Inspection on 29/11/06 for Rest Haven

This inspection was carried out on 29th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Rest Haven 21/02/06

Rest Haven 09/08/05

Rest Haven 13/12/04

Rest Haven 14/06/04

Rest Haven 26/03/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Rest Haven 15 Gussiford Lane Exmouth Devon EX8 2SD Lead Inspector Michelle Oliver Unannounced Inspection 29th November 2006 09:15 X10015.doc Version 1.40 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Rest Haven DS0000022014.V312740.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rest Haven DS0000022014.V312740.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rest Haven Address 15 Gussiford Lane Exmouth Devon EX8 2SD 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) 01395 272374 01395 278748 resthavenhome@tiscali.co.uk Rest Haven Charitable Home Trustees Mrs Julie Christine Fletcher Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places Rest Haven DS0000022014.V312740.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st February 2006 Brief Description of the Service: Rest Haven is registered to provide personal care for up to 34 older people. It is a Christian home of charitable status run by Rest Haven trustees and managed on a day to day basis by a registered manager. The property is a large Victorian detached house situated at the top of a sloping driveway close to the centre of Exmouth. There are gardens to the front and rear of the property. All bedrooms are single, and most are very spacious. One is slightly below 10 square metres. 12 bedrooms have en suite facilities. There is a passenger lift to the first floor and most rooms have level access. There are three large lounges (one of which is a music room), a dining room, a conservatory, a Chapel, a salon/therapy room, and a large entrance hallway with sitting areas. Rest Haven DS0000022014.V312740.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place on Wednesday 29th November 2006 over a period of 8 hours. The manager, assistant manager and care coordinator were present throughout the inspection. Some positive informative discussion and exchange of information took place. During the inspection 3 residents’ files were looked at in detail, which helps the Commission to understand the experiences of people using the service. A number of other residents were met and spoken with during the course of the day. The inspector also spent a considerable time observing the care and attention given to residents by staff. Several staff were also spoken with during the day. As part of this unannounced inspection the quality of information given to people about the care home was looked at. People who use services were also spoken to, to see if they could understand this information and how it helped them to make choices. The information included the service user’s guide (sometimes called a brochure or prospectus), statement of terms and conditions (also known as contracts of care) and the complaints procedure. These findings will be used as part of a wider study that CSCI are carrying out about the information that people get about care homes for older people. This report will be published in May 2007. Further information on this can be found on our website www.csci.org.uk. Prior to the inspection 11 questionnaires were sent to residents to obtain their views of the service provided; 3 were returned. Comments were in the main satisfactory with the majority of the respondents confirming that they ‘usually’ receive the care and support they need. Seventeen staff were sent questionnaires in order to hear their confidential views; six were returned. The staff responses indicate that staff feel supported in their role and receive support from the manager. Questionnaires were also sent to health and social care professionals prior to the inspection, nine of which responded with positive comments about Resthaven. During the visit the inspector toured the premises and a sample number of records were inspected which included care plans, medication records/procedures, staff recruitment files and fire safety records. Rest Haven DS0000022014.V312740.R01.S.doc Version 5.2 Page 6 The manager had completed a pre-inspection questionnaire and the inspector appreciated the preparation undertaken by the manager to assist with this inspection and by residents and staff during the inspection. The outcome of the inspection was discussed with the manager at the completion of this visit. What the service does well: The atmosphere at Resthaven is relaxed, caring and homely. People are given good information about the home before a decision to make it their home is made. A member of the management will normally visit people at home or hospital to get to know them and to carry out an assessment of their needs. Individual care plans provide staff with good, comprehensive information based on assessment details . People are also encouraged and supported to visit the home as often as they wish and to have a meal if they wish before moving in. Information from relatives and health or social care professionals is also sought to enable staff to treat people as individuals by having as much information as possible to meet health and social care needs. Care plans are regularly reviewed to ensure they give accurate, up to date detailed information to care staff about how each resident wants to be cared for. Care plans