Inspection on 04/11/08 for Primrose Bank

This inspection was carried out on 4th November 2008.

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

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

Other inspections for this house

Primrose Bank 21/10/06

Primrose Bank 24/01/06

Primrose Bank 01/08/05

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Primrose Bank 153 Breck Road Poulton Le Fylde Lancashire FY6 7HJ     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: Lesley Plant     Date: 0 4 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: Primrose Bank 153 Breck Road Poulton Le Fylde Lancashire FY6 7HJ 01253884488 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Jacqueline Ellen Moore Type of registration: Number of places registered: Primrose Bank Limited care home 28 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category/ies of service only: Care home only - Code 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 - Code OP The maximum number of service users who can be accommodated is: 28 Date of last inspection Brief description of the care home Primrose Bank is a residential home situated on Breck Road in Poulton-le-Fylde. It is situated in its own grounds with garden areas and a small parking area at the rear. The village shops, facilities and the train station are in close proximity. The home accommodates 28 residents in single bedrooms, some of which have en-suite facilities. There is a stair lift to the rear of the home. There are three lounges and a large airy dining room. There are adequate toilets and bathing facilities. The registered providers are Mrs J Moore and Mrs E Abbas who manage the home on a day-to-day basis, with Mrs J Moore being the registered manager. The current fees are £365 to £395 weekly. Care Homes for Older People Page 4 of 29 Over 65 28 0 Brief description of the care home The home provides information for prospective residents regarding what is covered by the fees. 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: This key inspection focused on the outcomes for people living at the home and involved gathering information about the service from a wide range of sources over a period of time. The visit to the home was unannounced and looked at all of the key national minimum standards, plus the standard relating to staff supervision. At the time of the visit there were 24 people resident at the home. The inspector spoke to one of the owners, who is the registered manager, the cook, three care staff and several people living at the home. Information was also gained from the Annual Quality Assurance Assessment completed Care Homes for Older People Page 6 of 29 by the registered manager. The Annual Quality Assurance Assessment is a selfassessment that focuses on how well outcomes are being met for people using the service. It also provided some numerical information. CSCI survey forms inviting feedback about Primrose Bank were received from 6 members of staff and 17 people living at the home. Some friends and relatives also added their comments on these surveys. Records were viewed and a tour of the building took place. Time was also spent observing staff and the people living at the home, as they went about the day’s activities. The last key inspection was in October 2006, with a service review in February 2008. The report relating to the service review is held at the CSCI office and would be made available if requested. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 29 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 9 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. Assessments take place prior to people coming into the home, helping to ensure that their needs can be met. Evidence: Information about the home is available for prospective residents and their families. This helps people to make an informed choice about moving into Primrose Bank. Information is also available in large print, for anyone who may have difficulty reading standard size text. CSCI surveys received from people living at Primrose Bank also confirms that they had enough information about the home, before they made their decision to move in. The records for an individual who had recently moved into Primrose Bank were viewed. A written assessment of the persons needs, a contract and a profile giving a personal history of the person, were all available in the file. It was also evident that relatives Care Homes for Older People Page 10 of 29 Evidence: are involved in the assessment process as appropriate to the individual concerned. The assessment information helps to ensure that the home can meet the persons needs and prevents people moving into the home if their needs cannot be met. The registered manager of Primrose Bank explained that respite and short term care are provided at the home. Sometimes people may be admitted for a period of convalescence and rehabilitation following ill health or hospitalisation before returning home. Primrose Bank does not provide a specialised intensive rehabilitation service. Care Homes for Older People Page 11 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. Personal and health care needs are met and people are treated with dignity and respect, promoting a feeling of wellbeing and confidence that any health problem would be dealt with. Evidence: Each person has care plan, which also acts as a record of the care provided, as staff use them as a recording tool to confirm different elements of personal care giving. Each care plan sheet is reviewed every two weeks, when new paperwork is put in place. Changes are made as appropriate. The care planning information viewed shows the area of need, such as bathing or dressing, and the support required. The system for care planning was discussed with the registered manager, as the current paperwork mainly focuses on practical support for personal care. The registered manager explained that staff know the people living at the home very well and are able to provide support