Inspection on 12/02/09 for Nova House

This inspection was carried out on 12th February 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Nova House 19/03/07

Nova House 24/01/06

Nova House 26/08/05

Nova House 08/02/05

Nova House 28/07/04

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 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Nova House Belgrave Road Seaford East Sussex BN25 2EG     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: Melanie Freeman     Date: 1 2 0 2 2 0 0 9 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. that people have said are important to them: They reflect the things 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 © (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 31 Information about the care home Name of care home: Address: Nova House Belgrave Road Seaford East Sussex BN25 2EG 01323896629 01323898332 dmham@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Seaford Homes Ltd Name of registered manager (if applicable) Mrs Roberta Rutherford Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 20. The registered person may provide the following category/ies 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: Old age, not falling within any other category (OP) . Date of last inspection Brief description of the care home Nova House is a care home registered for up to twenty older people. The home is a converted large detached house situated in a residential area of Seaford. It is located within a short journey of the seafront and town centre amenities. The home is furnished and decorated to a high standard. The accommodation comprises of nineteen (19) single rooms with twelve (12) of these providing en-suite facilities. The home is presented across three floors with a passenger lift to the first Care Homes for Older People Page 4 of 31 care home 20 Over 65 20 0 Brief description of the care home floor. There is also a chair lift. There is a large lounge with a separate dining room, both with views out to a well-maintained rear garden. The homes literature states that it aims to provide a Home from Home and provide an environment where residents can choose their own lifestyles. The fees for residential care are currently 1,720 to 2,236 pounds per month, depending on the services and facilities provided. Extra such as: newspapers, hairdressing, chiropody and toiletries are additional costs. 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: The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001, uses the term service user to describe those living in care home settings. For the purpose of this report, those living at Nova House will be referred to as residents. This was a key inspection that included an unannounced visit to the home on Thursday 12th February 2009, and follow up contact with a visiting health care professional. The allocated inspector spent approximately seven hours in the home and was able to discuss matters with the manager who received the inspection feedback at the conclusion of the visit. Care Homes for Older People Page 6 of 31 A tour of the premises was undertaken and a range of documentation was reviewed including the homes statement of purpose and service users guide, pre admission assessment procedures, the systems in place for handling complaints and protecting residents from harm, staff recruitment files, quality assurance systems and some health and safety records. The care documentation pertaining to three residents were reviewed in depth and the inspector ate a midday meal with a group of residents in the dining room. Comments shared by residents and their representatives during the inspection process included I am very happy and well looked after at Nova House. It was a wrench to leave my home and things were difficult at first but the staff are all so helpful and supportive and now 18 months on I am happy and settled and would not want to be anywhere else A lovely lady called Lynn always arranges activities for us to take part in from games to crafts Nothing is too much trouble they all deserve medals. At the time of compiling the report, in support of the visit, the Commission received survey forms about the service from four residents, and one staff member. The required Annual Quality Assurance Assessment (AQAA) was completed by the appointed manager and returned when requested and was used to inform this inspection report. What the care home does well: What has improved since the last inspection? What they could do better: The admission process needs to be improved to include written confirmation that the care home is suitable for the purpose of meeting the prospective residents health and welfare needs. This will ensure that decisions around admission to the home are informed and evidenced and enable propective residents to make an informed choice about their admission to the home. The individual plans of care need to reflect a person centred approach to care and to clearly record peoples care needs and how these are to be met. These should reflect peoples choices,preferences and need to be written in consultation with the resident or their representative and take into account relevant risk assessments. This will ensure that staff are given clear guidelines on how to meet peoples needs in an individual way and in a way that takes into account peoples choices and preferences. The registered person needs to ensure suitable procedures are in place for staff to follow on all aspects of medicine handling, to ensure staff always adminsiter and store medicines in a safe way. The registered person must ensure that all staff have a clear understanding of all safeguarding vulnerable adults issues and are suitably trained in how to recognise and respond to any suspicion or allegation of abuse. This will ensure that residents are not put at risk of harm and abuse. The registered person needs to implement clear procedures for the prevention of infection control and ensure staff adhere to them. This will ensure that staff promote high practice of infection control when working in the home. Care Homes for Older People Page 8 of 31 The registered person needs to operate a thorough recruitment procedure that ensures the fitness of people who work in the home. This should include the use of a thorough application form that records all previouse employment, and the retention of all the required documentation. The registered person must ensure that all staff receive suitable training to ensure that they are appropriately qualified and competent and have the skills to meet all the needs of residents in the home. This will ensure that care is appropriate care is provided to residents in a safe way. A suitable quality monitoring system needs to be maintained to ensure that the service is run in a way that responds to residents and their representatives views and continues to evolve and improve the service in response to information gained. Suitable arrangements need to be adopted to promote residents and staff health and safety. This should include appropriate staff training, suitable environmental risk assessments and thorough safety examinations on all lifting equipment. This will ensure that resident and staff are as safe as possible. 