Inspection on 14/08/08 for Sandridge House Nursing Home

This inspection was carried out on 14th August 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Sandridge House Nursing Home 14/08/07

Sandridge House Nursing Home 23/05/06

Sandridge House Nursing Home 13/10/05

Sandridge House Nursing Home 19/04/05

Sandridge House Nursing Home 16/11/04

Sandridge House Nursing Home 19/08/04

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Sandridge House Nursing Home London Road Ascot Berkshire SL5 8DQ     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: Helen Dickens     Date: 1 4 0 8 2 0 0 8 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. the things that people have said are important to them: They reflect 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 © (2008) 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: Sandridge House Nursing Home London Road Ascot Berkshire SL5 8DQ 01344 624404 01344 874474 sandridgehouse@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): Type of registration: Number of places registered: Amberbrook Limited Mrs Gillian May Elston care home 38 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Up to 2 (two) service users within the overall registered numbers can be between the ages of 60 - 65 years. 0 0 Over 65 19 38 Date of last inspection Brief description of the care home Sandridge house is owned and managed by Amberbrook Management Ltd, a private company, who are registered to provide nursing care for up to 38 older people. The property is a large Victorian building that is situated near to Ascot racecourse. Heatherwood Hospital and the premises of the primary care trust are also in the immediate vicinity. The home is clearly signposted and there is space for car parking on the site. Ascot village is close by and there is access to public transport. Care Homes for Older People Page 4 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: This key inspection was unannounced and took place over 7 hours. The inspection was carried out by Mrs. Helen Dickens, Regulation Inspector. The registered manager, Mrs. Gillian Elston, and the deputy manager, represented the establishment. A partial tour of the premises took place and a number of files and documents, including resident’s assessments and care plans, staff recruitment files, quality assurance information, and the annual quality assurance assessment (AQAA) were examined as part of the inspection process. A number of questionnaires were sent out to residents and health and social care professionals, and these were also considered in writing this report. Care Homes for Older People Page 5 of 30 The inspector would like to thank the residents, staff and registered manager for their time, assistance and hospitality. Fees at this home range from £535-£700 per person per week. What the care home does well: What has improved since the last inspection? There have been improvements in virtually every aspect of this home since the last inspection and the Requirements and Recommendations made a year ago have all been met. All staff have had training in person centred care since the last inspection and specialist dementia training has been delivered. The home now has more than 50 its care staff with a qualification in social care, in addition to the qualified nurses who cover every shift. The manager has been on a train the trainer course with a neighbouring local authority so that she can deliver safeguarding adults training to her own staff. A new chef has been recruited, and the menus have changed following consultation with residents. The new chef visits residents after lunch each day to ask them what they thought of their meal. Cooked breakfasts are now also available on four mornings Care Homes for Older People Page 7 of 30 per week. The outside of the property has improved including the building being painted, and some sensory aspects have been added to the garden, for example wind chimes and a water feature. There is now also a summer house which residents were seen to be using on the day of the inspection. There is now a second activities worker and therefore more hours available for activities within the home. There are better records of the activities undertaken by each resident, and a greater variety of activities, including light domestic tasks such as folding the napkins before lunch. A new pet has come to live at Sandridge House since the last inspection, a grey rabbit called Phoenix. He lives in his own very clean quarters at the rear of the lounge and goes out into the garden when the weather is fine. The manager said a number of residents have shown an interest in looking after the rabbit and he is certainly a talking point. The dining area has been refurbished with new furniture and decoration, and most other communal areas and bedrooms have been repainted during the last year. CCTV has been fitted outside the building for security reasons, and a new TV has been purchased for the lounge. A new gas cooker has been fitted in the kitchen and more special beds and mattresses have been purchased. The home has also had a second bathroom refurbished to include a special shower. 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. 