Inspection on 09/07/09 for Southview

This inspection was carried out on 9th July 2009.

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

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

Other inspections for this house

Southview 26/02/10

Southview 08/08/08

Southview 09/08/07

Southview 11/09/06

Southview 13/03/06

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 17/02/2010.

Key inspection report CARE HOMES FOR OLDER PEOPLE Southview Woodside Lipson Plymouth Devon PL4 8QE Lead Inspector Stella Lindsay Key Inspection (unannounced) 9th July 2009 9:30 DS0000064360.V376372.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Southview DS0000064360.V376372.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Southview DS0000064360.V376372.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Southview Address Woodside Lipson Plymouth Devon PL4 8QE 01752 667853 01752 667853 southview@yahoo.co.uk 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) Ashley Residential Care Ltd Care Home 19 Category(ies) of Dementia - over 65 years of age (19), Old age, registration, with number not falling within any other category (19) of places Southview DS0000064360.V376372.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The categories of registration are OP and DE(E). The home may accommodate a maximum of 19 older people (over the age of 65) who may also have dementia. 8th August 2008 Date of last inspection Brief Description of the Service: Southview is a care home that is registered to provide accommodation and personal care for up to 19 older people, aged over 65, who may also have dementia. Nursing care is not provided in this home. It is privately owned by Ashley Residential Care Ltd. The Responsible Individual is Mrs Anna Chapman. The present owners took over the running of the home on 7th March 2006. The home is a single storey detached property situated in the residential area of Lipson, Plymouth. It is close to local amenities and transport links. Southview offers 17 single bedrooms and one double bedroom: eight of the single bedrooms have en-suite toilet facilities. There are two bathrooms and four toilets for communal use. The home has a large lounge and a dining room. Accommodation is centred around an attractive courtyard and garden and all areas are accessible to the residents. There is a small area of on-street parking available outside the home. The current weekly fees for the home range from £313 to £345 dependent upon individuals’ care needs. Taxis to medical appointments or social outings are charged to the resident. Information relating to the services provided at Southview can be obtained directly from the home. Southview DS0000064360.V376372.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 1 star. This means the people who use this service experience adequate quality outcomes. Prior to the unannounced inspection we sent questionnaires to people who use the service and received ten back. We also sent ten questionnaires to staff and received four back. The visit to the home was unannounced and took place on 9th and 10th July 2009. On the first day we were accompanied by an ‘expert by experience’. An ‘expert by experience’ is a person who either has an experience of using services or understands how people in this service communicate. They visited the service with us to help us get a picture of what it is like to live in or use the service. During our visit we spoke to three people who use the service, the Manager, one of the deputy managers, seven staff members and four visitors to the home. The expert by experience spoke to ten people who use the service and one visitor. We case tracked two people who use the service. We spoke to staff about their care, looked at records that related to them and made observations if they were unable to speak to us. We looked at staff recruitment records, training records, and policies and procedures. We did this because we wanted to understand how well the safeguarding systems work and what this means for people who use the service. All this information helps us to develop a picture of what it is like to live at Southview. What the service does well: All newcomers, whether new residents, staff or visitors, appreciated the warm welcome they receive at Southview. We found that without exception the residents were well dressed and presented. This house is all on one level, which makes it easy for residents to get around, and they have ramped access to the garden. The bathing facilities are attractive and suitable for people with mobility problems. A good variety of meals were served in comfortable surroundings. What has improved since the last inspection? Southview DS0000064360.V376372.R01.S.doc Version 5.2 Page 6 Care of residents had been made more consistent and reliable by improving the status and quality of the handover meetings when staff came on duty. At least twenty minutes were spent considering each resident in turn, to ensure that any changes or messages were passed effectively. Good training had been provided. This included training in Dementia care, which several staff told us they had found particularly interesting. The Manager was introducing practices to the home to promote good experiences for the residents. These included reminiscence work, development of life stories, and memory boxes for the entrance to peoples’ rooms, to personalise with their own emblems. At meal times, a staff member sits at each of the three tables, ensures that residents have food that suits them, then eats with them. This has been found to be effective in making the meal more sociable, and people who were inclined to eat little or to leave the table early are more settled and eating better. Essential work to the roof had been carried out, so it should now be watertight. Following this the hallway was redecorated and re-carpeted, and was looking bright and smart. Work on replacing windows had started. A new call bell system was being fitted at the time of this inspection, to ensure that staff go to the caller