Inspection on 07/06/07 for Sandbanks Care Home

This inspection was carried out on 7th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 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

Sandbanks Care Home 06/07/06

Sandbanks Care Home 15/02/06

Sandbanks Care Home 12/08/05

Sandbanks Care Home 04/02/05

Sandbanks Care Home 12/07/04

Sandbanks Care Home 02/02/04

Sandbanks Care Home 09/12/02

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Sandbanks Care Home Southville Road Bedfont Middlesex TW14 8AP Lead Inspector Jane Collisson Unannounced Inspection 11:30 7th June 2007 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 Sandbanks Care Home DS0000032618.V335217.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. Sandbanks Care Home DS0000032618.V335217.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sandbanks Care Home Address Southville Road Bedfont Middlesex TW14 8AP 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) 0208 890 4872 0208 890 1160 paula.bilbie@hounslow.gov.uk London Borough of Hounslow Miss Paula Carol Bilbie Care Home – Care Home only 34 Category(ies) of Dementia - over 65 years of age (0), Old age, registration, with number not falling within any other category (0) of places Sandbanks Care Home DS0000032618.V335217.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Registered Person may provide the following categories of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old Age, not falling within any other category - Code OP Dementia - Code DE The maximum number of service users who can be accommodated is: 34 2. Date of last inspection 6th July 2006 Brief Description of the Service: Sandbanks is a purpose built home for 34 older people. Owned and managed by the London Borough of Hounslow, it is situated in a residential area of Bedfont, with local shops and buses within half a mile. There is adequate parking for staff and visitors, both in front of the home and in the nearby road. Changes to the home’s registration in 2007 had just been completed at the June inspection. Two units, Swallows and Lapwings, provide fifteen beds for people with dementia on the ground floor. On the first floor is the Magpies unit with ten beds for older people who may be frail because of illness, disability or age. The Community Rehabilitation Unit, with eight beds, was relocated to the first floor. This provides Intermediate Care, for up to six weeks, for people who have been in hospital, or at home, and require support to enable them to continue to live at home. A physiotherapist and an occupational therapist, employed by the Primary Care Trust, support the people using the service. A new therapy room has been created on the ground floor. Each unit has a pleasantly furnished lounge, kitchenette and dining area. Thirty two of the bedrooms are single and there is one double room. All of the rooms are over 12 sq. metres and each has a wash hand basin. There are four bathrooms, including a shower room and baths with equipment for people with disabilities, and nine toilets situated throughout the home. The communal facilities include a large lounge, suitable for entertainment, functions and meetings. There is a large entrance hall with seating, and a room for visitors, residents and staff to use to make drinks. The well-furnished Sandbanks Care Home DS0000032618.V335217.R01.S.doc Version 5.2 Page 5 conservatory is used as the smoking area. The home has an extensive garden, with a pond and seating. Part of the garden has been separated to provide an area for people from the dementia units to use in safety. The Registered Manager has the title of Resource Centre Manager, as she is also responsible for the day centre located on the same site. There is a Deputy Manager, three Team Leaders and a team of day and night support workers and auxiliary staff, an administrator and an activities organiser. The fees are £650 per week. Sandbanks Care Home DS0000032618.V335217.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection commenced on the 7th June 2007 from 11.30am to 4.45pm. The Registered Manager was present. The changes were almost complete, including the opening of the second unit for people with dementia. The two units, Swallows and Lapwings, will accommodate fifteen people in all. The Community Rehabilitation Unit (CRU) had just relocated to the first floor. This had seven people being accommodated for Intermediate Care at the time of the inspection and one person on respite. The Magpies unit on the first floor remains as a unit for ten frail older people. The home can accommodate two people on respite. A tour of all of the units and communal areas was made. Some refurbishment work has been undertaken and has resulted in a comfortable and homely environment to benefit the people using the service. The second visit of the inspection was made on the 22nd June from 10.05am to 2pm. During the visits, the majority of the people living in the home were met, together with staff, the activities organiser and the administrator. The new Team Leader and the physiotherapist were met in the CRU. No visitors were seen to speak to but it was confirmed by residents that relatives and friends are welcomed to the home. All of the units were full, with the exception of Lapwings, which had only just opened and had four vacancies. The activities organiser and the staff were undertaking group activities in the Swallows unit including, on the first visit, a game of dominoes. In the smaller unit of Lapwings, one person was enjoying