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 9 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents admitted to this home can be sure their needs will have been properly assessed and they will have been assured these needs can be met, prior to them moving in. Evidence: Three resident’s files were sampled during this inspection including their initial assessments. The manager or her deputy, both nurses, do all the assessments for prospective residents. Those residents funded by social services also had assessments from social care professionals and all those sampled had detailed GP referral information. There was evidence of involvement from other health care professionals including the Community Psychiatric Nurses where appropriate. Care Homes for Older People Page 10 of 30 There were good records of residents needs in relation to personal and health care support and their social interests. All activities of daily living were covered. Assessments looked at risks including in relation to falls, nutrition and skin care. Family details and involvement from them were noted. There was also evidence of involvement from service users, including signatures of agreement from residents or their family. The manager has adopted the more detailed Berkshire Care Association template for assessments which is recognised locally as a good practice format. The inspector was able to examine some of these, as those residents admitted in recent months had had their assessments recorded in this new format. A MAP of Life was found on all three files. This provides an at a glance social history and background for each resident, together with their current interests. Pre-admission visits are clearly recorded including the activities participated in (e.g. having lunch) and any staff the prospective resident spoke with. The home has a Buddy system in place whereby new residents are introduced to an existing resident to ease their transition to their new home. Service User comments from the latest survey at the home are included in the service user guide. Care Homes for Older People Page 11 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. Residents needs are clearly set out in their care plans, and their health needs are met. Arrangements for the administration of medication safeguard residents. Residents are treated with dignity and respect by the staff who work at Sandridge House. Evidence: There have been a number of improvements at this home since last inspection, including introducing a more person centered approach to care. Staff have all received training on this and should be congratulated for the noticeable improvement since the previous report. Three care plans were sampled and it was noted that they included what each resident would like to be called, as well as that residents views about their needs and interests. Clear involvement from service users was also recorded and all were signed off either by the resident or their family. The care plans sampled all derived from the Care Homes for Older People Page 12 of 30 detailed assessments taken on admission, and the home now uses the Gold Standard Framework care plan format. Care plans covered health and personal care support including each residents preferences, and all three sampled had been reviewed regularly on a monthly basis. The home does a detailed Care Plan Evaluation each month which is a written summary of what has happened in the previous month, progress towards any specific goals, and any changes needed. Risk assessments were in place and covered moving and handling, falls, nutrition and skin care. Other potential risks were covered as appropriate, for example use of bedrails. Residents were pleased with the care, described by one as Out of this world. Another resident told the inspector: This nursing home, for carers, is the best. A relative who completed a service user survey for CSCI wrote: My relative had been in two other homes before but this has been the best. She is well looked after, happy and always looks nice. Health care arrangements are good at this home and there are two trained nurses and six care workers during the day, and a nurse plus two care workers all night. Nursing instructions to staff on the care plans are very detailed. Residents are weighed regularly and nutritional risk assessments are in place. The Waterlow tool is used to assess each residents risk of developing pressure sores, and there are currently no pressure sores at Sandridge House. Psychological support to residents is identified and recorded - e.g. the importance of charging up one residents mobile telephone so that they can keep in regular contact with their relatives. There were good records of visits from doctors and other health care professionals, as well as of hospital visits and the outcomes. Aids and equipment include special mattresses, hoists, bedrails, and bath and shower chairs. Individual specialists e.g. physiotherapist visits and advice are noted, and the exercise regime was recorded for one resident for whom this had been recommended. All four surveys returned showed residents were satisfied with the medical help provided at the home. Opinions of two GPs were sought in regard to this inspection at Sandridge House. One completed a questionnaire for CSCI and raised no concerns regarding the care of residents. They ticked usually for all the questions on the survey, including whether individuals health care needs are met by the service, and do staff have the right skills and experience. When asked what the service did well, this GP wrote Attending patients and giving medication when needed. A second GP was interviewed by telephone following the inspection and asked specifically whether they thought the Care Homes for Older People Page 13 of 30 home had improved in the last year. This GP said they felt the home had improved over the last year though there was still room for further improvement, particularly in relation to residents requiring end of life care. The details of this were passed on to the manager for further action and it is an issue which would be followed up at the next meeting between the GP and the home manager. Medication arrangements are well organised and the community pharmacist makes regular visits to the home. She made no recommendations at her last visit in March. Sandrige House does not use a monitored dosage system, and all medication is dispensed directly from the original containers. Only trained nurses give medication and new nurses have a supervised drugs round to check their competency; the manager said more supervision is arranged if needed. The home has monthly medication audits and there were no unexplained gaps over the previous month for the two records sampled by the inspector. The home uses a recognised pain assessment tool in relation to as required analgesia for residents. This was discussed with the manager who agreed to draw up, with