Inspection on 05/05/09 for Rendlesham Care Centre

This inspection was carried out on 5th May 2009.

CQC 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

Rendlesham Care Centre 28/04/10

Rendlesham Care Centre 17/02/10

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 28/06/2009.

Key inspection report CARE HOMES FOR OLDER PEOPLE Rendlesham Care Centre 1A Suffolk Drive Rendlesham Woodbridge Suffolk IP12 2UL Lead Inspector Julie Small Unannounced Inspection 5th May 2009 09:05 DS0000073073.V375288.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Rendlesham Care Centre DS0000073073.V375288.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Rendlesham Care Centre DS0000073073.V375288.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rendlesham Care Centre Address 1A Suffolk Drive Rendlesham Woodbridge Suffolk IP12 2UL 01394 461630 01394 461699 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Caring Homes Healthcare Group Limited Mrs Jan James Care Home 60 Category(ies) of Dementia (60), Old age, not falling within any registration, with number other category (60) of places Rendlesham Care Centre DS0000073073.V375288.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home with Nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the service are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE The maximum number of service users who can be accommodated is: 60 New Service 2. Date of last inspection Brief Description of the Service: Rendlesham Care Centre is part of Caring Homes Healthcare Group Limited and was registered with Commission for Social care Inspection November 2008. The home provides nursing care and support for up to sixty older people. The home is purpose built and is situated in the village of Rendlesham. There are two floors in the home, each of which are furnished and decorated to a good standard. The fees for the home at the time of this inspection ranged from £810 to £950 per week dependant on the care package that is provided. Rendlesham Care Centre DS0000073073.V375288.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The unannounced inspection took place Monday 5th May 2009 from 09:05 to 16:15. The inspection was a key inspection, which focused on the core standards relating to older people and was undertaken by regulatory inspector Julie Small. The report has been written using accumulated evidence gained prior to and during the inspection. The manager was present during the inspection and the requested information was provided promptly and in an open manner. During the inspection health and safety records, staff training records and the recruitment records for three staff were viewed. The care records of five people that live at the home were tracked, which included care plans and medication records. Further records viewed are detailed in the main body of this report. Observation of work practice was undertaken and seven staff members, three visitors and five people who lived at the home were spoken with. During the inspection there were twenty one people that were accommodated at the home. Prior to the inspection an Annual Quality Assurance Assessment (AQAA) was sent to the home and it was returned to us in the required timescales. Staff, health professional and service user surveys were sent to the home. Seven staff, one health professional and seven service user surveys were returned to us before the inspection. What the service does well: The home was clean and attractively furnished and decorated. People told us that the home was comfortable and homely. Interaction between the staff and the people that lived at the home was observed to be respectful and professional. Staff that were spoken with had a good knowledge of the needs of people and how they were to be met. Staff were provided with a good training programme, which provided staff with the knowledge that they needed to meet people’s needs. People that lived at the home were provided with a balanced diet. A comment made in the health professional survey was ‘as a visitor I am always made to feel welcome, staff are always honest and open. Care is delivered in a person centred way’. Rendlesham Care Centre DS0000073073.V375288.R01.S.doc Version 5.2 Page 6 Comments made in the service user surveys included ‘fantastic staff and care’, ‘admission and assessment to the home was dealt with very quickly and efficiently’, ‘we are amazed at the standard of the home and the wonderful atmosphere contained therein’ and ‘Rendlesham has been a God send. My (person) is happy here and the staff are very kind and caring. It’s like one big happy family’. 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Rendlesham Care Centre DS0000073073.V375288.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rendlesham Care Centre DS0000073073.V375288.