Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: Roseland Nursing Home Roseland Parc Fore Street Tregony Truro Cornwall TR2 5PD The quality rating for this care home is:
two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Diana Penrose
Date: 1 3 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area.
Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection.
This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home
Name of care home: Address: Roseland Nursing Home Fore Street Roseland Parc Tregony Truro Cornwall TR2 5PD 01872530665 01872530222 jfloydnorris@roselandcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Roseland Care Ltd Name of registered manager (if applicable) Ms Lynne Brown Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is 37. The registered person may provide the following category of service only: Care home with Nursing - Code N to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (Code OP) - maximum 37 places Physical Disability (Code PD) maximum 15 places Dementia, excluding learning disability and Mental Disorder (Code DE) - maximum 17 places Date of last inspection 17 0 15 Over 65 0 37 0 care home 37 Care Homes for Older People Page 4 of 30 Brief description of the care home Roseland Nursing Home is a purpose built property adjacent to the previous home, Penlee. The is part of a care village where people over 50 years of age can live. It is in the village of Tregony, which offers shops, a post office, a public house and three churches. There is ample car parking close to the home. Accommodation is provided on two floors, with staircases and a shaft lift for access. There are 36 bedrooms all with en-suite wet room shower facilities and all have overhead hoist tracking installed. They have been furnished to a high standard. One bedroom is large enough to accommodate two people who choose to share. Separate assisted bathing facilities and toilets suitable for wheelchair users are also provided. Corridors are wide and communal space is available throughout the home. There are several smaller areas where people can sit in addition to the more formal lounges and dining areas and there is an activities room. A shop, hairdressing salon, computer facilities, library, swimming pool and gymnasium are accessible from within the home and to people in the village. The complex has good security to deter people from wandering into the nursing home undetected. Externally the grounds have been landscaped with wheelchair accessible paths and seating areas. There are ponds, flowerbeds and troughs of plants. Suitably qualified nurses and care assistants provide nursing and personal care within a relaxed friendly atmosphere. An experienced team of staff provide structured activities every day. Entertainment, outings and events are also organised. Information about the home is available in the form of a statement of purpose and a service user guide. A copy of the most recent inspection report is available in the home. Fees range from 550 to 800.00 pounds per week. Additional charges are made in respect of private healthcare provision, hairdressing and personal items such as newspapers, confectionary and toiletries. Care Homes for Older People Page 5 of 30 Summary
This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: An inspector visited Roseland Nursing Home on the 12 February 2009 and returned to complete the inspection on 13 February 2009. She spent ten and a half hours at the home in total. This was a key inspection and an unannounced visit. The purpose of the inspection was to ensure that residents needs are properly met, in accordance with good care practices and the laws regulating care homes. The focus was on ensuring that residents placements in the home result in good outcomes for them. It was also to gain an update on the progress of compliance to the requirement identified in the random inspection report dated 13 August 2008. All of the key standards were inspected. On the day of inspection 33 people were living in the home. The methods used to Care Homes for Older People
Page 6 of 30 undertake the inspection were to meet with a number of residents, relatives, staff and the registered manager to gain their views on the services offered by the home. Records, policies and procedures were examined and the inspector toured the building. This report summarises the findings of this inspection. The registered manager has complied with the requirement set at the last inspection. Residents and relatives expressed high satisfaction with the care and services provided at the home. What the care home does well: The service provides a purpose built building that is very well maintained. The home is set in lovely surroundings; it is very clean, warm and comfortable. There are very good measures in place for the prevention of infection. Information about the home is available in the form of a statement of purpose and service user guide. The manager said she would aim to produce these in large print or different languages if requested. Residents are only admitted following an assessment to ensure the home can meet their needs. Prospective residents and their family are invited to visit the home prior to any decisions being made to live there. A relative said she visited the home and was given good information prior to her mother being admitted. Peoples healthcare needs are met and specialist healthcare professionals visit the home as required. The system for medication in the home is appropriate and safe. Medicines are stored securely and only qualified nurses administer the medicines. Relevant equipment is provided for moving and handling purposes and pressurerelieving equipment is supplied as required. Adjustable hospital beds are provided throughout the home. Each person using the service has an individual care plan and risk assessments are undertaken. All residents spoken with said the care is very good and they are happy living in the home. They said they are treated with respect and dignity and their privacy is upheld at all times. They also said their individual preferences are respected and they can choose what they do each day. Visitors said they are always made welcome in the home and offered