Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 18/08/08 for Southminster Residential Home

Also see our care home review for Southminster Residential Home for more information

This inspection was carried out on 18th August 2008.

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

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

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

Visitors are always made welcome. We noted the warm and personal interaction between the staff members and the visitors. Relatives felt that staff communicated with them well and kept them up to date with any issues concerning their relative.People spoken with reported that they liked the home. They said that the food was good. A healthcare professional surveyed as part of this inspection process reported that `residents were treated as individuals` and that the home had `Excellent management`.

What has improved since the last inspection?

Clearer information has been developed since the previous inspection visit so that prospective residents, their families and representatives can understand what care and support may be expected at Southminster residential Home. The management of medication has improved so that people can now feel more confident that this aspect of their care will be managed well. All the staff team have attended training or refresher training on safeguarding vulnerable adults, this means people may be confident they will be kept safe from abuse. The manager has a robust system for recruiting new staff, ensuring that all the necessary checks are made to be certain the right people are employed to look after people safely.

What the care home could do better:

People considering moving into Southminster Residential Home would benefit from the Statement of Purpose including detail of the number of staff employed by the home and their relevant experience and qualifications. This would help people make an informed decision as to whether the support available at the home would meet their needs. Some peoples` care plans and daily records needed to include more individual detail for care staff to follow to ensure people received person centred care and support. Quality Assurance information needs to be collated and made available to all interested parties and for copies to be kept on the premises. The registered provider reported plans to extend the home and refurbish the existing building. This will benefit the people living at the home giving them more pleasant surroundings and more communal space.