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5, 6 People using the 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 who use this service can expect to be provided with the information that they need to enable them to make decisions about if they choose to move into the home, to be provided with a written contract of terms and conditions, to be provided with a needs assessment prior to moving into the home and to be informed that their needs will be met when they move in. The home does not provide an intermediate care service. EVIDENCE: People were provided with detailed information about the service that was provided by the home in the Statement of Purpose and Service User’s Guide. A copy of each document was kept in people’s bedrooms and in the entrance hall to the home, which stated that a copy would be provided to individuals if requested. Rendlesham Care Centre DS0000073073.V375288.R01.S.doc Version 5.2 Page 9 The Statement of Purpose was viewed and it provided information such as the purpose and objectives of the service, details of the provider, the management structure, training and qualifications of the staff team, facilities and services that were provided, fire safety, a summary of the complaints procedure and the contact details of Care Quality Commission, should people wish to contact us. The Service User’s Guide included information such as the contact telephone numbers and extension telephone numbers of the service, an explanation of the uniforms that staff wore (such as the colours of uniforms that carers and nursing staff wore), the accommodation that was provided, the service that was provided at the home, care planning, the arrangements for needs assessments and the procedure for making comments, complaints and compliments. The AQAA stated ‘we have a Statement of Purpose and a Service User Guide. These will be updated as the home develops and we obtain more services, staffing etc’. Seven service user surveys said that they were provided with enough information about the home before they moved in so that they could decide if it was the right place for them. Comments included ‘good brochure and visit was informative’, ‘yes we visited twice and had an assessment at our home and we had the details of the home thoroughly explained and were very impressed’ and ‘visited the home and met a number of the staff. Also had a very long conversation with the manager and senior nursing staff when they came to assess my (person) ahead of (the person) moving in’. People were provided with the opportunity to visit the home before they moved in to help them to decide if they chose to live there. During the inspection we observed two people who were looking for a placement for their relative. The visitors were spoken with and told us that they had been made welcome in the home and that they were impressed with what they had seen. The care records of five people were viewed and each included a contract which identified the terms and conditions of living at the home. The contract was signed by the person who lived at the home or their representatives to show that they had agreed with the terms and conditions. Six service user surveys said that they had been provided with a contract and one said that they had not and commented ‘respite stay’. The care records of five people that were viewed included a detailed needs assessment, which had been undertaken prior to them moving into the home. The needs assessments included information such as the person’s health and well being, support that they required in their daily living, their personal interests and preferences, communication, history of falls, details of any Rendlesham Care Centre DS0000073073.V375288.R01.S.doc Version 5.2 Page 10 diagnosis of their mental health and details of their prescribed medication. There were also local authority assessments for local authority customers. The AQAA stated ‘we carry out full assessments to ensure we can meet the needs of individual prior to moving into Rendlesham Care Centre’. Care plans were in place in people’s records, which identified how their assessed needs were met. Rendlesham Care Centre DS0000073073.V375288.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 People using the 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 who use the service can expect to have their assessed needs set out in a care plan which shows how their needs are to be met, to have their health care needs met, to be protected by the home’s medication procedures and to be treated with respect. EVIDENCE: The care plans of five people were viewed and each detailed how their assessed needs, health care needs and preferences were met. The care plans included details of people’s personal care, their preferred form of address, behaviour plans, mobility, communication, manual handling, eating and drinking, dietary requirements, emotional support and the areas of support that they could attend to independently. There were detailed risk assessments in place which identified the methods of minimising risks in their daily living in areas such as nutrition, manual handling, falls and skin viability. The care Rendlesham Care Centre DS0000073073.V375288.R01.S.doc Version 5.2 Page 12 plans and risk assessments were reviewed on a monthly basis and where people’s needs and preferences had changed. There were records of regular weight checks and where there had been identified issues actions were identified to minimise the risks, for example it was identified that one person had gained weight and they were supported to control their weight. The daily records were viewed, which clearly identified the support that people had been provided with, their activities and their well being each day. The manager was spoken with and agreed that they would ensure that there were increased detail of the specific behaviours that were displayed by people, for example one record had stated that a person had been ‘demanding’, this did not clearly explain the types of behaviour that the person had displayed. There were records of health care support that people had been provided with, such as doctor appointments and the outcomes were clearly recorded. During the inspection we observed a doctor providing information to the manager regarding a health care