oil painting. Conversations about items in the newspaper were taking place in the Swallows unit during the second visit and a game of bingo had been held. In the other units, where residents are more able to choose their own activities, people were watching television and reading papers in the lounges or spending time in their own rooms. A singer was due to entertain on the following Sunday and a cream tea has been arranged. People expressed their appreciation of the various activities, including skittles and craftwork, which are available to them. Few people required any specialist cultural needs to be met but it was confirmed that special diets can be provided if required. The religious needs of people are provided by communion and church services being available in the home. One person is continuing to attend a specialist day centre. Staff had found visual prompts to support their communication with a person, in the home on a temporary basis, whose first language was not English. A total of twenty three Commission for Social Care Inspection surveys were returned, including ten from families. The Registered Manager provided all of Sandbanks Care Home DS0000032618.V335217.R01.S.doc Version 5.2 Page 7 the information required by the CSCI in the Pre-Inspection Questionnaire, including training records, training plans, menus, rotas and an improvement plan. Samples of care plans, risk assessments, health records, and maintenance records were examined. The posts of the Manager and Deputy Manager are currently “acting up posts”. When a Hounslow local authority home closed in 2006, some of the residents and staff transferred to Sandbanks. As the changes are now complete, the positions are to be recruited as permanent posts. The home also has vacancies for care support workers which are to be filled. There were five requirements at the last inspection and all of these have been met. What the service does well: What has improved since the last inspection? What they could do better: Sandbanks Care Home DS0000032618.V335217.R01.S.doc Version 5.2 Page 8 The previous requirements have been met and none were made on this inspection. Two recommendations were made. One was in regard to the provision of larger print menus, to enable people to see what is available. The second was for the Registered Providers to carry out a review of policies and procedures to ensure they are up-to-date with new legislation and good practice. 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 be made available in other formats on request. Sandbanks Care Home DS0000032618.V335217.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 Sandbanks Care Home DS0000032618.V335217.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): 1, 2, 3, 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The information is available for people who may wish to live in the home to make an informed decision. People with dementia are having their needs met by the provision of comfortable and secure accommodation, with staff trained to provide a good quality of life. The Community Rehabilitation Unit is working to maximise the independence of the people to enable them to return to their own homes. EVIDENCE: The Statement of Purpose and Service Users Guide have been updated to take into account the changes to the home and its units and copies were supplied. The documentation would assist in helping any prospective resident or their representative to make a decision about moving to the home. The Service Users Guide provides, in larger print, clear information on the facilities and services available in the home, which includes the complaints procedure. Signed copies of the terms and conditions were seen in the files examined. Sandbanks Care Home DS0000032618.V335217.R01.S.doc Version 5.2 Page 11 Information was seen in the eight files examined of the assessments received from Social Services or the hospital prior to admission. These included information on the needs of the person and how they could be met. The majority of the permanent beds in the home are for people with dementia and adaptations have been made to accommodate them. Staff have been trained to provide support for people with dementia and the care plans reflected how the individual needs of the person were to be met. Relatives responding to the surveys said that the home always or usually meets the needs of the people admitted. None of the responses were negative and among the comments received were that “personal needs are attended to”, people are “well dressed”, “well fed” and staff are “pleasant and responsible”. One person living in the home said, “staff listen to my needs”. The first floor unit, Magpies, provides a large, open plan lounge with a dining area and kitchenette for ten people who may have physical disabilities but are generally more able. The people spoken to in this unit were complimentary about the staff and there was noted to be a good rapport between them. One person was supported to retain movement and skills by being encouraged to lay the table for lunch. Changes have been made to the Community Rehabilitation Unit (CRU) since the last inspection. The unit, which has a lounge and kitchen/diner, has been relocated to the first floor and provides for eight people. A new treatment room has been created on the ground floor and has the equipment required to assist the staff to undertake the specialist support for rehabilitation. A newly employed Team Leader for the CRU was met on the second visit to the home, together