Inspection on 20/09/07 for Silverways

This inspection was carried out on 20th September 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

Silverways 20/12/06

Silverways 19/12/05

Silverways 03/06/05

Silverways 06/09/04

Silverways 26/04/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

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 Silverways Silver Way Highcliffe Christchurch Dorset BH23 4LJ Lead Inspector Carole Payne Key Unannounced Inspection 20th September 2007 08:30 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 Silverways DS0000020493.V350875.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. Silverways DS0000020493.V350875.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Silverways Address Silver Way Highcliffe Christchurch Dorset BH23 4LJ 01305 263403/260927 01425 277981 silverways@btclick.com 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) Christchurch Housing Society Mrs Marie Madders Care Home 69 Category(ies) of Old age, not falling within any other category registration, with number (69) of places Silverways DS0000020493.V350875.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th December 2006 Brief Description of the Service: Silverways Nursing Home was purpose built in 1985 and is situated in a quiet residential area of Highcliffe. It is set in one and a half acres of gardens and provides facilities for sixty-nine service users. The home is owned and managed by Christchurch Housing Society, a voluntary organisation registered with charitable status. The society was founded in 1946 to provide accommodation and care services for older people. Silverways has accommodation on the ground and first floors. The premises comprise of single and shared rooms, assisted bathrooms, showers and toilets, and a hairdressing salon. Each wing of the home has a communal lounge /dining area. The home also has an activities and exercise room. Christchurch Housing Society is considering up grading and refurbishment of the home to create better use of available space. The home is managed by Mrs M Madders. Current fees are £546 to £621. See the following website for further guidance on fees and contracts: http:/www.csci.org.uk/about_csci/press_releases/better_advice_for_peop le_choos.aspx Silverways DS0000020493.V350875.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was carried out on the 20th and 24th September and took a total of 15.5 hours, including time spent in planning the visit. The inspector was made to feel welcome in the home during the visit. This was a statutory inspection and was carried out to ensure that the residents who are living at Silverways are safe and properly cared for. Requirements and recommendations made as a result of the last inspection visit and key standards met at the last inspection on 20th December 2006 were also reviewed. The premises were inspected, records examined and the daily routine observed. Time was spent in discussion with three residents living in the home and four staff members on duty. Survey forms were received from eleven residents and three General Practitioners. The home also returned an Annual Quality Assurance Assessment (AQAA). Throughout the inspection the management and staff team demonstrated a positive and proactive commitment to addressing any issues raised and continuously improving the quality of life for people living at Silverways. What the service does well: Detailed assessments and admission procedures ensure that people moving into the service can be assured that their needs can be met and their wishes and choices respected in their new home. Two new residents said that they were settling well and one said that they ‘felt very welcome’ when they had arrived at the home. The staff team work with commitment to continuously improve the meeting of residents’ personal, health and social care needs, in a manner that is sensitive, compassionate and reflective of the wishes of people living at Silverways. One resident returning a survey form said ‘The medical cover for the home is exceptional.’ One resident spoken with said ‘the care is excellent. The staff are so kind and caring.’ The home has a varied programme of activities and social interaction, enabling residents to make choices about their daily routine and exercise control of their Silverways DS0000020493.V350875.R01.S.doc Version 5.2 Page 6 daily lives, including enjoying meals and mealtimes in the surroundings of their choice. One resident said ‘I so enjoy the staff coming in and having a good chat.’ The home has a detailed complaints procedure, which is made available to people involved with the life of Silverways, promoting an open culture to the receipt and response to any concerns. Eleven people returning survey forms said that they know how to make a complaint. A new resident said they had ‘no complaints.’ Staff members are trained in protecting vulnerable people from abuse, keeping residents safe and well cared for. Silverways provides residents with a clean, comfortable and safe environment, which is pleasantly decorated and furnished to a good standard. One resident returning a survey forms said ‘The cleanliness and hygiene of the home is excellent.’ The home benefits from a well-qualified and experienced staff team, who are recruited and employed in sufficient numbers to meet the needs of residents. Silverways benefits from an excellent management team, whose leadership benefits the efficient running of the home in the consistent best interests of residents. Residents’ financial interests are scrupulously safeguarded. What has improved since the last inspection? The service’s Welcome Pack has been improved, providing residents with information about their new home. The home has improved the checking of care plans, to ensure that they are always up to date and reflect residents’ current and changing needs. The home has introduced a formal system for auditing medicines held in the service, protecting residents living in the home. Progress is being made in ensuring that this provides a full audit trail of medicines from receipt to administration / disposal and that it highlights any areas of improvement that can be made, to support the home’s commitment to receive medication safely. Stickers have been introduced to ensure that Registered nurses are alerted to dose changes in medicines. Full checks of the Protection of the Vulnerable Adult’s register were seen on new staff members’ files, supporting good recruitment practice in protecting residents from harm. Silverways DS0000020493.V350875.R01.S.doc Version 5.2 Page 7 Since the last inspection some of the home’s bathrooms and toilets have been refurbished making them larger, more easily accessible and inviting areas for bathing. Two double bedrooms have also been converted into single rooms with en suites. The rooms are spacious, light, pleasantly furnished and the en suites offer space and are wheel chair friendly. 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. Silverways DS0000020493.V350875.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Silverways DS0000020493.V350875.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3, Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Detailed assessments and admission procedures ensure that people moving into the service can be assured that their needs can be met and their wishes and choices respected in their new home. EVIDENCE: Pre-admission assessments were viewed for two people who had recently moved into the home. Thorough assessments had been completed which contained clear details of the prospective residents’ personal, social and healthcare needs as well as reflecting their individual preferences and choices about daily life. A medical history, list of medication and details from other health and social care professionals supports the home in making a decision as to whether the service is able to meet people’s health care needs. Silverways DS0000020493.V350875.R01.S.doc Version 5.2 Page 10 The manager had completed assessments seen. The deputy manager confirmed that prospective residents, their families and friends are welcome to come and look around the home before making a decision about moving in. The AQAA returned by the home states that subject to the manager’s assessment, people could come and try out the home, prior to making a decision about permanently moving into the service. It also states that the service’s Welcome Pack has been improved, providing residents with information about their new home. Eleven resident survey forms were returned and all stated that people felt that they had received enough information about the home before moving in. The assessments included details of the people who had been consulted as part of the assessment process and there was a letter on individual files confirming that, according to the assessments, the home is able to meet the prospective residents’ needs. Two new residents said that they were settling well and one said that they ‘felt very welcome’ when they had arrived at the home. A new room had been arranged so that it felt like home. A friend visiting said that they were ‘very impressed’ by the care of staff in welcoming their friend to the home and making sure that they had everything that they needed. A summary of care needs is completed on admission to inform staff members of care needs so that they are able to provide supportive care in the initial period following moving into the service. Silverways DS0000020493.V350875.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff team work with commitment to continuously improve the meeting of residents’ personal, health and social care needs, in a manner that is sensitive, compassionate and reflective of the wishes of people living at Silverways. EVIDENCE: Detailed assessments are carried out, which inform planning of care. Comprehensive care plans had been completed for three people living in the home. This included details of support required to meet personal needs, reflective of the wishes of residents, for help needed with personal care. There was evidence within individual files that people are involved in their care plans if they wish to participate in planning, which will support staff members to provide appropriate and sensitive care. Silverways DS0000020493.V350875.R01.S.doc Version 5.2 Page 12 Care plans seen had been reviewed regularly and reflected changes recorded in daily records and assessments. Thorough daily records had been completed, which inform staff coming on duty of residents’ ongoing care and support. The deputy manager regularly audits the care plans to ensure that they are kept up to date and relevant to residents’ current and changing needs. In the home’s AQAA the service has recognised that in the past Registered nurses have not acted to update documentation when changes in care needs have occurred. The further improvement of auditing and following up of outcomes