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Please note that the information on this website is now out of date.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 07/01/09 for Old Village School Nursing Home

Also see our care home review for Old Village School Nursing Home for more information

This inspection was carried out on 7th January 2009.

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.

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

People liked living at the home, one resident said to us, "there is nothing that I can think of that is wrong", and another said, "Everyone is so kind, it is a lovely place to be". The home ensured that prospective residents were fully assessed prior to moving in. This meant that any additional equipment could be sourced and all staff were aware of the care needs of a prospective resident. The home was well organised in the way it was run, and the staff team made sure that peoples health needs were looked after. The nurses kept updated with training. Training was considered to be very important at the home. The owner and the manager were accessible to staff, residents and relatives and would address any concerns immediately. Visitors were welcomed at any time. One visitor told us they he looked forward to his visit to his mother because everyone was so friendly and welcoming. People told us they enjoyed the food, one person said, "it is always good but sometimes better than others". The home had a range of equipment suitable for caring for people with complex needs. There was positive interactions between staff, residents and visitors . Staff were treating residents respectfully and offering personal choices when delivering care. Care plans were written in detail and promoted continuity of care in a person centred way. A local GP visited twice a week. The complaints procedure was accessible to everyone living in the home. Staff working at the home understood the procedures for safeguarding, and knew when and to whom to report incidents. The manager demonstrated a clear vision for the service. She was dedicated to the Old Village School and worked with the staff team to make continuous improvements to promote the health, safety and welfare of the residents.

What has improved since the last inspection?

There were no requirements made at the last inspection but the manager and the owner had a vision for the home and continued to make improvements. The benefits of the training manager were clearly visible in the training records and in the delivery of care.

What the care home could do better:

There were no requirements made as a result of this inspection but the manager was advised to ensure that the systems in place for recoding medication made it as easy as possible for the registered person to reconcile the medications in the home as part ofany audit of medication.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Old Village School Nursing Home Bedford Road Marston Moretaine Bedfordshire MK43 0ND     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: Sally Snelson     Date: 0 8 0 1 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. 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 Adults (18-65 years) 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 Adults (18-65 years) 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 Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Old Village School Nursing Home Bedford Road Marston Moretaine Bedfordshire MK43 0ND 01234768001 01234767693 oldvillageschool@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Old Village Care Limited care home 60 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home The Old Village School Nursing Home comprises of three units, two of these are located in a building attached to the original home by a partially covered corridor. There are plans for alterations to join the two buildings, and in the process completely cover the walk way, and reduce the number of shared rooms in the older building. The two units in the newer building provide care for younger adults with physical disabilities and complex healthcare needs, and the unit in the original converted schoolhouse accommodates older adults with nursing care needs. The newer building is purpose built and the accommodation is over two floors in separate units with passenger lift access. The rooms are all single occupancy and they all have en suites. The accommodation in the schoolhouse is all on the ground floor and there are three shared occupancy rooms with screening, and three rooms with en suite facilities. The home is in Marston Mortaine, which is situated between Bedford and Milton Keynes with good road links to both towns and easy access to the M1 motorway. There are garden areas and parking is available to the rear. The following information about fees Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 20 40 0 40 Brief description of the care home was obtained on 16th January 2009: - Lowest fee, £539.32 Highest fee, £1432 Items not covered by the fee include hairdressing, chiropody and aromatherapy. Further information about this home is available by phoning, emailing, or visiting the home. Care Homes for Adults (18-65 years) 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was carried out in accordance with the Commission for Social Care Inspections (CSCI) policy and methodologies, which requires review of the key standards for the provision of a care home for younger adults and older people. The methodology that takes account of residents views and information received about the service since the last inspection. Information from the home, through written evidence in the form of an Annual Quality Assurance Assessment (AQAA) has also been used to assess the outcomes within each standard. Evidence used and judgements made within the main body of the report include information from this visit. Sally Snelson undertook this inspection of the Old Village School. It was a key inspection, was unannounced, and took place over parts of two days from 09.30hrs on Care Homes for Adults (18-65 years) Page 6 of 30 the 7th January 2009. The home provided care for older people and younger adults with a variety of complex physical needs. There were more people under the age of 65 years living at the home, so this report has been completed on a younger adult template. The inspection spanned two days in order for the separate areas of the home to be inspected independently. The home was divided into three areas for operational purposes. Knebworth and Woburn were in the new building and mainly cared for those residents under 65 years, and Old school, as the name suggested, was in the old school building and most of the people living there were over 65 years of age. Mrs Badiaini the owner, and Alice McCauley the manager were present for the inspection. Feedback was given throughout the inspection, and at the end. During the inspection the care of six people who use the service (residents) was case tracked in detail. This involved reading their records and comparing what was documented to what was provided. In addition to sampling files, people who lived at the home, visitors, and staff were spoken to, and their opinions sought. Any comments received from staff or residents about their views of the home, plus all the information gathered on the day was used to form a judgement about the service. We would like to thank all those involved for there assistance with the inspection. What the care home does well: What has improved since the last inspection? What they could do better: There were no requirements made as a result of this inspection but the manager was advised to ensure that the systems in place for recoding medication made it as easy as possible for the registered person to reconcile the medications in the home as part of Care Homes for Adults (18-65 years) Page 8 of 30 any audit of medication. 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 Adults (18-65 years) Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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. There was clear evidence that the manager, or a nurse, would assess any prospective resident before offering them a place at the Old Village School. This ensured that the staff team had sufficient experience and training to provide the necessary care, and that the home had, or could, access any additional equipment or training they needed in advance of the admission. Evidence: The home had a statement of purpose that covered all the areas required by the National Minimum Standards. There was a Service Users Guide available and prospective resident were sent an information and welcome pack for new residents and relatives. These documents outlined what the home provided, and information about any additional costs, such as hairdressing and chiropody costs. In order to ensure the reader that the information was most current, these documents would benefit from a record as to when they had been updated or reviewed. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: All of the people using the service whose care we tracked, had been assessed by the manager, or a nurse from the home, before moving in. The assessments were in detail and where information was given by the hospital, or another home, the person supplying the information was also asked to sign the document to confirm it was correct. During the inspection we witnessed staff ensuring that a specialist bed was available before an admission was agreed. This showed that staff understood the importance of pre-admission assessments. Residents spoken with confirmed that they, or someone on their behalf had visited the home prior to them moving in. The home had had new contracts drawn up by their solicitor. These clearly indicated the fees and how the fee was broken down into accommodation, nursing and personal care costs and who was responsible for what cost. All residents whether private, partially, or fully funded were asked to sign the contract of terms and conditions of residency. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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. Wherever possible people using the service were consulted about the care they received. Care plans were written for all aspects of the care provided. Evidence: Each of the people using the service had plans of care. Where possible the plans had been agreed by the resident, or by a relative on their behalf. The care plans were well set out, and gave clear guidance to staff about the care and support required by the resident. Care plans were reviewed monthly in all units (for those people under the age of 65 years the regulation does not require the review to be so frequent, but this is obviously good practise and avoids confusion). We also noted that where changes were made to the plan of care these were clearly recorded, and that when an episode of care was complete, the documentation to support the discontinuation of care, was also clear. All aspects of the individual care of the residents were incorporated within the care Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: plans and where problems were identified risk assessments had been carried out. For example a resident who was at risk of weight increase had clear instructions about how she could be supported to prevent this. In this section of her care plan were monthly weight records, nutritional assessments and any other documentation relating to nutrition. The risk assessments provided guidance for staff on how to identify the triggers to problem behaviours, and should they present themselves, gave clear instruction on how to respond and de-escalate or manage the behaviour. Any restrictions considered necessary for the safety of the individual, or others, was recorded within the documentation, and where necessary an agreement for a restriction was in place. For example a resident, or a relative on a residents behalf, was requested to sign to agree the use of bed rails. Staff completed detailed daily logs. Throughout the day they recorded exactly what residents were doing, and their condition. We saw staff sitting with residents as they completed these details and explaining to the resident what they were writing. This informs the resident and gives them the opportunity to challenge their plan of care. In all areas of the home the staff supported residents, in a respectful manner that recognised the residents skills to be as independent as possible. There was a homely atmosphere within the home, the residents were relaxed and friendly with each other and the staff. We saw that the activity co-ordinator organised residents meeting. The minutes from these meetings were taken to the next staff meeting to be addressed. By looking at the minutes of staff meetings we were able to see how some decision making jointly involved the people using the service, and the staff. It appeared that food and meals were discussed regularly, giving people the opportunity to influence the menu planning process. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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. A variety of activities were organised that helped to keep the people living at Old Village School interested and stimulated. Evidence: As already mentioned the home was divided into three for operational purposes. There were three activity co-ordinators employed to be responsible for planning the activity programme for each area of the home. The activity programmes were planned to suit the needs and expectations of the individual groups, however it was possible for residents from one area of the home to join another group if they wished to take part in their activity programme. The activity programme included a range of group activities and individual one to one time. The activity co-ordinators all worked flexible hours and would plan day time and evening Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: events according to needs. One relative surveyed told us,the activity lady has helped my mum in her room when she has been too unwell or not able to join other residents in the lounge. Following an activity the co-ordinator wrote in the care record how the activity had been received by the person using the service. The activity co-ordinator also spent time looking at the life history of the person living at Old Village School. One resident was particularly happy to be living at the school where her father had been a teacher. Many of the resident were from the local area and it was noted that visitors often knew many of the residents. Local church leaders visited and offered communion to those residents who wanted it. One of the residents we tracked enjoyed trips out of the home to do shopping, and have a meal out. Some of the younger residents attended day centres and some of the residents were supported to participate in home visits. For example staff visited a resident when he/she spent time with family, and administered an insulin injection so that the person did not need to return to the home before they were ready to do so. Visitors were welcomed in the home and could have a meal with their loved one. People on all the units told us that they could get up and go to bed when they wanted and that the homes routines were flexible to their needs. During the inspection we witnessed lunchtime on one unit. The meal arrived in a hotlock and was served up to the residents by the staff. There was a rolling menu plan and residents were offered a choice at each mealtime. On the day of the inspection the lunch choice was beef in ale casserole with a selection of fresh vegetables, or chicken and rice, followed by a strawberry flan. Pureed diets were served appropriately by keeping each food component separate. Where people using the service needed the assistance of staff at mealtimes this was given to them in a quiet unobtrusive way. Care Homes for Adults (18-65 years) Page 16 of 30 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was able to care for people with complex health needs and provided people using the service with good quality healthcare. Evidence: In each unit of the home we tracked one person with complex health needs and it was apparent that staff had the skills and experience to provide the necessary care. This will be discussed in full in the staffing section of this report. The home had good relationships with local family doctors; one of whom visited twice a week and made extra visits when necessary. During the inspection we witnessed the staff in one area having a unit meeting. At this meeting all staff from the unit met together to discuss each individual with the manager. The manager told us that she meets with the staff on each unit each week, and that from these discussions the staff team as a whole make changes to how care is delivered. The manager also received a daily progress chart from each unit that informed her of any significant changes to a persons care or condition. Other health care professionals also visited the home. These included dietitians, Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: therapists, specialist nurses, dentists, and opticians. The home had its own physiotherapy room. We noted that one specialist nurse had started her report about her visit with, It is good to see * being so well looked after. Staff should be commended for this, as this person would see alot of care services in the course of her work. Trained staff at the home had a good understanding of the needs of the people using the service and how their care should be delivered. The nurses were witnessed supporting and explaining conditions to care staff appropriately. Moving and handling equipment was available and being used during the inspection visit. The training manager ensured that staff were trained in the use of equipment, and she could suggest what equipment was necessary. The home also had the appropriate scales with which to weigh people in a wheelchairs. One person told us as part of a questionnaire, the nursing care has been excellent. There is attention to small detail that you rarely find in an acute setting nowadays, e.g. detailed updated, completed turning charts. We believe the person completing the form had a medical background. During this inspection we checked the Medication Administration Record (MAR) sheets for some of the residents. Medications were appropriately stored in a locked trolley. Monthly deliveries had been correctly signed into the home, but rather than using the MAR sheet to record the medications that arrived in the home, and those that were carried forward from the previous month, the home used a book. It was therefore difficult, but not impossible to reconcile all of the medications (whether provided in a blister pack or not). It would be expected that staff could easily reconcile medications at anytime, so consideration should be given to changing this procedure. Controlled drugs (CDs) were stored appropriately, and all administrations had been recorded accurately with two signatures in the CD register. There was evidence that staff spoke to residents and their families about end of life wishes. The home treated the person using the service holistically and involved the whole family. We witnessed the young family of a resident, who was very ill, being supported to visit and accept the situation. We were also told that the manager had been visited by the family of a resident who had passed away at the weekend, as they wanted to thank her for coming in on her day off and supporting them so sensitively through this time. Staff had been trained to use the Liverpool Care Pathway (LCP); this is a plan used at the end of life to ensure the residents receive the best care possible. Care