CARE HOMES FOR OLDER PEOPLE Southminster Residential Home Station Road Southminster Essex CM0 7EW Lead Inspector Jane Greaves Unannounced Inspection 18th August 2008 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 Southminster Residential Home DS0000063215.V370268.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. Southminster Residential Home DS0000063215.V370268.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Southminster Residential Home Address Station Road Southminster Essex CM0 7EW 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) 01621 773462 southminsterrh@tiscali.co.uk Top Care Homes Ltd Mrs Elizabeth Wynn Care Home 29 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (29) of places Southminster Residential Home DS0000063215.V370268.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 29 persons) Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 15 persons) The total number of service users accommodated in the home must not exceed 29 persons Minimum daytime staffing to include five carers on duty Date of last inspection 21st August 2007 Brief Description of the Service: Southminster Residential Home provides residential and personal care for up to 29 older people, fifteen of who may have a diagnosis of dementia. The home is run by an organisation named Top Care Homes Ltd. Southminster R.H. is located in the rural village of Southminster a few miles from Maldon, Essex. The premises were originally built as the village Manor House. There are two floors to the home, accessed by stairs and a passenger lift. In total there are thirteen single bedrooms and eight double bedrooms between the two floors, with two lounge/dining rooms on the ground floor. There are gardens to the front and side of the property that are attractive and accessible. Southminster is accessible by road and rail. The nearest station is in the village, approximately 300 metres away from the home. Visitors’ car parking is available to the front, side and rear of the property. The fees for the home range between £ £383.04 and £ £690.00 depending on the accommodation provided, who is funding the care and the level of dependency of the resident. Additional charges are advised as being made for hairdressing, chiropody, a fixed £5 pounds per month charge for general toiletries and extra charges for extra items. Southminster Residential Home DS0000063215.V370268.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was an unannounced site visit. At this visit we looked at how well the service meets the needs of the people living at Southminster Residential Home and how staff and management support people to have a lifestyle that is acceptable to them. The level of compliance with requirements made at the previous inspection was assessed. The site visit took place over a period of six and a half hours. A tour of the premises was undertaken, care records, staff records, medication records and other documentation were selected and various elements of these assessed. Time was spent talking to, observing and interacting with people living at the home, and talking to staff. Prior to the site visit the manager had completed and sent in to us (the Commission for Social Care Inspection) the home’s Annual Quality Assurance Assessment (AQAA). This provided detail of how the service feels they are performing against the National Minimum Standards, and how they can evidence this. Before the site visit a selection of surveys with addressed return envelopes had been sent to the home for distribution to residents, relatives, involved professionals and staff. The views expressed in survey responses have been incorporated into this report. Feedback on findings was provided to the manager throughout the inspection. The opportunity for discussion or clarification was given. We would like to thank the manager, staff team, residents and visiting relatives for their help throughout the inspection process. What the service does well: Visitors are always made welcome. We noted the warm and personal interaction between the staff members and the visitors. Relatives felt that staff communicated with them well and kept them up to date with any issues concerning their relative. Southminster Residential Home DS0000063215.V370268.R01.S.doc Version 5.2 Page 6 People spoken with reported that they liked the home. They said that the food was good. A healthcare professional surveyed as part of this inspection process reported that ‘residents were treated as individuals’ and that the home had ‘Excellent management’. What has improved since the last inspection? What they could do better: People considering moving into Southminster Residential Home would benefit from the Statement of Purpose including detail of the number of staff employed by the home and their relevant experience and qualifications. This would help people make an informed decision as to whether the support available at the home would meet their needs. Some peoples’ care plans and daily records needed to include more individual detail for care staff to follow to ensure people received person centred care and support. Quality Assurance information needs to be collated and made available to all interested parties and for copies to be kept on the premises. The registered provider reported plans to extend the home and refurbish the existing building. This will benefit the people living at the home giving them more pleasant surroundings and more communal space. Southminster Residential Home DS0000063215.V370268.R01.S.doc Version 5.2 Page 7 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. Southminster Residential Home DS0000063215.V370268.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 Southminster Residential Home DS0000063215.V370268.