show how residents are encouraged and supported to make choices in many aspects of their daily lives. A resident said “I can please myself where I go and what I do, we all can”. Residents spoken to during this visit said that they were not interested in their care plans but that “staff talk to us all the time about everything”. Care has been taken to ensure that medicines are stored and administered safely. Staff have received training in the safe administration of medicines, therefore protecting residents’ safety and welfare. Residents spoken to during this visit all agreed that if they had any concerns they would feel comfortable speaking to any member of staff about them. They felt sure they would be listened to and their concerns taken seriously and acted upon. No complaints have been received by the Commission since the last inspection. Residents are protected from potential abuse through good training and good recruitment procedures. At the time of this visit Resthaven was comfortable, attractive and homely throughout. Generally most areas had been maintained to a good standard. Staff are to be commended for the excellent standard of cleanliness, which Rest Haven DS0000022014.V312740.R01.S.doc Version 5.2 Page 7 residents confirmed is always maintained, at the home. Equipment has been regularly serviced and maintained. Risk assessments have been carried out on all areas of the home and the tasks carried out. Staff have received training and updates on all health and safety topics. The provider has systems to monitor the quality of the care and services provided to ensure continuous improvements and to ensure the home is run in the best interests of residents. Comments from residents during this inspection included “I think I made a good choice to come here, I am quite happy” and “ staff are always caring and very helpful”. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can Rest Haven DS0000022014.V312740.R01.S.doc Version 5.2 Page 8 be made available in other formats on request. Rest Haven DS0000022014.V312740.R01.S.doc Version 5.2 Page 9 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 Rest Haven DS0000022014.V312740.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): OP 1, 2, 3 & 6 in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive clear information about the home, it’s facilities and services. The initial assessment procedure does not always ensure accurate information is provided prior to people moving into the home. EVIDENCE: The home has a comprehensive statement of purpose and service user guide. This is made available to all prospective residents, or relatives, when making an enquiry about admission to the home. The document is detailed and during discussion with the manager it was discussed as to whether it was “resident friendly”. The manager said that often residents did not read them. Relevant, up to date information was made available in individual residents’ rooms, for example, meal times, weekly activities, church services and what to do if residents were unhappy about anything at the home[ complaints procedure]. During this visit the inspector spoke to a relative who said they had received Rest Haven DS0000022014.V312740.R01.S.doc Version 5.2 Page 11 “plenty of information”. Another residents said her family had “dealt with all information and they were happy”. Three residents who responded to questionnaires sent before this visit all commented that they had received information on which they were able to make a decision to make Resthaven their home. During this visit three residents files were looked at. All included signed contracts/ terms and conditions of residency between the resident and the home. These were clear and easy to understand. A resident commented in a questionnaire that they didn’t know whether they had received a contract. This was discussed with the manager who confirmed that all residents are given a contract 4 weeks after admission, but often relatives are involved in this and not residents. The first 4 weeks spent at the home is on a trial basis so that the residents may change their mind or the home may decide that they are unable to meet all the residents’ health and social care needs. This is clearly set out in the homes’ contract and is also included in a letter which is sent to all new residents when the home confirms that they can meet their assessed needs. The manager said that she or the assistant manager, sometimes both, visit all prospective residents before a decision is made regarding their moving to the home. This is to ensure that the environment, staff competencies and the home’s registration category are able to meet individual health and social care needs. Three residents files, one of which had recently moved to the home, were looked at. A comprehensive assessment of needs had been undertaken but this had been done after admission to the home. The manager said that the resident had been visited at their home and had visited Resthaven before moving there. A record of the assessment had not been kept although the needs of the resident were discussed with staff who are also involved in the decision making. The home does not admit people who need intermediate care. Rest Haven DS0000022014.V312740.