Inspection on 22/10/08 for Selly Wood House Nursing Home

This inspection was carried out on 22nd October 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Selly Wood House Nursing Home 17/12/09

Selly Wood House Nursing Home 12/10/09

Selly Wood House Nursing Home 29/10/07

Selly Wood House Nursing Home 16/11/06

Selly Wood House Nursing Home 28/11/05

Selly Wood House Nursing Home 29/06/05

Selly Wood House Nursing Home 14/12/04

Selly Wood House Nursing Home 15/07/04

Selly Wood House Nursing Home 10/02/04

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Maple Lodge

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Inspirations

Ashcroft Hollow Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Selly Wood House Nursing Home 161 Selly Wood Road Bournville Birmingham West Midlands B30 1TJ     The quality rating for this care home is:   one star adequate 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: Sarah Bennett     Date: 2 2 1 0 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 31 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 31 Information about the care home Name of care home: Address: Selly Wood House Nursing Home 161 Selly Wood Road Bournville Birmingham West Midlands B30 1TJ 01214723721 01214140731 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Juliet Bates Type of registration: Number of places registered: Bournville Village Trust care home 44 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: 44 beds of which 24 are for nursing care and 20 for residential care. The maximum number of service users who can be accommodated is: 44 The registered person may provide the following category of service only: Care Home with Nursing (Code N) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) 44 Old age, not falling within any other category (OP) 44 Date of last inspection Brief description of the care home Selly Wood House provides nursing and residential care for up to 44 persons of 65 years of age or more. The home is owned by Bournville Village Trust and is situated on the Trust land within the suburb of Selly Oak, South Birmingham. The building is set in a pleasant quiet residential area and has sufficient off road parking to accommodate Care Homes for Older People Page 4 of 31 44 0 Over 65 0 44 Brief description of the care home eight vehicles. The main communal rooms are situated on the ground floor. Bedrooms are located on all three floors with both upper floors providing small lounges for residents use. Care can be provided for persons with limited mobility and wheelchair users. There is a shaft lift for access to each floor, assisted bathing facilities located on all floors, mobile hoists and a call bell system. All bedrooms are single status, seven of which include en-suite facilities. Toilets are situated directly adjacent to each bedroom. The home has a garden that may be accessed from the front of the premises or the ground floor lounge. There is a small parade of shops nearby and bus and rail services are within fairly close proximity. Information about the services and facilities was available on entering the home to enable anyone visiting to make an informed decision about moving in. Separate information was available about the fees on request and fees are reviewed annually. The scale of charges at the home ranged from £472 £640.68 per week, which includes the nursing element that is paid by the Primary Care Trust. The fee information included in this report applied at the time of inspection and the reader may wish to obtain up to date information from the care service. Care Homes for Older People Page 5 of 31 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: one star adequate 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: The quality rating for this service is one star. This means the people who use this service experience adequate quality outcomes. This inspection was carried out over one day; the home did not know we were going to visit. This was the homes key inspection for the inspection year 2008 to 2009. The focus of inspections we, the commission, undertake is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. Care Homes for Older People Page 6 of 31 Prior to the fieldwork visit taking place a range of information was gathered to include notifications received from the home and an Annual Quality Assurance Assessment completed by the Manager. This provides information about the home and how they think it meets the needs of the people living there. Four of the people living in the home were case tracked. This involves establishing individuals experience of living in the care home by meeting or observing them, discussing their care with staff, looking at care files, and focusing on outcomes. Tracking people’s care helps us understand the experiences of people who use the service. We looked around some areas of the home. A sample of care, staff and health and safety records were looked at. Due to the needs of some people living there it was not possible to ask for their views on the home so time was spent observing practices and interaction from staff. Where people were able to comment on the care they receive their views have been included in this report. Some relatives visiting, the Manager, the Operations Manager and staff on duty at the time were spoken with. Some relatives and people living there completed our Have your say survey about the home. Their views have been included in this report. What the care home does well: What has improved since the last inspection? What they could do better: The care plans of all the people living there should be in the new format so they all detail how the person should be supported. Care Homes for Older People Page 8 of 31 As peoples needs change care plans should be updated so that staff know how to support them. Peoples weight should be monitored particularly where there are concerns to ensure individuals health and well being. There should be sufficient intervals between meals so that people can enjoy these and are not hungry if there is too long a gap. All the people living there and their relatives should be told how to make a complaint if they are unhappy with the service provided. This will ensure that the views of all the people living there can be listened to. The bathrooms should be more personal so they are comfortable for people to use. Sufficient staff must be employed to ensure that people are supported by staff who know how to support them so ensuring their well being. Staff should have the training they need so that they know how to support people to meet their needs. Staff must know how to move people safely so that they are not at risk of being injured. There should be regular fire drills to make sure that the people living there and staff would know what to do if there was a fire and they would be safe. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 31 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 10 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good. People have the information they need so they can make an informed choice as to whether or not they want to live there. The assessment process ensures that peoples needs can be met before they move in so that they do not move to a home where they will not receive the support they need. Evidence: Since the last inspection the homes statement of purpose had been updated. This ensured that people have the information they need to make an informed choice as to whether or not they want to live there. People said that they had the information they needed about the home before they moved in. The manager said that they were working in partnership with a local school. They were Care Homes for Older People Page 11 of 31 Evidence: doing some work with the people living there about their lives at the home with the students using their IT skills to create a blog. It is hoped that this will continue to update the service users guide involving the people living there so they have more control over what is included in it. Since the last inspection the assessment process had been updated so that this was more detailed. This ensured that all the needs of the person were assessed before they moved into the home. This helps to decide whether the persons needs can be met there. In the morning of the visit the manager went to assess a person using the assessment process. Records of people who had been admitted using this process showed that it was a useful tool to ensure that peoples needs could be met. The home does not provide intermediate care. Therefore the standard relating to this was not assessed. Care Homes for Older People Page 12 of 31 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. Quality in this outcome area is good. Staff generally know how to support individuals to ensure their health needs are met so ensuring their well being. Evidence: The records of four of the people who live there were looked at. Since the last inspection the format of the care plans had changed to make them more centred on the person so they were more individual. Staff said that this new format was good but some plans still needed more work to include all the information so that staff know how to support the person. One persons care plan had not been updated using the new format. Care plans in the new format were detailed and included all needs of the individual. All care plans should be completed in this format so that staff know how to support people appropriately. Care plans had been signed by the person where they were able to or by their family or friend to show their involvement. Care Homes for Older People Page 13 of 31 Evidence: One person had fallen over the previous weekend. Their records did not show that they had been seen by their GP following the fall although the manager said they had and no treatment was needed. This should be recorded to ensure that people get the treatment they need. The persons care plan and risk assessments had not been reviewed since their fall to ensure that all suport is being given to prevent them from falling as much as possible. Records generally recorded appointments with health professionals and showed that referrals are made to health professionals as needed to ensure peoples health and well being. Records showed that people have regular health check ups with the dentist and the optician. The outcome of these is recorded so that any advice given can be followed. Records sampled stated what support people needed to ensure they receive the nutrition they need and were not losing weight which could be an indicator of an underlying health need. One persons records stated that they should be weighed monthly. Their records showed that they had not been weighed since the beginning of September. Another persons records showed that they had lost weight during this year and their weight was monitored. In September this year their record stated they had gained weight. Their weight had not been checked since to ensure they were not losing weight again. The manager said that she had changed the tool used to assess whether people are receiving the nutrition they need. She said the previous tool did not evaluate this correctly which could put people at risk of being malnourished. The manager said that they are going to ensure staff know how to use this tool before starting to use it so that nobody is at risk of not receiving the nutrition they need to be well. Records included risk assessments to ensure that staff know how to support individuals to be independent whilst being as safe as possible . The people living there were well dressed in individual styles that reflected their age, gender and cultural background. A hairdresser visited regularly and was there on the day of the visit. People who wanted to were supported to have their hair done. Attention had been paid to individuals personal care so promoting their self esteem and well being. The medication was looked at on the ground floor. A local pharmacy provides the medication using the monitored dosage system. The pharmacist pre packs the medication in blister packs for each dose. This makes it easier for staff to know when and what to give to individuals so reducing errors. The qualified nurses administer the medication. At the front of each persons medication record there was a photograph of Care Homes for Older People Page 14 of 31 Evidence: the individual so that unfamiliar staff would know who to give the medication to. The morning blister packs were looked at and had been given as prescribed. Some medication cannot be stored in blister packs so this is provided in boxes from the pharmacy. Records showed that as each tablet is given the nurse records how many are left in the box and this is audited regularly to ensure that medication is given as prescribed. The manager completes regular audits of the medication to ensure that it is being given as prescribed. They said that in the recent audit she had found some errors and would be dealing with the nurses involved using the disciplinary procedures. When errors are found nurses are given additional training to try to ensure they have the skills and knowledge to give medication as prescribed. It is good that regular audits are done to ensure the safe administration of medication so that peoples health needs can be met. Throughout the day staff were observed treating people with privacy and dignity and ensuring