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): 1, 3 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People considering moving into the home can be assured that their needs will be assessed to make sure that the home will be suitable for them. EVIDENCE: Since the previous inspection of this service the registered manager had developed a clearer Statement of Purpose that included more information to help prospective residents and their families and representatives understand what care and support the home can provide. The guide detailed what people can expect providing a clear account of the specialist services provided, quality of the accommodation and how to make a complaint. The Statement of Purpose did not include reference to the number of staff employed by the home or adequate information about their relevant experience details qualifications. Southminster Residential Home DS0000063215.V370268.R01.S.doc Version 5.2 Page 10 We looked at the pre admission process for two people admitted since the previous inspection visit. This showed us that admissions were not made to the home until a full needs assessment had been undertaken to enable the registered manager to reassure the prospective resident that the service could meet their identified needs. The registered manager and an experienced member of staff undertook these assessments, involving the individual and their family and healthcare professionals where appropriate. Where the assessment had been undertaken through Local Authority care management arrangements the registered manager insisted on receiving a summary of the assessment however these were not always updated to reflect the situation at the time of admission. Admissions to the home only took place if the registered manager was confident that the staff team had the skills, ability and qualifications to meet the assessed needs of the person considering making Southminster Residential Home their home. People had the opportunity to spend time in the home talking to established residents, their visitors and staff. Visiting family members said they felt the process was smooth and sensitively handled by the staff and management team at the home. One person said “It was a very difficult time for us, everyone here was so kind that it made the whole thing a lot easier for us all” Southminster Residential Home does not provide intermediate care. Southminster Residential Home DS0000063215.V370268.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 and 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 were successful in delivering appropriate care, although this may not always be documented appropriately. EVIDENCE: The provider’s response to the previous inspection report and the manager’s AQAA told us that a new care plan system had been introduce in the home since the last visit. The new system included reference to every aspect of care and support that may be needed to meet peoples’ needs. These care plans were a ‘one size fits all’ template and much of the content was not relevant for many of the people living at the home. The previous inspection had identified that care plans ‘did not include detailed actions for staff to follow in practice to ensure consistency of care’. Despite the provision of a new care plan system this situation remained the same. Whilst some care plans included more detail than others, the four seen at this visit did not include sufficient detail for care staff to follow when delivering Southminster Residential Home DS0000063215.V370268.R01.S.doc Version 5.2 Page 12 personal care and support to ensure consistency of care across the staff team and any agency staff that may be needed to provide cover at the home. Daily records were completed at the end of each shift however the recording was ‘sparse’ and uninformative. Daily records are a good source of evidence to show that care is being provided, as detailed in the care plan, however the term All care given is not helpful or adequate. Daily records when well written, help ensure a consistent approach and good quality of care for people living at the home. This information was discussed with the provider and registered manager during the inspection and the registered manager reported that this was work in progress and acknowledged that there was more work to do to include sufficient detail for each area of identified need. This is so that people can be confident that staff members have the knowledge to meet their needs consistently in an individual and person centred way. Staff members demonstrated and exhibited good knowledge of the needs and preferences of the people they were supporting and relatives were warm in the praise they gave about the staff team and the care that residents received. Comments included “X couldn’t be better looked after, never had a complaint” “The important thing is good care which I believe the patients are getting” and “Me and my family have a lot to thank the home for as X’s condition when they went in was bad and now they have improved in every way” Care plans contained reference to routine health checks being offered and provided, and where specialist support had been accessed for individuals. The manager reported a good relationship with the community district nursing team. There were no residents with pressure sores at the time of this visit; there was evidence of pressure sore relieving equipment such as airflow mattresses for those people assessed to be at risk. Some pre admission assessments we looked at indicated that people had been admitted to the home with pressure areas however the district nursing team had provided the necessary support for staff. A healthcare professional responding via a survey said, “The home treats residents as individuals and leaves no stone unturned when they have a problem” The manager reported seeking advice through a company recommended to them by the Alzheimer’s society. Residents now completed a new life history form with assistance from family members at the time of admission. Each person now had a ‘memory’ box being developed with the aid of relatives. These boxes were utilised in many ways, to reassure people if they become anxious or for the activity co-ordinator to interact with people who were inclined to isolate themselves. Advice had been taken around colour co-ordinating the toilet facilities. The manager reported they have done this in one of the communal toilets and had Southminster Residential Home DS0000063215.V370268.R01.S.doc Version 5.2 Page 13 noted a reduction in the incidents of incontinence as a result. When the home is refurbished as part of the forthcoming project the intention is to incorporate the advice throughout the home. In