Inspection on 26/07/07 for Sandown Nursing Home

This inspection was carried out on 26th July 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

Sandown Nursing Home 21/11/06

Sandown Nursing Home 15/02/06

Sandown Nursing Home 11/08/05

Sandown Nursing Home 25/02/05

Sandown Nursing Home 16/08/04

Sandown Nursing Home 16/02/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Sandown Nursing Home 28 Grove Road Sandown Isle Of Wight PO36 9BE Lead Inspector Janet Ktomi Unannounced Inspection 26th July 2007 10:00 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 Sandown Nursing Home DS0000012565.V341449.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. Sandown Nursing Home DS0000012565.V341449.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sandown Nursing Home Address 28 Grove Road Sandown Isle Of Wight PO36 9BE 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) 01983 402946 01983 407975 admin@sandownnursinghome.co.uk Miss Belinda Jane Davies Mr Richard Henry Davies, Mrs Elizabeth Davies Mrs Teresa Joan Riley Miss Belinda Jane Davies Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (39), Terminally ill over 65 years of age (5) of places Sandown Nursing Home DS0000012565.V341449.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home can accommodate three service users between 18 - 65 years of age The registered managers are to within twelve months attain NVQ Level 4 in care and management as applicable 21st November 2006 Date of last inspection Brief Description of the Service: The home is located at the cross section of Grove Road and The Broadway, Sandown and is within walking distance of the main town, its facilities and amenities. The local railway station is situated some 500 metres from the home, which is also well serviced by the local bus company. Sandown Nursing Home is a large Victorian residence that has been adapted and extended across the years to meet the needs of the individuals accommodated, with rooms provided on two floors accessible via a passenger lift. The home is owned by Miss B Davies, Mr R Davies and Mrs E Davies. The registered manager is Miss B Davies who is supported by an experienced head of nursing care. Weekly fees range from £598.22 to £700.00. Sandown Nursing Home DS0000012565.V341449.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report contains information gained prior to and during an unannounced visit to the home undertaken on the 26th July 2007. All core standards and a number of additional standards were assessed, as was compliance with previous requirements. The inspector would like to thank the people who live at the home and the staff for their full assistance and co-operation with the unannounced visit. The visit to the home was undertaken by one inspector and lasted approximately six and a half hours commencing at 10.00 am and being completed at 4.30 p.m. The new manager who has commenced the registration process will replace the homes current registered manager in the near future. The inspector was able to spend time with the new manager, head of nursing care and care staff on duty and was provided with free access to all areas of the home, documentation requested, visitors and people who live at the home. Prior to the visit the manager completed an annual quality assurance questionnaire, information from which is included in this report. Service user and relative comment cards were sent to the home. Two relative responses were received. Information was also gained from the link inspector and the home’s file containing notifications of incidents in the home. During the visit to the home the inspector was able to meet with and talk to people who live at the home and two visitors. What the service does well: People able to express an opinion, stated to the inspectors that they were happy living at Sandown Nursing Home, and that staff treated them well. They confirmed that the home was always clean and they felt safe. People unable to express an opinion due to the level of frailty appeared relaxed and well cared for. People spoken with were happy and satisfied with the service provided and felt that their expectations had been met. Visitors confirmed that they were made welcome when they visit and that they were happy with the level of care provided to their relative. One stating in a survey response ‘if my husband was a private patient he could not receive better treatment’. Sandown Nursing Home DS0000012565.V341449.R01.S.doc Version 5.2 Page 6 The home was warm and very clean; the atmosphere felt relaxed, happy and friendly. The environment is well maintained with an ongoing programme of redecoration and renewal. All staff, nursing, care and ancillary are motivated and committed to ensuring people receive a quality service. All staff were helpful and demonstrated compassion and a commitment to core values of dignity and rights of people living at the home. Staffing levels appear appropriate for the number and level of care required by people. Ancillary staff, housekeeping, kitchen, maintenance and administration, are available to support direct nursing and care staff. People were positive about the food provided, and this was seen to be of a good standard with choice and alternatives available at all meals. Local Environmental health officers have awarded the home five stars for their kitchen. What has improved since the last inspection? What they could do better: No requirements are made following this inspection. In their annual quality assurance assessment the home identified some areas that it needed to improve. Sandown Nursing Home DS0000012565.V341449.R01.S.doc Version 5.2 Page 7 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. Sandown Nursing Home DS0000012565.V341449.R01.S.doc Version 5.2 Page 8 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 Sandown Nursing Home DS0000012565.V341449.R01.S.doc Version 5.2 Page 9 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): 3, 4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All service users are assessed prior to moving into the home to determine that their individual care needs can be fully met. Service users, or their representatives, are able to visit the home prior to admission to assess the quality, facilities and suitability of the home. Standard six is not applicable, as intermediate care is not provided at Sandown Nursing Home. EVIDENCE: The head of nursing care explained