has ensured that care plans are current and up to date. In the home’s AQAA it states that as a result of the home’s internal questionnaires to ask residents about the care that they receive, eighty nine per cent of residents responding said that the care provided is either good or excellent. Details of health care needs are recorded and assessed, including diabetic and wound care. Any wounds are closely monitored and any changes in condition recorded and acted upon as appropriate. One diabetic care plan did not include details of the parameters of blood sugars, which would enable staff members to recognise an unstable condition and details of the action to take in the event that this occurs. Since the inspection the manager confirmed that this care plan has been updated and a tool introduced to ensure that all aspects of residents’ care in relation to diabetes are fully recorded, in line with the good standards of care given. Contacts with medical professionals are detailed within individual files. Three residents returning survey forms said that they always receive the medical support that they need; five said that this usually the case; one person said sometimes. One person said ‘The medical cover for the home is exceptional.’ Risk assessments are carried out in relation to the risk of pressure sores. The home has pressure relieving mattresses and cushions in place. Hoists and stand aids are used to support residents to be safely moved about the home. Care plans include specific details regarding the support that people need in safely moving around the home and specific details such as size of sling required when hoisting, ensure that staff members are made fully aware of residents’ needs. Continence care is included in the home’s assessment and care plan. The home has installed new spacious toilets, which make it easier for people to use the facilities in safety and privacy. Silverways DS0000020493.V350875.R01.S.doc Version 5.2 Page 13 From observation during the inspection staff members take great care to support the psychological well being of residents, including coming into the home, outside of their normal duties to support a resident who may need emotional and practical help in coming to terms with a bereavement. From records seen residents receive regular visits from external health care professionals including the chiropodist and dental service. Since the last visit to the home, a new system has been introduced for the safe administration of medicines. New medicine cupboards have been installed. In the last inspection report it was required that the home introduce a system for auditing medications. A thorough audit sheet has been produced and implemented. It was advised that to support the audit trail, individual medications checked against the Medication Administration Record (MAR) chart are recorded, to include details of any anomalies and action taken. The two Registered nurses checking the medication received by the home had not signed handwritten entries on the MAR charts. On the second day of the inspection the deputy manager had ensured that the second person had signed to say that they had verified the amounts of medicines received. The staff members on one MAR chart had omitted to record the amount of warfarin given on every occasion. It is important that this is recorded where there is a variable dose. The home has clear details in individual records regarding topical creams to be administered. It was advised that a system is introduced so that the person administering creams, signs following administration, to say that the cream or emollient has been applied. The home has a Monitored Dosage System for the safe administration of medication. Boxes of medicines are dated when they are opened. All boxes, aside from a box of warfarin had been dated when started. Allergies are recorded on MAR charts and photos are included with the MAR charts, supporting the service to ensure that medicines are safely administered to the right resident. The temperature of the drugs fridge seen is routinely monitored, ensuring that medications requiring refrigeration are stored at the correct temperature. The home benefits from a stable team of Registered nurses, ensuring that the staff members working are kept continuously aware of residents’ needs in terms of safe medication administration. Stickers have been introduced to ensure that Registered nurses are alerted to dose changes. Silverways DS0000020493.V350875.R01.S.doc Version 5.2 Page 14 During the visit staff members were observed providing sensitive and caring support to residents. This includes consulting people about their wishes, knocking on residents’ doors and taking care and time when supporting residents with eating. Care plans viewed included reference to the privacy and dignity of residents and the core values of care are part of the home’s induction programme. One resident spoken with said ‘the care is excellent. The staff are so kind and caring.’ Silverways DS0000020493.V350875.R01.S.doc Version 5.2 Page 15 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, 15, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a varied programme of activities and social interaction, enabling residents to make choices about their daily routine and exercise control of their daily lives, including enjoying meals and mealtimes in the surroundings of their choice. EVIDENCE: Social care plans including life biographies help the home to plan activities and social engagement, which reflects the wishes of people living in the home. One social care plan said that the resident enjoys spending time in-group activities with other residents. The record of activities showed little participation in events. The manager said that the resident now prefers to spend time in one of the communal areas, watching television, or keeping their own company. The resident said ‘I like watching television and watching what is going on. Sometimes there isn’t other residents I can talk to, but the staff chat with me.’ Silverways DS0000020493.V350875.R01.S.doc Version 5.2 Page 16 During the visit staff members were observed spending time with residents in companionship. One staff member was taking a resident out on the first day of the inspection. The home has a roster for activities provision, which includes time to spend individually one-to-one with residents. There is an extend class held regularly, as well as trip to local places of interest. A newsletter keeps people informed about what is happening in the home. The home benefits from an activities area, where there is craft and artwork completed by residents and there is space to engage in shared activities. Individual records of participation in events in the home and social engagement did not reflect the actual interaction observed during the visit. The manager and deputy made suggestions about how they could improve this aspect of recording, so that residents’ needs are monitored and responded to. One resident had a trolley beside them, with all the items that they might need during the day. Four residents returning survey forms said that there are always activities that they can take part in, three said sometimes, one said usually. Three residents did not comment. One resident said that they felt too poorly. Some residents in the home spend their days in bed as they are unwell. Staff members have adjusted the way that they approach the organisation of oneto-one time to take this into account. One resident said ‘I so enjoy the staff coming in and having a good chat.’ On the first day of the inspection the hairdresser was visiting the home. Two residents were in the room and clearly enjoying the time spent with the hairdresser and the relaxing environment provided. One resident said ‘It’s so good to get my hair done. It makes me feel better.’ A notice board displays details of events happening in the home. This includes visits from local representatives of religious denominations. The home’s AQAA states that staff members are allocated to spend fifteen hours a week devoted to activities. In addition to this a volunteer visits once a week and plays board games with residents who are interested. In addition giant scrabble and regular visits from entertainers make the daily routine varied and offer residents a variety of social opportunities. The AQAA also states the intention to survey residents who wish to spend their time in their rooms to ensure that the home is doing its utmost to meet the needs and interests of everyone living in the home. Silverways DS0000020493.V350875.R01.S.doc Version 5.2 Page 17 During the inspection residents spend time with their relatives and friends. The visitor’s book showed that during the day a lot of people visit the home. One person, who was visiting a friend was offered a cup of tea and made welcome. Another relative of a new resident spent time talking to the deputy manager and the deputy manager made sure that she had time to reassure and listen to the relative. Records seen included thorough details of personal contacts and meaningful relationships, including when and where people can be contacted. During both visits residents were offered choices about how they live. This was recorded in care records. Some residents were still in bed on the first day of the visit; others had chosen to get up early. During the day staff could be heard offering choices about what residents would like to do, and about their preferences, including, for example, whether they take sugar in their hot drinks, and if they want more to eat. Some residents have a particular place in which they like to sit in the communal areas and this is respected. Breakfast on the first day of the inspection was served in individual rooms and communal areas according to the wishes of residents. Lunch on the first day of the inspection was well presented and people were offered choices about what they would like to eat. Records are kept of food provided, which reflect that alternatives are offered. Fresh fruit and vegetables were present in food stores. People needing help with eating, were offered sensitive support. Two residents said that they enjoy their meals and being able to eat in the surroundings of their choice. Silverways DS0000020493.V350875.R01.S.doc Version 5.2 Page 18 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, 18, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a detailed complaints procedure, which is made available to people involved with the life of Silverways, promoting an open culture to the receipt and response to any concerns. Staff members are trained in protecting vulnerable people from abuse, keeping residents safe and well cared for. EVIDENCE: The home has a complaints log for the recording of complaints received. The manager confirmed that no complaints have been received since the last inspection. The complaints procedure is included in the home’s service user’s guide and is displayed in the reception area of the home, so that people living in and visiting the service are aware of how to raise any concerns. Residents’ meetings also provide a forum for people living at Silverways to raise and discuss any issues that they have. The minutes of the meetings are displayed so that anyone unable to attend is aware of items raised and how they have been responded to. The manager also has a measure for auditing any complaints received, which is reviewed monthly. Silverways DS0000020493.V350875.R01.S.doc Version 5.2 Page 19 Eleven people returning survey forms said that they know how to make a complaint. A new resident said they had ‘no complaints.’ The home has a copy of the Dorset No Secrets Adult Protection policy. Staff training takes place in protecting vulnerable people from abuse. An external training company provides the training and copies of certificates were viewed on individual files. The manager is aware of action to take in the event of an allegation of abuse. Silverways DS0000020493.V350875.R01.S.doc Version 5.2 Page 20 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, 26, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Silverways provides residents with a clean, comfortable and safe environment, which is pleasantly decorated and furnished to a good standard. EVIDENCE: Silverways provides a comfortable and homely environment. It benefits from pleasant grounds and gardens. Since the last inspection some of the home’s bathrooms and toilets have been refurbished making them larger, more easily accessible and inviting areas for bathing. In addition to the newly refurbished bathrooms the home has retained two parker bathrooms, providing a choice of bathing facilities. The home has listened to feedback from residents and incorporated additional handrails. Silverways DS0000020493.V350875.R01.S.doc Version 5.2 Page 21 Two double bedrooms have also been converted into single rooms with en suites. The rooms are spacious, light, pleasantly furnished and the en suites offer space and are wheel chair friendly. In addition all vacant rooms are redecorated. Occupied rooms visited were very personal to each resident. Special photographs were placed on the walls, were residents can see them when they are in bed. Many room have pleasant views from the windows. The home benefits from a large spacious laundry. As part of the home’s quality assurance programme, the service has discussed with residents as part of meetings, how services can be further improved in respect of the laundry service. From discussion with the manager she also listens and responds to individual queries regarding the care of residents’ laundry. Nine residents retuning survey forms said that the home is always clean and fresh; two people said that this is usually the case. People living at Silverways returning survey forms said: ‘The cleanliness and hygiene of the home is excellent.’ ‘The supervisor of the cleaners has trained her staff well.’ ’Some of the décor could do with an update, wardrobes and basins and loos.’ It was required in the last report that sluices are fitted with extractor fans. Suitable fans are, in fact, in place and there were no unpleasant odours in sluices, or throughout the home. Gloves were appropriately worn during the inspection and aprons, to minimise the risk of cross infection. Silverways DS0000020493.V350875.R01.S.doc Version 5.2 Page 22 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, 30, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home benefits from a well-qualified and experienced staff team, who are recruited and employed in sufficient numbers to meet the needs of residents. EVIDENCE: From observation on the two days of the inspection staff members are rostered to work in sufficient numbers to meet the needs of people living at Silverways. One resident responding in a survey form felt that there is not enough staff working at the service. Staff rosters are clear and include all levels of staff working in the home. One resident said ‘There are always staff there when I need them. They are very caring.’ From information provided in the home’s AQAA, the service has significantly reduced its reliance upon agency staff. From files seen the home has been able to recruit Registered nurses with significant skills in the care of older people, bringing their relevant experience to the running of the home. Silverways DS0000020493.V350875.R01.S.doc Version 5.2 Page 23 At the time of the visit there were nineteen staff members who possess a National Vocational Qualification in Care (NVQ) at level 2 and three staff members who hold a level three qualification of the thirty nine care staff working at the home. Three recruitment files were viewed for staff members who had recently started work at the home. Thorough recruitment checks are completed, which includes a detailed interview; records of the interviews demonstrate that skills and competencies are assessed and discussed, particularly in relation to the clinical skills of Registered Nurses. The home has responded promptly to the omission of a photograph from one file seen to ensure that all staff working in the home have a photograph on their file. Photographs were present on two other files sampled. The home has not had any care staff members that have started work since the last inspection, who have their record of induction in the home. The home has a thorough induction programme. This will