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): OP 7, 8, 9 & 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents benefit from care plans that are well formulated and give clear information to enable staff to meet resident’s health and social care needs. Good practice needs to be extended to encompass all areas of risk. Residents are safeguarded by good methods of administration and recording of medicines. Residents are treated with dignity and their privacy is respected. EVIDENCE: All residents at Resthaven have comprehensive plans of care which are clearly written and provide information to enable staff to meet residents needs in a manner which they prefer. For example, a key worker had included details of exactly how a resident chose to have personal care given. This ensures consistency of care is given by all staff. Rest Haven DS0000022014.V312740.R01.S.doc Version 5.2 Page 13 Staff confirmed they find the plans useful and that they refer to, and record in them, regularly. Records were seen of some excellent observations made by staff. Residents said they were not interested in their care plans but knew that information was written about them. One resident said “the staff treat me well and talk to me every day about everything”. Three care plans read contained comprehensive information covering all aspects of individual residents’ needs and how they are met at Resthaven. The plans did not show how the home considered the goals they hoped to achieve when assisting residents to maintain or regain independence. One resident said that they had set them selves a goal of walking without an aid. No details of this were recorded. Staff were aware of goal setting and were able to discuss individual residents’ aims. Records showed that individual plans of care are reviewed at least once a month and additionally when changes take place. The documents are stored in files which staff have daily access to. The manager said that residents or their relatives, with the residents; consent, can look at the plans at any time they wish. The care plans looked at included information about individual health care needs, including diabetes. Seven GP’s responded to this inspection by completing questionnaires, and their responses showed that they are satisfied with the care provided by the home. Nutritional screening is not regularly carried out when people move into the home but has been where necessary. For example an assessment had been undertaken for a resident when it was noted their normal, healthy, appetite had decreased. A GP was consulted and nutritional supplements were prescribed. Residents’ weight is monitored regularly, and assessments are carried out to ensure pressure sores are prevented by ensuring all residents have a healthy, balanced nutritional diet. Staff have received a range of training on health topics including diabetes and well being for older people. Residents have access to healthcare services that meet their needs including chiropody, opticians, dentists and specialist services such as dietician, diabetic and skin care specialist nurses. Moving and handling risk assessments have been completed with clear instructions on how staff should move residents safely. Staff have received appropriate training to ensure they understand such needs. They demonstrated an excellent knowledge of residents’ needs, risks, likes and dislikes. Communication between staff is very good. Residents liked the family atmosphere and said “nothing was too much trouble”. Three residents who responded to questionnaires confirmed that there care needs were met by the staff at the home. Rest Haven DS0000022014.V312740.R01.S.doc Version 5.2 Page 14 The management of medication was looked at; all staff who administer medication have received training on the safe handling and administration of medicines, therefore protecting residents health and welfare. Unused or unwanted medicines are disposed of correctly. Medicines with a limited shelf life once open, such as insulin, had not been dated to ensure it was used within the appropriate timescale. The medicines fridge had been maintained at the necessary temperature to ensure that medication was safe and effective. All medication is securely stored in locked cabinets, one for each floor, in a locked room. Residents’ privacy and dignity are met and promoted by the staff and management at the home. Staff are aware of the home’s guidance on respecting residents’ privacy and dignity and were seen treating all residents kindly and gently during the inspection. Residents confirmed that all staff are friendly, kind and treat them as they wish to be treated. Throughout the visit good interactions were seen between staff and residents, they were patient, gentle and kind when assisting residents. Rest Haven DS0000022014.V312740.