a cup of tea. Social activities take place every day of the week and are co-ordinated by a team of carers who have undertaken appropriate training in this area. Arts for health is enjoyed along with exercise classes and games. Trips out are arranged and entertainers come into the home. Time is also spent on one to one sessions which people appreciate. There is a nutritious menu with several choices available including a vegetarian option; residents said the food is very good or excellent. Fresh fruit and vegetables are included and there are homemade cakes provided each day. Some people chose to eat in their rooms but everyone spoken with said they enjoyed their lunch. There is a system in place that ensures complaints are dealt with promptly and records are kept. There is a suitable policy for the prevention of abuse; staff have received training in the protection of vulnerable adults and the procedure to be followed. There is a very robust recruitment procedure and appropriate training is provided for staff. There are appropriate staffing levels with a skill mix to meet peoples needs. A qualified nurse is on duty at all times. Residents said the staff are kind and caring and very patient. 53 of care staff have an NVQ qualification in care and others are working towards a qualification. The Registered Manager is a qualified nurse who has managed the home since July 2008. She is a competent and experienced manager who is very motivated and keen to keep up to date. Staff said she is very fair and deals with things promptly before they Care Homes for Older People Page 8 of 30 get out of hand. Everyone said she is approachable and they feel they can air their views. There is a quality assurance system in place that allows people to air their views. The management strive to review and continually improve the service. There is a suitable system in place for managing peoples monies and money is stored securely. The management team promotes the health safety and welfare of people using the service and the staff. There are suitable policies, procedures and safety checks in place. What has improved since the last inspection? The statement of purpose and service user guide have been updated and contain the information required by legislation. The document gives clear information about the home and is presented with a colourful cover. Policies have been reviewed and the manager has started to produce local simplified procedures for staff to follow. She has reviewed the care planning system and produced plans that are more directional for staff. She has also improved the medicines system and is compiling a file of medicine procedures. Staff are continually supported with training and most have attended the No Secrets training, to protect vulnerable adults from abuse. The Liverpool Care Pathway has been introduced and the home is hoping to introduce The Gold Standard Framework for palliative care. Staffing levels and skill mix of staff has improved so that peoples needs can be met. Social activities have been developed really well and the co-ordinators have full time roles. Activities are provided every day including weekends, trips out are organised and entertainers visit the home. There is more community involvement and the programme of activities has improved. Monthly newsletters are produced and residents discussion groups are encouraged. Although the home is very new with the official opening taking place in July 2008, maintenance and refurbishment are ongoing. The cafe area beside the activities room has been provided with tablecloths and vases of flowers so more people utilise it now. The garden area has been provided with more plants, shrubs and water features, and there are plans to develop raised beds to enable the residents to actively become involved in gardening. A herb area is to be developed which will benefit those people who are visually impaired. Documentation in many areas has improved and further auditing is taking place to ensure continual monitoring and improvement. Care Homes for Older People Page 9 of 30 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 10 of 30 Details of our findings
Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 11 of 30 Choice of home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Suitable information is given to prospective residents enabling them to make an informed choice as to where to live. Residents are only admitted to the home following an assessment of their needs to ensure the home can provide suitable care. Evidence: The home has a statement of purpose and a service user guide and both have been recently reviewed and updated. They include all of the information required in Schedule 1 and are presented well with colourful covers. The registered manager said that if required these documents could be produced in larger print and if necessary they would try to re-produce in a different language. The manager told us that it is usually her that visits prospective residents prior to admission but she hopes to extend this to include the nursing staff. She carries out a needs assessment to ensure that the home is suitable and that they can care for the
Care Homes for Older People Page 12 of 30 Evidence: person appropriately. We were shown the forms for recording this initial assessment; they comply with standard 3.3 and have space for dating and signing. Completed forms have detailed information recorded and information from social workers and hospital nurses is included as well. The manager said that prospective residents and their relatives are encouraged to visit the home before deciding it is the right one. This was confirmed by talking to people using the service and their relatives. Care Homes for Older People Page 13 of 30 Health and personal care