be reviewed at the next inspection. An introduction to the home was also included on Registered nurses files seen. Silverways DS0000020493.V350875.R01.S.doc Version 5.2 Page 24 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, 32, 33, 35, 38, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Silverways benefits from an excellent manager, whose leadership benefits the efficient running of the home in the consistent best interests of residents. Residents’ financial interests are scrupulously safeguarded. The home consistently strives to ensure that residents’ health and safety are protected and is prompt in response to any issues or concerns, that are highlighted from the efficient monitoring of the service. EVIDENCE: Silverways DS0000020493.V350875.R01.S.doc Version 5.2 Page 25 Silverways benefits from an experienced and well-qualified manager, who is ably assisted by a deputy and a strong team of Registered nurses. The manager attends relevant courses in terms of the efficient running of the home, including Partners in Care management courses and learning in relation to recruitment and mental capacity. She has brought this learning back to the home, so that the staff team benefit from being updated in current good practice and this is reflected in the care and support provided to residents. The manager holds the Registered Manager’s Award. Responsibilities for areas of practice are delegated and standards are continuously monitored so that the home is well organised and run in the interests of residents. The management team have introduced various audit tools including monitoring care plans and accidents occurring in the home, so that practices are improved and open. Regular meetings are held when people are consulted about the service and minutes are made available to people living in the home and their friends and relatives. Staff meetings are also held on a regular basis. A regular Newsletter is published and a recent edition included the results of questionnaires, which had been sent out to people involved with the life of the service. From information received the management team have produced a development plan for the coming year, detailing how the home hopes to further improve and enhance the quality of service provided to people living at the home. Feedback seen was open and honest, promoting an environment where people feel at home to raise any concerns and can feel part of the future improvement and development of the service. The home keeps some monies on behalf of residents, so that they are able to access money when they need it and enjoy making purchases. Residents who are unable to get out can use the home’s shop. Meticulous documentation and recording ensures that residents’ financial interests are safeguarded. Regular health and safety training takes place in the home; copies of certificates were seen on files viewed and a summary record is maintained of all training, so that ongoing training needs can be monitored and identified. Courses include food hygiene, safe moving of residents and first aid. Single items of hazardous substances were seen in three areas of the home on the first day of the inspection. These were promptly removed and the manager has already organised for lockable cupboards to be placed in areas were easy access to cleaning fluids is required. Although the risk to the current residents Silverways DS0000020493.V350875.R01.S.doc Version 5.2 Page 26 accommodated is minimal the service is committed to ensuring that all areas of health and safety are prioritised. Regular health and safety meetings take place, minutes were seen and reflected the commitment of the home to keep people safe and improve services. A fire log is maintained, which includes records of regular checks of fire safety equipment in the service. Invoices are also kept of maintenance of equipment and facilities, supporting the maintenance of a safe environment. Silverways DS0000020493.V350875.R01.S.doc Version 5.2 Page 27 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 4 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 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 4 4 4 X 3 X X 2 Silverways DS0000020493.V350875.R01.S.doc Version 5.2 Page 28 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. 1. Standard OP9 Regulation 13 Timescale for action The registered person shall make 31/10/07 arrangements for the safe recording of medicines received into the care home, which are not printed on the Medication Administration Record. Hazardous substances must be safely stored at all times. 31/10/07 Requirement 2. OP38 13 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 OP9 Good Practice Recommendations It is recommended that a record of the balance of medications held is carried forward to the current months administration record. This recommendation was issued in the report of the visit to the home on 19/12/05. Silverways DS0000020493.V350875.R01.S.doc Version 5.2 Page 29 2. OP7 Daily records completed should describe details of care given, support and details of residents’ current condition and needs. Care plans should be updated, where audits completed identify key changes required to make sure that plans inform care giving, meeting the needs of residents living in the home. Silverways DS0000020493.V350875.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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. 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