equality and Diversity training was done. Service users told us staffing levels are beginning to increase with the new manager but it is early days. Relatives told us staff appears to be rushed all the time and do not appear to have time to talk with service users. One told us my relative have communication problems which makes it even more difficult when dealing with some of the non-English-speaking staff. On the day of the visit all staff spoken to were able to understand and respond in English. Care Homes for Older People Page 24 of 29 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 manager supported by Heads of departments manages the home and works to continuously to improve services and provide an increased quality of life for the service users. There is a strong ethos of being transparent and open in all areas of running the home. The views of service users and their relatives are actively sought in the running of the home and The service provides training on health and safety issues for all staff and service users are involved in the running of the home. Service users financial interests are safeguarded. Evidence: The newly appointed manager is a registered nurse; with many years experience of managing care homes for older people. She has compled the Registered managers Award. She has had experience in dealing with safeguarding issues in her previous job, but is not experienced in using the Surrey multi-agency safeguarding policy. She told Care Homes for Older People Page 25 of 29 Evidence: us she has made contact with Surrey County Council for a place on the next available course. The manager has demonstrated that she has kept herself updated on issues relating to care of the service users and staff in her charge. In discussion, it was evident she was knowledgeable about the training needs of the care workers to meet identified needs of the service users. There are clear lines of accountability within the home, each member of staff spoken to on the day of inspection aware of their role and responsibilities. We were told that regular residents meetings are arranged and minutes of the meetings are passed to the owners who will action requests as soon as possible. The home does not become involved in service users finance except for service users spending money, which the home oversees. Receipts are kept and logged for all transaction carried out on behalf of service users. Review of documented records demonstrated that health and safety checks are routinely carried out at the home. All equipment examined on the day was properly maintained. Random sample of care workers training files demonstrated that up to date and relevant training were carried out by care workers to protect service users health, welfare and safety. In discussion with care workers they discussed their understanding and implementation of appropriate procedures to safeguard service users. Further more they spoke about their understanding of promoting safe working practices based on their health and safety training. The AQAA stated that equipment necessary for the care of service users are serviced and records kept. In discussion with the managers she was able to evidence this. Care Homes for Older People Page 26 of 29 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 27 of 29 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 16 To replace the worn recliner armchair in Lounge 2. To reduce the possibility of injury due to misalignment of service users hip whilst using the armchair 14/01/2009 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 19 To ensure good team work is practiced by all staff and toilets are left clean after being used by each service user. Care Homes for Older People Page 28 of 29 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. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!