that they were comfortable. One person got upset as they became confused and thought everybody was leaving them. Staff spent time with the person gently reassuring them so ensuring their well being. Care Homes for Older People Page 15 of 31 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. Quality in this outcome area is good. Activities provided ensure that people experience a meaningful lifestyle that is appropriate to their cultural background. Menus and food provided do not meet the tastes and needs of all the people living there. Evidence: The home has an activity co ordinator who works there four days a week. They plan activities inside and outside of the home and care staff are encouraged to participate in these with individuals as much as possible. There are three volunteers working at the home who each work one day a week. They help with activities as well as serve drinks and snacks to people during the day. Several activities were taking place during the day including walks in the grounds, games, listening to music and dancing and people choosing to spend time in their bedrooms watching TV. The hairdresser was visiting. Several other visitors come to the home to run activities including an exercise class, aromatherapy, pet therapy, art and Care Homes for Older People Page 16 of 31 Evidence: there is a service of Holy Communion monthly. There is also a monthly coffee morning. Parties were being arranged to celebrate Halloween and Bonfire Night. Activities have been and are being arranged outside the home including going to the theatre, going to see the Walsall Lights and visiting the Bullring at Chritmas time. A car is provided to enable people to go out. Relatives said that not many staff can drive the car so it was not used that often. Staff said that if there were no drivers alternative transport was used but the car was useful to take individuals out on activities and to health appointments. People have the newspapers they prefer delivered if they want. There are also a selection of newspapers available in the lounge for people to read. Meetings are held with the people living there and their relatives. This gives people an opportunity to say what they want and how they want the home to be run. Since the last inspection there had been changes in the kitchen staff and people said that the food was not as good as it used to be. Records showed that the manager had been working with the kitchen staff and that a new menu had been developed that was to be started in November. Attention had been paid to ensuring that the menu was nutritionally balanced as well as being varied and providing foods that people said they liked. People were unaware of what was for lunch on the day of the visit. After lunch staff were observed asking people what they wanted for lunch the next day. Some people were confused as to what they were being asked about and when they were going to have this meal. It is good that people are asked what they would like to eat but it seemed a long gap between the time they were asked and the meal. Whilst it is necessary that kitchen staff know how much they are preparing in advance some review should take place as to how much notice is needed. One person said that lunch is served at 1pm and then they have their tea at 5pm. They said they could both be cooked meals and there is not always enough gap to have an appetite to eat it. They then do not have another meal until breakfast the next day apart from a snack about 8pm. Thought should be given to appropriate gaps between meals for individuals so that people do not become hungry which could affect their sleep pattern. Care Homes for Older People Page 17 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is adequate. Some people living there are not aware of how to make a complaint which could mean that not all the views of the people living there are listened to. This could impact on their well being and safety. Evidence: The AQAA stated that the complaints procedure is clear and accessible. Three of the nine people who responded to our survey of the people living there said they did not know how to make a complaint. All people should be made aware of this procedure so that all their views can be listened to. The AQAA stated that in the last 12 months fifteen complaints had been received, eleven of which were upheld. These related to food, maintenance of the home, clothing of the people living there and how correspondence was dealt with. One complaint had not yet been resolved so the outcome was not clear. A log of complaints is kept and most complaints logged showed what action had been taken to resolve it. One complainant had to complain again a week later as it did not appear that action had been taken. However action was then taken to ensure that this was resolved to their satisfaction. One relative said that they were happy with how their complaint was handled and the outcome of this. They had met with the manager and discussed the Care Homes for Older People Page 18 of 31 Evidence: issues raised. The manager had taken action to resolve these. We received one complaint about the home. This was passed back to the Provider to investigate and is included in those received by the home. The AQAA stated and training records showed that all staff had received training in how to safeguard the people living there from abuse. The AQAA stated that two safeguarding referrals had been made and investigations undertaken to ensure that people are protected from abuse and neglect. The Provider had responded positively to these and an action plan has been put in place with clear timescales stating how improvements to the home and the care given to people who live there are to be made. The AQAA stated that they could do better by increasing staff knowledge of the Mental Capacity Act 2005. This legislation came into force in April 2007. It requires an assessment to be done of a persons capacity to make a choice or decision about their life when it is felt that they lack the capacity to do this. If the person does not have the capacity an Independent Mental Capacity Advocate can be appointed to assist them in their decision. All staff should be aware of this legislation and the implications it has for the poeple living there.The action place addressed this and stated that all care staff would receive a two hour training session by the end of December 2008. Care Homes for Older People Page 19 of 31 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. Quality in this outcome area is good. People live in a homely, comfortable, clean and safe environment that generally meets their individual needs. Evidence: The home was generally well decorated and