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Inspection on 26/07/05 for Seven Rivers Cheshire Home

Also see our care home review for Seven Rivers Cheshire Home for more information

This inspection was carried out on 26th July 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The standard of care is good, and the home has a happy atmosphere. The staff team is well trained and able to meet the needs of the residents. The home`s real strength is the relationships that the team have built up with the residents and their families. The residents felt valued and respected.

What has improved since the last inspection?

Staffing numbers has improved and the home has a full compliment of staff available to meet personal, health and social needs of the residents. Residents indicated that staff always had time for them and their care was never rushed.

What the care home could do better:

Residents care plans and documentation need to reflect all identified needs and could be a lot more informative for staff to ensure delivery of structured and consistent care and better reflect the actual standard of care givenThe home needs to work on quality assurance and monitoring issues to look at the actual quality of care being given to the residents and where improvements, if any, can be made.

CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 Seven Rivers Cheshire Home Hall Road Great Bromley Colchester Essex CO7 7TR Lead Inspector Elvin Gaynor Unannounced 26 July 2005 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 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 and Care Homes for Adults 18 – 65*. 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. Seven Rivers Cheshire Home I56-I05-S15362 Seven Rivers V237212 260705 Stage 4 Mixed Category.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Seven Rivers Cheshire Home Address Hall Road, Great Bromley, Colchester, Essex, CO7 7TR. Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01206 230345 01206 231011 Leonard Cheshire Foundation, Central Office, 30 Millbank, London, SW1 4QD. Mrs. Gillian Mary Sleightholm Care Home 28 Category(ies) of Physical Disability (PD) - 21; Physical Disability registration, with number over 65 years of age (PD(E)) - 11 of places Seven Rivers Cheshire Home I56-I05-S15362 Seven Rivers V237212 260705 Stage 4 Mixed Category.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, aged 18 years and over, who requiring nursing care by reason of a physical illness/disability (not to exceed 21 persons). 2. People with a physical disability who may be aged over 65 years (not to exceed 11 persons). 3. No more than five persons may attend the home on a daily basis in addition to those 28 accommodated. Date of last inspection 3 February 2005 Brief Description of the Service: Seven Rivers is part of the Leonard Cheshire Foundation. It is a care home registered to provide nursing and personal care to adults and older people who have a physical disability. The home originates as a Georgian style mansion and has a 1960s extension and a further extension built in the 1990s. The main house is a two-storey building with access to the upper floor provided by a passenger lift. Seven Rivers is located in the small rural village of Great Bromley, geographically central to the larger towns of Colchester and the seaside towns of Clacton on sea and Harwich. However public transport is minimal although a bus route runs past the home, which serves the surrounding villages. The local train station is in a neighbouring village of Gt Bentley approximately three miles away. Great Bromley village has a local shop and public house. The home is set in large well-maintained grounds. The main house provides a flat for accommodating visitors for overnight stays and a flat for volunteer over sea GAP students. Seven Rivers Cheshire Home I56-I05-S15362 Seven Rivers V237212 260705 Stage 4 Mixed Category.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on one day in July 2005, over 6 hours. The inspection process included an informal discussion with the manager; the Care Supervisor, one carer who held an additional post of responsibility as Health and Safety officer for the home and one Registered Nurse, who held an additional post of responsibility as training development co-ordinator for the home. There was also informal discussion with three residents and observation and examination of records and documentation. It was noted that 6 of the 27 residents were over the age of 65 years. Discussion took place with regard to looking at National Minimum Standards for Older People as well as National Minimum Standards for Young Adults, also taking into consideration the majority of residents under 65 years had high nursing needs. It was agreed the inspection would be looking at appropriate individual outcomes according to individual needs and the report format used would be for Mixed Category, majority adults 18 – 65 years. For the purpose of this report service users will be referred to as residents, this being the preferred form of reference. What the service does well: What has improved since the last inspection? What they could do better: Residents care plans and documentation need to reflect all identified needs and could be a lot more informative for staff to ensure delivery of structured and consistent care and better reflect the actual standard of care given. Seven Rivers Cheshire Home I56-I05-S15362 Seven Rivers V237212 260705 Stage 4 Mixed Category.doc Version 1.40 Page 6 The home needs to work on quality assurance and monitoring issues to look at the actual quality of care being given to the residents and where improvements, if any, can be made. 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. Seven Rivers Cheshire Home I56-I05-S15362 Seven Rivers V237212 260705 Stage 4 Mixed Category.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Standards Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) Seven Rivers Cheshire Home I56-I05-S15362 Seven Rivers V237212 260705 Stage 4 Mixed Category.