Inspection on 27/11/08 for Peterhouse

This inspection was carried out on 27th 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Peterhouse 12/12/06

Peterhouse 20/12/05

Peterhouse 14/06/05

Peterhouse 17/02/05

Peterhouse 19/07/04

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 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Peterhouse Church Street Old Town Bexhill On Sea East Sussex TN40 2HF     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: Deborah Calveley     Date: 2 7 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: Peterhouse Church Street Old Town Bexhill On Sea East Sussex TN40 2HF 01424-730809 01424731204 l.crisford@nabs.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Hazel Silverlock Type of registration: Number of places registered: NABS care home 36 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: That a maximum number of three (3) service users over the age of fifty five (55) years can be accommodated to receive nursing or residential care. That the maximum number of service users in receipt of nursing care must not exceed twenty six (26) That the maximum number of service users receiving residential care must not exceed ten (10) Date of last inspection Brief description of the care home Peterhouse is a purpose built care home situated in a quiet part of the old town in Bexhill on Sea. It is within a short walking distance of local shops, church and train station. There are several close amenities that include a GP surgery and pharmacy, community centre, public house and a corner shop. The East Wing at Peterhouse is Care Homes for Older People Page 4 of 29 0 0 Over 65 10 26 Brief description of the care home registered to accommodate up to 26 older people who require nursing care and 10 residential places for those requiring only a level of personal care. Accommodation is provided over two floors. Shaft lifts are fitted to assist those residents who have additional mobility needs. A number of sheltered housing flats adjoin the care home with some shared facilities. There is level access to well-maintained communal gardens. Peterhouse is owned by the National Advertising Benevolent Society (NABS), which is a charitable organisation based in London. The charity provides a wide range of support to those who have worked in the advertising and related industries, but opened its services to local people not connected to the industry in 2002. Peterhouse is its only care home. 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 reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term service user to describe those living in care home settings For the purpose of this report those living at Peterhouse will be referred to as residents This was a key inspection that included an unannounced visit to the home and follow up contact with residents representatives and visiting health and social care professionals This unannounced inspection was carried out over 8 hours on the 27 November 2008 and a follow up meeting with the appointed manager. There were 29 residents living in Care Homes for Older People Page 6 of 29 the home on the day of which five were case tracked and met. During the tour of the premises six other residents both male and female were also spoken with The purpose of the inspection was to check that the requirements of previous inspections had been met and inspect all other key standards A tour of the premises was undertaken and a range of documentation was viewed including the Service Users Guide Statement of Purpose care plans medication records and recruitment files Four members of care staff and the cook were spoken with in addition to discussion with the general manager, registered manager and the deputy manager Telephone contact was made with visiting professionals following the visit and their views and comments are incorporated into the report along with the information received verbally during the site visit. An Annual Quality Assurance Assessment was received from the Manager completed in full prior to this key inspection The response to surveys sent out prior to this key inspection was good and the comments received have been included in the inspection report. There are two range of fees, residential care fees currently range from 675 pounds to 795 pounds per week, nursing care fees range from 850 pounds to 1200 pounds per week. Additional charges are made for individual newspapers, chiropody, hairdressing and physiotherapy. The latest edition of the homes inspection report is kept in the reception area along with the latest in house newsletter. What the care home does well: What has improved since the last inspection? What they could do better: The home needs to confirm in writing to the prospective resident or their representative that with regard to the needs assessment completed the home can meet the needs of the prospective resident. This ensures that decisions around admission to the home are informed. Care Homes for Older People Page 8 of 29 As discussed there are some areas of the care planning that need to be improved to ensure that the staff have the information necessary to meet the residents needs consistently. The call bell facility is available for all residents and a new system has just been installed, however there is a need to risk assess those residents that can not use the call bell facility and ensure that a suitable plan of monitoring their well being is included in their care plan. The documention in respect of the less abled residents participation in activities needs to be further developed. 