with the physiotherapist. The Team Leader and the support staff are employed by Social Services, while the Primary Care Trust employs the physiotherapist and the occupational therapist. They discussed with the Inspector the way in which the unit is run and confirmed that there is satisfactory liaison with the health services and the hospitals to try and ensure that there is a good outcome for the people admitted. For those admitted to the CRU, referrals are generally received from a number of hospitals, although referrals are also taken from people still in the community who may need a period of rehabilitation. The physiotherapist and the occupational therapist are involved in carrying out the pre-admission assessments for the unit. There is a maximum stay of six weeks. Home visits are arranged prior to discharge from the unit to assess for any equipment and to build the confidence of the person returning home. The people met within the unit were appreciative of the service that the unit provides and the opportunity to return to live in their own homes. Letters were seen to confirm that people’s needs could be met and contracts are in place to show that people accept the support of the CRU. Sandbanks Care Home DS0000032618.V335217.R01.S.doc Version 5.2 Page 12 Although some of the support staff met in the CRU were from an agency, there is a team of permanent staff employed who have received training to support the work in the unit. There are two staff on the unit during the day and the evening when it is full and single cover when the unit has five residents or less. Sandbanks Care Home DS0000032618.V335217.R01.S.doc Version 5.2 Page 13 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): 7, 8, 9, 10, 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are personalised and easy to follow. The health needs of the people living in the home are met by the community services. The medication administration and staff competency are monitored. People using the service were seen to be treated appropriately, with respect and good humour. EVIDENCE: A sample of eight care plans was examined, including two in the Community Rehabilitation Unit. These provide information, in an easy to follow format, of the care that each person requires. A social history is included, which is particularly important in the dementia units to help staff to support people with activities and reminiscence. Two relatives commented very positively on the way in which people living in the home are supported to look presentable, clean and tidy, reflecting the care given. The health needs of the people living in the home are met through the community services. It was noted that people are registered with a number of Sandbanks Care Home DS0000032618.V335217.R01.S.doc Version 5.2 Page 14 different general practitioners’ practices in the area. the home twice weekly. The district nurses visit The medication is administered from a 28 day Monitored Dosage System in three of the units. The medication was examined in two of these and found to be in order. Only senior staff are responsible for administering medication and records of the observation of the staff administrating, to check on competency, were seen to have been carried out regularly. Regular audits are also recorded and records kept on a daily basis. A small number of medication errors have been recorded and the Commission for Social Care Inspection notified where appropriate. Where this has occurred, staff are retrained and have their competency assessed. In the Community Rehabilitation Unit, the majority of people coming into the home are self-medicating as they are generally responsible for their medication when they return home and staff work to retain their skills. On the last visit, two people in the CRU were not self-medicating and staff were administering the medication received from the hospital. It was being placed into unsealed dosette containers to replicate how they might take their medication when at home. Although this does involve dispensing the medication from labelled containers into a dosette, the team leader said that this is carried out by staff, with the person concerned. It is not possible to get the medication dispensed in sealed and labelled dosettes and the team leader was aware of the care that was needed with this system. The people who self-medicate have a locked space in their rooms in which to store their medication. The feedback received from people who use the service was generally positive. One relative said that the resident was “always treated with respect” and spoke of the “exemplary” way in staff had been heard to treat all of the residents. Another commented “I feel the staff work hard and are always respectful to their charges and visitors”. However, one family of one person reported that their female relative was embarrassed to receive personal care from male staff. Although in some of the care plans information was seen about preferences, this was not recorded in all of them. Those people with dementia may not be able to make an informed choice and, to safeguard their privacy and dignity, their representatives should be involved in these decisions. This was discussed with the Registered Manager who undertook to ensure that people have their preferences respected. There are few male staff in the home and female staff are available at all times to undertake personal care. In a number of the care plans, information on peoples’ wishes with regard to their funeral arrangements was seen. Where people are unable to state their own wishes, the families have been involved in completing the records. Sandbanks Care Home DS0000032618.V335217.