the communal lounge there was a memory board of the village as it used to be, most of the residents were local people and they found this interesting and comforting. The home had received a recent medication audit visit by local pharmacist. A new medication trolley had been provided since our last visit to the home. The manager reported that senior care staff were responsible for administration of the medication at the home. Training records showed us that the manager, deputy manager, 4 care assistants and 5 of the 6 senior care staff had undertaken distance learning medication training in October 2007. The registered manager reported undertaking competency assessments of care staff by observing medication administration specifically looking at elements such as concentration, infection control practice, safety and key control. The previous inspection highlighted that the home did not have a protocol in place for those medications being administered to residents when required (PRN). This policy was made available for scrutiny at this visit. The medication trolley was stored in a dedicated clinical room. There was cupboard for storing controlled medications secured to wall. Controlled medications for three people were checked and agreed with the register. Since the last visit to the home the manager had secured a small fridge for storage of drugs that was lockable. Medication Administration Records (MARs) were generally well completed with gaps in recording for one resident. The manager was able to confirm that this person’s medication had not been given and why, however, there were no records to confirm this. Observation during the course of the inspection provided us with evidence that the care staff team treated the residents sensitively with dignity, respect, courtesy warmth and consideration. Southminster Residential Home DS0000063215.V370268.R01.S.doc Version 5.2 Page 14 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. This judgement has been made using available evidence including a visit to this service. People can expect to enjoy a balanced and varied diet and a developing leisure activity programme to meet their individual needs. EVIDENCE: Southminster Residential Home employed an activities coordinator for 15 hours each week; they were on annual leave at the time of the site visit. There was a white board in the lounge informing residents of that fact and naming a member of care staff who would be spending time with them today. The activities co-ordinator had attended training in caring for people living with dementia and was undertaking the NVQ level 2 in care. Since our last visit to the home a trolley shop had been introduced for the residents to be able to make small purchases such as snacks, sweets, toiletries, birthday cards etc. Those people not able to manage their own money were supported to shop this way. Items were entered in a book and families were invoiced for trolley shop purchases monthly. The manager reported, “We are trying to treat the home like a community rather than an institution”. People gathered together when the trolley shop came round twice weekly and chatted about what they were Southminster Residential Home DS0000063215.V370268.R01.S.doc Version 5.2 Page 15 buying. People had the opportunity at residents’ meetings to suggest items they would like to have on the trolley shop. The daily care notes sampled did not paint a picture of what people had done during their day or what stimulation had been provided for them. The care plans sampled did not provide detail of what support individuals’ needed to entertain themselves in order to lead as fulfilling a lifestyle as possible. We noted that some people were reading books and newspapers; some had visitors, some were knitting and some just chatting. One person told us “I’m quite content just to sit”. People spoken with praised the outside entertainment that is brought into the home. One person said, “We often have entertainment, music and singers, we like that very much”. One person told us “we sometimes have a film and there is a prayer meeting held here weekly” and “ We are lucky, we can have our hair done here, the hairdresser comes in weekly and someone comes to do our nails monthly if we want them done”. We discussed daily routines of the home with some residents, one person told us “I get called every day between 10 to 6 and 10 past 6, the girls bring me the things to wash etc” “At bedtime if you can’t walk you need to wait to be helped in a wheelchair, this tends not to happen before 7pm unless you really want to go early”. Minutes of residents’ meetings were available to show us that three meetings had taken place year to date; the minutes were not always informative. We took lunch with some people living at the home. This was a pleasant and lively affair that took place at a small dining table in the smaller of the communal lounges. The table seated 6 people. The manager reported that very occasionally some residents chose to sit at the table to eat their meals however the majority of the time they chose to sit in their armchairs and eat from a small table. The manager reported that when families visited they often took meals with their relatives at the dining table. The plans for the extension to the home and the refurbishment of the existing part of the building include a purpose built dining room. People were offered a choice of meals at the table and some were physically shown the options they had to choose from. All people said the food was good. Comments included “Food is very good, lovely and hot” and “We always look forward to our meal”. Comments received from our surveys prior to this visit included, “The food is very good”, “Meals are A1. Well cooked and a good choice”, “The food is variable ‘up and down’, depends on who is on duty” and “They have fish and chips a lot.” Southminster Residential Home DS0000063215.V370268.R01.S.doc Version 5.2 Page 16 Food stocks were plentiful and included quality brands and fresh fruit and vegetables. The manager reported that the food store was never locked and that if people fancied snacks at any time of the day or night they were able to have them. It was positive to note that people were offered