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitablity of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3 & 4 The admission process is well managed and residents receive a warm welcome and are provided with clear and relevant information regarding the service. EVIDENCE: The home was still in the process of further developing the Statement of Purpose and Service User Guide, as required in the previous inspection, to include all the information a prospective service user would need to make an informed choice about where to live. From documentation and discussions with the manager, it was clear that the majority of resident’s needs were noted to be complex and highly dependant. Many admissions were from hospital and therefore introductory visits were not Seven Rivers Cheshire Home I56-I05-S15362 Seven Rivers V237212 260705 Stage 4 Mixed Category.doc Version 1.40 Page 9 always possible but the opportunity is offered. The Primary Care Trust now funded many residents. Care Management assessments and reviews were in place and noted to be nurse led, purely looking at nursing needs. A full holistic needs assessment is carried out by the home prior to admission. One new resident spoken to expressed satisfaction with the way their admission was managed and with the way the home was meeting their needs. Clear information was given verbally to their family. Seven Rivers Cheshire Home I56-I05-S15362 Seven Rivers V237212 260705 Stage 4 Mixed Category.doc Version 1.40 Page 10 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14, and 33 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7 & 9 Residents are looked after well in respect of their health and personal care needs and were actively supported to remain in control of their care wherever possible. Further attention needs to be given to the care plans to include each aspect of the person’s identified needs and how they are to be met. EVIDENCE: Care plans examined were well-structured utilising risk assessments associated with dependency level; mobility, continence; skin viability and other identified health care needs. The risk assessment forms had been altered to allow for more detailed information to be recorded for care staff in managing or reducing the identified risk. Seven Rivers Cheshire Home I56-I05-S15362 Seven Rivers V237212 260705 Stage 4 Mixed Category.doc Version 1.40 Page 11 The care planning process was carried out by the Registered Nurses and tended to focus heavily on physical needs. The care plans required a more holistic approach with more detailed information of the planned care for staff to follow ensuring a consistent and structured delivery of care. Residents spoke positively about the care they received and confirmed their care was discussed with them. They considered they were able to make decisions about their lives and that staff supported them and gave them assistance where necessary. Seven Rivers Cheshire Home I56-I05-S15362 Seven Rivers V237212 260705 Stage 4 Mixed Category.doc Version 1.40 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. Service Users find the lifestyle experiencd in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. 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. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. 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. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,15,16 & 17. Social activities were well-organised, creative and provided stimulation and interest for people living in the home. Seven Rivers Cheshire Home I56-I05-S15362 Seven Rivers V237212 260705 Stage 4 Mixed Category.doc Version 1.40 Page 13 Visiting arrangements were open and relaxed and staff welcomed relatives to the home. The home supplied sufficient quantity and quality of food and provided a well balanced diet that met individual needs and choices. EVIDENCE: The home views activities as being integral with care. The activities coordinator, volunteer co-ordinator and volunteers provided additional support for the residents to undertake activities, promote social interaction and stimulate thought. The majority of residents met each morning in the activities room; a smaller informal setting, where general chit chat, group discussion on current affairs and decision making with regard to day to day activities within the home, took place. Residents were observed participating in a general quiz before lunch. Democratic decisions were made with regard to the choice and organisation of social events in and outside of the home. Residents enjoyed the planning, preparation and participation with family and friends, in large themed events put on in the home throughout the year. Some relatives were observed taking residents out and others were visiting, sitting and enjoying the relaxed environment of the tranquil gardens. One resident, recently admitted, said staff provided lots of support enabling her small children to visit whenever they were able to, and she loved to watch them play outside in the vast gardens. Another resident spoken with preferred not to participate in group activities within the home, except for at Christmas, but enjoyed going into Colchester shopping and trips to the coast with her key worker. This resident also chose to take her meals alone in her room. The staff respected her wishes. Residents who spoke about the food described it as good. Meals were observed to be of good proportion, nutritious and well balanced. Assistance was given with dignity and patience. Those residents unable to eat and received their dietary intake through other methods, met together in the sitting room at meal times to participate in other activities. Seven Rivers Cheshire Home I56-I05-S15362 Seven Rivers V237212 260705 Stage 4 Mixed Category.doc Version 1.40 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) Service users retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicines. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19 &21 Staff engaged positively with each individual and demonstrated a good understanding of the residents they were supporting. The health needs of the residents were met and supported by good multi disciplinary team working. EVIDENCE: Respectful and helpful interaction was observed between the staff and residents, delivered with understanding and using a person focused approach. All the residents appeared calm and relaxed, one recently admitted resident said she felt safe and well looked after and carers gave care how she preferred it to be given. Seven Rivers Cheshire Home I56-I05-S15362 Seven Rivers V237212 260705 Stage 4 Mixed Category.doc Version 1.40 Page 15 Staff were observed to protect and promote residents’ privacy and dignity and spoke to residents in a respectful way. Appropriate pressure relieving equipment was in use, and care plans reflected preventative care required. Seven Rivers Cheshire Home I56-I05-S15362 Seven Rivers V237212 260705 Stage 4 Mixed Category.doc Version 1.40 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16, 18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are sageguarded. (OP NMS 35) The Commission considers Standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 16, 18 and 35 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 Satisfactory arrangements were in place for protecting residents and responding to their concerns. EVIDENCE: No complaints had been received by the home or the CSCI. Outcome for OP18/YA23 was not fully inspected on this occasion, only the requirement from the last inspection. Regarding this, the home’s policy on the protection of vulnerable adults included the procedure to be followed in the event of suspicion of abuse, and the need to make referrals to other agencies. The manager had obtained a copy of the Essex Guidelines. Staff spoken with were aware of abuse issues, one carer said that they felt safe in the knowledge that all staff treated residents well and with respect and would not hesitate to report anything untoward to the appropriate people. Residents spoken with said they were confident to raise any issues with their key workers or the manager but had never had any reason to do so. Seven Rivers Cheshire Home I56-I05-S15362 Seven Rivers V237212 260705 Stage 4 Mixed Category.doc Version 1.40 Page 17 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28, 29 & 30. The old age of the main building of Seven Rivers affects the ability of the home to provide a completely suitable environment with regard to the accessibility of the bedrooms on the first floor of the main house. Specialist equipment and aids were available to promote optimum independence and well-being. Rooms clearly presented individuality with personal possessions and photographs around them. EVIDENCE: Seven Rivers Cheshire Home I56-I05-S15362 Seven Rivers V237212 260705 Stage 4 Mixed Category.doc Version 1.40 Page 18 The home created a comfortable and homely ambience and areas seen were cleaned to a high standard. The size and standard of accommodation varied considerably in different parts of the home, depending on whether the rooms were in the original building or in one of the newer extensions. Areas of the original building require upgrading. Each room provided access to the call system with alternatives available for those persons unable to use the system. Varied aids were observed such as overhead tracking hoists, manual hoists, pressure relieving mattresses and monkey poles. The corridors had rails to assist mobility and toilets and bathrooms had appropriate rails and grab rails. A passenger lift provided access to the first floor. A programme of routine maintenance to the buildings and redecoration of the premises was evident for 2005 – 2006. Carpet replacement and redecoration was noted to some areas, however the dining room still required a new carpet and redecoration. The manager indicated this was planned for in the programme. The grounds were well maintained, attractive and accessible to the residents. Seven Rivers Cheshire Home I56-I05-S15362 Seven Rivers V237212 260705 Stage 4 Mixed Category.doc Version 1.40 Page 19 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 34 and 35 (Adults 18-65) and Standards 27,29 and 30 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) & 36. 32, 33, 34, 35 The number of staff was adequate to meet resident’s needs. Staff training is provided in a planned way, to ensure understanding, knowledge and skills are provided for to meet the general and specialised needs of the residents. The home has a stable, loyal team, which ensures consistency in the delivery of care. The residents were protected by the homes recruitment procedures. EVIDENCE: The ratios of care staff to residents are determined according to the needs of the resident. The home uses the Leonard Cheshire needs assessment tool to individually assess dependency, mobility, health and nursing, social, Seven Rivers Cheshire Home I56-I05-S15362 Seven Rivers V237212 260705 Stage 4 Mixed Category.doc Version 1.40 Page 20 psychological, educational and leisure activity needs and the grades of staff involved to meet those needs. On the day of the inspection the manager, care supervisor, two registered nurses and nine carers were on duty throughout the day shift, as well as the chef, kitchen assistant, activity co-ordinator, five domestics, two administrators, the maintenance man and volunteers. All staff employed are entered into the training matrix, which identifies specific mandatory training requirements for specific roles. The training development co-ordinator, who is also a registered nurse, ensures all staff receive the appropriate training. For requirements for training and development outside of the matrix the co-ordinator endeavours to try and meet those needs if they are beneficial to meet the needs of the resident and the aims of the service. These have included training sessions provided by Healthcare Professionals in Multiple Sclerosis, Huntingdon’s disease, Diabetes, Tissue Viability, Breast care and the dietician. External training sessions are regularly arranged with regard to Peg feeds; and with companies such as Tenna, in the correct use of continence pads. Completed Induction and Foundation folders