the homes admission procedure and three pre-admission assessments were viewed. The head of nursing care or the matron undertake pre-admission assessments on all prospective people. The Sandown Nursing Home DS0000012565.V341449.R01.S.doc Version 5.2 Page 10 home has a comprehensive assessment tool that covers all the relevant areas necessary for the home to decide if it is able to meet a prospective persons needs. The head of nursing care stated that she would not admit a new person if the necessary equipment, such as pressure relieving mattresses, was not available. The head of care was clear about the level of care needs the home can accommodate. The home has a high occupancy rate and the head of care stated that there is no pressure to admit people whose needs they cannot meet. The inspector was unable to speak with the most recent people admitted to the home due to their level of health needs. Other people confirmed that they had received a visit from the head of nursing care and written information prior to moving to the home. Most admissions are from hospital and visits to the home by prospective people are not always possible. The head of nursing care stated that relatives or representatives are invited to visit the home and view the available room. The administrator provided the inspector with the administration files for new people. These contained contracts and admission sheets. The admission sheets provide a checklist to ensure that all pre-admission work is completed including provision of service users guide and contract. Contracts were not viewed during this visit as they had been viewed during the previous inspection and were appropriate. The service users guide was also viewed during the previous inspection. Sandown Nursing Home DS0000012565.V341449.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People’s health, personal and social care needs are set out in an individual plan of care. Medication is appropriately stored and records fully maintained. People are treated with respect and are assured that at the time of their death, staff will treat them and their families with care and sensitivity. EVIDENCE: The inspector viewed five care plans for new and existing people. Care plans are individual and relevant to the needs of people, with sections covering all the areas of need identified in the assessment. Care plans are reviewed by the named nurse monthly or more often if needs change. The home is considering how it demonstrates that people or their relatives have agreed care plans, and the head of care stated that it is likely that care managers or relatives will be asked to sign care plans during the first review undertaken approximately one Sandown Nursing Home DS0000012565.V341449.R01.S.doc Version 5.2 Page 12 month after admission. During the inspectors visit nursing and care staff were observed making recordings of care provided in individual care plans. Following the previous inspection a requirement was made that all relevant information must be included in the individual care plan and not within a general record such as the dressings book. The head of care explained that the dressings book was no longer used and all information about a persons care was now included in the care plan. The inspector saw this when viewing care plans and therefore this requirement has been met. Specific assessments were seen in care plans for manual handling, nutrition and falls. New assessments were seen in all care plans that cover all the areas required. Care staff were observed using manual handling equipment during the inspectors visit and the techniques used appeared appropriate. Training records confirmed that staff have undertaken manual handling training and the home has a trained manual handling assessor and trainer. The inspector was able to meet many of the people living at Sandown Nursing home. Those able stated that they felt well cared for; others whose level of disability made conversation difficult appeared comfortable and well cared for. The inspector spoke with two visitors who both stated that they were very happy with the level of care their relative received. Comment cards were received from two relatives, both stated that medical and care needs were always met. No concerns about the level of care were raised in these comment cards. The inspector undertook a tour of the home with the new manager and was therefore able to meet people who needs necessitated they remain in bed. Care staff stated that they felt they had enough time to meet people’s health and personal care needs. Comment cards received from people confirmed that staff are available when required. The home has a range of equipment to support people with moving and handling as well as pressure area management. A storeroom containing supplies of equipment was seen. As the home provides a service to people with increasing needs it may need to review the equipment, specifically pressure relieving mattresses it has to ensure that adequate equipment is available for people whose needs increase once they have been admitted. Only qualified nurses administer medication in the home. The inspector viewed Medication Administration Records, storage and administration procedures. All medication was seen to be appropriately stored in secure locked facilities. The home uses a pre-dispensed blister system where possible. The home has lockable medications trolleys that are used to dispense and administer medication to one person at a time. The Medication and Administration records were viewed. These now all contained a photograph of the person, clear statements as to allergies or none known, and had been fully completed as to medication administration. The home now uses a bulk prescription service with Sandown Nursing Home DS0000012565.V341449.R01.S.doc Version 5.2 Page 13 various frequently prescribed medications such as laxatives available to be dispensed by the nurses. The home has arranged with the local pharmacist for training for qualified nurses in medication administration using the bulk prescription process. Comment cards received from people confirmed that staff listen and act on what they say. The home provides both single and twin bedrooms. Twin bedrooms were seen to contain screens to ensure privacy during personal care tasks. People and relatives the inspectors spoke with confirmed that staff treat them with respect and that their privacy