for other areas, as it is required. The file information includes a personal history and this too guides staff in their work. Care Homes for Older People Page 12 of 29 Evidence: The people spoken to said that they felt well cared for and that the staff were very good. Some friends and relatives had added comments on the CSCI surveys given to people living at the home. One person stated,I am very pleased with the care my Aunty gets. Care plans should address all areas of need, including social and emotional needs. There was no evidence to suggest that such needs were not being met however changes do need to be made. This will help to ensure that nothing is missed and that staff are moving toward a more person centred way of working. Responses in the CSCI surveys completed by people living at the home confirmed that medical support is provided when required. Health care appointments are recorded in the daily records kept by staff. At the time of this visit one person was being cared for in bed and additional recording was taking place. Records of pressure care, food and fluid intake were being kept. The district nurse was in regular contact and was providing advice to the staff team. A falls risk assessment is completed for all those at the home and these are regularly reviewed. Should anyone have an accident, a record is kept and changes to the care plan made if needed. A record is kept of each person’s weight, with any significant changes being responded to. The inspector advised that this should be kept as an individual record, with not everyone’s weight records kept on one page as at present. Individual records should always be kept, as combining records does not follow the good practice principles of data protection. One person living at the home explained that because of a health problem the district nurse was coming twice a week. This person said that they felt well cared for and were happy at the home. Another person explained how they had been supported to visit an optician and a dentist. The people spoken to all felt confident that their health care needs were being met. Comments from CSCI surveys completed by people living at the home included; The staff and district nurse arrangements really deliver what I need. The medication arrangements at the home were discussed with one of the deputy managers. Some changes have been made, since the last key inspection, with the home now using a different dispensing pharmacy. New medication trolleys have been provided and the pharmacist has conducted staff training regarding handling medication. Medication is safely stored in locked trolleys, with any controlled drugs being kept in a Care Homes for Older People Page 13 of 29 Evidence: locked cupboard in the office. Senior staff who administer medication have all received training. The medication administration records viewed had all been completed appropriately. However, where details of the prescribed medication have to be handwritten, this is currently being done by one member of staff. Checks in this area would help to reduce the chances of mistakes being made. There is no one currently looking after their own medication but some people do keep their own inhalers, as they know when to use them and need them close at hand. There is a separate medication trolley for each floor of the home, meaning that medication administration can be done more easily and in an organised manner. The controlled drugs record book was viewed and a check of the medication and records was made in relation to one person and was correct. The dispensing pharmacist visits the home to carry out checks and provide advice. The privacy and dignity of those living at Primrose Bank is supported and promoted. The importance of this is addressed within the induction programme for new staff. It was seen during the inspection that staff would knock on the bedroom door and seek permission before entering. During lunch staff provided support in a quiet and sensitive way, so as not to cause embarrassment to the individual concerned, who needed food to be cut up. All bedrooms are single and all have a washbasin, with some having en suite facilities, meaning that individuals can wash in the privacy of their room. Staff clearly understand the importance of helping people to maintain a clean and tidy appearance. Everyone appeared smart, the ladies hair looked nice and all clothing appeared to be well cared for. On receiving a compliment about her appearance one person said they look after all my clothes. A hairdresser visits the home twice each week, providing a service to those living there. The people spoken to all responded positively when asked if staff spoke to them kindly and acted in a respectful manner. Care Homes for Older People Page 14 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. People are supported to maintain their chosen lifestyle and enjoy the meals provided at the home. Evidence: Daily routines are kept flexible. It was seen that some people choose to stay in bed later, people could eat in their bedroom if they wished and the different lounges give people a good choice of where to spend their time. Feedback about activities within the CSCI surveys completed by those living at the home was mainly favourable. It is difficult to arrange activities that all will enjoy and this was reflected in the responses. The registered manager did explain that staff also sit and chat to people as well as having more organised events, such as tai chi classes. This was evident during the visit, as the good staffing levels do allow for individual time to be spent with residents. One person spoken to stated that she enjoyed listening to the singer who visits the home and that she was looking forward to bonfire night as they were having a bit of a do. Notices were displayed giving details of some of the planned Christmas events. Care Homes for Older People Page 15 of 29 Evidence: People are able to continue with activities they enjoyed before