before cancelling the bell. The garden was looking attractive, and several residents told us they had enjoyed sitting out there during the recent good weather. New staff members had also brought ideas of social activities the residents would enjoy. A Senior Carer had compiled a booklet showing local places of interest, to advise visitors of interesting and accessible places to take people. What they could do better: The staff were working hard to make sure all personal and health care needs were met. Because many of the staff had been recently recruited, they had not yet built up their knowledge of residents’ care needs and therefore had not yet built up fluency in their work, so tasks took a long time. The Manager will need to monitor progress, but we considered that there may be sufficient staff, once a settled team is achieved, to offer the service including social engagement in the mornings, according to the Manager’s plans. Improved skills for people in managerial and supervisory positions, and development of good working relationships, leading to a settled and confident staff team would enable the staff to perform more effectively. The home would then benefit fully from the person centred care practices that the Manager is introducing. Some residents reported that staff response time was sometimes slow, particularly at night. The Manager undertook to monitor and deal with this. Southview DS0000064360.V376372.R01.S.doc Version 5.2 Page 7 Some window frames were in a serious state of decay. The programme of renewal must proceed, with risk management in place to protect residents from harm. Record keeping of medication needed to be improved to ensure that all medication could be accounted for. More staff needed up to date First Aid training to ensure that there is a first aider on duty at all times. Locks should be fitted to residents’ private accommodation that are suited to their needs, and allow for staff access in an emergency. This is so residents can maintain privacy, as well as securing their possessions if they are away. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Southview DS0000064360.V376372.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 Southview DS0000064360.V376372.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 and 3 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are given information about the home and opportunities to look around. Admission to the home is offered following suitable assessment. Emergency admissions are accepted with professional support. EVIDENCE: The home’s Statement of Purpose was on display in the entrance hall, and had been updated recently by the Manager. All but one of the residents who completed surveys said that they received sufficient information before deciding to move to Southview, and all but one knew they had been given a statement of terms, to explain what is included in the service. The Manager explained that these are not given when the person first arrives, but at the end of their trial period. Southview DS0000064360.V376372.R01.S.doc Version 5.2 Page 10 We looked at the information received by the Manager on behalf of two recently admitted residents. One had been a supported discharge from hospital. Information had been provided three days before one admission to Southview, and the Manager had seen them in order to make an assessment of the home’s ability to meet their needs. The other had been an emergency admission the previous day. The social worker had come to the home to complete the needs assessment. There were still unanswered questions, including how staff should respond to disturbed behaviour, and how plans were to be made for this person’s future. We met a person who had been admitted to the home a few weeks earlier, and a family member who was visiting. They were both delighted with the reception they had at Southview – ‘the people are lovely’ and ‘I’m delighted with it’. Southview DS0000064360.V376372.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal support is responsive to peoples’ varied needs; staff respect privacy and make sure residents receive health care when they need it. EVIDENCE: Without exception the people seen were well dressed in clean clothes with good personal hygiene. A relative of a resident who had been admitted a few weeks earlier said that this resident had previously been depressed and neglecting themselves, had been unwilling to get dressed, but now they were joining with the others, eating and looking well. Each resident had a needs assessment recorded, and care plans which showed the care tasks that people could manage independently, and those for which they needed help. We saw that these had been reviewed, and that risk assessments had been carried out with respect to falls, weight loss and skin care. Southview DS0000064360.V376372.R01.S.doc Version 5.2 Page 12 Of the ten residents who completed surveys, eight said they ‘always’ get the care and support they need, one ‘usually’ and one ‘sometimes’. We saw good practice in handovers, ensuring that staff were aware of any problems and any particular care needs. The shift leader had asked one of the staff to read the information about the person who had been admitted the previous day, and inform the team about their needs, as there had not been time for all to do this. Development of individuals’ dementia was acknowledged, along with the effect on other residents, leading to consideration of further specialist attention. A District Nurse who visits regularly told us that she has been well supported by staff in the home, who have followed any instructions she has left, and obtained prescriptions promptly. Records showed that referrals to dieticians and other specialists had been made as needed. The Continence Advisor visited the home during this inspection, to monitor progress, order pads correctly and advise staff. Work was on-going to gather information with the help of families and friends, to compile life stories, particularly for those who could not tell their own story. The home had a detailed policy and procedure with respect to the administration of medication. The medication trolley was securely stored and five of the current staff had been trained this year in safe administration. One of the Deputy Managers had been given responsibility for auditing medication. A mistake had been made in her absence, and it was not possible to account for all medication at the time of this visit, but it was clear that she was dealing with this and that residents’ safety was ensured. We saw that Controlled Drugs were stored and recorded correctly. Painkillers could not be accounted for, because staff did not record whether the person was given one or two. Southview DS0000064360.V376372.