is maintained during personal care. During the inspectors visit staff were observed to treat people with respect and to explain procedures to people before commencing manual handling tasks. As with most nursing homes the home supports some people who are at the end of their life. The head of nursing care confirmed that the home has good links with the hospice and that advice from specialist nurses is sought when required. The home also supports a number of people with advanced age related illnesses. Care staff stated that they have support as required and felt able to meet people’s needs at this time. The manager identified in the annual quality assurance assessment that the home intends to provide further training for the head of care on the Liverpool care pathway and bereavement training for all staff. The inspector heard the head of nursing care keeping a relative informed about changes in a persons needs. As stated previously the home has a range of equipment that should ensure that a persons last days are comfortable. Sandown Nursing Home DS0000012565.V341449.R01.S.doc Version 5.2 Page 14 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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The routines for daily living and activities made available are flexible and varied to suit people’s individual needs. Family and friends are able to visit. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. EVIDENCE: The routines for daily living and activities made available are flexible and varied to suit people’s individual needs. People and relatives confirmed to the inspector that they are able to choose where in the home they spend their day, many were seen to spend time in the homes spacious and bright lounge with others remaining in their bedrooms. The design of the lounge means that it effectively has several areas such that people can sit quietly or join in activities if they wish. People were observed being asked where they wanted to have their meals. People confirmed to the inspector that they are given choice over their meals with options being chosen on a daily basis. Bedrooms seen contained personal items brought into the home. Care plans and assessments include information about leisure activities and religious needs. Sandown Nursing Home DS0000012565.V341449.R01.S.doc Version 5.2 Page 15 An activities list was noted on display in the lounge. This listed activities planned for the morning and afternoon and provided by care staff and external groups from independent arts and the local vicar who provides a monthly church service at the home. A list is maintained of who has attended different activities sessions which the inspector saw. Activities’ training has been provided by age concern. Discussions during the inspection with the administrator who organises activities indicated that she is flexible to peoples needs and has sought new activities for people with the higher dependency needs the home is accommodating. The inspector was able to meet two visitors. The weather on the day of the inspectors visit was not pleasant and the head of nursing care stated that there are usually more visitors but she felt that as many visitors were elderly the weather would have put them off. Those relatives the inspector was able to meet and comment cards received from relatives indicated that relatives are able to visit at any time. Visitors are able to enjoy a meal with people who live at the home if they wish and a small charge is made for this. In addition to the large lounge, whose design provides several distinct areas, the home has a smaller room that could be used for private visits when not in use on a Tuesday by the hairdresser. Options are available at all meals with the inspector overhearing care staff asking people what they wanted for their next days lunchtime meal during the afternoon of the inspection. The home has a good-sized dining room where many people choose to have their meals. The head of nursing explained that the home operates two sittings for meals due to the number of people who require support to eat. This ensures that adequate staff are available to support people who receive their meal hot. People stated that the food provided is always/usually good and choice provided. Relatives confirmed that they are able to have meals at the home if they wished and that their relatives appeared to enjoy their food. The inspector was present for the main lunchtime meal. The food appeared well presented and appetising. Drinks and snacks are also available throughout the day with people confirming this as well as the inspector observing people being given morning and afternoon hot drinks and biscuits. The need for special diets or supplements is recorded pre-admission. The home has a large kitchen and full range of kitchen staff such that nursing and care staff do not have to prepare meals/snacks other than requested by people during the evening or night. The kitchen has been awarded five stars by the local environmental health department. Sandown Nursing Home DS0000012565.V341449.R01.S.doc Version 5.2 Page 16 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. People are protected from abuse. EVIDENCE: The homes complaints procedure is included in the service users guide provided to all prospective admissions or their relatives. Care staff stated that they would try to resolve any issues raised by people or relatives, if they were unable to do so they would inform the qualified nurse. The qualified nurses stated they would record the complaint and inform the head of nursing care or manager. The annual quality assurance assessment completed by the home prior to the inspection stated that one complaint had been received in the previous twelve months. The inspector viewed the documentation relating to this and the complaint had been appropriately investigated and responded too. The complaints procedure had been revised in February 2007. A record of complaints is maintained in a folder and the management team investigates complaints. People the inspector spoke with also stated that although they had no concerns or complaints they would feel able to raise any issues with staff or the head of nursing care. Comment cards received from relatives stated that they knew how to make a complaint and the home had responded appropriately if any issues had been raised. Sandown Nursing Home DS0000012565.V341449.R01.S.doc