visit that they had made. The AQAA stated ‘we are able to use very local GP’s – surgery is directly across the road – some residents are retaining their present GPs’. The service user survey asked if they were provided with the care and support that they needed. Six answered always and one answered usually. The survey asked if they were provided with the medical support that they needed. Four answered always, one answered usually and comments included ‘excellent support no need to be anxious it’s all sorted well’ and ‘my (the person) did need medical help on several occasions. The home liaised with the doctor and my (the person) situation is much more stable’. Two people who lived at the home told us that they felt that their needs were met and that they were provided with appointments with their doctor if needed. The health professional survey said that people’s health care needs were always met and that the staff always sought advise and acted upon it to manage and improve people’s health care needs. A visitor to the home was spoken with and they told us that their relative had previously lived at the home. They said that the support and care that was provided to their relative was excellent and that they were happy that they had chosen the service provided at Rendlesham Care Centre. Three staff members were spoken with and they told us that the care plans clearly detailed the support that people needed. The staff survey asked if they were provided with up to date information about the needs of the people that they supported. Three answered always and four answered usually and one commented ‘always informed about the changes in paperwork and handover’. The survey asked if the ways that information was passed on between staff worked well. Three answered always, three answered usually and one answered sometimes. A staff member told us that they participated in a detailed handover of each shift where the staff team discussed any issues with individuals that had arisen. We observed the morning staff in a handover meeting with the afternoon staff during the inspection. Rendlesham Care Centre DS0000073073.V375288.R01.S.doc Version 5.2 Page 13 People were protected by the home’s medication procedures. The medication procedures were viewed and they clearly identified the methods of the safe handling, storage and administration of medication. Staff training records that were viewed showed that staff that were responsible for the administration of medication were provided with medication training. A training matrix was viewed, which showed that 100 staff who were responsible for medication administration had been provided with training. Two staff members that were spoken with told us that they had been provided with medication training. The care plans of five people that were viewed detailed the arrangements for the administration of their prescribed medication. The AQAA stated ‘if residents are able to self medicate safely then they may do so’. The health professional survey said that people were always supported to administer their own medication or manage it correctly where this was not possible. The storage of medication was viewed in the ground floor secured medication room. Medication was stored in a secured trolley in MDS (monitored dosage system) blister packs and in original packaging where the MDS system was not used. Medication that required refrigeration was stored in a secure medication refrigerator. The daily temperature checks of the refrigerator and the medication room were viewed, which showed that the medication was stored at appropriate temperatures. The MAR (medication administration records) charts for five people were viewed for 3rd to 30th April 2009 and 1st to 5th May 2009. It was noted that the appropriate codes had been used to identify where medication had not been taken, such as if people had refused their PRN (as required) medication. There were two gaps identified in one person’s MAR charts for PRN pain relief and PRN eye drops. All other MAR charts were checked with the MDS blister packs and medication storage and it was found that all the medication was accounted for. The manager was spoken with regarding the gaps that were identified in the MAR charts and they assured us that issues were addressed in regular medication audits. The monthly Regulation 26 visit reports were viewed and they showed that the medication was monitored and issues were addressed. People that lived at the home were treated with respect and their privacy was respected. The health professional survey said that people’s privacy and dignity was always respected. People that lived at the home told us that the staff treated them with respect and that their privacy was respected. Staff were observed to knock on bedroom and bathroom doors before entering them during the inspection. The interaction between staff and people that lived at the home was observed to be caring, respectful and professional. Efforts were made at the home to ensure that people’s dignity was respected. People were clean and smart and it was noted that their hair was clean and Rendlesham Care Centre DS0000073073.V375288.R01.S.doc Version 5.2 Page 14 combed. The care plans of people identified their choices of how they dressed and how their independence was maintained. The care plan of one person that was viewed showed that their mobility had improved since they had moved into the home and the changes to the aids that were provided when they had a hot drink, which ensured that they did not spill the drink and that they were supported to maintain their independence. Rendlesham Care Centre DS0000073073.V375288.