the GP, more individual guidance for each resident, in relation to as required medications. The inspector felt the current Universal Pain Assessment Tool will have limited use for residents with dementia and a more individual approach is needed. Controlled Drugs were not checked at this inspection as they had been checked by the community pharmacist in March. On arrival at the home the manager not on site and the inspector sat in the lounge with residents and then accompanied the activity worker for the first 30 minutes of the inspection. During this time a number of resident and staff interactions were observed. Two residents were observed being hoisted into chairs in the lounge. Staff explained clearly what they were doing and this was repeated for one resident who was hard of hearing. Other staff were heard to speak gently to residents, they gave them choices, and carried out tasks in the residents own time, without rushing. The activity co-ordinator, a worker in the laundry and the handyman were all spoken with and found to be respectful to residents, involving them in the life of the home. Staff have had training in better communication and person centred care since the last inspection and should be congratulated for the improvements now noted. No negative comments were found on surveys, or on the day of the inspection, about not being treated respectfully. In answer to the question Do the staff listen and act on what you say all three service user surveys said yes - and one added Of course they do. At lunch there were many more examples of staff respecting residents individuality, including when they supported residents who needed help to eat, offering choices, and intervening discreetly when more assistance was required. Care Homes for Older People Page 14 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have opportunities to take part in a variety of activities, and community contact is encouraged. They have opportunities to exercise some choice and control over their lives, and mealtimes offer a pleasant and relaxing experience. Evidence: There are two activities co-ordinators employed to work with residents at Sandridge House. A record of each residents interests is kept, together with a note about any activities they have participated in. On the day of the inspection the activities plan said there would be domestic activities. This gave residents the opportunity to assist with household tasks such as ironing and collecting their own laundry from the laundry room, and folding all the napkins in preparation for lunch. Some residents were also seen wiping down the placemats after lunch. There is also the opportunity for one to one activities, for example one resident who is bedbound had the activities coordinator assisting them with some correspondence in the afternoon. It was also noticeable that activities tended to be in small groups for example four residents went Care Homes for Older People Page 15 of 30 out to the summer house after lunch for a reminiscence session with the other activities worker. They have a pet rabbit at Sandridge House called Phoenix, and he went out in the garden in the afternoon. There were no negative comments from residents either on their surveys to CSCI or on the day of the inspection in relation to activities. One wrote, in answer to the question are there activities you can take part in?: I go to the high street for coffee. Ive been in the garden doing a bit of gardening. I have other men to talk to. I watched Ascot. I went to the theatre. Another wrote: I play dominoes in bed and do quizzes and have physiotherapy. Some sensory aspects have been added to the garden such as wind chimes, a water feature, and some fragrant plants. There are photographs around the home, including in individual residents rooms showing the activities they have participated in, including having coffee at the coffee shop in the High Street, and one resident drinking champagne with some racegoers at the nearby Ascot racecourse. Visitors are encouraged at this home and two surveys returned to CSCI had been completed by relatives who were very pleased with the care and activities at the home. The AQAA summarises the improvements made since the last inspection and notes that there is now more contact with the local community including the local church and local schools, one of which invited residents to the school to watch a preview of their school play. More trips out to the local shops are arranged and each resident has a one to one day each month where they choose a specific activity to do; one resident who had not seen their relative in another nursing home for many years chose to go on a visit, and this was arranged by the staff. There are many examples of residents being able to exercise some choice and control over their day to day lives. For example one resident prefers to have their door locked when they are in the room, and there is a risk assessment in place in this regard. A resident who prefers to eat their main meal in the late evening is also accommodated. Menus are discussed in more detail below but it was noticeable on the day of the inspection that in addition to the two main meals, a number of other options had been offered and opted for by residents. Residents said this was because the chef visited them every day to enquire about what they would like the following day, and see how they had enjoyed their lunch. Care plans showed that where residents had been offered choices or expressed a preference, this was clearly recorded. Six residents rooms were visited during the inspection and all found to contain personal possessions including photographs and pictures, and in many instances, some of their own furniture. Meals have also improved since the last inspection with many favourable comments about the new chef. He was seen to be discussing meals with residents, and visited Care Homes for Older People Page 16 of 30 those who ate in their rooms after lunch. There are nutritional risk assessments on files for residents, and they are regularly weighed. The