Inspection on 13/06/07 for Silver Threads

This inspection was carried out on 13th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Silver Threads 04/07/06

Silver Threads 17/11/05

Silver Threads 25/07/05

Silver Threads 10/01/05

Silver Threads 22/04/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Silver Threads 1 Lyndale Terrace Instow Bideford Devon EX39 4HS Lead Inspector Andy Towse Unannounced Inspection 13th June 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Silver Threads DS0000022162.V335002.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Silver Threads DS0000022162.V335002.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Silver Threads Address 1 Lyndale Terrace Instow Bideford Devon EX39 4HS 01271 860329 01271 860020 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Robert John Flynn Angela Flynn Mr Robert John Flynn Care Home 14 Category(ies) of Dementia - over 65 years of age (14), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (14), Old age, not falling within any other category (14) Silver Threads DS0000022162.V335002.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th July 2006 Brief Description of the Service: Silver Threads is situated in the village of Instow, between the towns of Bideford and Barnstaple. The homeowner aims to make every residents stay as comfortable as possible. Silver Threads caters for 14 service users over the age of 65 years, who may be physically or mentally frail. The property is an adapted three-storey terrace house and significant improvements have been made in the last four years. The accommodation is comfortable and homely. There is a stair lift to the first and second floors, with two communal lounges, a dining and reception area on the ground floor. There is also an attractive courtyard area with summerhouse for service users use. The fees charged at this home range from £385--£400 per person per week. Additional fees are levied for toiletries, newspapers, hairdressing and chiropody. Copies of previous inspection reports are available for staff, residents and visitors. Silver Threads DS0000022162.V335002.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection. It took place over a period of eight hours. Prior to the inspection surveys were forwarded to nine members of staff, ten residents and two health care professionals. Of these, responses were received from five members of staff, five residents and one health care professional. In addition to the information contained in the surveys, the registered manager also completed a pre inspection questionnaire. Further information, used in the collation of this report was gained from the inspection which included a site visit, discussions with staff and residents, observation and examination of records including care plans. What the service does well: The home operates a good admissions procedure which ensures that residents are only admitted when assessments, which show that their needs can be met, have been completed. Also the home’s policy of encouraging potential residents and their families to visit the home as part of the admissions process, allows them to make an informed choice about moving into the home. Residents’ files contain very relevant information gained from a variety of sources which enable staff to appreciate the individual history of each resident. The home has a commitment to training and staff attend specialist courses as well as those which it is mandatory for them to attend. This is a small family run home and many residents and relatives alike commented on choosing the home because of its homely atmosphere. Staff are aware of the right of residents to privacy and dignity and gave good examples of how they ensured that residents received this. The home has a schedule of home based activities available for each day which were seen to be enjoyed by residents. The home offers residents a enjoy a varied diet from a menu chosen to reflect their preferences. The home is well maintained and has a good standard of cleanliness which is commented upon by residents and their relatives alike. The home operates a robust recruitment policy which ensures the safety of residents by only allowing staff to commence work after police checks had been carried out on them. Silver Threads DS0000022162.V335002.R01.S.doc Version 5.2 Page 6 Staff felt supported by the management and receive regular supervision. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Silver Threads DS0000022162.V335002.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Silver Threads DS0000022162.V335002.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 5 and 6 Quality in this outcome area is good. Residents benefit from an admissions procedure which ensures that the registered manager has enough information upon to make a decision about whether the potential residents’ needs can be met. Potential residents can make an informed choice about whether to move into the home after visiting it. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The files of three residents were examined and case tracked. Silver Threads DS0000022162.V335002.R01.S.doc Version 5.2 Page 9 Records relating to a recently admitted resident showed that the manager had visited this person in hospital and, in addition had also discussed the person’s needs with healthcare professionals and family members. The deputy manager had also visited the prospective resident in hospital, following the visit by the manager. This process had enabled the home to get ample information from which to make an assessment about whether this person’s needs could be met. Whilst this prospective resident had, due to circumstances, been unable to visit the home prior to being admitted there, his/her relatives had done so. The management encourages prospective residents and their relatives to visit the home prior to any decisions being made about moving in there to live. Another resident’s file showed that The home’s admissions policy was seen to be very resident focussed and includes instructions to staff about ways in which they can reduce the level of stress experienced by people when they first come into care and thereby make the experience more enjoyable. Records showed that when compiling assessments for potential residents the registered manager sought information from various people, including relatives and healthcare professionals such as general nurses or community psychiatric nurses as well as the potential resident. Silver Threads does not offer intermediate care. Silver Threads DS0000022162.V335002.