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Manager is introducing person centred practices. The staff did not always have time to give sufficient attention to social activities, and there were not enough opportunities to go out. Good meals are served, in a relaxed atmosphere. EVIDENCE: With one exception people were content that they retired and rose at times of their own choosing. The exception complained that sometimes they were awoken by a carer returning laundry, the banging of a fire door or by staff talking in the corridor. The Manager was in the process of agreeing new care plans, to reconsider with residents how their routines could be changed to suit them better. The first day of this inspection was disrupted and made difficult for staff, as the cook (new in post) had failed to turn up for work. The care staff and housekeeper worked well together to provide care and breakfast, so that everyone received the personal care they needed. The result was that breakfast and medication was not over for some people till 10.30am, which was then close to lunch, and the staff did not have time to engage in social Southview DS0000064360.V376372.R01.S.doc Version 5.2 Page 14 activities that morning. A relief cook was brought from another home owned by the company. In the morning the majority of residents were found to be sitting in the lounge. One had a current newspaper. Residents did not engage in conversation with each other, and staff were busy elsewhere. In the ‘Communication Book’ the manager had written a note drawing staff attention to a new activities list posted on a notice board in the hallway giving details of events to be run by staff morning and afternoon seven days a week. According to residents, the staff seldom had enough time to run the activities. They said, ‘They have too much to do and I have to remind them’, ‘Inclined to hurry you up’, ‘Everything here is too quick’. Staff told us that they normally do engage in a word game or other activity in the lounge during the morning, and this morning was an exception. We saw staff leading activities during both afternoons of this visit. Some people said that they preferred not to join any activity - one adding, ‘I seldom go into the lounge now as it is not like it used to be’, because more dependent people now live at the home. One person said, ‘It’s very noisy here with the television or radio on all the time’. We were told that a monthly visit had been made by a person leading exercises and the Plymouth City Museum staff had also visited. A visitor from a Church comes each month to lead prayers and to talk. A resident returning a survey suggested that the home would benefit from having a vehicle, for appointments and trips out, and three others said they would like more outings. A new wheelchair had been obtained, to enable residents with mobility problems to be taken on walks by visitors or staff. The Manager said she planned to promote a keyworker system in the home, to enable increased individual attention including informal trips to the park or shops. There had been a group outing to the Theatre, which had been much enjoyed. Residents could choose whether to take lunch in the pleasant dining room or in their bedroom. The menu of the day was either breaded chicken or sausages with onion gravy accompanied by mashed potatoes, broccoli and peas. Desert was a steam sponge or yoghurt, served from a trolley so that residents were able to see the choices. One member of staff sat at each of the three dining tables eating the same food as the residents. No one was seen to need assistance other than with the cutting of food. Staff told us that since this practice has been introduced, a resident who used to find it impossible to sit still long enough to eat a full meal now sits in a relaxed way and eats well. Residents said that snacks were available with their mid-evening drinks if desired. People were generally content with the quality of the food but said that it was better when there was a cook who knew them well. Several residents mentioned what they saw as a high turnover of staff and in particular cooks. Southview DS0000064360.V376372.R01.S.doc Version 5.2 Page 15 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home had a complaints procedure, and the Manager dealt promptly with issues that were brought to her attention. Some people had not felt their concerns were dealt with satisfactorily by management in the home, which resulted in some issues being raised in complaints to the CQC. EVIDENCE: The home’s Complaints Procedure was displayed on the notice board, where residents could refer to it. Some staff had received training in the Protection of Vulnerable Adults, and all who responded to our survey said that they knew what to do if a resident had concerns about the home. Eight of the ten residents who responded said they knew how to make a complaint, and all knew who to speak to if they were not happy. There was a book available for visitors to write comments, on display in the entrance hall. Staff were aware of their responsibilities under the ‘whistle-blowing’ policy. There was a safeguarding alert in October 2008. A staff member told us they had brought verbal abuse by a colleague to the attention of the management, but that nothing had been done. However, the Plymouth City Council Review team