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 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. The home provides prospective residents and relatives, with a good level of information about the home its facilities services and the costs involved The admission procedures allow for the needs of prospective residents to be assessed by a competent person before admission although people are not assured in writing that their needs will be met Evidence: There is a range of information about the home and the services it provides. The home has a Statement of Purpose and Service Users Guide and a copy of this is available in the reception area of the home and on request along with the last inspection report and a copy of the homes terms and conditions of residency. All the bedrooms have a copy of the residents guide (Service Users Guide) along with the key worker diary. Care Homes for Older People Page 11 of 29 Evidence: It was confirmed whilst talking to residents that the contract arrangements were clear and understood. There is a copy of the terms and conditions of residency included in the homes information documents. A review of the care documentation confirmed that pre admission assessments are completed by the manager. The last three admissions to the home were identified and the records relating to the admission procedures followed were reviewed. This confirmed that the pre admission assessments are completed and provide a clear assessment of prospective residents care needs. The ones viewed were person centred and full of relevant information. It was confirmed that these are used to ensure new admissions to the home are appropriate and that the home have the staff equipment and environment to meet their care needs. Prospective residents are seen either in their home or hospital before admission and the input from relatives and other professionals is used whenever possible. The venue and people involved in the assessment could be more clearly reflected in the documentation. From talking to the manager it was stated that this is now happening. It was however noted that the home does not confirm having regard to the assessment that the home can meet the assessed needs of the prospective resident. This was discussed with the manager who was advised that this should be completed in writing in accordance with the required documentation. It was discussed that the Statement of Purpose needs to clearly state the conditions that the home can care for and demonstrate this by the staff experience and qualifications. The manager was able to verbally demonstrate her knowledge and awareness of the different specialities required in the home and ensures that the nurses and carers employed have attended relevant courses to deal with the needs of the elderly and also specialised courses for certain diseases. Trial visits to the home can be arranged. It was confirmed that residents are invited to a trial period to ensure suitability of the home this is clearly stated in the Statement of Purpose and in the statement of terms and conditions 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. Care documentation provides a good framework for the delivery of care, it has been developed to provide clear guidance to care staff on all the care needs of the residents along with robust systems for risk assessment to ensure individual person centred care is delivered. The homes practices ensure residents medicines are stored and administered safely and residents are treated with respect and have their privacy and dignity maintained. Evidence: The care documentation pertaining to six residents was reviewed as part of the inspection process, three of those included the last admissions to the home. These were found to include plans of care, nutritional assessments, personal histories and risk assessments. The care documentation starts with the pre-admission assessment which leads in to the admission profile and then to the health risk assessments and care plans. The admission profiles viewed were not all signed, dated and some not fully completed. This was brought to the deputy managers attention and she assured that this would be rectified immediately. Care Homes for Older People Page 13 of 29 Evidence: The care plans are pre populated and then adjusted to the individual residents needs. The plans of care included personal care, nutrition, mobility needs, reduced hearing, diabetes, social needs, communication and breathing problems. They were seen to be person centred and provide clear guidance for staff to provide consistent care. However as discussed one resident who has been in the home for 3 weeks did not have a completed admission profile or care plans in place to care for all her care needs which include wandering and dementia. It is acknowledged that the staff are getting to know her but there is a need to provide a plan of care that will of course be adjusted as she settles in the home. A resident admitted for respite care needs a more detailed care plan to ensure her needs are met. Risk assessments for health needs and residents safety are included in the care plan system used by the home and in the main risk assessments were found to be completed competently and based on clear criteria. There are areas identified that need to be developed and this included: Call bell risk assessments to be introduced for those residents that are unable to use this facility to ensure the residents safety and an awareness in the care documentation regarding those that have a pace maker insitu. The home operates a key worker system. Staff spoken with confirmed that they received a full report on each resident daily and complete the care diary that is kept in the residents bedrooms. They felt that their views were taken into account when planning residents care. The surveys received from residents and relatives evidenced they were satisfied with the care provided at the home, comments received included wonderful care very attentive and helpful. Residents spoken with were complimentary regarding the care they receive. Comments included could not ask for better care caring staff and nothing too much for them. Records indicated that local G.Ps are called regularly and are involved in the care of residents. The manager confirmed that specialist external advice is sought as necessary and included the Dietitian and input from the Primary Care Trust Tissue Viability Nurse. The clinical room is on the ground floor and was clean and well organised, the clinical fridge was clean and temperatures of the fridge and room are recorded daily. Staff were observed administering medicines safely and professionally. The records seen were found to be accurate and the storage areas were found to be appropriate and well managed. Some recommendations of good practice were made during the site visit and include: The opening dates on liquid antibiotics and controlled medication Care Homes for Older People Page 14 of 29 Evidence: need to be recorded as they a limited shelf life, the photographs of residents to be dated and updated regularly. The equipment used for emergency situations needs to be kept clean and ready for use. Staff were seen to be kind and pleasant and atmosphere friendly and inclusive. The residents spoken with confirmed that they felt that their privacy and dignity was respected. 