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. Prospective residents receive sufficient information on the home to enable them to make an informed decision over whether the home is the right place for them. All prospective residents are assessed by the manager to ensure that staff have sufficient skills and training to enable the home to meet residents needs. Evidence: The home has a combined statement of purpose and service users guide that has been reviewed with the change of ownership. A copy of an updated version was available on request from the manager. The last inspection report was not available on request, and needs to be readily available at all times with reference to its location being made within the statement of purpose/service users guide. Surveys received indicated that residents were aware of the contract arrangements and were involved in the decision to move into Nova House. The AQAA recorded that all prospective residents and their representatives are initially provided with a brochure of the home Care Homes for Older People Page 11 of 31 Evidence: and invited to visit the home, when details of the home and service can be discussed. Once a resident is admitted to the home a copy of the statement of purpose/service users guide is given to them to keep. An assessment of the admission process included a review of the documentation used in respect of the last two admissions to the home. This demonstrated that all prospective residents are assessed prior to admission by either the manager or one of the two deputy managers. This assessment can either take place in the care home during a pre-admission visit, or in the hospital or the prospective residents own home. The assessment documentation used is based on a dependency score tool and although covers key assessment areas the level of information is limited, and should be more comprehensive and record where the assessment was completed and who else was involved in the assessment process. The AQAA recorded that documentation relating to family history is important and should be gathered early to improve communication and interaction with a prospective resident, relatives and the carer. The home plans to develop ways that they can gather and record this information in consultation with the prospective resident and their relatives. Although prospective residents and their representatives are told verbally if the home is able to meet their needs following their assessment, this is not currently confirmed in writing. This was discussed with the manager who confirmed that she would discuss this matter with the new home owners. Intermediate or rehabilitative care is not provided at Nova House. 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. The home was found to be meeting residents health and general needs with assessed additional community support when needed, however residents specific care needs, choices and preferences are not reflected in a plan of care. On the whole the homes practice ensure residents medicines are administered safely. Care is delivered in such a way that promotes and protects the residents privacy, dignity and individuality. Evidence: The care documentation pertaining to two residents were reviewed in depth as part of the inspection process and each of these residents were seen during the inspection visit to the home. Although there was evidence within the care documentation that an in depth assessment process had been completed plans of care had not been generated on all areas of care, to give staff clear guidance on how to care for each resident in an individual way. An example of this is the lack of any personal care guidelines and the lack of any reference to residents likes and choices. In addition one Care Homes for Older People Page 13 of 31 Evidence: resident was very slight and needed her nutritional status monitoring, this was not recorded. These shortfalls were discussed with the manager along with the need to provide individual plans of care for each resident based on the assessments, to provide clear guidelines for each area of care covering personal, social and psychological care needs. Some routine risks assessments are completed and take into account residents personal environment. Nutritional screening is not completed and the manager advised that the use of these is being considered and are to be implemented. It was recommended that the manager sourced a dietitian to advise on a suitable screening tool and to access some staff training on recognising the nutritional needs of residents and responding to them appropriately. This should include how to fortify foods in order to maintain a healthy weight for people living in the home. Records confirmed regular contact with GPs and other health care professionals that support the home in providing a high level of care to residents. A community nurse contacted confirmed that the home provided a good standard of care and responded to any advice and instruction given to them. Despite the lack of clear documentation the care provided at Nova House is individualised with staff knowing the residents well, and responding to their health and personal care needs. Observation during inspection confirmed that residents care is tailored promoting a level of independence and decision making. All feedback about the care provided was positive and comments received included I am very happy and well looked after at Nova House. It was a wrench to leave my home and things were difficult at first but the staff are all so helpful