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 People using the 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 that use the service can expect to be provided with an activity programme, which is of interest to them, to be supported to maintain their chosen contacts and to be provided with a balanced diet. EVIDENCE: People were provided with the opportunity to participate in activities which were of interest to them. There was an activities co-ordinator employed at the home and a designated activities room, which held lots of materials for the activities provision, such as board games and arts and crafts materials. The manager was spoken with and they told us that they had planned to obtain pet rabbits for the home to enable people to participate in looking after them. A person at the home had a pet cat and they told us that they had been provided with a bedroom on the ground floor which enabled the cat to go outside and that they looked after the cat themselves. Rendlesham Care Centre DS0000073073.V375288.R01.S.doc Version 5.2 Page 16 During the inspection the activities co-ordinator and two care staff were observed to take a group of people out for lunch. We observed the discussions about the planned activity, which was to go out for fish and chips. However, due to the poor weather people discussed alternative options and they decided on a visit to a local garden centre for lunch. Upon their return two people told us that they had enjoyed the activity. People told us that there were several activities that were provided on a daily basis in the home and that they could participate in them if they chose to. The service user survey asked if there were activities at the home that they could participate in. Two answered always, two answered usually, one answered sometimes and comments included ‘(the person) is not well enough at the moment by has some 1 – 1 time’ and ‘this was one of the attractions for me. My (person) is physically active and I like the fact that there are things for (the person) to do – including dancing!’ The care plans of five people were viewed and they detailed the activities that people had participated in. Activities included a visit from the Easter Bunny who gave people an Easter egg, playing dominoes, visits to local coastal areas, visits to local towns for shopping, games and visits from the library. The AQAA stated ‘currently due to a small number of residents, our activity coordinator is able to spend chunks of quality time on a one to one basis with residents’. People’s care plans clearly identified the contacts that people chose to maintain and the support that they required to maintain their contacts, such as with using the telephone or writing letters. The daily records identified where people had maintained contacts with their families or friends. There had been recent issues regarding how visits from previous carers were allegedly adversely affecting people who lived at the home, which had resulted in decisions to prevent the visits to ensure that they were safeguarded. The people had been provided with the service from an IMCA (Independent Mental Capacity Advocate) to support them to make decisions about their lives. During the inspection we observed friends visiting people who lived at the home and it was noted that they were welcomed into the home by the staff. The visitor told us that their relative had previously lived at the home and they told us that they were always made welcome. People who lived at the home told us that their family and friends were always welcomed into the home. Two people that were spoken with told us that they made choices about their lives and what they wanted to do each day. Seven service user surveys said that the staff listened to them and acted upon what they said. Comments included ‘very attentive, very well trained, extremely good at acting on my wishes’ and ‘they have always consulted with me on important issues. Equally I appreciate their professional advice’. The health professional survey said that people were always supported to live the life that they chose. Rendlesham Care Centre DS0000073073.V375288.R01.S.doc Version 5.2 Page 17 The daily records of five people were viewed and each identified how people were provided with choices on a daily basis and the monthly care reviews showed that people were consulted with about the support that they were provided with. Staff were observed to ask people what they chose to do and what they wanted to eat and drink during the inspection. A member of the kitchen staff was observed to ask people what their choices were for the evening meal. The menu was viewed and it was noted that people were provided with a choice of each meal and the menu was balanced and healthy. Lunch on the day of the inspection was a choice of sauté supreme chicken with mushroom sauce or medallions of pork with tomato sauce, cabbage, carrots and new potatoes, treacle tart and custard or chocolate mousse. Dinner was a choice of leek and potato soup or home made sausage roll and chips, or choice of sandwiches or jacket potato and a selection of sweets. Lunch looked and smelled appetising and people told us that they had enjoyed their meal. The service user survey asked if they liked the meals at the home. Three answered always and four answered usually and comments included ‘often too large portions’, ‘excellent! Well balanced, a major part of my life well done’ and ‘excellent – really good home cooked food with plenty of variety’. People were observed to help themselves to cold and hot drinks throughout the day. It was noted that each communal area provided a glass fronted drinks refrigerator, which was accessible to people with dementia. Staff were observed to offer people a choice of drinks throughout the day, which ensured drinks were provided to those who did not help themselves to or ask for drinks. The AQAA stated ‘our lounge areas have kitchenette areas that have glass fronted fridge, cooker and hob so that residents can organise cooking if they so wish’. Rendlesham Care Centre DS0000073073.V375288.R01.S.doc Version 5.2 Page 18 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 People using the 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 can expect to have their complaints listened to and acted upon and to be protected from abuse. EVIDENCE: People were provided with information about they could raise concerns about the service that they were provided with in the detailed complaints procedure, which was also summarised in the home’s Service User’s Guide and Statement of Purpose. Seven staff surveys and staff that were spoken with said that they were aware of actions that they should take if a person wished to raise concerns about the support that they were provided with. The service user survey asked if they knew who to speak to if they were not happy. Six answered always and one answered sometimes and comments included ‘the staff are very good at explaining everything and who to speak to if need be’ and ‘but I have never had the need’. Seven service user surveys said that they knew how to make a complaint and one commented ‘yes, but I have never had the need’. The health professional survey said that concerns were always responded to appropriately. Rendlesham Care Centre DS0000073073.V375288.R01.S.doc Version 5.2 Page 19 The AQAA stated ‘residents with lack of capacity have access to advocacy services’. The complaints records were viewed and it was noted that complaints and concerns were investigated and responded to in a timely manner. We had received a complaint about the service that was provided to people who lived at the home. A copy of the complaint had been forwarded to the home, it had been fully investigated by the home’s manager and responsible individual and a response had been forwarded to the people who had made the complaint. The complaint had not been upheld. There was an album of several thank you letters and cards from people that lived at the home and their relatives regarding the support and care that they had been provided with. Staff that were spoken with told us that they had been provided with safeguarding training and they were aware of actions that they should take if they had concerns about the safety of people that lived at the home. Staff training records that were viewed confirmed that staff had been provided with safeguarding training. A training matrix was viewed and showed that 91 staff had been provided with safeguarding training, with three staff members that needed to be provided with the training. Staff were further provided with information about safeguarding in the home’s safeguarding procedure and the local authority safeguarding guidelines, which were available in the office for staff reference. A person’s care plan that was viewed clearly identified how the person and staff were safeguarded following allegations made by the person, which included that all personal care was to be provided by two staff members. The manager had made safeguarding referrals appropriately and they had kept us informed of the issues and the actions taken to ensure that people were protected from abuse. The AQAA stated ‘staff receive safeguarding of vulnerable adults training. We have robust policies and procedures to educate staff, making them aware. Adult protection training is robust’. Rendlesham Care Centre DS0000073073.V375288.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 26 People using the 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 can expect to be provided with a clean, homely and well maintained environment to live in. EVIDENCE: The home was clean, homely and attractively furnished and decorated throughout. It was noted that there were no unpleasant odours. People that lived at the home who were spoken with were complimentary about the environment. Seven service user surveys said that the home was always fresh and clean and comments included ‘extremely high standard’ and ‘spotless’. The home provided accommodation on two floors with thirty five bedrooms on the ground floor and twenty five on the first floor. A lift and stairs provided Rendlesham Care Centre DS0000073073.V375288.R01.S.doc Version 5.2 Page 21 access between the floors. Each floor provided a communal lounge, dining room and kitchen area. The kitchen areas provided adjustable work surfaces, which were accessible to people who were wheel chair users. There was a refrigerator with a glass front in each kitchen area, which was accessible to people with dementia. The communal areas provided grab rails to ensure that the environment assisted people to move around the home. In the corridors there were pictures, which provided a homely feel to the home and outside each bedroom door there was a glass fronted memory area, in which items were placed which was of importance to each person which helped them to identify their bedrooms. Each bedroom provided an en-suite which consisted of a toilet, shower and hand wash basin. In