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. Social activities and meals continue to be creative and provide daily variation and interest for people living in the home. Residents are able to make a range of choices about their lives as well as maintaining links with friends and relatives. Evidence: There are two activity co-ordinators who work within the home to provide activities and activities are provided Monday through to Sunday. A monthly activity programme was seen displayed on notice boards throughout the home. Care plans evidenced some residents past histories and social preferences, but they could be linked more constructively to the activity programme for the nursing wing. the records for those residents that do not participate in the group activities need to be developed and kept upto date. The AQAA confirmed that over the past year improvements to activities include the purchase of a new mini bus that accommodates higher dependency residents/ wheelchair users, opened a day centre that the care wing residents can attend for increased social activities, increased the number of staff hours available for activities and bought more equipment suitable for group activities. The home have also Care Homes for Older People Page 16 of 29 Evidence: improved the library facility and now have a computer with internet access. There is a new bar area with a comfortable seating area that residents from both the care wing and sheltered housing can access and the introduction of a mobile shop has increased residents’ choice and independence. The plans shared regarding future improvements to activities include provide more seat based exercise programmes and training staff in providing hand massage and other therapeutic therapies. The residents spoken with with look forward to the daily activity sessions and enjoy meeting with other residents. It was confirmed by staff that the residents are supported and enabled to join local events held in the vicinity and attend the Church Services at the nearby church. Residents are facilitated to maintain their independence for as long as they are able. There are no restrictions on visiting times as long as consideration is shown to all the residents. There are communal areas throughout the home that are available to residents and their visitors for private meetings if required. During the inspection visit it was noted that the reception area was always manned during the day and visitors were greeted with assistance being provided if needed. Many of the residents have individualised their bedroom with items from home and residents and relatives spoken with confirmed that they are encouraged to make it homely. It was observed during the inspection that the routines at the home are flexible, residents spoken with confirmed that they were consulted about all aspects of their lives. The home has an advocacy policy in place and the information regarding this is available to all residents. Breakfast and the mid day meal was observed and was seen to be organised and well managed ensuring that those residents needing assistance were given time and able to have the assistance that they needed in an unrushed manner. It was confirmed that residents had a choice at lunchtime, which included a vegetarian choice. Those residents saying they did not like the main choice were seen to have alternatives provided that they did want. Menus are used and circulated the day prior to the meals being provided, there are no records kept on what food is eaten by each resident unless there is a problem and it was discussed that records are beneficial in identifying appetite traits early. All feedback about the food was complimentary and comments included ‘good food’ ‘I have choices in the meals and the meals are good’. The dining areas are on two levels they are pleasant and well furnished with natural light. The Care Homes for Older People Page 17 of 29 Evidence: tables are attractively set with napkins and tablecloths. The meals provided looked appetising and were served in a manner that ensured it looked attractive. Fresh fruit is provided, and assessable to the residents. The chef confirmed that he meets with residents to discuss their dietary requirements when required. The ‘safer cooking better business’ book is completed in both serving areas. The Environmental Health Organisation have recently visited the home and it was confirmed that the recommendations made have been actioned. Information received from surveys identified that the communication between the care team and kitchen could be improved in respect of the nutritional needs of the residents. 