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. Information on care plans is comprehensive and residents are benefiting from the care plan system being revised. Residents benefit from good access to healthcare professionals and an appropriate system of medication administration and storage. Residents are treated with respect and their dignity upheld. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Silver Threads DS0000022162.V335002.R01.S.doc Version 5.2 Page 11 The examination of the files of three residents showed that residents at Silver Threads have care plans. These were seen to have been generated from the assessments, which had been compiled when the resident was admitted to the home. The home also liaises with relatives of residents and healthcare professionals when compiling detailed biographic profiles, which result in staff having a thorough knowledge of the residents through an appreciation of their past history, and important events in their lives. Care plans include regular reference to individual choice and preferences. Examples of this were preferred times of bathing, how many pillows a resident preferred, sleeps with night light and the strength of tea preferred. The care plans were thorough assessments, containing adequate information about each resident’s needs however they would benefit from being more directive about how the identified needs were going to be met and by whom. This was discussed with the manager who informed us that the care plan system in operation at the home was being upgraded by the deputy manager. Who would be addressing this issue. Whilst the deputy manager does go through the care plans with residents, they currently do not sign the documents to confirm this and their agreement with what is written down. From discussion with the manager and examination of files it was evident that the residents benefit from regular contact with healthcare professionals. There was evidence of the involvement of a community psychiatric nurse, discussions with a psychiatrist and the re assessment of a resident’s medication following observed behavioural changes. Daily records showed that the doctor was called or the advice of healthcare professionals sought whenever residents’ needs necessitated this. An example being the home planning to involve the dietician regarding one resident’s specific needs. One care plan contained very good information regarding diabetes which related specifically to that resident. Another file showed details of a community nurse’s involvement in supporting a resident in the successful treatment of leg ulcers. The home has a Pegasus bed for any resident who might develop pressure sores and would obtain any other necessary equipment from the community nurses if it was required. At the time of the inspection the home was seeking advice from an occupational therapist regarding equipment to enable residents to be more mobile and independent. Files were seen to contain risk assessments. Examples of these were an assessment carried out on a resident who had previously had a fracture. Other risk assessments covered falls and manual handling. The home has a written policy for the administration, storage and handling of medication. Medication is kept in a lockable trolley, which for safety is secured to the wall. The home uses a monitored dosage system of medication administration. At the time of the inspection there was no resident prescribed Silver Threads DS0000022162.V335002.R01.S.doc Version 5.2 Page 12 controlled drugs. When spoken to, a staff member knew the correct procedure for the storage, administration and recording of controlled drugs. Should any person be prescribed this medication the manager agreed that a separate lockable container would be secured inside the drugs trolley in compliance with the required storage of such medication. The administration of medication was observed during the inspection. It was seen that staff only recorded medication after seeing that it had been taken by the resident. The home has a separate fridge where medication requiring refrigeration can be safely and appropriately stored. Whilst most residents do not take responsibility for their medication, in instances where this does occur it is risk assessed and referred to in care plans. The home’s ‘Service User Guide’ refers to the right of residents to self medicate. Staff receive appropriate training, both in-house and from external trainers in the administration of medicines. A written record is kept of unused medication, which is returned to the pharmacy. Inspection of residents’ files showed that their welfare was safeguarded by there being regular access to healthcare professionals. Since the last inspection residents’ care plans have been kept in a lockable cabinet. This ensures that they are only seen by those people who need to see them, thereby respecting the right of residents to privacy. In conversation staff were able to give examples of how they ensured residents were treated with privacy and dignity. This included reference to how personal care was given or doors being closed if personal or private issues were being discussed. Another staff member spoke of delivering mail to residents but asking those unable to read if they wanted it reading to them in private. Residents’ files and observation, showed that they were addressed by the title of their choice. Silver Threads DS0000022162.V335002.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. Residents are offered a lifestyle which suits their needs and encourages their independence. The home encourages contact with friends and relatives who are made welcome. Residents enjoy good food which reflects their individual preferences and, where necessary their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Silver Threads DS0000022162.V335002.R01.S.doc Version 5.2 Page 14 The home makes considerable effort to obtain information about residents’ interests. This information is sought through discussion with both residents and their relatives and when obtained is entered on their files. Residents are encouraged to be as active as they are able and every afternoon a staff member arranges in-house activities for residents. On the day of the inspection ten residents were seen actively involved, with staff support, in a game of skittles. They were seen to be enjoying themselves. There was conversation and laughter between the residents themselves and also between the staff member and the residents. There was discussion about involvement in the local community and the registered manager did say that he had approached members of the local clergy regarding their visiting the home, but that this had not