Version 5.2 Page 17 The homes policies and procedures in respect of recruitment and people’s personal finances should ensure that unsuitable people are not employed at the home and that people will not be financially abused. Nursing and care staff have now had safeguarding adults training. Care and ancillary staff stated they would pass on concerns to nursing staff or the manager. Notifications to the commission indicated that the home would respond appropriately if they suspected that abuse might have occurred. Information contained within the annual quality assurance assessment indicated that the home were aware of what may constitute abuse and the actions they should take. Sandown Nursing Home DS0000012565.V341449.R01.S.doc Version 5.2 Page 18 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, 25 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a clean, safe, well-maintained environment that meets their individual and collective needs. EVIDENCE: The home is an extended older property suitable for the needs of the people, staff and visitors. The home is clean and well maintained, with a housekeeping team and part time maintenance person. The home has a programme of routine maintenance and a renewal/development plan. The homes annual quality assurance assessment listed the improvements to the home over the past year. These being six new squirrel airbeds, two new electric height adjustable beds and three new modular foam mattresses. The home has provided raised flowerbeds outside bedrooms along the annex corridor to Sandown Nursing Home DS0000012565.V341449.R01.S.doc Version 5.2 Page 19 improve the view for people occupying these bedrooms. The home has contracted with a health and safety company who have completed an audit of the home. The home has appropriate disposal contracts for waste. All staff have attended infection control training as required following the previous inspection. The home has a large lounge with pleasant views to the front of the home. People informed the inspector that they had enjoyed the new patio area and patio furniture is available should the weather be appropriate. Some people were noted to have chosen to sit looking out of the patio doors to the pleasant landscaped gardens. The home also has a good-sized dining room and a small quiet room that could be used for private meetings or visits when not in use by the hairdresser on a Tuesday. Furniture within all communal areas was appropriate to peoples needs with room for moving and handling equipment to access all areas. The home has a no smoking policy with an external covered area available for people who smoke. Toilet and bathroom facilities are provided to meet the needs of people living at the home. These were seen to be clean and well maintained. There are several sluice facilities located around the home. The home has a range of equipment and adaptations appropriate for people’s needs. The head of care was clear that she would not admit any new people to the home unless she had the necessary equipment to meet their specific needs. Equipment includes moving and handling, height adjustable beds, air mattresses for pressure relieve, passenger lift and hand rails along corridors. The home has suitable storage facilities for equipment. Some bedrooms have en-suite facilities with others having wash-hand basins. The home has a combination of single and twin bedrooms, twin rooms having screens to ensure privacy during personal care tasks. Bedrooms were seen to contain all the necessary furniture, fixtures and fittings, were well decorated and had co-odinating attractive soft furnishings. Bedrooms have adjustable heating via covered radiators with people confirming that their rooms and the home are always appropriately warm. Although the inspection visit was undertaken in July the weather on the day of the visit was unpleasant and the homes heating had been turned on. All bedrooms were clean with no offensive odours. A member of the housekeeping team explained to the inspector that they frequently shampoo carpets. The housekeeper stated that she generally has sufficient time and all the necessary equipment to complete all her tasks. The home has appropriate laundry facilities with the housekeeping staff being responsible for laundry. Care staff confirmed that they have adequate supplies of disposable aprons and gloves. Training information seen and discussions with staff confirmed that staff had undertaken infection control training as required following the previous inspection visit. Sandown Nursing Home DS0000012565.V341449.R01.S.doc Version 5.2 Page 20 Sandown Nursing Home DS0000012565.V341449.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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home employs appropriate numbers of nursing, care and ancillary staff that ensure that peoples needs are met. Staff receive the necessary training and a very high number of care staff have NVQ or equivalent qualifications. EVIDENCE: Duty rotas were seen during the visit to the home. The manager stated that the home has increased its staffing levels due to higher dependency levels of people living at and being admitted to the home. Duty rotas stated that three trained nurses are provided in the mornings and two in the afternoon and one at night. Five care staff are provided in the morning and four in the afternoon. Two care staff support the qualified nurse at night. In addition the home has a good compliment of ancillary support staff including administration, housekeeping, maintenance and kitchen. The administrator is also responsible for activities and has attended training provided by age concern. People and visitors stated that there are sufficient staff on duty. One comment card stating ‘when my husband or myself ring the bell – within a few moments someone is there’. During the inspectors visit staff on duty corresponded to those on the duty rota. Nursing and care staff stated that they generally have sufficient time to meet people’s needs and throughout the inspection care staff Sandown Nursing Home DS0000012565.V341449.R01.S.doc Version 5.2 Page 22 appeared to have time to meet people’s needs. The head of care and care staff explained to the inspector how work is organised throughout a shift. The home is divided into three areas. A qualified nurse and care staff are allocated to each area. The qualified nurse is responsible for organising