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 formal complaints system with evidence that residents feel that their views are listened to and acted upon. Staff receive training to protect residents from abuse Evidence: The complaint policy and procedure is clear and uncomplicated and a copy of this is readily available in the home and the Service Users Guide. A system of recording complaints was demonstrated during the site visit to the home. The home has received three complaints since the last inspection and all were investigated within the timescales set and a full investigation undertaken and recorded. Residents spoken with confirmed that they were confident that any complaints or concerns that they had would be listened to and responded to effectively. The home has relevant guidelines on the protection of vulnerable adults and staff have all received appropriate training. The management team has a clear understanding of adult protection guidelines and are aware of how to initiate an investigation if required. the home have made two safeguarding referrals and have been involved in one safeguarding investigation that was unsubstantiated. Care Homes for Older People Page 19 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 home provides a comfortable clean and safe environment for those living in the home and visiting. Residents are enabled and encouraged to personalise their room and rooms are homely and reflect the residents personalities and interests. Evidence: The home provides a comfortable clean and safe environment for those living in the home and visiting. Residents are enabled and encouraged to personalise their room and rooms are homely and reflect the residents personalities and interests. A tour of the home confirmed that the home is extremely well maintained and bedrooms are attractive with some being personalised and all bedrooms have an ensuite facility. All bedrooms have a cable television and telephone point. Residents spoken to said that they liked their rooms one saying that the home ‘felt like his home now’. The gardens surrounding the home are safe and well maintained and provide a lovely setting for residents to sit and enjoy the open air. The home have a choice of various communal areas which are attractive and allow for different uses ensuring residents have choice and how they spend their time. During the site visit the coffee and bar area was well used. It is a pleasant area for the residents and visitors to meet and spend their time. Care Homes for Older People Page 20 of 29 Evidence: There are adequate communal bathrooms and shower rooms in the home, with specialist equipment to ensure all residents can have a bath or shower. The home has specialised equipment available throughout the home to promote independence. During the inspection it was noted that staff were using lifting and supporting equipment appropriately. Call bells are provided in all areas and staff were seen to be attentive and ensured residents had access to these. However as discussed, those residents that are unable to use the call bell facility need to appropritely risk assessed and a system of monitoring put in place to promote their well being. The home has a range of special mattresses and seat cushions, which are used on an assessed needs basis to prevent tissue damage, the staff were able to discuss how they procure special equipment if they should need it. The lighting in the home is of domestic quality and there are above bed lights as well as the main ceiling lights. Water temperatures are controlled and monitored monthly and a record kept. Random temperatures were taken and were of the recommended level. There are systems in place for monitoring safety issues such as fire checks, fire drills, PAT testing, electrical tests and gas and boiler checks and all the rooms are routinely checked for safety and maintenance issues. The records in the home confirmed they were up to date. The tour of the home confirmed that staff are aware of the fire safety policies, no doors were found inappropriately wedged open. Polices and procedures for infection control are in place and are updated regularly. The home was clean and free from offensive odours on the day of the inspection Good practice by staff was observed during the day and there were gloves and aprons freely available in the home, all bedrooms have gloves and aprons attached to wall just inside the door. Sluice facilities were clean and hygienic and the laundry areas were found to be clean and safe. In the main good practice in respect of infection control by staff was observed during the inspection visit, soiled linen was appropriately put in red bags and all areas of the home were clean. Residents were very complimentary about the laundry service indicating clothes are generally returned the same day. Care Homes for Older People Page 21 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. Robust recruitment procedures are in place to protect residents and staff training ensures they are aware of their roles and are able to provide the support and care the residents need. Evidence: The staffing rota was viewed and the staffing levels were seen to be sufficient to meet the needs of the residents at this time It was confirmed by the manager that there is flexibility of the staffing levels and they are adjusted according to the changing needs of the residents Care staff spoken with said that the levels of staff on duty were sufficient to give the care required they also said that the senior staff always helped out This was also observed during the site visit Residents also confirmed that they had no complaints regarding the amount of staff A roster is held giving names of staff on shift Staffing levels include two registered general nurses (RGN) and eight care staff on duty each morning and one RGN and six carers during the afternoon- evening shift One RGN and three carers on at night Separate staff are employed for administration duties reception kitchen duties and cooking cleaning laundry maintenance and gardening Information taken from the completed AQAA provided by the manager stated that the home have 26 care staff of whom 18 have a National Vocational qualification There is Care Homes for Older People Page 22 of 29 Evidence: an induction programme in place and has been introduced for all staff files seen confirmed this. New staff are required to complete an initial induction programme and undertake mandatory training including fire and health and safety. The induction and foundation training is in line with the Skills for Care guidance. All new staff are also given a staff handbook and a pack of relevant policies and procedures used in the home at the beginning of their employment. A selection of staff recruitment files were viewed and demonstrate that a robust recruitment process has been maintained to protect residents and contained all the relevant information required. There