addition to the en-suite facilities there were assisted bathrooms and showers on each floor. There was a large attractive secured garden area in which people could safely use. The AQAA stated ‘our home is brand new and the home is suitable for it’s stated purpose, as it was purpose built. Our bedrooms have dementia specifically for individuals with dementia they include memory boxes next to each bedroom door to act as a trigger, inner courtyard with research based dementia specific design features providing a safe area to socialise and relax’. The large laundry was on the first floor and provided two large washing machines and two dryers. There were trolleys for the transportation of the clean laundry and others for the transportation of dirty linen, which minimised the risks of cross infection. There were three sluice rooms in the home, which provided equipment for the cleansing of commodes. The laundry, bathrooms and sluice rooms provided hand washing facilities, which included hand wash liquid and disposable paper towels, which minimised the risks of cross contamination. During the inspection staff were observed to use good infection control activities, which included hand washing and wearing protective clothing and gloves when working with food and supporting people with their personal care. Staff that were spoken with had a good knowledge of infection control procedures and they told us that they had been provided with infection control training, which was confirmed in the training records that were viewed. A training matrix was viewed and showed that 81 staff had been provided with infection control training and that six staff members needed to be trained. Rendlesham Care Centre DS0000073073.V375288.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 People using the 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 who use the service can expect to be supported by staff who are trained to meet their needs and to be protected by the home’s recruitment procedures. EVIDENCE: During the inspection it was observed that the staff were attentive to the needs of the people that lived at the home and call bells were answered promptly. The interaction between staff and people that lived at the home was observed to be caring, respectful and professional. The staff team were very pleasant and greeted us and visitors to the home. Staff were visible throughout the inspection and people were attended to as they required or needed throughout the day. There were twenty one people that lived at the home during the inspection and the manager advised us that as resident numbers increased they would ensure that staffing numbers was also increased. During the inspection we observed a nursing staff member arrive at the home for an interview, which showed that this was the case. The AQAA stated ‘we have recruited motivated, dynamic Rendlesham Care Centre DS0000073073.V375288.R01.S.doc Version 5.2 Page 23 staff from diverse backgrounds. The majority of our staff have been recruited from the village of Rendlesham’. Staff that were spoken with told us that there were sufficient staff numbers on duty to meet the needs of people and that there were always care staff and nursing staff on duty for each shift. The staff survey asked if there were enough staff to meet people’s needs. Five answered usually, two answered sometimes and one commented ‘more staff are always being employed’. People who lived at the home that were spoken with said that staff were available when they needed them. The service user survey asked if staff were available when they needed them. Five answered always, two answered usually and comments included ‘a very good system to ensure that staff are available in the vicinity’ and ‘there is always someone around’. Staff that were spoken with told us that they had been provided with an induction which they undertook when they started working at the home, which was confirmed in the training records that were viewed. The staff survey asked if the induction had covered everything that they needed to know about the job when they started. Three answered very well, four answered mostly and one commented ‘I learnt a lot learning on the job too’. The AQAA stated ‘staff receive a robust induction’. Staff that were spoken with told us that they were provided with a good training programme, which advised them of how they were to meet the needs of people that lived at the home. Five staff surveys said that they were provided with training which was relevant to their role and two said that they were not. Six staff surveys said that they were provided with training which helped them to understand and meet the needs of people and that kept them up to date with new ways of working and one did not answer. Three staff records that were viewed held copies of their training certificates which they had been provided with and had undertaken prior to working at the home. The organisation’s trainer was spoken with and they explained how they had developed a ‘rolling’ training plan, which would ensure that all staff were provided with the training to do their job, which included e-learning and group type training courses to meet individual staff member’s training preferences and needs. There was a good record of training that had been provided to staff, which included the percentage of staff that were trained on subjects, how many staff needed to be trained and the target of the numbers of staff to be trained each month to ensure that 100 staff were trained in all areas. Training that was