second helpings at lunchtime. People wore blue plastic aprons during lunchtime. They said they chose to because it was better than having to go and change if they spilt food down themselves and wouldn’t want to sit around in stained clothing. The manager said the residents insisted on wearing the aprons. Menus included daily choices of lunchtime meal and afternoon tea and showed us that the people living at Southminster Residential Home were provided with a balanced and healthy diet. Southminster Residential Home DS0000063215.V370268.R01.S.doc Version 5.2 Page 17 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. This judgement has been made using available evidence including a visit to this service. People can raise concerns about the service. They can expect that staff training and knowledge will safeguard them from abuse. EVIDENCE: There was a complaints policy and procedure in place that was accessible to all relatives and visitors to the home. The provider’s and manager’s approach to running the home was open and inclusive encouraging residents, their relatives or advocates and staff to approach them any time if they had any concerns or worries. None of the completed surveys from residents, relatives or staff had any comments to make in relation to the complaint handling processes at the home. The Commission for Social Care Inspection had not received any complaints since the previous inspection visit and the home’s records showed us that just one complaint hade been made. The manager responded that when people raised issues with the staff they were attended to immediately as a matter of priority and therefore did not get as far as a formal complaint. The manager acknowledged the need to track these perceived ‘minor issues’ as there may be trends or patterns of events that may be avoided in the future. The manager reported that residents’ meetings had been really useful tools to empower people to make suggestions or bring up any day-to-day issues. Southminster Residential Home DS0000063215.V370268.R01.S.doc Version 5.2 Page 18 Recruitment files showed us that all checks necessary to promote and protect the safety and welfare of residents were done before new staff started to work at the home. A staff-training matrix provided for the inspection subsequent to the site visit told us that the whole staff team apart from three people had attended training and refresher training in safeguarding vulnerable adults. The remaining people were scheduled to receive this training on return from annual leave. The registered manager is a safeguarding trainer. Southminster Residential Home DS0000063215.V370268.R01.S.doc Version 5.2 Page 19 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 adequate. This judgement has been made using available evidence including a visit to this service. People can expect to live in a comfortable, homely environment that would benefit from proposed refurbishment. EVIDENCE: The outside of the building appeared tired, shabby and in need of attention. The premises were originally built as the village Manor House and was a grade 11 listed building. The registered provider and registered manager reported plans for a new 11-bedded extension to be built and a refurbishment of the established building to follow. The provider acknowledged the building was tired and in need of tender loving care. Residents and relatives had been kept informed of the forthcoming plans for the home. Surveys included comments such as “The home is having an extension built. When this is done I think it will help the staff as they are short of room. Also I think the home is looking a little tired and in need of decorating which I believe will take place when the extension is finished”. Southminster Residential Home DS0000063215.V370268.R01.S.doc Version 5.2 Page 20 The provider reported an anticipated build time of 3 months and an overall project time, including refurbishment of the existing building, to be 12 months. We undertook a physical tour of the home as part of this visit. There was a pleasant quadrangle seating area in the centre of the building that had been developed for people to sit and enjoy fresh air and sunshine. There was some planting, a fountain and some benches. The manager reported this area was very popular with the residents and they were completely safe there. All the bathrooms facilities were in need of refurbishment. The manager reported that some were not used because they did not have hoists to assist people in and out and some because they were stained and unpleasant. The home also had a shower room; some residents said they found showering easier and more pleasant. There was a shortage of storage generally around the existing building for items such as wheelchairs and hoists, the manager reported that dedicated storage was included in the plans for the extension and refurbishment project. The sluice door did not have a lock and as such could be accessed by residents with potential implications for their safety. In the entrance hall there were a selection of certificates on the wall indicating the extent of the training provided for the staff working at the home. A discussion was held with the registered manager around how this may be reassuring to some relatives to know that staff were well trained however it did detract from a homely domestic and welcoming appearance. All residents and visitors spoken with said there were no negative issues with the laundry service at the home. The home appeared generally clean and tidy whilst maintaining a homely feel. On arrival at the home there was a slight aroma present in the ground floor communal hallway. It was noted that the flooring was ‘deep cleaned’ during the course of the day and the aroma reduced. Southminster Residential Home DS0000063215.V370268.R01.S.doc Version 5.2 Page 21 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. This judgement has been made using available evidence including a visit to this service. Residents can expect to be cared for by an established reliable team of trained and well-recruited staff. EVIDENCE: Copies of the staff rota provided us with evidence that 5 care staff were on duty in the morning, 4 in the afternoon with an extra person