dining area has been completely refurbished and offered a pleasant experience; there was relaxing background music playing during lunch, and plenty of help available for those who needed assistance. Tables were set with placemats, napkins and condiments. Written comments from residents to the inspector included; The cook comes and discusses what I want. It is an excellent service. Care Homes for Older People Page 17 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. Residents at Sandridge House can be confident any complaints will be taken seriously, and the current arrangements for safeguarding adults should protect residents from abuse. Evidence: There have been no complaints to CSCI since the last inspection about this home. The home has received 14 complaints and according to the AQAA, 100 were dealt with within 28 days as per the homes complaints procedure. Ten complaints were upheld. The general issue of complaints was discussed and it was suggested to the manager that more minor issues, such as comments on food for example, might be recorded separately in a minor complaints folder, rather than dealt with as a formal complaint. Following advice at the last inspection, the home now always responds in writing with the final outcome of any complaint. Three residents surveys returned to CSCI showed they knew how to make a complaint. Residents were also offered informal opportunities to raise concerns e.g. the chef does a daily round after lunch, Regulation 26 visits are made by the provider, and residents meetings are held. The complaints procedure is visible within the home and clearly shows CSCI contact details. There is a safeguarding policy in place and the home uses the local authority policy Care Homes for Older People Page 18 of 30 alongside their own. There are good recruitment practices in place and those staff files checked showed that staff had Criminal Records Bureau checks, and references from previous care employers. The registered manager has done a train the trainer course on safeguarding adults with the adjacent local authority, and therefore ensures all staff are trained in this regard. No safeguarding adults reports had been received in relation to this home at the time of the inspection, though one has been received since. This is currently being dealt with in conjunction with the local authority. Care Homes for Older People Page 19 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a well furnished and homely environment, which is clean and hygienic throughout. Evidence: The AQAA states that there have been significant changes within the last year and these were observed by the inspector. The outside of Sandridge House has been repainted, as have some bedrooms and communal areas. A walk-in shower has been fitted. The dining room has been redecorated and refurbished with new dining tables and chairs. For better security, CCTV has been fitted outside. The home has also purchased a new TV and new aerials throughout. Electrical circuit boards have been updated and a new gas cooker purchased. The home also has more pressure relieving mattresses and profiling beds for residents. Some sensory aspects have been added to the garden including wind chimes and a water feature. There are now three separate communal areas, giving a choice of daytime environment for residents. The laundry was visited during the inspection and found to have dedicated laundry staff on duty 7 days per week. The staff member working there on the day of the inspection was involving residents in domestic tasks such as ironing, and visiting the laundry to collect their clean clothes. There is a red bag system in place for soiled Care Homes for Older People Page 20 of 30 laundry to prevent the spread of infection. The manager was asked to review the suitability of the laundry floor covering as there was a gap between the floor covering and an appliance which would make it difficult to keep clean, and the floor also looked worn in some places. Water temperatures are checked regularly by the handyman but the home needs to check their arrangements for legionella prevention to make sure they are in line with the Health and Safety Executives guidance on preventing legionella in care homes. There were no unpleasant smells anywhere in the home. One nurse takes the lead on infection control and all hand washing points observed during the inspection had individually dispensed soap and paper towels. Hand gel was also available. All three service user questionnaires returned to CSCI answered always to the question about whether the home is fresh and clean. One added Exceptionally clean. M pulls my wardrobe out and cleans behind the furniture every week. Care Homes for Older People Page 21 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. Residents needs are met by the numbers and skill mix of staff and they are in safe hands. Recruitment arrangements are well developed. Staff are trained and competent to do their jobs. Evidence: There is a written staff rota in place which shows extra staff during busier periods, for example during the daytime there are up to six care workers and two trained nurses. In addition to the nursing and care staff there is a handyman, two activity coordinators, and laundry, cleaning and kitchen staff. The inspector observed that there were sufficient staff available to help residents throughout the day both with their personal and healthcare support, and with social activities. The manager stated that in addition to the trained staff, 13 of the remaining 22 care staff had at least an NVQ Level 2 qualification in care, and three more were working towards it. This exceeds the National Minimum Standard which recommends that at least 50 of care staff should have this qualification. Recruitment records at this home are well kept and the manager could demonstrate Care Homes for Older People Page 22 of 30 that proper recruitment checks had been carried out. This included Criminal Records Bureau checks, povalist checks to ensure staff had not previously been deemed to be unsuitable to