worked with the home owners to bring about and ensure a safe situation Southview DS0000064360.V376372.R01.S.doc Version 5.2 Page 16 for all residents. The Review Team confirmed that staff at the home had worked well with them, and continued to do so. We received four other calls during the year, who all required anonymity. At the end of March we received an anonymous complaint, and carried out a Random inspection to look into it. There were three main elements, including a need for Moving and Handling training, and some mistakes in medication administration. The Acting Manager at the time explained that the new hoist had been delivered, but would not be used until training had been provided. She had asked staff to bring to her attention immediately any evidence of bad practice in medication administration, in order that she could deal effectively and ensure good practice. Concerns about management also formed part of this complaint, but we were not able to look into this aspect of the complaint at this visit. During May 2009 two complaints were received by CQC, which were both passed to Mrs Chapman to investigate. She reported back promptly to us, having investigated and not found evidence to uphold these complaints, which we accepted. We then received a letter which included concern about the number of staff who had left, and poor staff morale affecting the residents. At the key inspection we found this view to be held by some staff and regular visitors to the home. The home owners considered that the high level of complaints might be due to the period of change that the home is going through. We have found since Mrs Chapman took over as Manager of Southview on 31st May 2009 that prompt action has been taken when matters have been brought to her attention. Southview DS0000064360.V376372.R01.S.doc Version 5.2 Page 17 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 24 and 26 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The capital programme of refurbishment was under way, with arrangements in place to deal with outstanding deficiencies. The house was clean, accessible and comfortable. EVIDENCE: We were given the programme of capital expenditure showing the major works completed and planned. Since the last inspection, the leaking roof had been fixed, with final insulating and felting due in August 2009. Following this the hallway had been redecorated and re-carpeted. The Manager said that residents had been involved in the choice of colours, and in choosing the new carpet. We saw bedroom windows that were in a serious state of disrepair. The plan showed that these were to be replaced by UPVC windows during September Southview DS0000064360.V376372.R01.S.doc Version 5.2 Page 18 and October of this year. This also applied to the rear window and door of the dining room. The garden was looking attractive, and several people told us they had enjoyed sitting out during the recent good weather. Two people mentioned that other residents had entered their bedrooms uninvited. In one case it was alleged the same person (of the opposite sex) had made three visits in the past two weeks late at night waking the sleeper. Residents said that the Manager had told them that it is against the law to have locks. The Minimum National Standard require doors to residents’ private accommodation to be fitted with locks suited to their capabilities and accessible to staff in an emergency. This is likely to mean a fitting which locks from inside the resident’s bedroom without a key (with a knob), and can be accessed by staff with a master key. Memory boxes had been fitted to bedroom doors, for residents to display emblems or figures of choice to demonstrate their skills or interests. We suggested that the frame or door to the lounge might be painted a different colour, to help people tell it apart from doors to bedrooms along the same corridor. A new call bell system was being installed during this visit, which needed to be cancelled at the place where the alarm had been sounded (instead of at the control panel) in order that staff must see the resident before cancelling the bell. Staff had carried out a monthly health and safety check of each room. We saw that liquid soap and paper towels were provided in communal toilets and in the laundry for good hygiene, and that the temperature of hot water in the bathroom was safe. The cleaner was very pleased that a new carpet shampooer had recently been obtained. We found the house was clean and sweet-smelling. Southview DS0000064360.V376372.R01.S.doc Version 5.2 Page 19 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, and 30 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Southview employs some good staff, but consistency and good support is needed for them to perform to the best of their ability. There had been good provision of training. EVIDENCE: Of the ten residents who completed our surveys, six said that staff are always available when they need them, and the other four said they usually are. However, residents told us that staff sometimes took a long time to answer their call bell. A new call bell system was being installed during this visit, which required staff to go to the point of call in order to cancel. Management should gather feedback from residents as to staff response, particularly by night. When the Expert by Experience spoke with residents, a very varied response was received in respect of the staff. The following comments were made; ‘The staff are 100 - never any problems’, ‘Staff OK – look after me alright’, ‘The girls do very well indeed’, ‘Some better than others – too much to do’, ‘You get both good and bad staff, some you like, some you don’t’, ‘Could do with more staff’, and ‘Some better than others’. Southview DS0000064360.V376372.R01.S.doc Version 5.2 Page 20 We observed that so many of the care staff were new appointments, that they were hampered by their lack of familiarity with the home and residents. We consider that the numbers of staff employed may well be sufficient, but until there is