maintained making it a homely and comfortable place to live. There were pictures of the local area around the walls in the hall. Some of these pictures were of how the area used to be so providing memories for the people living there many of whom lived locally. The manager plans to change some of the rooms into themed rooms to benefit the people living there. One room is to become a small kitchen so that people who are able to can make drinks and snacks there so to increase their independence skills. Another room is to be converted to a parlour where people who are able to can do some domestic tasks. This will encourage people to regain their independence and provide some activities in reminiscence that may benefit them. Another room is to become a pub or village hall so that people can spend time socialising and playing games in a relaxed environment. The manager said that she is currently securing funding for these. Care Homes for Older People Page 20 of 31 Evidence: Peoples bedrooms seen were personalised to individual tastes and interests. Some people had a view over the garden from their window and had planters and bird feeders outside their window. This provided a pleasant view and people said they felt like they had a piece of the garden to them. This was important as they were interested in gardening and this had been one of their hobbies. The AQAA stated that some bedroom carpets had been replaced in the last year. The bathroom on the ground floor had an adapted bath so that people could get in and out of this easily. There were tile effects on the walls and the mirrors had been painted. These had been done by the people living there with an artist who visits the home. This made the bathroom look homely and personal. The bathrooms on the first and second floors were stark in contrast and not personal. The manager said that in next years budget these would be redecorated so that they are homely and would benefit the people living there. On the ground floor there is a walk in shower room where hoists and equipment were stored. The manager said that in the next years budget it is planned that an equipment store be built so that this room can be used by people who want to have a shower. The home was clean and free from offensive odours making it pleasant for the people living there. People responded in our survey saying that the home was always clean. Care Homes for Older People Page 21 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is adequate. The arrangements for staffing, their support and development are variable which could impact on the health and well being of the people living there. Evidence: The manager said that there were 200 hours a week vacant for care staff and 15 hours a week vacant for nursing staff. One care staff was leaving that day and another care staff was leaving at the end of the week. One nurse was due to retire at the end of the week. Staff and relatives said that a lot of staff are leaving and this concerned them. Relatives said that they were concerned about staff changes and how this would affect the people living there. One relative said that the people living there feel insecure with all the changes. The Operations Manager said that at the recent recruitment day they appointed three care staff and one bank nurse. Another recruitment day was being held at the end of the week. Since the last inspection staffing levels had been reduced to one staff to five people in the morning, one staff to seven people in the afternoon and evening and one staff to eight people at night. The manager said that this was to ensure that resources are used effectively and that staff are deployed at the right times to ensure that the Care Homes for Older People Page 22 of 31 Evidence: service is run in the interests of the people living there. They said that this also allows for people who need it to receive 1 to 1 staffing within the budget. Relatives said that this was not enough staff and that recently staff had seemed tense. Staff said that they have less time to spend talking to the people living there. One person living there said that at night the staff seem rushed and that sometimes they will start supporting you and then have to support another person so you are left for a while not knowing when they are coming back. They said that it is often agency staff working at night who do not know the people and how to support them. The manager said that more permanent staff are needed to work at night and they have recently recruited one night staff who would start when they have had the necessary checks. Some people living there said that staff are usually available to support them when needed and one person said that staff are sometimes available. One person said that sometimes the care and support is poor as not enough staff and that recently it had been rather poor. Staff were observed to be busy supporting people particularly in the morning and not having time to spend talking to people. Staff seemed to have more time during the handover period of the day shifts and in the afternoon up until tea time. Staff meeting minutes showed that the frequency of these had recently increased. Meetings are held with Team Leaders, care staff and the kitchen and housekeeping staff. At a recent meeting staff said that they felt rushed and did not always have time to take breaks. One staff said during the day said that they had not had time for a break and some days were like this but not every day. The AQAA stated that 75 per cent of staff had achieved National Vocational Qualification level 2 or above in Care. This exceeds the standard and should ensure that staff have the skills and knowledge to meet the needs of the people living there. Student nurses do placements at the home and recently student nurses doing their mental health nurse training had started having placements there. There were two students from local college on placement who were doing the BTEC National Diploma in Health and Social Care course. As well as providing valuable experience for the students the home also benefits from them as it helps staff to keep updated with best practice and challenges practices helping to improve them. Staff records sampled showed that before staff started working at the home the required checks were done to ensure that suitable people are employed to work with the people living there. Care Homes for Older People Page 23 of 31 Evidence: Records showed that all staff have completed the Skills for Care induction workbook so they know how to meet the needs of the people living there. When new staff start working at the home they will be expected to complete this. Staff training records showed that staff receive