coming into the home, with one person maintaining contact with clubs and societies he is a member of. Community links are encouraged and people are supported to take walks out of the home, or to visit the local town. Visitors are made welcome and the different lounge areas mean that there is always a quiet area to chat. Some friends and relatives had added comments on the CSCI surveys given to people living at the home. One person stated, I try to visit once per month and always find the staff friendly and helpful. People are supported to make decisions about their day-to-day lives, such as when to go to bed, when to get up and how to spend their time. Individuals are supported to manage their financial affairs for as long as they are able. For some people a family member or a solicitor takes on this responsibility. Advocacy information is available at the home. A cook is on duty each day, with two staff covering the week between them. The cook on duty explained that care staff make breakfasts, with the cook preparing lunch and tea. The main meal is at lunch time and for tea there are 2 or 3 choices, including a hot meal. The cook keeps a record of the meals served and these were viewed. The cook also has information regarding peoples likes and dislikes. The dining room is spacious, light and airy, with views over the garden. Tables are nicely set, with linen napkins provided. It was evident that different needs and preferences are supported. On the day of this visit one person chose to have soup in his room, another person had fish as an alternative to the meat dish and liquidised food was provided for the person who was poorly in bed. The meal was tasty and nicely presented and all those spoken to said that they had enjoyed it and were complimentary about the meals provided at the home. There is a board in the dining room, where the days meals can be written. This is not being used. The registered manager explained that staff let people know what the main meal is, during the course of each morning. However the people spoken to, although complimentary about the food, did say that they dont always know what it is until it is served. It is advised that the menu board be brought back in to use as this would give people time to request an alternative if preferred. Care Homes for Older People Page 16 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. People living at the home are able to raise any concerns, with policies, procedures and staff training helping to ensure that any such concerns are dealt with. Evidence: A complaints procedure is provided at Primrose Bank and this was seen displayed at the home. The commission has not received any complaints since the last key inspection and the annual quality assurance assessment completed by the registered manager states that no complaints have been received at the home. CSCI surveys received from people living at Primrose Bank confirm that people know how to make a complaint or raise any concern. The surveys completed by staff also showed that staff know what to do if anyone has concerns about the home. A group discussion took place with three people living at the home. All said that they have never needed to make any complaint, that staff are very helpful and listen to any worries they may have. The atmosphere at the home appears very open and relaxed and staff were seen chatting to people and spending time in conversation. The quality review questionnaires regularly distributed to people living at the home, also give opportunity for any issues to be raised.Some of these were viewed and the registered manager was able to explain how an area of dissatisfaction raised by one Care Homes for Older People Page 17 of 29 Evidence: person at the home had been addressed. It is clear that any concerns are listened to and acted upon. Protection and vulnerability are covered within NVQ (national vocational qualification) training programmes, being included within the mandatory units of the level 2 award. Most care staff have undertaken this training and therefor understand the issues involved and how to report any concerns they may have. Abuse is also addressed within the induction programme for all new staff. The registered manager stated that specific training regarding abuse is being looked at as a future training course for staff. A copy of the locally agreed No Secrets document is available at the home. This details important aspects of reporting procedures and the responsibilities of different agencies in responding to any safeguarding issues. There are good arrangements in place for the safekeeping of personal monies, with separate records being kept and the cash held being checked regularly. Care Homes for Older People Page 18 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. Primrose Bank is comfortable, clean and well maintained, providing a pleasant and homely place to live. Evidence: Primrose Bank is situated just outside the centre of Poulton Le Fylde, which has an excellent range of shops and amenities. There is also a newsagents next door to the home. A look around the home showed that the building appeared generally well maintained, homely and comfortable, with a reasonable standard of furnishing and decoration. There are bedrooms on the ground and first floors, all are single rooms and all have washbasins, with some having en suite facilities. People are able to bring their own belongings into the home and so personalise their bedroom. There is a large bathroom on each floor. A stair lift enables people with mobility difficulties to access the first floor. There is a large dining room and a number of small lounges, meaning that people can choose where they spend their time. The garden areas extend to the side and rear of the home and there is a parking area for visitors. Care Homes for Older People Page 19 of 29 Evidence: Aids and adaptations are in place, such as grab rails and a bath chair. These help to ensure that personal care is provided in