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person using the service has a detailed written care plan that enables staff to ensure that healthcare needs are met. There is an appropriate system for the use of medicines that safeguards the people using the service. Evidence: Each person using the service has a written care plan that covers their health and personal care, social and religious needs. Life stories are included and are informative. Three care files were inspected during this visit. The Standex system is used and there are several risk assessments incorporated. The care plans contain detailed information about the people using the service but could be more specific in some areas to fully direct staff in the care to be provided. This was discussed with the manager. The manager said that the plans are compiled with the resident or their representative and they were signed as agreed. They were all reviewed monthly dated and signed. Daily records are maintained and generally informative. Consent forms were seen for the use of cotsides and were signed by the resident or
Care Homes for Older People Page 14 of 30 Evidence: their representative. The risk assessment in use needs to be more detailed. This was discussed with the manager who said she would address it. The inspector completed an observation of care practices for an hour and a half. This focused on observing the interactions of five of the six residents sitting in one of the lounges. Staff were coming and going and generally interacted well with residents when they came into the room. One resident was withdrawn and slept for short periods; staff did not interact with her as much as the others. This was discussed with the manager. Residents spoken with said their health needs are met very well and they have access to their GP or other health professionals when required. There were also records in the care files of health professionals visits. The manager said that links with specialist healthcare professionals is very good and the nurses employed keep themselves up to date on current practice. She said she is looking into commencing the Gold Standard Framework for palliative care and said they have utilised the Liverpool Care Pathway for end of life care in the home already. There is appropriate moving and handling and pressure relieving equipment in use and hospital style beds are provided. Care practice was observed to be appropriate during this inspection and staff informed people of what they were about to do prior to moving them and so on. There is a suitable policy and system in place for the use of medicines in the home. Medicines are administered from individual pots or packets that are stored safely in individual labelled trays in tidy trolleys. One person is self-administering at the moment and has signed an agreement to do this. Storage of controlled medicines and those requiring refrigeration is satisfactory with appropriate records maintained. Records are kept of all medicines entering and leaving the home. The medicine charts are typed and there were no gaps observed in the administration records. For people prescribed to have medicines administered when required we found that there were no care plans in place about the use of this medicine, or any directions on how to make an assessment if this medicine is required. The manager said that the documentation would be addressed with the nurses. There is a homely remedies policy; the list of approved remedies is due to be signed by a doctor. There are relevant reference books and patient information leaflets are available for staff or residents to refer to. Care staff receive some medicines training, the manager said she would ensure that basic training is formally included in the
Care Homes for Older People Page 15 of 30 Evidence: induction programme. Staff were observed to uphold residents privacy during the inspection and knocked on doors before entering. Residents said their privacy is always respected and they are treated with dignity. Privacy and dignity are referred to in the statement of purpose and are covered in the induction programme. Care Homes for Older People Page 16 of 30 Daily life and social activities
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A wide variety of activities and social events are provided every day in consultation with the residents, visitors are welcomed and people are encouraged to be independent and live a life of their preference. Evidence: Everyone spoken with was aware that activities are on offer seven days a week. There are staff employed solely to organise and provide activities, trips out and social events and they have a dedicated room provided. There is a library, gym and a swimming pool in the building, and a bowling green in the village that residents can use if they wish. Staff run a small shop for residents to buy toiletries and confectionary and there is a hairdressing salon on site. Computing facilities are available and training for resident who are interested. The home also has its own chapel. Social needs are included in the care plans and each person has a sheet detailing their participation. Activities include singsongs, exercise classes, bingo, photography art and crafts, trips out and one to one chats. The notice board advertised coming events, mobile library visits, todays activities and letters of thanks for fundraising. The manager said they are looking into activities specifically for people with dementia and
Care Homes for Older People Page 17 of 30 Evidence: short trips out are being arranged. As stated in the previous section, the inspector completed a structured observation in one of the communal lounges. The television was on throughout this period, but the volume was turned down. Residents looked at the television from time to time, looked around the room or out of the windows. Sometimes they stared at the floor or dozed. A nurse was doing a jigsaw with one resident for most of the hour and a half and two residents were taken out to join an exercise class for a while. They all had a cup of tea and a biscuits during the observation period and a member of staff looked at photographs with one resident. Activities staff were conversing with residents and other staff. The residents did not interact together very much. People talked about the activities team with enthusiasm and they seemed very busy during this inspection. Some people were helped with knitting and there was a residents meeting in the afternoon. One of the activities team spoke about the training courses she has undertaken, she has been working with the residents for several years