been very successful, although at Christmas the home is visited by carol singers from one of the local churches. A relative of one of the residents takes a service within the home approximately every eight weeks. Residents had been taken to local public houses but this had not occurred of late due to the physical decline of the residents concerned. Within the home residents clearly had autonomy about where they went and what activities they engaged in. The home welcomes contact with the relatives and friends of residents. During the course of the inspection residents were seen to be entertaining visitors. We spoke with two visitors. Both confirmed that they were made very welcome at Silver Threads. They confirmed that they could visit at any time. Both spoke positively about the home and the approachable nature of the staff and the manager. Mealtimes were observed to be relaxed, with residents being able to decide where to eat. Residents appeared to enjoy their food with four of the five responses to the pre inspection surveys saying they ‘usually’ enjoyed their food The respondent who said that he/she ‘sometimes’ enjoyed the food, qualified this with the comment, ‘very hard to please everyone, but on the whole the food is very good.’ We had a talk with one of the kitchen staff. She was very aware of the individual likes and dislikes of residents readily giving examples and referring to who liked what, what alternatives were provided and some individual dietary needs. Although the four week rotating menu did not show the alternatives, these were seen to be available and reference was made to them on the notice board in the dining room. On important occasions, such as birthdays, the member of staff produces specially made cakes. This was commented on very favourably by residents. The times of meals were discussed and it was found that mealtimes had been arranged to suit the preferences of residents. Silver Threads DS0000022162.V335002.R01.S.doc Version 5.2 Page 15 On the day of the inspection the catering was seen to include much fresh vegetables and fruit. The cook confirmed that vegetables and fruit were obtained daily from a local shop and that she had had experience of preparing special diets such as those for vegetarians or people with diabetes. The cook is implementing the recommendations and practices outlined in the ‘Better Safe food, Better Business’ manual, however, much of these practices had been in operation prior to the publication being received. Silver Threads DS0000022162.V335002.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. The home’s well publicised complaints procedure combined with the confidence expressed by residents and their relatives in approaching the manager and staff shows that those receiving the service are assured that their complaints will be listened to and acted upon. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Responses from both residents and their relatives showed that they had confidence in approaching the owners andstaff if they wished to raise any complaints or if there was anything about the service which they were not happy about. Comments from relatives and residents included the management being ‘very approachable’ and ‘I would speak to Bob Flynn if I was not happy.’ This was also confirmed in the responses received from residents to the pre inspection surveys. Silver Threads DS0000022162.V335002.R01.S.doc Version 5.2 Page 17 The home’s complaints procedure includes the right of the complainant to approach the CSCI (Commission for Social Care Inspection) at any time during the complaints process. The home also has a whistle blowing policy. The purpose of this policy is to protects staff who report poor practice or abuse Residents were made aware of the complaints procedure by copies of it being displayed in both lounges, where residents and any visitors to the home would be able to see them. The ‘Service User Guide’, which is issued to every resident and also to relatives also contains details of the home’s complaints procedure. . Residents are further protected by staff having received training relating to the protection of vulnerable adults and, in discussion showing that they were aware of what constituted abuse and what action to take if they thought that it was occurring. There have been no complaints since the last inspection. The registered manager is aware of the need to put forward any staff member regarded as unsuitable to work with vulnerable adults for possible inclusion on the Protection of Vulnerable Adults (POVA) register. Silver Threads DS0000022162.V335002.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. Silver Threads is a well maintained property which has a good standard of hygiene and cleanliness. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Silver Threads is an older type terraced property indistinguishable from other residential properties surrounding it. It is deceptive in size being on three floors which can be accessed either by stairs of chairlifts. It offers its residents a choice of different lounge areas. All bedrooms are single occupancy, with nine of the fourteen bedrooms having ensuite facilities. Silver Threads DS0000022162.V335002.R01.S.doc Version 5.2 Page 19 The home is on three levels all of which can be accessed either by stairs or use of chair lifts. There was a high standard of hygiene and cleanliness throughout the home. This was commented on by residents in the pre inspection survey when four respondents said it was always clean. One survey, referred to the home as being, ‘exceptionally clean’ and ‘a pleasure to visit.’ Comments made at the previous inspection included,’ it’s always fresh and clean’, ‘it is so beautifully clean and fresh’ and ‘the home is kept spotless always.’ On the day of this inspection the home was seen to have a good standard of hygiene and cleanliness. Bedrooms were seen to have been personalised and it was observed that residents were free to use their rooms at all times and decided who else was free to enter them. All bedrooms were seen to have lockable storage space where residents could safely deposit money or valuables. The laundry is separate from the main building, situated away from areas where food is prepared and eaten therefore ensuring the safety of residents and staff. Externally the home has a private and enclosed courtyard, which was easily accessed by residents. This provides them with a private and pleasant area which is also secure. Silver Threads DS0000022162.V335002.