the care of all the people in his/her area and undertakes all medication, dressing and recordings required. Care staff stated that they tend to work in pairs wherever possible; this would be the most appropriate method of working considering the high support needs of the majority of people who live at the home. The head of care and manager stated that they do not use agency staff and required shifts resulting from annual leave or sickness are covered by the homes existing staff. Care staff confirmed that they would cover additional shifts when required. Training and qualification information was provided with the pre-inspection questionnaire. This stated that approximately eight-eight per cent or care staff have an NVQ level 2 or equivelent. Two staff are now undertaking NVQ level 3. Information about training was provided by the administrator and manager. This included training for qualified nurses and care staff. This indicated that staff have received all the necessary training to meet peoples individual and collective needs. The home has procedures for identifying when update training is due. All staff have undertaken safeguarding adults and infection control training as required following the previous inspection. On the day of the inspection visit fire awareness training from an external trainer was being provided to staff on duty with many staff off duty coming in for the training. The manager explained the homes induction procedure and showed the inspector the induction booklet in use at the home for care staff. The home identified in its annual quality assurance assessment that it could do better by expanding the homes induction process to include nurses, housekeeping and ancillary staff. The manager showed the inspector the new health and safety booklets, which have been provided by the company commissioned by the home to provide health and safety advice. These are to be provided to all staff and included in the homes induction process. The recruitment records for the three newest staff were viewed. These contained all the required information and confirmed that all staff are fully checked including references, CRB and POVA checks. The homes recruitment procedures should ensure that unsuitable people are not employed at the home. Sandown Nursing Home DS0000012565.V341449.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, 37 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a management team who between them have the necessary skills and experience to ensure that the service is appropriately managed. Service users financial interests are safeguarded. Staff are appropriately supervised and annual appraisals have been completed. Records are appropriately stored fully completed. The health, safety and welfare of people and staff are promoted. Sandown Nursing Home DS0000012565.V341449.R01.S.doc Version 5.2 Page 24 EVIDENCE: The proprietors are frequently at the home and actively involved in administration and management of the service. The home has recently appointed a new manager who has commenced the registration process. The new manager continues to be supported by the existing registered manager who is also one of the proprietors. The management roles and responsibilities are clearly defined with each knowing the extent of their roles and responsibilities. These were detailed for the commission in the annual quality assurance assessment. All people, staff and visitors stated that they felt able to discuss any concerns with members of the management team. The new manager is not a nurse. The home has a Matron who is a Registered General Nurse and is completing her Registered Managers Award and a head of care who is also a qualified nurse with specific responsibilities for care. The manager explained the homes quality assurance systems. The home identified that it needs to update their questionnaires to try to formalise the views of people who live at the home, which has been done verbally in the past. The home has contracted with a health and safety company who have completed an audit of the home and the manager stated that advice from this is to be incorporated into induction information and any changes in procedures made as necessary. The home has completed the Registered Nursing Home Association quality audit tool. The home does not become directly involved in peoples personal finances and does not act as appointee for anyone. Services, such as papers, hairdressing and chiropody that are not included in the fees are either added to invoices, paid directly by people or paid from small amounts of personal money held on behalf of a small number of people. The inspector viewed invoices and these were seen to detail any additional costs and the specific reason for them. Receipts were seen for additional services for individual people and could be available for relatives/representatives if they wished to view them. Records and receipts were also maintained for personal money spent on behalf of people. Staff confirmed that they felt appropriately supervised. The home uses a cascade system for supervision with the Matron supervising the qualified nurses who in turn supervise the care staff. Records for supervision were seen in staff files. Following the previous inspection it was identified that staff had not received an annual appraisal. Records seen during this visit to the home evidenced that these have now been completed. Various records were viewed during the inspectors visit. All records were appropriately stored with access only available to people who should have access. Records were seen to be well maintained. Sandown Nursing Home DS0000012565.V341449.R01.S.doc Version 5.2 Page 25 The home provides a safe place for people, staff and visitors. The home is well maintained and clean, with staff having relevant training to meet people’s needs. Sandown Nursing Home DS0000012565.V341449.R01.S.doc Version 5.2 Page 26 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 X X 3 3 3 N/A 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 4 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 3 3 3 Sandown Nursing Home DS0000012565.V341449.R01.S.doc Version 5.2 Page 27 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. Refer to Standard Good Practice Recommendations Sandown Nursing Home DS0000012565.V341449.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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