the training they need so they know how to support the people living there. Where staff have not received the training they need they have been booked to do so. Care Homes for Older People Page 24 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is adequate. The management arrangements do not always ensure that people are safe which could put their health and well being at risk. People are asked what they think of the home and their views are considered to improve how the home is run. Evidence: The current Manager had been working at the home since April this year. Previously there was a General Manager and a Care Manager. The post of Care Manager had been reorganised and was to be advertised. The person appointed would be registered with us and would be responsible for the overall management of the home. Relatives and some staff said that recently the atmosphere in the home had been tense and they had felt that there had been too many changes made that they were not consulted about. Records showed that meetings had been held with relatives, the Care Homes for Older People Page 25 of 31 Evidence: people living there and staff to explain these changes. Some staff said that people generally do not like change and there had been several changes which had made the home unsettled. Relatives who had met with the new Manager to discuss their concerns said that they could see that some things needed to change and they were doing it. They said that when there are problems they are addressed and the home is very well run. The home has a quality assurance system that looks at all areas of the home and how it can be improved to ensure a quality service is provided. From this an action plan had been developed to address all the areas needed. Included in the quality assurance system is a survey of the people living there and their relatives. The Operations Manager said they would be presenting the results of this survey at the next meeting with the people living there and their relatives in November. They had recently received these and had highlighted the areas that they felt needed addressing to ensure that improvements were made. When people want their money to be looked after at the home there is a secure place for this. Four peoples money was looked at that was held securely in the home. Money is held individually and individual records are kept. The records cross referenced with the amount in individuals envelopes. Receipts are kept of all expenditure to verify the amount spent. These showed that people had spent their money on personal items and not on things that should be provided by the home as part of their fees. Staff supervisions had not happened regularly until recently and now staff were having supervision at least once every two months. This will ensure that the standard of at least six per year is met and that staff are supported in their job role so they know how to meet the needs of the people living there. Staff training records showed that all staff had received training in moving and handling people. Observations showed that staff did not move people in a way that was safe for the person and themselves. Staff were observed pulling people instead of guiding them to walk which could put them at risk of injury. Staff were observed assisting people to transfer from chairs in the lounge to their wheelchair. They put their arms under the persons arms and physically moved them around to their wheelchair. This move could put people and the staff moving them at serious risk of injury. This was observed several times duringt the day. The Manager said that she had ordered equipment so that staff could move people safely and that all satff would receive further training in this. The manager said that some equipment had been ordered to move people safely from the home in the event of an emergency. There had not been a fire drill for a year and Care Homes for Older People Page 26 of 31 Evidence: there should be at least two a year. The manager said that when the equipment arrives a fire drill would be done to ensure that people can be safely evacuated. Regular tests of the fire equipment had been completed to make sure it is working. Records showed that all equipment in the home had been regularly serviced to ensure it is well maintained and safe to use. Maintenance staff regularly test the portable electrical appliances to make sure they are safe to use. Care Homes for Older People Page 27 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 28 of 31 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 27 18 Staff must be recruited and sufficient staffing levels maintained. This will ensure that the needs of the people living there are met. 28/02/2009 2 38 13 People must be moved safely. To ensure they are not at risk of injury. 30/11/2008 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 1 7 Where peoples needs change their care plan should be updated to ensure that staff are supporting the individual appropriately and their needs are met. All care plans should be completed in the new format so that staff know how to support individuals so that their needs are met. Staff should monitor individuals weight to ensure that they receive the nutrition they need to be well. The new menus should be regularly reviewed and people 2 7 3 4 8 15 Care Homes for Older People Page 29 of 31 consulted about them to ensure that they meets peoples needs and tastes. 5 15 The intervals between meals should be reviewed to ensure that people can eat the meals provided and are not hungry inbetween meals. People should be asked at appropriate times what they would like to eat for their main meal so they can make an informed choice. The complaints log should show how all complaints have been responded to and what action is taken to resolve them so to improve the quality of the service provided. All the people living there should be informed of how they can make a complaint so that all their views are listened to and can be acted on. All staff should be aware of The Mental Capacity Act 2005 and the implications it has for the people living there. The bathrooms should be redecorated so that they are homely and comfortable for people to spend time in. The shower rooms should be cleared of equipment so that all the people living there can have a choice of having a bath or a shower. There should be at least two fire drills each year to ensure that staff and the people living there would know what to do if there was a fire and people could be moved safely. 6 15 7 16 8 16 9 10 11 18 21 21 12 38 Care Homes for Older People Page 30 of 31 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). 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