a safe way and also promote independence. Information within the annual quality assurance assessment completed by the registered manager confirms that there is a rolling programme of improvement in place. There are also plans to re vamp the external areas of the building. There are no domestic staff employed at the home. Care staff carry out cleaning duties and this appears to be well organised and work well. A schedule of tasks was seen, showing that staff record when certain domestic tasks have been completed. Night staff also have specific jobs to do during the night. One of the senior staff has overall responsibility for the organisation of the housekeeping at Primrose Bank. The home appeared clean. Staff were seen wearing aprons and disposable gloves when carrying out certain tasks and the use of these is covered within the induction programme for new staff. The staff training matrix for the home shows that most staff have completed infection control training, meaning that they know how to reduce the risks of infection within the home. Care Homes for Older People Page 20 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Most of the staff are qualified, meaning that people living at the home are supported by competent staff. Good staffing levels allow for individual time to be spent with those living at the home. Robust recruitment practices help to ensure that only suitable staff are employed at the home. Evidence: On the day of this unannounced visit there were 24 people resident at the home. Six care staff were on duty, with two more staff coming on duty a little later in the morning. The registered manager and one of the cooks were also working. These staffing levels allow for individual time to be spent with those living at the home. During the evening there are four care staff on duty. Night time support is provided by two night staff,with another member of staff sleeping in at the home, available for extra support should any emergency arise. Responses from the CSCI surveys completed by those living at the home confirmed that staff are available when needed and the members of staff who completed surveys also responded that there are enough staff to meet the individual needs of the people in the home. Comments from staff included; More staff are usually on at busy parts of the day and Staff know their roles well. Care Homes for Older People Page 21 of 29 Evidence: Feedback, about the staff, from those living at the home was extremely positive, with comments including; The staff are A1 and they come in the night quickly, if you ring. There have been few changes to the staff team, meaning that people living at the home are supported by staff who know them well. This was clear, when watching staff going about their duties and when listening to their communication with the people living at the home. From looking at training records, information within the Annual Quality Assurance Assessment and discussions with staff it is clear that qualification training for staff is promoted at Primrose Bank. This means that staff have their work practice assessed and will lead to the staff team gaining skills in care work. There are 27 care staff, including senior staff, and 18 have gained an NVQ (national vocational qualification) award at level 2 or above, or are qualified nurses. Two members of staff are doing nurse training and another three have commenced the NVQ level 2 award. The numbers of qualified staff exceed the recommended 50 for care homes. Excellent progress has been made in this area and this is commended. Equal opportunities are evident in the recruitment of staff of both sexes, of mixed ages and different ethnic backgrounds. The recruitment records for a recently appointed member of staff were viewed. The records for this person included an application form; health questionnaire, two references and a Criminal Records Bureau (CRB) clearance plus a check against the Protection of Vulnerable Adults (POVA) list, a list of staff who it is deemed should not be working in care services. These references and checks help to ensure that only suitable people are employed and that people living at the home are protected. Looking at training records, talking to staff and feedback from the surveys completed by staff, all show that good staff training is arranged at Primrose Bank. The induction of new staff was discussed with the registered manager of the home. All staff, including new night staff spend time with one of the senior managers going through an introduction to the home and covering important health and safety matters such as fire safety and the alarm system. Some completed induction records were viewed, showing the areas covered. The registered manager explained that the aim is to cover these areas during the first month of employment, with staff then registering for NVQ training. A discussion took place with a member of staff who confirmed her induction and also explained that she then shadowed more experienced staff. Staff also sign to Care Homes for Older People Page 22 of 29 Evidence: confirm that important policies have been received and read. The staff training matrix shows that the majority of staff have undertaken basic training, which includes moving and handling, health and safety, first aid, fire safety and infection control. Some staff have also received training regarding medication. Two members of staff were spoken to and both confirmed that they receive good training. The staff who completed CSCI surveys responded that their induction covered everything they needed to know and that they received relevant training, including training to help them meet the individual needs of people living at the home. Comments included; Training is always kept up to date with every aspect of working and health and safety and employers are always supportive in our training. In house courses are made available to us. All staff have been encouraged to obtain NVQ qualifications. The registered manager is planning some training for staff regarding alzheimers disease, which will complement the programme of basic training at the home. 