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): 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. The activities are provided in accordance with the wishes of the people living in the home and those which are suited to their needs. A variety of both group and individual activities are provided for stimulation and interest. The menu is varied and suits the needs of the people using the service. EVIDENCE: The home has an activities organiser employed for three days a week who was met on the first visit to the home. On the first visit, she was carrying out a conversational group activity in one of the dementia units. Various people in the unit were seen, throughout the two visits, enjoying dominoes, discussing events in the newspaper and conversations with the staff. A game of bingo had also been held. The other unit for people with dementia is not yet full but one person was enjoying painting. Staff said that the residents particularly enjoy baking and gardening is also one of the activities they undertake. Both units have access to a secure garden with space for walking and sitting. There is also a patio area and extensive, well-maintained grounds for everyone to enjoy. Sandbanks Care Home DS0000032618.V335217.R01.S.doc Version 5.2 Page 16 Some organised activities and entertainments are also arranged. For the Sunday following the last visit, a singer was booked and a cream tea arranged. This was advertised in the small lounges. The large lounge on the ground floor provides sufficient space for all of the residents in the home to attend any function. The feedback from people using the service was that they enjoyed the activities, including craft work, outings and skittles. Information on how religious needs can be met are provided in the Statement of Purpose, including information on a diverse range of religious establishments. No families were seen to speak to on this inspection and staff said that the majority visit at weekends. However, the replies to the surveys indicated that they are very happy with the support in the home. Although not all of the people in the home are fully able to make choices about their daily lives, because of dementia, those who can said that they were free to make decisions about when to get up, go to bed and whether they wished to stay in their rooms. In the examples of care plans seen, it was recorded how people like their care delivered and most of their personal preferences were detailed. Meals are served in the individual dining areas and the tables were seen to be nicely laid. The meals seen during the inspection included a roast, and scampi or gammon with pineapple. In addition to a dessert or ice cream, cheese and biscuits can be served as an alternative. Some of the food was sampled and found to be well cooked and tasty. Menus are displayed in the units but it is recommended that these are printed in a larger format so that the resident can be more aware of what is offered. One person said that “the food is served well and punctual”. Relatives commented that “food is excellent” and people “are given a choice” and “individual attention at mealtimes”. While the majority of the verbal and written comments were positive, one person replying to the survey said that they would “sometimes like an improvement in the food”. Individual meals taken by residents are recorded and a comments book is kept for their views about the meals. Sandbanks Care Home DS0000032618.V335217.R01.S.doc Version 5.2 Page 17 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): 16, 17, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedures and the systems in place for helping to safeguard the people living in the home are robust. People were confident about being able to make their concerns known to the staff. People are being supported to exercise their legal rights with regard to voting. EVIDENCE: There have been four complaints recorded since the last inspection in July 2006, which were satisfactory resolved. The file also contained a number of compliments from people using the service and their relatives. Information was seen about the complaints procedure in the Service Users Guide and in the Statement of Purpose. Although one relative responding to the Commission for Social Care Inspection survey said that they were not aware of the procedures, the remainder said that they were. Those people living in the home who are able to voice their concerns were confident that they could report them and made some suggestions, with staff present, as to how things could be improved. One person commented that the complaints procedure had been explained to them when they were admitted to the home. Comments regarding the meals are recorded in the units. Staff who were asked about the procedures for adult protection were clear about the way in which they should report any untoward incidents. There have been no adult protection issues in the home and the records showed that Sandbanks Care Home DS0000032618.V335217.R01.S.doc Version 5.2 Page 18 twenty eight of the staff had training in adult protection procedures in 2006. The majority have received separate training on whistle blowing. The training should be extended the remainder of the staff team to ensure that they are fully aware of the procedures. In some of the files examined, information on postal voting was recorded to