and supportive and now 18 months on I am happy and settled and would not want to be anywhere else.I am well looked after here the care given here is very good. Medicines are stored in locked cupboards and are dispensed from the pharmacist in a Monitored Dosage System. The Medicine Administration Records (MAR) charts evidenced that on the whole medicines are administered safely and in accordance with prescriptions. It was however noted that when medicines are omitted staff do not record accurately the reason for this omission. Those medicines prescribed an an a required basis individual guidelines need to be written to ensure staff administer these in a consistent way. Suitable procedures to cover all areas of the safe handling of medicines were not in place and these need to be put in place for staff to follow to ensure best practice is Care Homes for Older People Page 14 of 31 Evidence: followed at all times. A record of signatures for those staff able to administer medicines used for audit purposes was not available in the home and the manager said that this would be supplied. The current Controlled Drugs storage arrangements are not adequate and need to be improved to ensure when any Controlled Drug is brought into the home they are stored in accordance with current legislation. The manager acknowledged this shortfall and agreed to address the storage facilities. Further information on this matter is available on the CSCI Internet within the guidance document The safe management of controlled drugs in care homes. The supplying pharmacist visits the home to give advice and the manger has arranged a further visit to address issues raised at this inspection visit. Throughout the day in the home staff were pleasant and kind to residents and responded to them as equal adults. Staff were seen to be respectful and considerate towards residents and when spoken to they said that they were treated with respect, and that their privacy is upheld. Staff were observed to knock on bedrooms doors before entering. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a relaxed atmosphere where some activity is supplied and residents are supported in maintaining relationships with their families and friends. Residents choices are well respected and the food provided at midday is both appetising and wholesome and served in a way that promotes social interaction. Residents would benefit from more variety and choice with regard to breakfasts and evening meals. Evidence: Nova House has a relaxed feeling with residents able to spend time around the home as they wish. The AQAA recorded that an activities person is employed to work in the home. The service users guide confirmed this and recorded that she comes to the home three times a week providing music to movement, some individual activity like scrabble and some social outings. At the time of this visit there was no activities in the home and there was no evidence that residents had been asked about what they enjoyed doing or wanted to be involved in. This needs to be assessed as part of the care documentation. Surveys completed indicated that residents appreciated the Care Homes for Older People Page 16 of 31 Evidence: activities provided recording A lovely lady called Lynn always arranges activities for us to take part in from games to crafts I enjoy the activities as I have always been active. Some residents spoken to however said that there was not much to do along with one survey saying further entertainment would be good some visiting entertainment and singing etc. Interaction with staff is very important to the residents and this was seen to be positive and proactive. Visitors are very much encouraged and are able to stay for lunch if they want. The home is located very close to a church and residents said that they can attend church if they wish. Some residents attend regularly and are supported by staff to do this. A meal was eaten with all the residents apart from two who stayed in their rooms for lunch. The meal was displayed on the blackboard in the dining room and residents said that they were always given a choice of meal. Surveys received recorded the following comments on the food provision a very good cook at the home variety of foods, healthy and nutritional All my food is lovely meals are very good well presented but I am unfortunately a very hard person to feed and so many foods I do not eat. The meal on the day of the inspection visit included gammon parsley sauce sauteed potatoes and other roasted vegetables. It was well received by residents who said that they enjoyed it and that the midday meal was always good. One residents identified that her breakfast was always the same and that a cooked breakfast would be nice occasionally, other residents agreed with this view. These comments were shared with the manager. The dining room provides a pleasant environment for residents to eat and each table is laid with a linen table cloth, flowers and condiments. Discussion with staff identified that staff do not have an understanding of fortifying food and further training needs to be provided on this matter to ensure residents are helped in maintaining a healthy weight. The manager has confirmed that the kitchen has retained a clean food award for the third year. Care Homes for Older People Page 17 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. People are confident that any complaint made would be listened to and responded to appropriately. The managers overview of the home would ensure that any safeguarding issue raised would be responded to quickly and appropriately. Evidence: A clear complaints procedure is in place and displayed within the entrance area of the home. The surveys received confirmed that people knew how to complain and would if they needed to. Recorded comments within the surveys included I do not have any complaints I would speak to Bobby the matron. The manager maintains a complaints record and only one formal complaint has been made since the last inspection. Although this complaint has been responded to clearer and fuller records need to be maintained. Clear records demonstrated that a complaint has been dealt with fully and can be used to provide evidence if any relating concern is raised in the future. This was raised with with manager for her to address. There are written policies covering adult protection and whistle