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. Residents benefit from an appropriately staffed home, where staff receive training relevant to offering a good standard of care. Residents are protected by the home’s robust recruitment procedure. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Rotas provided showed that there are usually four care staff and a manager on duty on weekday mornings and at least two staff and a manager during the afternoons. Over night the residents’ needs are met by two staff, one of who is on wakeful duty. At weekends there are two care staff on duty in the mornings and a minimum of two in the afternoons and evenings. Discussion with the manager and staff confirmed that they considered this to be appropriate to meet the needs of the residents and there was evidence that staffing levels were increased if changes in the needs of residents required it. Silver Threads DS0000022162.V335002.R01.S.doc Version 5.2 Page 21 The home has a commitment to staff training and development. Currently four out of the ten care staff have NVQ 2 qualifications, two staff are participating on the course and will complete it in September and then two further staff will start the training. This will lead to the home having a good percentage of its staff having a recognised qualification and increased knowledge of how to effectively deliver a good standard of care. Over the last twelve months staff have received training in a variety of subjects. These include Food Hygeine, Medication administration, infection control, falls awareness and the protection of vulnerable adults. Further training is planned, which as well as including some of the above courses for those staff who haven’t as yet attended, will also include training of a more specialist nature, such as a course about cooking for people who have diabetes. At the last inspection reference was made to the home having the ‘Quality Dementia Care in Care homes’ manual published by the Alzheimer’s Society. At that time staff used the book as a point of reference. Since that inspection three staff have attended a training course in dementia care and the manager intends sending a further four staff on the course Two staff files were examined to see whether the home’s recruitment policy safeguarded residents. This showed that residents were protected as the home had only allowed staff to commence work after a police check had been carried out. Staff files also contained other required documents such as two references, and items confirming the identity of the members of staff. All staff go through a six month induction. This includes ‘Skills for Care’ training which ensures that staff have adequate knowledge and skills to meet the assessed needs of residents. The file of a recently recruited member of staff contained an ‘Induction, Foundation and Training Record’ complimented by a Skills for Care induction. There was also information which confirmed that staff were aware and understood the General Social Care Council’s Code of Practice for staff working within the care field. In discussion, those staff spoken to considered that staffing levels were adequate to meet the needs of residents and returned surveys showed that staff considered that they had not been asked to perform work tasks outside their areas of expertise. Staff were also aware of the need to protect the dignity and privacy of residents and gave examples of how they ensured this. Silver Threads DS0000022162.V335002.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. Residents benefit from a safe, well run home, where their feedback is actively sought. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager was present throughout the inspection. In discussion he demonstrated that he was knowledgeable about the needs of individual Silver Threads DS0000022162.V335002.R01.S.doc Version 5.2 Page 23 residents and that there were clear lines of accountability regarding the running of the home. He has the qualifications expected of a registered manager and the relevant managerial experience. In order to develop his service the manager, through use of questionnaires, seeks out the views of visiting professionals, residents and their relatives regarding how they perceive the home. Ongoing Quality Assurance has been a regular feature of the home, with the views of residents first being sought in December 2003. This was repeated in July 2005 and the results of a further Quality Assurance survey were forwarded to the Commission for Social Care Inspection (CSCI) in November 2006. Questionnaires were forwarded to visiting professionals, relatives and residents. The questionnaire asked about quality of care, cleanliness, friendliness of staff, over impressions, décor and laundry service. Responses such as, ‘a good home to visit always feel at home’, ‘my mother has excellent care’ and ‘don’t think l could find a nicer home’ reflected a high level of satisfaction felt by residents, and their relatives. The home operates an appropriate system for recording financial transactions. All transactions relating to the finances of residents are recorded with, wherever possible, receipts are being retained. The home operates a system of supervision. This takes place every two months. Records are kept of supervision. Supervision notes showed that training needs were discussed and there was discussion to ensure that staff were up to date regarding issues important to the delivery of good care. Staff felt supported by the system of supervision in place at the home and the induction programme they had received following their recruitment. Responses by the registered manager to the pre-inspection questionnaire show that the safety of residents is ensured by the home having appropriate policies and procedures, which are updated, and the regular safety checking and servicing of appliances. A letter from Devon Fire and Rescue dated February 2006 stated that fire safety precautions in the home were satisfactory. Records showed that there is regular fire safety training for all staff and there is a schedule, which ensures that fire safety equipment within the home is regularly tested for safety. Silver Threads DS0000022162.V335002.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Silver Threads DS0000022162.V335002.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations The plan is drawn up with the involvement of the service user, agreed and signed by the service user whenever capable and/or representative (if any) Silver Threads DS0000022162.V335002.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Silver Threads DS0000022162.V335002.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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