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. Strong leadership and systems for maintaining high standards mean that the people living at Primrose Bank receive a good standard of care. Policies, procedures, good practice and staff training promote the health and safety of those living and working at the home. Evidence: The owners are both actively involved in the day to day running of the home, with one being the registered manager and both working at the home on consecutive weeks. The staff spoken to felt that this was working well and there were no issues raised regarding this management arrangement. The staff team are lead by a manager and a team of deputies, with the owners overseeing all aspects of service delivery. Both of the owners are experienced and the registered manager is a qualified nurse and has also gained a degree in quality management. Management meetings involving the owners, one being the registered manager, the manager, the deputies and the Care Homes for Older People Page 24 of 29 Evidence: housekeeping manager are held every two months. Staff provided much positive feedback regarding the management of the home. Comments included; We are well supported in our work and The owners and the management are both very approachable, as are all the staff, if any problems arise. The management team appear to work well together and provide strong leadership in the home. There are good arrangements in place for people to give feedback about the home, for any views to be responded to and for continual improvements to be made. These aspects, along with good management are a real strength of the home. Surveys are regularly distributed to people living at the home and their relatives. These give good opportunity for people to give feedback about the standard of service provided. Some of the recently returned surveys were viewed and showed a general satisfaction with the care provided at the home. The registered manager was able to explain what action had been taken regarding an individual who had been dissatisfied with one aspect of the home. Efforts had been made to meet this persons particular requests. Quality assurance surveys are also sent to businesses providing supplies, such as meat, to the home. The atmosphere at the home is warm and informal with staff spending time talking to and listening to the people living there. There are also occasional meetings for the people living at the home, where suggestions for any changes can be made, although the majority of people prefer to share their views and ideas on an individual basis as part of day-to-day life at the home. This individual approach also means that people with hearing difficulties are not excluded or disadvantaged. Primrose Bank has gained ISO (international standards organisation) accreditation, which is an internationally recognised externally accredited quality management award. Annual reviews take place, with a full assessment for continuing accreditation taking place every three years. Staff meetings are mainly informal, as seen on the day of this visit, when staff met in the dining room to discuss arrangements for the day. Some more formal meetings also take place, with a meeting of the night staff arranged for the following week. These allow for staff to put forward suggestions about how the service could be improved. There are some very good quality monitoring systems in place at Primrose Bank. The management team should now focus on improving the care planning arrangements at the home. Some of the existing quality monitoring systems will prove useful in Care Homes for Older People Page 25 of 29 Evidence: monitoring improvements in this area. There are good arrangements in place for looking after personal money if this is needed. Small amounts of spending money can be held on behalf of people living at the home. Individual records showing income, expenditure and the balance of money held, were seen. All money is securely kept and the accounts are regularly checked. Staff spoken to confirmed that supervisions and appraisals take place and records of these were viewed. The format for the annual appraisal includes staff signing to confirm that key policies have been read and understood. This helps to ensure that staff are up to date regarding how things should be done at the home. The way that supervisions are recorded was discussed with the registered manager of the home. Records include dates of discussions, training, observations and appraisals. It is advised that more detail is included regarding supervision meetings, such as what has been discussed and any outcome or areas for action. Records relating to health and safety were seen. These included records of checks such as fridge and freezer temperatures, which are kept by the cook. Records also show that equipment such as fire equipment and the emergency lighting are regularly serviced and that the electrical circuit and electrical appliances at the home are also checked. Water temperatures are regularly monitored to make sure that the water is at a safe temperature. Fire drills take place. Records are kept of any maintenance jobs which need to be done and when this has been completed. All these checks and practices, along with the training staff receive help to protect the people living at the home and the people working there. Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 Care planning documentation should be improved upon, to include all areas of need and how they are to be met. This will help to ensure that staff know how to meet needs other than personal care needs. Handwritten entries on medication records should be checked and signed by two members of staff. This will help to reduce the chance of errors being made. 2 9 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. 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