ensure that those people who wish to do so can be enabled to exercise their rights at election times. Sandbanks Care Home DS0000032618.V335217.R01.S.doc Version 5.2 Page 19 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): 19, 20, 21, 22, 23, 24, 26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well maintained, with comfortable communal areas, outdoor facilities and personalised private spaces. Suitable equipment is available for bathing and showering safely. The home is clean and hygienic. EVIDENCE: The home is pleasantly furnished, well maintained, clean and comfortable. Where changes have been made to the home to accommodate the second dementia unit, and increase in the size of the Intermediate Care unit to eight beds, redecoration has taken place where required and new furniture purchased. The Registered Manager provided details of the improvement work which had been carried out in 2006 and 2007. There was only a small amount of work to be done to complete the new units, such as pictures to be put up. Sandbanks Care Home DS0000032618.V335217.R01.S.doc Version 5.2 Page 20 The garden provides a large open space, with seating areas, for people to enjoy. There is a pond, which is fenced, and an enclosed garden for the dementia units. All of the areas of the home are comfortable and furnished in a domestic style. There is ample space for people to meet with their relatives and friends. Some of the areas had air conditioning units as certain areas can become very warm. The conservatory is used as the area where people can smoke and changes were being made to meet the new legislation on smoking from the 1st July 2007. All of the bedrooms are more than 12 sq. metres which provides sufficient space for people to have their personal belongings. All of the rooms seen were comfortably furnished and personalised. There are four bathrooms in the home, and nine toilets. These are located throughout the home and some are near to the larger communal facilities. A variety of equipment is available, including a shower room and assisted baths. Some of the people using the Community Rehabilitation Unit made suggestions regarding how some additional equipment, including an additional raised toilet seat and the use of taller waste bins, would make them easier to use and to save unnecessary bending. These were mentioned to the Registered Manager. Some items were already in hand and she agreed to look at the provision of the others. The home was found to be very clean on both of the visits of this inspection, with no malodours. One relative commented that the “home is always very clean”. The laundry is located on the ground floor and is kept locked for safety when staff are not present. Sandbanks Care Home DS0000032618.V335217.R01.S.doc Version 5.2 Page 21 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): 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 training programme provides a wide range of courses for staff to undertake, including specialised courses. Staff are encouraged to take their National Vocational Qualifications. Feedback from the people using the service and their relatives demonstrates that the staff are competent and professional. EVIDENCE: A sample of the rotas was provided with the Pre-Inspection Questionnaire. These showed a minimum of two staff are on each shift in the Swallows, Magpies and Community Rehabilitation units. As the Lapwings unit was not full, only one staff was on duty. A senior member of staff is on duty on every shift to manage the home. Three staff are on waking night duty. There were four care staff vacancies. Information on the number of agency staff used is recorded on the Regulation 26 monthly visits to enable monitoring of the situation. The closure of another London Borough of Hounslow home resulted in staff being redeployed at Sandbanks and the current management staff are in “acting up” positions. Now that the changes are complete, the positions of Manager, Deputy Manager and other posts are to be recruited. Staff are trained in manual handling regularly and the Registered Manager is a trainer. Two staff were to undergo the training shortly so that it can be carried Sandbanks Care Home DS0000032618.V335217.R01.S.doc Version 5.2 Page 22 out in-house. Senior staff are trained in risk assessment. Eleven staff have the 4-day first aid qualifications and the majority of the remainder have oneday training. A record of all of the staff training was provided together with an annual training plan for 2007. This showed a wide of range of training has taken place and regular courses were to be held for the basic training courses and some specialist courses. The core courses include manual handling, health and safety, infection control, fire training and food hygiene. In addition, training on diabetes awareness, Parkinson’s Disease, funeral awareness and bereavement have been undertaken for a number of staff. It was noted that most of the staff have equality and diversity training and are trained to work with people with challenging behaviour. Dementia training has been provided by the Alzheimer’s Society and this is to be extended to all staff including the auxiliary staff. The professional training and development of the therapists in the Community Rehabilitation Unit is managed through the Primary Care Trust. The home has the permission of the Commission for Social Care Inspection to keep a recruitment record of each staff member as the London Borough of Hounslow holds the original records. The work to