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. JUDGEMENT – we looked at outcomes for the following standard(s): OP 12, 13, 14 & 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Social needs and meals are well managed. Meals are wholesome and nutritious, taking account of the likes and dislikes of individuals. Residents are encouraged to maintain contact with their families or friends as they wish and their rights are recognised and respected within the home. EVIDENCE: The daily routine, including getting up, going to bed and mealtimes, appeared to be flexible. Staff said there were no actual routines at the home, residents were able to choose what they did and when. Several residents said they are told of activities going on in the home and are able to choose whether to take part or not, others said they enjoyed spending time in their rooms and chose not to take part. On the day of this visit some Rest Haven DS0000022014.V312740.R01.S.doc Version 5.2 Page 16 residents took part in an exercise to music session, which is carried out daily in one of the lounges. Regular activities include day trips and lunch out, craftwork, aromatherapy, shopping and having speakers visit the home. Three questionnaires received from residents stated there were always or usually activities arranged by the home that they can take part in. When asked if they could change one thing to improve the way the care works, one staff member commented “to have more funds available to employ extra staff to cope with social needs of residents, for example, taking a resident out shopping or to enjoy a tea or coffee out somewhere”. Another commented, “the manager has listened to staff and has acted on several issues including more activities for residents. As a result residents are enjoying a weekly aromatherapy session and quizzes and bingo are now a regular weekly occurrence”. Several residents’ rooms were looked at during this visit. All were well decorated, warm and comfortable. Residents said they were able to bring many of there cherished possessions to Resthaven when they moved into the home. All bedrooms visited had been personalised with items such as pictures, photographs and various pieces of furniture. The home is a Christian home and residents are supported to maintain their religious beliefs by staff at the home. A resident commented “The home is a Christian home so residents who have a faith enjoy worship in the chapel although nobody is forced to attend” Several residents attended a morning service during this visit. A resident said the chapel is used by those who wish to sit in a private, peaceful setting and also by groups also use the room to chat. One of the residents enjoys arranging flowers for the chapel and these were admired at the time of this visit. There is no restriction on visiting times and throughout the day visitors came to the home and were made to feel welcome. Staff greeted them in a kind, friendly manner and visitors confirmed that this was always the case. Residents may choose where they want to spend time with their visitors, either in the privacy of their rooms or the public rooms. All residents spoken to said they generally enjoyed the food served at the home. One resident said that because of health issues her diet was somewhat limited and found the puddings monotonous at lunchtime. More choice was offered at evening mealtime. During the visit good quality, fresh, fruit and vegetables were seen and the midday meal was balanced and nutritious. The home caters for all dietary needs including vegetarian and diabetics. Residents are given the choice of being served their meals either in their rooms, the lounge or the dining room. Staff consult with all residents daily Rest Haven DS0000022014.V312740.R01.S.doc Version 5.2 Page 17 telling them the meal planned for the day and offering an alternative if requested. A comprehensive record of residents’ likes and dislikes are recorded and included in residents’ plans of care. The inspector was present when lunch was served; the meal was well presented and nutritious. A questionnaire returned by a resident stated that the home has an “imaginative menu”. Another commented “there used to be a better variety menu”. A member of staff commented “Excellent varied diet. Fresh fruit and veg each day. We celebrate occasions such as bonfire night, Easter, Christmas, and have barbeques, cream teas and fetes in the summer”. Rest Haven DS0000022014.V312740.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. JUDGEMENT – we looked at outcomes for the following standard(s): OP 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are assured they will be listened to and their concerns and complaints acted upon. Good measures have been put in place to protect residents from abuse. EVIDENCE: The home has a complaints procedure, which is included in the information available to residents before admission. A copy of the procedure is prominently posted on a notice board in the entrance hall and all residents have a copy of it in their rooms. No complaints have been received by the home or Commission since the last inspection. The residents who responded to this inspection by completing a questionnaire said they always know who to talk to if they aren’t happy, or if they want to make a complaint. Comments included “ the staff often ask if we are content, they don’t wait for us to tell them”. Residents said if they were unhappy they would talk to any member of staff or management team. Staff were able to confidently describe how they would deal with the situation if a complaint was made to them. A resident confirming they were aware of how to complain commented “ We have a complaints box where we can put a written note in”. Rest Haven DS0000022014.V312740.R01.S.doc Version 5.2 Page 19 At a residents’ meeting, held recently, it was proposed that the home had a suggestion box. This is now in place and the manager confirmed that several residents have made suggestions which are being attended to. The home has a range of policies and procedures in place relating to the prevention of abuse. All staff have had training on the protection of vulnerable adults. All staff demonstrated an excellent understanding of different types of abuse and understood what to do if they suspected any. Staff described Resthaven as being “the residents’ home and as such is one big family”. Rest Haven DS0000022014.V312740.