and knows their likes and dislikes. She said they respect the wishes of those who do not like to join in with group activities. There is a record of visitors to the home and there were visitors in the home during this inspection. People said they could receive visitors in private and at any time. Visitors spoken with said they are always made welcome in the home and can call whenever they like. They said the staff and manager are very friendly and helpful. People using the service said the telephone arrangements are good and people were seen to have telephones in their rooms. People said they choose when they get up and go to bed. They said they choose what clothes to wear and how they spend their day. They said they choose whether to stay in their room or go to the lounge. All residents were suitably dressed in clean clothes. Peoples rooms were personalised with their own belongings and furniture. Staff said that some people control their own money. Meals are cooked in a large kitchen that also provides meals for the restaurant and some meals for people in the retirement village. The catering manager showed us a 4week menu that has good choices available including a vegetarian option. There are hot meals available at lunchtime and teatime and fresh fruit is on offer at all mealtimes. Meals are ordered in advance and the menu is available on the dining tables. Not all people could remember what they had ordered for lunch but everyone said the food is very good. Snacks and drinks are available between meals; water and juice is provided in all
Care Homes for Older People Page 18 of 30 Evidence: rooms. Meals are served in the dining room, lounges or private rooms; it is the individuals choice. There is also a restaurant where residents can eat if they wish. All dining tables were laid with linen tablecloths and serviettes. Care Homes for Older People Page 19 of 30 Complaints and protection
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are suitable policies and processes in place for complaints and adult protection to ensure that people using the service are safeguarded. Evidence: There is a suitable complaints policy for the home; the manager was advised to include the option of reporting complaints to the department of adult social care. There is a suitable system for recording complaints and the outcomes. Nine complaints have been reported to the home and suitably dealt in the past year. Letters of thanks are kept. People using the service said they could raise issues with any of the staff or the manager. The home has a copy of the local inter-agency procedures for safeguarding adults from abuse and its own policy. Staff have received abuse training in house and most have attended the local council courses. There have been four abuse allegations since the last inspection, these have been appropriately reported and investigated. The Commission has undertaken two random inspection visits as part of these investigations, one in December 2007 the other in August 2008. Breaches in regulations had occurred in respect of recruitment, fitness and competence of staff and staffing levels. The registered providers addressed all of the issues promptly. No breaches have been identified during this visit.
Care Homes for Older People Page 20 of 30 Care Homes for Older People Page 21 of 30 Environment
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is purpose built, clean, well maintained, decorated and furnished to a very high standard, there are no unpleasant odours, making it a very pleasant place to live and work in. Evidence: The home has been purpose built and complies with the National Minimum Standards. All bedrooms have en suite wet room shower facilities and overhead hoists are provided. There are assisted bathing facilities and toilets adapted for wheelchair users. All of the corridors and doorways are also wide allowing ample room for wheelchairs. There are two large lounges and other seating areas around the home. There is a lovely chapel with stained glass windows that is used for religious services and communion as well as for meetings and other social activities. There is a restaurant, library with computer, gym and swimming pool that people using the service can share with residents of the retirement village. There is a shop and a hairdressing salon on site. There is also a treatment room where Doctors hold two surgeries per week and a physiotherapist treats residents. A training room is provided for staff use. The manager said they are looking to have themed corridors to make the environment more interesting for people using the service. The grounds are well cared for and accessible with ponds, troughs of plants and bird
Care Homes for Older People Page 22 of 30 Evidence: tables. There is outdoor seating available. The manager said she has more plans for the garden to include raised beds and a herb garden for residents to get involved in. Staff said the new home is fully equipped and wonderful to work in. They also said it has taken some time for the residents who moved from the previous home, Penlee, to settle in to their new surroundings. Relevant policies and procedures are in place for infection control and records show that staff receive training in this subject. There are appropriate hand-washing facilities for staff in all areas and alcohol hand cleansing gel is in use. There are disposable plastic aprons and disposable gloves. Individual hoist slings are provided for residents and washed as required. The laundry is large with industrial machines; people said the laundry service is good. There are however some unclaimed items in the laundry that have not been labelled with residents names. Care Homes for Older People Page 23 of 30 Staffing