were examined and seen to be in line with The National Occupational Standards for Health and Social Care. Leonard Cheshire has its own NVQ centre in Poole, Dorset and an assessor visits the home monthly. Eighteen carers have achieved NVQ level 2 in care and six are working towards it. Two have achieved NVQ level 3 in care and support and one is working towards it. The home has already achieved the minimum ratio of 50 trained members of care in NVQ level 2 and is looking to achieve 75 or more by the end of 2005. Staff spoken with felt well supported and received supervision. The training co –coordinator confirmed that the registered nurses who had received or were receiving supervision training supervised the carers. Two files of the most recently recruited care staff were examined and included all required information for the protection of residents. Seven Rivers Cheshire Home I56-I05-S15362 Seven Rivers V237212 260705 Stage 4 Mixed Category.doc Version 1.40 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. 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. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 39 and 42 (Adults 18-65) and Standards 33,35 and 38 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39 & 42 The home is managed efficiently and in the best interests of the residents and staff. Overall, the health, safety and welfare of residents and staff are promoted and protected. Seven Rivers Cheshire Home I56-I05-S15362 Seven Rivers V237212 260705 Stage 4 Mixed Category.doc Version 1.40 Page 22 EVIDENCE: The Registered Manager is a Registered Nurse with considerable experience in managing care homes of varying sizes and caring for various groups of service users including persons with physical disability, older persons and persons with dementia and is currently working towards the Registered Managers Award. Mrs Sleightholme demonstrated a comprehensive knowledge base and an understanding of the service users psychosocial, physiological and healthcare needs including the needs of the service users families, especially their children. A commitment to the essential elements of management such as staff supervision, training and development were evident. During the inspection there was clear evidence of progress in achieving the homes aims and stated purpose. The service users and staff spoke highly of the manager and felt that her approach of the home created an open, positive and inclusive atmosphere. Service user and staff meetings provided further evidence of inclusion. The staff said that they felt supported and encouraged in their role and responsibilities. The manager indicated that quality assurance and quality monitoring still required further development. Staff training records demonstrated an appropriate range of training to promote the knowledge and skills required by staff to maintain the health, safety and welfare of residents such as; infection control, moving and handling, COSSH. The chef has achieved Advanced Food Hygiene. All nurses are trained in First Aid and all care staff are certified appointed persons in First Aid training. A trained Fire Marshall is on duty on each shift at all times. A yearly update in fire awareness is received yearly by all staff to include update in legislation; practical experience and assimilation, and timing of response to carrying out fire procedure. A carer is also the appointed person for Health and Safety within Seven Rivers and works closely with the maintenance person ensuring a safe environment is maintained. Risk assessments in the work place were being reviewed on the day of the inspection. Updates with regard to health and safety issues are received via Leonard Cheshire; during discussion it was not clear if the home had access to Medicines and Healthcare products Regulatory Agency for Medical Device Alerts with regard to any medical equipment, which may be used within the nursing home. Policies and procedures were not examined on this occasion. Seven Rivers Cheshire Home I56-I05-S15362 Seven Rivers V237212 260705 Stage 4 Mixed Category.doc Version 1.40 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 3 3 x Standard No 22 23 Score 3 3 Score ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 3 x 3 3 3 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING 3 3 3 4 4 3 3 Score 11 12 13 14 15 16 17 Standard No 31 32 33 34 35 36 x 3 3 3 3 3 3 3 2 x x 3 x Version 1.40 Page 24 CONDUCT & MANAGEMENT PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Seven Rivers Cheshire Home Score 3 3 x 3 37 38 39 40 41 42 43 I56-I05-S15362 Seven Rivers V237212 260705 Stage 4 Mixed Category.doc yes Are there any outstanding requirements from the last inspection? 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. 1. Standard 1 Regulation 4,5 Schedule 1 Requirement The Registered Manager must review and update the Statement of Purpose to accurately reflect the services and facilities of Seven Rivers.Previous requirement not met within given timescale. The Registered Manager must ensure individual care plans reflect all assessed needs and detail all information required for care staff to give appropriate support and consistency.Previous requirement not met within given timescale. The Registered Manager must continue to develop an effective quality assurance and monitoring system to measure the homes success in achieving the homes aims and objectives and working to the Statement of Purpose. Previous requirement not met within given timescale. Timescale for action 1st October 2005. 2. 6 14 1st October 2005. 3. 39 24 1st October 2005. Seven Rivers Cheshire Home I56-I05-S15362 Seven Rivers V237212 260705 Stage 4 Mixed Category.doc Version 1.40 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Seven Rivers Cheshire Home I56-I05-S15362 Seven Rivers V237212 260705 Stage 4 Mixed Category.doc Version 1.40 Page 26 Commission for Social Care Inspection First Floor, Causton Road Colchester Essex CO1 1RJ. National Enquiry Line: 0845 015 0120 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. 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