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. JUDGEMENT – we looked at outcomes for the following standard(s): OP 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment within the home is good providing residents with a safe, attractive and homely place to live. Attention is needed in some areas where the décor is looking “tired”. The cleanliness and standard of hygiene maintained at the home is excellent. EVIDENCE: The home is extremely clean and well maintained both inside and out. The home has an open, welcoming reception area. Décor is of a generally good standard, and refurbishment is on-going to ensure the home remains comfortable and homely. Some areas of decoration in the home is looking tired and would benefit from redecoration. For example, paintwork on several doors and skirting boards have been scuffed and look unsightly. This could also make Rest Haven DS0000022014.V312740.R01.S.doc Version 5.2 Page 21 them difficult to clean. This was discussed with the manager who said that some parts of the house are due to be changed and during this process several areas will be redecorated. A passenger lift and stair lift ensure that all areas of the home are accessible to residents. At the time of this visit the home was exceptionally clean and fresh, for which the staff are to be commended. All residents responding to questionnaires said that the home was “Always” clean and fresh, “staff are always cleaning” and “my room is thoroughly cleaned”. Staff had knowledge of infection control issues such as MRSA and there was evidence of good practice, for example the manager will liaise with other health professionals to ensure that practice is up to date. There are gloves, paper towels and liquid soap around the home, to promote good basic hygiene. The laundry is well equipped and appeared to be well organised. Sluice areas were clean and the home was generally hygienic. During this visit a crack extending the height of a wall in the laundry was seen. This was discussed with the manager who said that an architect had been consulted about this and the crack was “ being monitored”. It was thought that it was caused by tree roots in an area of garden close to the building. The manager confirmed that according to advise she had been given the appearance of the crack residents health and safety was not at risk. The situation continues to be closely monitored. Rest Haven DS0000022014.V312740.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. JUDGEMENT – we looked at outcomes for the following standard(s): OP 27, 28, 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The number of staff on duty throughout the day and night meets residents’ personal and health needs. Residents benefit from being cared for by staff who are qualified and competent and are protected by the robust recruitment practice followed at the home. EVIDENCE: On the day of the inspection the manager, deputy manager, care coordinator, five carers, a cook, a kitchen assistant and two domestics were on duty. In the afternoon this changed to four care staff and a laundry person. The rota shows that there are two waking and one sleeping staff on duty throughout the night until 8 am. There is always a senior carer on duty throughout the day and night at the home. Three residents who returned questionnaires felt there are always enough staff to care for them at all times. Rest Haven DS0000022014.V312740.R01.S.doc Version 5.2 Page 23 The manager promotes the role of key workers for each resident with the aim that they know the resident well and support them with personal tasks. This works towards meeting the homes’ ethos of maintaining person centred care for all residents living at Resthaven. All newly employed staff undergo a period of training when they start working at the home to enable them to get to know the residents, the home’s philosophy of care, safety procedure, care procedures, and the general layout of the home. The time taken to complete this training will depend on past experience and individual ability. All staff have received a good level of training and over 33 of the team have completed a nationally recognised qualification [NVQ] at level 2 or above, which is a good achievement. Training included diabetes, basic food hygiene, fire safety, medication and manual handling. The manager said that training would be provided according to the needs of the residents as and when necessary. Staff demonstrated an excellent awareness of residents needs and risks throughout the inspection. According to pre inspection information staff have undertaken a variety of training including basic food hygiene, first aid and protection of vulnerable adults. Training planned to take place during the next 12 months include manual handling training and 3 members of staff are undertaking NVQ training. Ensuring that residents are cared for by a competent team of staff further promotes person centred care and safety. The home operates a good recruitment procedure that clearly highlights the processes to be followed. Two staff recruitment files were looked at during this visit. The documentation was consistent with evidence of a safe