was evidence of health questionnaires, Criminal Record Bureau (CRB) checks, two references, a resume of previous employment and work permits where necessary. All the paperwork is kept within a locked room. The home does employ volunteers and it was confirmed that all have been CRB checked. The provider facilitates regular training sessions and recent ones have included safe cleaning, food hygiene, nutrition, infection control, moving and handling. There is a rolling programme of training which will ensure that staff receive the training necessary to meet the residents needs. Staff spoken with said that training opportunities at the home are good and they are well supported by the senior staff and the manager. There is always an appointed first aider on each shift, all staff complete job related training in wound care, catheter care, bowel care, continence care, Parkinsons disease epilepsy and multiple sclerosis. As the home does have residents with a diagnosis of dementia, all staff need training in understanding dementia so as meet the needs of those residents. One RGN is also the appointed trainer for the home she has an A1 assessors qualification and is qualified to training all mandatory training to the staff Care Homes for Older People Page 23 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 overall management of this home is good with effective systems in place to protect residents. Evidence: The registered manager is a registered general nurse and has completed her Registered Managers Award (RMA), two other senior managers in the home have also gained the RMA. The manager has also worked as a health visitor and holds a degree in community health studies and has previously managed a nursing home. She has the necessary experience and qualification to manage the home effectively. During the inspection visit there was no doubt that the manager had a good working relationship with everyone in the home and everyone spoken to said that she was approachable fair and responded to issues raised quickly. There is a clear management structure in the home with staff having designated responsibilities and clear job descriptions. The care manager who is registered with the CSCI is supported by the general manager and other senior members of staff in the organisation. Care Homes for Older People Page 24 of 29 Evidence: There are systems in place to monitor the quality in the home and include the use of questionnaires. The general manager confirmed that these are audited reported on and responded to. It was recommended that the use of questionnaires is expanded to staff and visiting professionals. There are resident relative meetings and staff meetings which are minuted and these are used effectively to monitor the homes performance. There are regular staff meetings and head of department meetings that are recorded and areas for improvement discussed. The registered manager told the inspector that she regularly quality monitors the standards of care, cleaning, cooking, administration of medication, care plans including reviews and these are now recorded. The registered manager oversees the management of personal allowances for some residents in the home, each of these residents has a cash sheet with their name on it and these sheets record monies received and monies being spent, along with receipts. Personal allowances are checked monthly to ensure that they are correct and all money transactions are signed by two persons. All personal allowances are kept securely within the home The health and safety policies and procedures were viewed and it was noted noted that many policies and procedures are in need of review, it was confirmed that these are being undertaken in the near future. All staff have undertaken moving and handling, fire safety first aid, food hygiene and infection control training. All new staff are appropriately supervised until they have received their mandatory training and completed their induction programme. The AQAA confirmed that all equipment used in the home have current service certificates. The HSE accident book was viewed and it was confirmed that all accidents are appropriately recorded and where necessary the appropriate authorities are informed. The first aid boxes are spread out throughout the home and are regularly checked and topped up. The kitchen first aid box would benefit from including a burns treatment and an eye wash for immediate first aid. Good practice was observed throughout the inspection in respect of promoting the safety and well being of the residents. The environmental risk assessments were viewed and were satisfactory. Care Homes for Older People Page 25 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 26 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 3 14 That the registered person 02/02/2009 confirms in writing that having regard to the assessment made on any prospective service user that the home can meet those needs. To ensure that decisions around the admission to the home are informed. 2 7 9 That the registered person ensures that all residents have a care plan in place to guide the staff in meeting the care needs of service users living in the home. To ensure the service users safety and well being is promoted. 02/02/2009 3 22 23 That the registered person ensures that the residents that are unable to use the call bell facility are appropriately risk assessed and a system put in place to promote their safety. 02/02/2009 Care Homes for Older People Page 27 of 29 To ensure and promote the residents safety. 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 9 That the opening dates on liquid antibiotics and controlled medication need to be recorded as they have a limited shelf life. That the photographs of residents to be dated and updated regularly. That the equipment used for emergency situations needs to be kept clean and ready for use. That the records and activities for the residents that do not attend the group activities are further developed. That a formal record of residents food consumption is kept. 2 3 12 15 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!