Homes for Adults (18-65 years) Page 18 of 30 Care Homes for Adults (18-65 years) Page 19 of 30 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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 homes complaints procedure was robust. It ensured that people using the service had the opportunity to bring up any concerns with the manager in the first instance, but to take the complaint further if they wished to, or were not satisfied with the initial outcome. Evidence: The home had a clear complaints procedure and the manager told us that complaints were viewed positively as lessons could be learnt from them. There had been one complaint made to the home since the last inspection and this had been dealt with following the homes complaints procedure. Because all the documentation relating to a complaint was held together it was possible for us to see exactly how the investigation had taken place. In contrast to the one complaint there were numerous letters and cards thanking the staff team for the care they had provided. Throughout the home were saw notices reminding visitors that if they were unhappy about anything they should report it immediately. There had been a multi-agency protection meeting following the reporting of alleged abuse by a staff member to a resident. When senior staff had been made aware they had acted correctly by suspending a member of staff and reporting the incident to the local safeguarding team. All staff had had training to understand the different types of abuse and their responsibility in reporting anything they considered abuse. Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: The home encouraged either residents, or a family member on their behalf, to be responsible for financial affairs. The home would however hold small amounts of money on behalf of a resident. We sampled these and it was apparent that records and receipts were kept of all transactions. Care Homes for Adults (18-65 years) 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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. Old village school nursing home was clean, tidy and tastefully decorated and provided the people living there with a homely environment. Evidence: At the time of the inspection there were two distinct areas to the home. The twostorey new building, which had been erected in 1997, and the original old school. The new build was purpose built for people with physical disabilities and was light airy and had wide corridors. In contrast the original building had maintained the character of the old school. Although the two buildings were very close to each other the owner was aware of the benefit of completely joining the buildings and had planning permission to do this.Two maintenance men were employed at the home, and decoration and maintenance were ongoing and consequently the home was in good decorative order. In addition to communal lounges and dining rooms the home had office space, staff rooms and laundry facilities, kitchens, and a chill out area. On the whole each unit of the home was self-contained but staff and residents were seen moving about the home as necessary. Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: There was evidence that people could personalise their bedrooms, and that if people would prefer a different room this could be arranged as one became available. There was a variety of different bathing facilities available throughout the home. A team of housekeeping staff were employed, and the communal rooms and bedrooms seen during the inspection visit were clean and comfortable. As in many care homes there is limited storage areas and we did note that wheelchairs had to be stored in the lounge and that weighing scales were stored in the dining room. Care Homes for Adults (18-65 years) 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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. A variety of training was offered to all of staff to ensure that collectively, they had the skills and experience, to meet the needs of the people living at the home. Evidence: At the time of the inspection the manager was recruiting to the homes bank. The home had a good bank of staff that could be called upon for occasional shifts. As a consequence the home did not have to use agency staff very often. Some of the staff team were well established. The manager had worked at the home for over 20 years, she was supported by a sister on each unit, one of whom was her deputy. Staff were allocated to an area of the home and the staffing levels were sufficient to meet the needs of the residents in that area. The duty rota confirmed that there were two nurses and four carers on each unit during the morning, in addition to any staff who were detailed to provide one to one support or physiotherapy. The home employed a training officer, who was a nurse with a number of years experience in managing a care home and training. She was a train the trainer in moving and handling, safeguarding and dementia care and could deliver other training, but would also outsource specialist training. Staff spoke highly of the amount, and level, of training they received. The training officer kept detailed records of each individuals training and could easily identify the need for training and for updates. The training manager would Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: provide training during the night to accommodate the night staff if necessary. It was clear that staff training was discussed at individuals bi-monthly supervision sessions. Records were kept of these meeting. All of the care staff working at Old Village School either held an NVQ or were working towards it. Many of the qualified nurses had or were working towards a management NVQ and the housekeeping staff were also gaining qualifications. All new staff had a period of induction whether they had worked in care or not. Staff induction training was linked to the common induction standards. The training manager had developed a quarterly newsletter for all staff in which she reminded staff about issues, for example needlestick injuries, or informed them about new legislation and how this related to the care they provided, for example Mental Capacity Act. We examined the personal files of three members of staff. All were well-kept and contained fully completed application forms, appropriate references, induction checklists and training records and certificates. Criminal Record Bureau (CRB) checks had been carried out on all staff, and home office paperwork was present where required. Care Homes for Adults (18-65 years) Page 25 of 30 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager had a clear understanding of the key principles and focus of the service and worked with the staff team to continually improve and evaluate the care that was provided. Evidence: As already mentioned the manager had worked at the home under the same owner for many years. One relative wrote in the have your say about questionnaire; staff here are exceptionally kind and thoughtful. There is excellent nursing care and excellent organisation which is primarily due to the exceptional matron. The home had processes for ensuring the quality of the care that was provided by sending out satisfaction questionnaires. The surveys we saw for 2008 were positive, but they had yet to be fully evaluated and reported on. Previous annual quality reviews had been reported on. All of the documentation in the home was well presented and kept updated. Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: We looked at health and safety documentation, including the fire log and maintenance book. There was evidence to indicate that fire call points and the emergency lighting were being tested on a regular basis, and that fire drills were carried out periodically. Maintenance issues and redecorations were being addressed in a timely fashion. The last fire check had been the 2nd of January and the last fire drill 19th December. Care Homes for Adults (18-65 years) 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 Adults (18-65 years) 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 1 The statement of purpose or the Service users guide should be dated when it is reviewed to ensure the reader that it is the most current information. Consideration should be given to an easier system for auditing and reconciliation of medication. 2 20 Care Homes for Adults (18-65 years) 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. Care Homes for Adults (18-65 years) Page 30 of 30 - 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!