covering for the twilight shift (17:00hrs to 21:00hrs) and three waking night staff. The rotas showed us that domestic staff members were on duty 7 days per week, two people Monday to Thursday and one person Friday to Sunday. The manager worked Monday to Friday, was supernumerary to care duties and was able to cover sickness and other absences where necessary. Twenty of the thirty-four staff members had achieved a minimum NVQ2. Training records showed that seven more staff members were working towards NVQ2. This exceeds the recommended minimum ratio and should be commended. Evidence was available to confirm that all staff attended induction training in line with Skills for Care within six months of employment. We looked at recruitment records for two staff recently employed to work at the home. Both files included evidence that checks had been completed Southminster Residential Home DS0000063215.V370268.R01.S.doc Version 5.2 Page 22 necessary to ensure the right people were employed to promote and protect the safety and well being of the people living at the home. Two written references were received and a check was made against the Protection of Vulnerable Adults register before people started to work with the vulnerable people living at the home. Subsequent to the inspection site visit the manager was able to provide us with an updated training matrix to reflect the training provision at the home. Training is offered to the whole staff team in areas such as safe moving and handling, safeguarding vulnerable adults, fire awareness, 1st aid, food hygiene and Dementia awareness. This showed us that the registered manager has a pro-active approach to training and places an emphasis on providing the staff team with the knowledge to meet the needs of the people living at the home in a professional and safe manner. Southminster Residential Home DS0000063215.V370268.R01.S.doc Version 5.2 Page 23 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. This judgement has been made using available evidence including a visit to this service. The management of the home is stable with an open and approachable ethos, which ensures the health, safety and welfare of all residents. EVIDENCE: The registered manager had been in post 8 years and was a registered nurse. She had qualified as a trainer in dementia awareness, adult safeguarding, 1st Aid and safer moving and handling and had completed the NVQ assessors’ course. The manager was able to report the intention to undertake training in Deprivation of Liberty Act and tissue viability in near future. The manager had developed an annual Quality Assurance process. To date surveys had been competed by family members to assess the home’s success in delivering all aspects of care and support for the people living at the home. Southminster Residential Home DS0000063215.V370268.R01.S.doc Version 5.2 Page 24 There was no formal process at this time to gain feedback from outside stakeholders such as visiting healthcare professionals, social workers, chiropodist, hairdresser etc. The manager reported that residents’ meeting minutes and staff meeting minutes would feed into the annual summary of quality satisfaction. The manager told us that she would summarise the responses from all areas and make an action plan to identify any areas of identified shortfall and this would be forwarded to the commission and included within the home’s Statement of Purpose. The registered manager maintained pocket monies for some of the people living at the home. These were safely locked away in the manager’s office and were maintained in separate plastic zipped wallets for each person with receipts for any monies spent. The manager maintained a cashbook with separate records for each person providing evidence of when monies were given to individuals for personal expenditure. Two cash balances were checked against the records at this visit. One was accurate and the cash balance of the other was 9 pence. The manager was able to provide us with evidence that checks of fire alarms and system testing took place weekly and fire drills monthly. The fire officer had visited the home prior to this visit to undertake a full inspection of the home; this resulted in 3 recommendations that had been actioned. Evidence was available to show that portable appliance testing, fire extinguisher servicing, gas installations checks, lift servicing, electrical system checks, Legionnaires and Asbestos checks had taken place in a timely manner. All wash hand basins had regulators fitted. The registered manager reported that the handyman undertook routine water temperature testing however did not document this therefore no evidence was available to confirm this practice. Window restrictors were fitted to all windows in the home to promote and protect the safety of residents. All external doors were fitted with alarms to alert against intruders and to make staff aware if anyone left the building. The manager had a full risk environmental assessment of the home and reviewed this quarterly. The manager reported that she felt this would become more frequent as the refurbishment and extension project got under way. Southminster Residential Home DS0000063215.V370268.R01.S.doc Version 5.2 Page 25 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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 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 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Southminster Residential Home DS0000063215.V370268.R01.S.doc Version 5.2 Page 26 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 OP7 Regulation 15 Requirement So that residents are cared for safely, individual care plans must detail all their assessed needs and care preferences. Care plans, daily records and associated documents must include enough detailed information so that staff can offer residents consistent person centred care and assistance. Timescale for action 30/09/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Southminster Residential Home DS0000063215.V370268.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Southminster Residential Home DS0000063215.V370268.R01.S.doc Version 5.2 Page 28 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!