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are suitable staffing levels for the number of residents and evidence that staff hold nursing and NVQ qualifications. Recruitment procedures are robust and staff receive regular training this helps to safeguard people using the service and ensures staff have the knowledge and skills to care for them. Evidence: The registered manager said that staffing levels have improved and are much better; she said there are no vacancies at present. The duty rota shows that there are two nurses on duty during the day and one at night. There are generally seven care staff in the mornings, four in the afternoon and three at night. These numbers cover two floors. There are separate activities, catering, housekeeping and maintenance staff. The AQAA states that agency staff have been used but staff told us that this is not very often now. Staff spoken with said that staffing levels and skill mix of staff has improved since the CSCI random inspection in August 2008. They were all satisfied in their roles and said the team works well together. People using the service said the staff are very kind and caring and there are enough on duty. One person said they always answer the call bell promptly and dont keep you waiting. Care Homes for Older People Page 24 of 30 Evidence: We were told that new care staff undertake an induction programme that includes the skills for care induction standards and leads on to the NVQ level 2 course, in care, when the person is ready for it. 53 of care staff are qualified to at least NVQ level 2 in care and others are enrolled on courses. An equal opportunities policy was seen and the manager said she treats everyone equally. Staff said she is very fair and gets things sorted quickly. Three recruitment files were inspected and contain the documents required by legislation. Relevant employment checks were seen. Interview records were seen and show that there is equality in the recruitment process. Staff are issued with terms and conditions of employment and a relevant job description. A 2009 training timetable is displayed on the notice board in the managers office. It shows that training is scheduled every month for the next six months. Training on offer includes, moving and handling, Parkinsons Disease, tissue viability, documentation and key worker responsibilities. This training is in addition to the statutory training provision. Certificates of training attended were seen in the personnel files along with feedback forms completed by the members of staff. The manager said she is in the process of devising a training matrix that will show easily who has attended training and when updates are due. Staff said there is plenty of training available to them and there are opportunities to attend external courses if they wish. Care Homes for Older People Page 25 of 30 Management and administration
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered manager is competent in running the home and systems are in place to monitor and improve the service for residents and staff. An appropriate system is in place for managing peoples monies and training and safety checks are undertaken to ensure the health, safety and welfare of residents, staff and visitors. Evidence: The registered manager is a first level registered nurse who has also completed an NVQ level 4 in management. She has been competently managing this home since July 2008. Staff said she leads the team well and has been methodically working through systems and making improvements. They said she very fair and they can approach her at any time as she has an open door policy. It is evident that a great deal of documentation has been reviewed and updated since she took up her post. A quality assurance survey is undertaken annually, the last was done before Christmas 2008. The results were seen and are very encouraging. The manager said she is
Care Homes for Older People Page 26 of 30 Evidence: addressing any issues raised. Various audits are undertaken and include care plans, care files, infection control and personnel files. The results were seen in a file. Other audits undertaken by management include medicines, environment and procedures. Someone from the companys head office visits monthly and undertakes an inspection followed by a written report, in line with regulation 26. These reports were seen in a file. The manager completed her Annual Quality Assurance Assessment (AQAA) in detail and returned it to the Commission within the allotted timescale. Staff meeting minutes were seen and a residents meeting took place during this inspection. People said they can air their views and things get done. Money is held by the administrator for twenty-eight residents. Others control their own money with the assistance of their relatives. Lockable facilities are provided in the bedrooms. Money is held securely in individual plastic wallets in the safe. Appropriate individual records are maintained and receipts are kept for all purchases. Discussion took place with regard to numbering the receipts for auditing purposes, providing receipts for money received and signing each transaction on the record sheets. The balances were checked by the registered manager or her line manager and signed regularly. Two balances were checked by the inspector and found to be correct. The policy in respect of managing residents monies needs to be reviewed and updated. The registered manager said she will also produce a local procedure. Key holding for the safe and access to money out of office hours needs to be included. The manager said they endeavour to ensure that working practices are safe. Heads of departments meet every two months and minutes are kept. There is also a health and safety action plan. Relevant service checks take place as required and details are maintained in a file. Fire maintenance checks are held in a file and are up to date. Health and safety risk assessments have been undertaken and so has a fire risk assessment. Records show that staff receive statutory training regularly and all of the nurses have undertaken first aid training. The catering staff have undertaken appropriate food hygiene training and records were seen. They have received very good reports from the environmental health officer and a certificate for achieving the gold standard award is displayed in the main reception. Accident reporting complies with data protection; there are very few accidents in the home on average 2-4 per month. Accidents are audited and reports were seen. Care Homes for Older People Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 28 of 30 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