work with vulnerable adults, and references as set down in Schedule 2 of the Care Homes Regulations. The manager has been on a course with the Home Office to ensure the home is knowledgeable about illegal workers and how to recognise falsified recruitment documentation. The manager was asked to ensure that a full employment history was taken for all staff as the current application form only asks for 10 years. The home follows the Skills for Care induction format for staff and two new staff files checked showed that the induction had been properly completed and signed off. Staff training certificates are kept on their files, and since the last inspection the manager has devised a central training matrix where it is easy to see, at a glance, which staff have done which training courses. There were no complaints about staff either in surveys returned to CSCI, or in person on the day of the inspection. Comments such as Nothing is too much trouble for them and The staff are wonderful, were typical. Care Homes for Older People Page 23 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. This home is well managed and service users can be confident their views will be taken into account. Residents who need support to manage their day to day finances can be confident that the homes policies safeguard their interests. The health, safety and welfare of service users are promoted and protected at Sandridge House. Evidence: The current manager has many years experience in managing a care home and is also managing another home. There is a deputy manager in each home and the current postholder at Sandridge House will be starting a Management and Leadership course in September. The manager herself keeps up her own professional training and Care Homes for Older People Page 24 of 30 already has a BSc in Gerontology. She is currently studying for an MSc in Positive Care of Older People. Since the last inspection she has completed a train the trainer course in protection of vulnerable adults (Safeguarding) with the local authority. Arrangements for quality assurance at this home include monthly Regulation 26 visits by the provider, and annual service user surveys. The latest survey results were collated and an action plan drawn up. Quotes from these surveys are now included in the homes service user guide and the results of the survey are posted on the board and on the agenda for the following service users meeting. Regular auditing takes place including audits of the administration of medication, nutrition, pressure area care and accidents. There is a general home audit and regular care plan audits. This home carries out monthly reviews and detailed evaluation of care plans and these are signed off by each resident. There are weekly informal meetings between residents and the co-ordinator as well as 3 monthly formal residents and relatives meetings. The home also holds staff meetings about 4 times per year. There is an annual development plan set out in the same format as the current CSCI AQAA and the manager is developing this into a more structured document. The Requirement made under this Standard at the last inspection is now considered to have been met. The majority of residents manage their own money with assistance from relatives. For those who cant there is an option to keep limited monies in the safe and the home then keeps a record of all incoming and outgoing transactions. Random checks are carried out on these arrangements during Regulation 26 visits by the provider. The inspector looked at two residents records and the balance noted in the record corresponded with the cash balances. Health and safety arrangements are well organised at Sandridge House. The has manager has completed a health and safety course and has overall responsibility. Some aspects are delegated to other staff e.g. checking call points, identifying trip hazards, and monitoring hot water temperatures.The handymans book records any issues which are then crossed out when they have been dealt with.The last EHO report made some requirements and recommendations and the manager confirmed these had now been met. Other measures include health and safety and moving and handling training for staff, and regular audits, for example of medication. The legionella test certificate was on file and there is a basic general policy on legionella prevention. The manager was advised to obtain the Health and Safety Executive booklet on legionella prevention in care homes, or take advice from the local environmental health department to ensure that the current arrangements for legionella prevention are appropriate. Care Homes for Older People Page 25 of 30 Care Homes for Older People Page 26 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 27 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 1 29 19 All the information set out in 14/09/2008 Schedule 2 of the Care Homes Regulations 2001(as amended) must be obtained for all staff. This is to safeguard the interests service users. 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 12 9 The guidance for staff on the administration of as required medication should be drawn up individually for each resident, and agreed with that residents GP, as discussed with the manager. The current Universal Pain Assessment Tool will have limited use for residents with dementia and a more individual approach is needed. The floor covering in the laundry should be reviewed as there is a gap around one of the appliances which would make it difficult to keep clean. The home may decide to replace the floor covering as it is quite worn in places. The manager should obtain the Health and Safety Executive booklet on the prevention of legionella in care homes, or seek guidance from the local environmental health department to ensure current arrangements to prevent legionella are satisfactory. Page 28 of 30 13 19 14 38 Care Homes for Older People 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 © (2008) 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. 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