an experienced team working together, there will be a rush to complete tasks. We looked at the files of four recently recruited staff. We found that two written references had been obtained for all. The Manager had written a number on their file, which she said was from a newly obtained Criminal Record Bureau check, but we were unable to confirm this. These checks should be kept in the home until the inspector has seen them. Concern had been raised by some regular visitors to the home as to the qualifications of night staff. We found that some night staff were new in post. Their records suggested they were suitable for this work. They had shadowed day and night shifts in order to start getting to know the residents before taking responsibility, but they had not yet got their first aid qualification. Most nights they were on duty with an experienced colleague, but not all. Some day staff told us they felt their induction had been inadequate, with just a couple of shadow shifts. We looked at their files, which showed the manager had cross referenced their previous learning and qualifications, and recorded a progress log. This should be done in conjunction with the new employees, so they can confirm their confidence in these areas. The Manager told us that the new employees had been given a workbook, which they were completing, and would bring to supervision. Staff were encouraged to enrol for NVQ training. The training record showed that six staff had achieved at least NVQ2 in care. The Manager told us that both the Deputy Managers are enrolled on NVQ4, two Seniors in NVQ3, and six other staff including the new Night Carers, are enrolled to study for NVQ 2 in care. The Manager had recently been accredited with the University of Bradford as a Dementia Care Mapper, and had started to deliver training to staff in person centred care and understanding dementia. Several staff told us how interesting and helpful this had been. Other training delivered this year had included Infection control, palliative care, and moving and handling including use of the hoist. Southview DS0000064360.V376372.R01.S.doc Version 5.2 Page 21 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A settled spell of management, developing skills of communication and building trust with the staff team, is essential to the development of this service. EVIDENCE: Mrs Anna Chapman is the Responsible Individual for Ashley Care Ltd. Since the resignation of the last Manager on 29th May 2009, she has taken over management of the home, and is in the process of registering as Manager with the Care Quality Commission. Mrs Chapman holds the Registered Managers’ Award and NVQ 4 in Care. She has undertaken specialist training in dementia care and has already introduced good person centred practices, which she is keen to promote within the home. Southview DS0000064360.V376372.R01.S.doc Version 5.2 Page 22 This is the fourth change of Manager in the past year. The failure to provide good management over the past year means that the staff team had been unsettled, and residents and visitors had become aware of this. We found that management needed to work consistently to build trust with their staff, and to gain confidence in each others’ abilities. Mrs Chapman was planning to be assisted by two Deputy Managers who were experienced in residential care. Other staff had been promoted as shift leaders. Training in supervision skills is recommended, for all supervisory staff to develop their practice in supporting staff. We saw that cash held on behalf of residents was recorded accurately, with receipts kept. Professional fire training was provided on 26/05/09. Staff turnover since then already meant that new staff had not benefited. However, a fire drill for new staff had taken place on 07/07/09. The fire precaution system was professionally serviced in April 2009, and a comprehensive room by room Fire Risk assessment was in place. Keys in boxes had been fitted by external doors that were kept locked, to allow for quick access in an emergency. Some staff had received training in First Aid this year. However, further staff including the new Night Care Assistants, need to be qualified First Aiders in order to ensure that there is a First Aider on duty at all times. Southview DS0000064360.V376372.R01.S.doc Version 5.2 Page 23 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 3 3 3 X X N/A 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 3 3 X X X 2 X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x 3 2 x 2 Southview DS0000064360.V376372.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes 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(2) Requirement The audit trail for all medication must be complete. This is so the Manager can account for all medication that is in the home, and includes PRN painkillers. There must be a qualified First Aider on duty at all times, to ensure as far as reasonably practical the health and safety of service users and staff. Timescale for action 31/08/09 2 OP38 13(4) 30/11/09 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. 2. 3. 4. Refer to Standard OP12 OP24 OP31 OP36 Good Practice Recommendations The Manager should enable staff to give attention to residents’ social needs through the mornings. Locks should be fitted to residents’ private accommodation that are suited to their needs, and allow for staff access in an emergency. The Manager should be registered with the Care Quality Commission as this is a legal requirement. All those in managerial and supervisory positions should DS0000064360.V376372.R01.S.doc Version 5.2 Page 25 Southview receive training and develop their supervision skills, in order to support staff and promote better team working in Southview. Southview DS0000064360.V376372.R01.S.doc Version 5.2 Page 26 Care Quality Commission Care Quality Commission Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Southview DS0000064360.V376372.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. 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!