provided included fire safety, safeguarding, manual handling, health and safety, infection control, medication, COSHH (control of substances hazardous to health), first aid and the Alzheimer’s Society training course ‘yesterday, today and tomorrow’. There were nursing specific training courses that were provided to the nursing staff in the home. Rendlesham Care Centre DS0000073073.V375288.R01.S.doc Version 5.2 Page 24 The home had not yet met the target of 50 staff to have achieved a minimum of NVQ level 2 as identified in the National Minimum Standards relating to older people. The training matrix that was viewed showed that 33 staff had achieved the award. However, the home was a new service and the trainer and the manager clearly explained the actions that they were taking to ensure that staff were provided with the opportunities to achieve the appropriate qualifications to do their job, which included the assessor training of several staff members. The recruitment records of three staff members were viewed and they showed that the appropriate checks had been made to ensure that people were protected by the home’s recruitment procedures. Checks that had been made included POVAfirst (protection of vulnerable adults) checks, CRB (Criminal Records Bureau) checks, their work history, identification and two written references. The checks had also been made for the home’s hairdresser and a volunteer. The AQAA stated ‘our recruitment procedure is robust’. Seven staff surveys said that checks, such as CRB and references, were undertaken before they started work and one commented ‘we weren’t allowed to work until all checks came back’. Rendlesham Care Centre DS0000073073.V375288.R01.S.doc Version 5.2 Page 25 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 38 People using the 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 that use the service can expect the home to be well managed, to be run in their interests and to have their health, safety and welfare promoted and protected. EVIDENCE: The manager was fit to be in charge of the home and they were successful in the CSCI (Commission for Social Care Inspection) registered manager application process November 2008. The manager had achieved the qualifications that were required to manage a nursing home, which included a nursing qualification and the RMA (registered manager award). The manager Rendlesham Care Centre DS0000073073.V375288.R01.S.doc Version 5.2 Page 26 was supported in their role by a deputy manager, who was also a qualified nurse and an administrator. The manager returned the AQAA in the required timescale. The manager was receptive to the inspection process and they had a clear understanding of their role and responsibilities and the needs of the people that lived at the home. People that lived at the home and staff that were spoken with were complimentary about the management style of the home. Staff told us that they could approach the manager at any time if they had concerns that they wished to discuss. The AQAA stated ‘the management of the home ensures that it runs smoothly and has the resident’s best interests as a priority. The home is managed to allow a relaxed, positive and inclusive atmosphere’. People that lived at the home told us that they were consulted with about the support that they were provided with. This was confirmed in their inclusion in their monthly care plan reviews and how we observed people making choices throughout the inspection. The organisation regularly monitored the running of the home and the monthly Regulation 26 visit reports were viewed. During the visits people that lived at the home and staff were spoken with about their opinions of the service that was provided and the record keeping was checked, which included the medication and care plans. The AQAA stated ‘resident opinion is sought and actioned as appropriate. Regulation 26 have been carried out by the responsible individual’. The finance records of four people were viewed and they showed that people’s finances were safeguarded. People’s individual spending money was kept in individual pouches in the home’s safe. There were clear records of people’s transactions and receipts of their spending were filed. People’s care plans that were viewed clearly showed the arrangements for people’s spending money and identified their appointee, where required. The AQAA stated ‘residents have their own monies if able to do so and for those who are not able we have robust procedures’. People’s health and safety was protected at the home. The maintenance person was spoken with regarding their role and responsibilities in ensuring the safety of the building. They had a clear understanding of their role and they showed us the records that they maintained, such as regular health and safety checks of the building, water temperature checks and fire safety checks. The training records that were viewed showed that staff were provided with health and safety training, which included food hygiene, COSHH, manual handling and fire safety. Rendlesham Care Centre DS0000073073.V375288.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 3 Rendlesham Care Centre DS0000073073.V375288.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? No, new service STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Rendlesham Care Centre DS0000073073.V375288.R01.S.doc Version 5.2 Page 29 Care Quality Commission Eastern Region Care Quality Commission Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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