and robust recruitment process being carried out before a person is employed at the home. This protects residents, as only people who have undergone this robust procedure will be employed to work at their home. Communication between the manager and staff is excellent which ensures residents’ needs are fully understood at all times. Rest Haven DS0000022014.V312740.R01.S.doc Version 5.2 Page 24 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is generally well managed, run in the best interest of residents, and their health and safety are properly attended to. The Responsible Individual for the home is not fully complying with their duties. EVIDENCE: The manager, who has been in post since May 2006, and has been involved in elder care since 1993 and in the field of nursing, NVQ assessing and residential care since 1982. The manager is a qualified level 2 nurse and has completed the Registered Managers Award and City & Guilds in Advanced Management and Care. She says she enjoys training and will request to go on courses if she feels a need to do so. She also enjoys undertaking staff training and is able to Rest Haven DS0000022014.V312740.R01.S.doc Version 5.2 Page 25 recognise her own limitations. She described ways in which she updates her knowledge. Having a competent registered manager ensures residents are cared for by an experienced and qualified person, therefore protecting their health, welfare and safety. A member of staff commented “I am enjoying working with our new manager very much. She listens very carefully to staff and residents needs, worries and complaints”. Several residents said that they felt the manager was approachable and is always available During the inspection the manager demonstrated good knowledge about the needs of residents A quality audit has been undertaken since the last inspection to gather views of residents related to the running of, and the quality of life experienced at, the home. This included comments about standards of care, quality and variety of food, activities, cleanliness, laundry, privacy and management and administration at the home. The results of the survey have not yet been made available to current or prospective residents, or their representatives/ interested parties or the CSCI. Reports relating to unannounced monitoring visits by the person undertaking responsibility for the home have not been supplied to the Commission as they should. Residents are encouraged and supported to look after their own financial affairs. Secure storage is provided for their money, which is safely handled by the home. The temperature of hot water in bathrooms is checked before a resident is bathed to ensure that the resident is protected from the risk of scalds. All first floor windows checked were fitted with window restrictors promoting safety within the home by reducing the risk of residents falling from them. Fridge and freezer temperatures are recorded which is good practice. Staff involved in food preparation confirmed that they had food hygiene qualifications. All radiators seen during this visit radiators had been covered to promote the safety of residents. Records show that staff undertake training in the prevention of fire, and fire alarms and emergency lighting have been carried out regularly. An assessment Rest Haven DS0000022014.V312740.R01.S.doc Version 5.2 Page 26 of identified hazards and associated risk relating to the environment, including fire hazards, has been undertaken which contributes towards ensuring that Resthaven is a safe place to live. Rest Haven DS0000022014.V312740.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 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 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 4 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x 3 2 3 x 3 3 3 Rest Haven DS0000022014.V312740.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? Yes 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. 1 Standard OP3 Regulation 14[a][b] Requirement Timescale for action The registered person shall not provide accommodation to a 30/12/06 service user at the care home unless, so far as it shall be practicable to do so , the needs of the service user have been assessed by a suitably trained person and the registered person has received a copy of the assessment. This relates to undertaking an assessment before people are admitted to the home. The registered provider shall supply a copy of the report to be made under paragraph (4)(c) (on the conduct of the home) to the Commission. [This refers to the lack of report following the monthly unannounced visits by a representative of the organisation] This is the 2nd time this requirement has been made. 2. OP33 26(5) 30/12/06 Rest Haven DS0000022014.V312740.R01.S.doc Version 5.2 Page 29 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2. Refer to Standard OP8 OP33 Good Practice Recommendations Nutritional assessment should be undertaken on admission and subsequently on a periodic basis. The results of residents’ surveys should be made available to all interested parties including current residents. Rest Haven DS0000022014.V312740.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Devon Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Rest Haven DS0000022014.V312740.R01.S.doc Version 5.2 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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