blowing. These need to be updated to accurately reflect the new local policies and procedures on Safeguarding Vulnerable Adults. Discussion also identified that all staff need to attend relevant staff training, as this has not been provided for the past two years. Care Homes for Older People Page 18 of 31 Evidence: Staff recruitment files confirmed that staff have a POVA check completed along with a Criminal Records Bureau check (CRB). Care Homes for Older People Page 19 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from living in a homely, clean, well maintained and decorated environment. Residents bedrooms are decorated and furnished to a high standard and in accordance with their individual preferences and needs. Although very clean further attention needs to be given with regard to infection control practice in some areas. Evidence: The home is a converted and extended domestic dwelling located in a residential area on the outskirts of Seaford. The environment is very attractive and the furnishing and fittings are welcoming and very attractive giving a hotel style. The communal space is found on the ground floor and consists of a large lounge dining room, which overlooks a well maintained front garden. There is also a small rear courtyard, which a resident said is nice to sit out in the summer. All areas in the home were found to be clean and residents rooms were attractive and personalised. Residents spoken to said how much they liked their own rooms. The manager reported that bedroom doors are fitted with appropriate locks but that no residents have requested a key. She also reported that a lockable facility is provided in each bedroom to facilitate the safe storage of personal items. There are varied bathing facilities some of which are assisted. One of the ground floor Care Homes for Older People Page 20 of 31 Evidence: bathrooms is not used and the possibility of converting this into an assisted shower was discussed with the manager. On talking to residents it was clear that bathing is rather routine led one resident said that she missed her day for bathing and so was not able to have a bath. Improved facilities and a more flexible approach to bathing now needs to be adopted and this was raised with the manager for her to address. During the inspection it was noted that bars of soap were in the communal bathing areas. The risk of cross infection with the use of soaps in this way was highlighted to the manager who agreed to remove them and ensure soaps are only used for one person. There is a range of individual aids and adaptations to assist residents mobility and independence, including raised toilet seats, assisted baths, walking aids and grab rails. A passenger lift and chair lift are available to aid the access to the floors above ground level. The laundry is located in the basement and includes a washing machine and a drier. During the visit it was noted that dirty linen was waiting on the floor waiting to be put into the washing machine. It was also noted that the laundry flooring needs to be repaired to ensure an impermeable surface suitable for effective cleaning. The home has the most recent guidelines on infection control in care homes, and now needs to use these to ensure suitable procedures are in place with regard to infection control throughout the home. Care Homes for Older People Page 21 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing numbers and skill mix provides well-motivated staff team that meets residents health and personal care needs. Staff training needs to be improved and structured to ensure staff have the appropriate skills to care for all residents safely. Recruitment practice needs to be improved to ensure residents are protected. Evidence: At the time of this assessment visit 19 residents were living at Nova House. Staffing arrangements provide three carers working in the morning with two working in the afternoon and evening up to 10 pm. There is one carer working at night. The manager also works in the home weekdays and cleaning and catering staff are employed in addition. The manager confirmed that extra staff are provided if the dependency of residents increases, and that she or one of her deputies are on call at all times, and available to come to the home in the case of an emergency.She feels that the staffing provision is adequate and able to meet the current needs of residents living in the home. Surveys indicated that the home was short of staff at times but residents during the Care Homes for Older People Page 22 of 31 Evidence: inspection visit said that when they rang for assistance staff were always available and they felt that there were enough staff to look after them. They also said that all the staff on days and nights were very nice. All other feedback received about the staff working in the home was very positive and comments received included Nothing is too much trouble they all deserve medals. The recruitment files pertaining to three staff were reviewed as part of the inspection process and identified some shortfalls. The application was very short and did not include a full employment history. There was a limited health check and evidence of employees identity was not retained in the home including a photograph. References were sourced and the required Criminal Records Bureau (CRB) and POVA checks were however completed. Job descriptions and terms and conditions of employment were not available and the manager said that these were being reviewed and updated by the new owners of the home. All identified shortfalls were raised with the manager who was asked to address all the employment records to ensure all required information is retained in the home. The AQAA recorded that an induction training is completed by all new staff employed. The manager was able to advise that over 50 of care staff have achieved and National Vocational Qualification in care level 2 or above. The staff survey received complemented the training provided, however the records available within the home identified that the staff training was not sufficient to ensure staff had the relevant skills to meet residents needs in a safe way. The manager was aware that the current training arrangements were not adequate and she said that she had been discussing ways of establishing a training programme with the new owners including the possibility of a training