complete these was being undertaken and the information for new staff will be available in this format. A sample of new more recently recruited staff were examined and found to be in order. Information on Criminal Records Bureau disclosures was provided for all of the staff team. Information for the agency staff employed is obtained and includes Criminal Records Bureau disclosures, references, photo identification and training. Staff are encouraged to gain their National Vocational Qualifications and, at the time of this inspection, 24 of 28 care staff had NVQ Level 2, with three also having Level 3. Four of domestic staff had NVQ Level 1. Further staff were joining the National Vocational Qualifications programme in September. Sandbanks Care Home DS0000032618.V335217.R01.S.doc Version 5.2 Page 23 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): 31, 33, 35, 36, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Positive feedback from people using the service, their relatives and staff indicates a well run home. The financial, health and safety and other systems in place help to safeguard the people using the service. EVIDENCE: The Registered Manager has a number of years experience of managing residential homes and has the Registered Managers Award qualification. She is currently the Acting Manager of the home and recruitment is commencing shortly for the permanent post. She has worked in home as Deputy and Acting Manager for four years. Staff expressed their satisfaction in working in the home and this was reflected in the home’s pleasant and relaxed atmosphere. Efforts were seen to be made Sandbanks Care Home DS0000032618.V335217.R01.S.doc Version 5.2 Page 24 by the staff to ensure that the people living in the home were spending their time as they wished and, for those in the dementia units, that they were involved in conversations and activities to help to keep them stimulated. Among the comments from relatives were that “staff are caring and kind, as well as professional”, “the staff and pleasant and responsive” and “nothing seems too much trouble”. The Administrator showed the Inspector the systems for holding the money on behalf of the people living in the home which appeared to be well maintained. Only three people have management of their own finances. The majority have sums of money provided through their relatives for items such as hairdressing, newspapers, toiletries and chiropody. The monies are held in a London Borough of Hounslow account and provided to the people in the home as required. The system is maintained on the computer and residents and their families can have access to their individual records if required. Receipts are kept for all transactions. The Registered Manager reported that the quality assurance systems are in the process of being reviewed. The home has gained a Charter Mark for quality. Regular meetings are held with the people living in the home and their families and samples of the minutes were seen. The home supports the staff by having regular supervision sessions, with a target set of nine sessions a year. Schedules are maintained of the sessions, which are provided by senior staff. There is also an annual appraisal system. The Registered Manager provided a pre-inspection questionnaire, which had all of the required health and safety checks documented. She showed the Inspector the improvements they have made in keeping the records of the maintenance and servicing. A sample of those seen included the regular water testing has taken place to ensure that it conforms to the standards required. Weekly fire drills take place when the alarms are tested to ensure that all of the staff are fully aware of the procedures. The records showed that all of the staff have attended fire training. A new fire risk assessment, in line with the new legalisation, is to be completed by an external specialist in the near future. It was noted, from the information recorded on the pre-inspection questionnaire, that some of the policies and procedures, which are produced by the London Borough of Hounslow, may not have been reviewed for sometime. As some have probably been subject to changes in legislation since the date of implementation, it is recommended that the Registered Providers demonstrate that reviews of all of the policies and procedures is undertaken to ensure that they are up-to-date and relevant. Sandbanks Care Home DS0000032618.V335217.R01.S.doc Version 5.2 Page 25 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 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 4 3 3 3 3 3 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 3 X 3 X 3 3 X 3 Sandbanks Care Home DS0000032618.V335217.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No 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. 1 2 Refer to Standard OP15 OP36 Good Practice Recommendations That the menu are produced in a larger format and displayed to support people to know what is on offer. That the Registered Providers demonstrate that reviews of all of the policies and procedures are undertaken to ensure that they are up-to-date and relevant. Sandbanks Care Home DS0000032618.V335217.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection West London Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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 Sandbanks Care Home DS0000032618.V335217.R01.S.doc Version 5.2 Page 28 - 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. 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