co-ordinator to arrange and record all training. Care Homes for Older People Page 23 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. Residents benefit from an experienced and established manager who ensures a clear ethos and values of the home that enables staff to provide good quality care to residents. Quality assurance processes need to be established to ensure that the Home is well run and in the best interests of residents. Residents financial interests are safeguarded. The health, safety and welfare of residents and staff are generally promoted although staff training and regular safety checks in the home need to be maintained. Evidence: The manager has been in post since 1997 and is a registered nurse, she is well respected by staff and has an excellent rapport with residents that she has regular contact with. The home was purchased in February 2008 and although the Care Homes for Older People Page 24 of 31 Evidence: management structure within the home has not been changed the input from the owners has changed with less management support being provided. The manager however did confirm that the responsible individual visited the home at least every three weeks, and she is able to purchase what she wants for the home. Since the change of ownership there have been no quality monitoring completed and only two of the required monthly reports have been completed by the new owners. Although the manager has completed the AQAA as requested this was not used to audit the service accurately, and was therefore not a useful quality monitoring tool. The home holds small amounts of money for some residents in a secure way. A selection of these individual holdings were checked and found to be accurate. There was no procedure to underpin the practice in the home and the use of receipts needs to be formalised to protect staff and residents monies. The manager advised that she would ensure suitable procedures are adopted. The AQAA recorded that the policies and procedures are in place and are up to date and that all the necessary safety checks have been completed. It was however noted that thorough environmental risk assessments are not completed routinely and although the passenger and chair lift are serviced there was no evidence that they had been thoroughly examined in accordance with health and safety legislation. Following the inspection visit the responsible individual aknowledged the shortfalls in respect of environmental risk assessments and safety checks, and confirmed that they would be adressed as a priority. Care Homes for Older People Page 25 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 26 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 3 14 Prospective residents must be provided with written confirmation that the care home is suitable for the purpose of meeting their health and welfare needs. This will ensure that decisions around admission to the home, are informed and evidenced. Enabling prospective residents to make an informed choice about their admission to the home. That individual plans of care providing specific guidance on person centered care to cover the health, personal, psychological and social care needs of each resident are devised. These should reflect peoples choices,preferences and need to be written in consultation with the resident or their representative. Taking into 06/04/2009 2 7 15 01/06/2009 Care Homes for Older People Page 27 of 31 account relevant risk assessments. This will ensure that staff are given clear guidelines on how to meet peoples needs in an individual way, and in a way that takes into account peoples choices, and preferences. 3 9 13 The registered person needs 01/05/2009 to ensure suitable procedures are in place for staff to follow on all aspects of medicine handling, and that all staff have received thorough training on these and adhere to them. This will ensure staff have clear guidance to follow and ensure consistent and safe handling of medicines. The registered person must ensure that all staff have a clear understanding of all safeguarding vulnerable adults issues and are suitable trained in how to recognise and respond to any suspicion or allegation of abuse. This will ensure that residents are not put at risk of harm and abuse. 06/04/2009 4 18 13 5 26 13 The registered person needs 01/05/2009 to implement clear procedures for the prevention of infection control, and ensure staff adhere to them. These need to address the use of soap Care Homes for Older People Page 28 of 31 ensuring they are used for one person only and the laundering of any linen and clothes. This will ensure that staff promote a high practice of infection control when working in the home. 6 29 19 That the registered person 06/04/2009 operates a thorough recruitment procedure that ensures the fitness of people who work in the home. This should include the use of a thorough application form that records all previous employment, and the retention of all the required documentation. This will ensure that any staff employed are fit to be employed within the home. 7 30 18 The registered person must ensure that all staff receive suitable training to ensure that they are appropriately qualified and competent, and have the skills to meet all the needs of residents in the home. This will ensure that care is appropriate, and care is provided to residents in a safe way. 8 33 24 That a suitable quality monitoring system is maintained to ensure residents and their representatives views are 01/05/2009 01/05/2009 Care Homes for Older People Page 29 of 31 taken into account. Demonstrating ongoing review and improvement to the quality of care and services in the home. This will ensure the registered provider reviews the quality of the homes service, and can continue to evolve and improve the service in response to information gained. 9 38 13 That suitable arrangements are put in place to promote residents and staff health and safety. This should include appropriate staff training, suitable environmental risk assessments, and thorough safety examinations on all lifting equipment. This will ensure that residents and staff are as safe as possible. 06/04/2009 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 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 © (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. 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