Inspection on 11/05/07 for Spindrift Care Home

This inspection was carried out on 11th May 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Spindrift Care Home 17/08/06

Spindrift Care Home 07/11/05

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Spindrift Care Home 36/39 Cleveland Road Lytham St Annes Lancashire FY8 5JH Lead Inspector Lesley Plant Unannounced Inspection 11th May 2007 10:15 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 Spindrift Care Home DS0000064223.V336178.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. Spindrift Care Home DS0000064223.V336178.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Spindrift Care Home Address 36/39 Cleveland Road Lytham St Annes Lancashire FY8 5JH 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) 01253 737014 01253 794742 Spindrift Care Home Limited Mrs Alison Elizabeth Murgatroyd Care Home 34 Category(ies) of Dementia - over 65 years of age (16), Old age, registration, with number not falling within any other category (34) of places Spindrift Care Home DS0000064223.V336178.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only:Care home only - code PC, to service users of the following gender:Either Whose primary care needs on admission to the home are within the following categories:Old age not falling within any other category - Code OP (maximum number of places 34). Dementia over 65 years - Code DE (E) (maximum number of places 16) One named person in the category of PD (adults with physical disabililty) Two named people in the category of LD (adults with learning disabilities) Date of last inspection 17th August 2006 Brief Description of the Service: Spindrift is located close to Lytham town centre, providing excellent access to a range of community facilities and services. The majority of bedrooms are single; however there are two double bedrooms available for people who may choose to share a room. Parking for visitors is provided at the rear of the home and there are enclosed rear garden areas for sitting out during the summer months. The good range of communal space, including a small conservatory, means that individuals can choose to join in activities or spend time alone/in smaller groups. The home is registered to provide personal care to up to 34 residents of both sexes who are aged 65 years and over. The Commission for Social Care Inspection has recently agreed a change to the registration status of the home, allowing for up to 16 of these places to be provided for residents over the age of 65 years who have dementia. Specific registration conditions are in place, to allow the home to continue to provide care to one person with a physical disability and two people with learning disabilities. Activities inside and outside the home are arranged. The home has a strong Christian ethos and ministers from a number of local churches regularly visit the home. Spindrift Care Home DS0000064223.V336178.R01.S.doc Version 5.2 Page 5 The three directors of the provider company, Spindrift Care Home Limited, are all closely involved in the running of the home, with one being the registered manager. The current fees range from £385 to £430. Spindrift Care Home DS0000064223.V336178.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced, took place during the course of a full day and looked at all of the key national minimum standards. The inspector spoke to the registered manager; a care assistant, a senior care assistant, the assistant care manager, six people living at the home and a GP who was visiting an individual on the day of the inspection. Time was also spent observing staff and the people living at the home, engaged in daily activities. Records were viewed and a tour of the building took place. Feedback surveys were received from seven relatives, a GP and eight people who live at Spindrift. Information was also gained from a pre inspection questionnaire completed by the registered manager. At the time of the inspection there were 28 people resident at the home. The registration status of Spindrift has recently changed to allow for up to 16 people with dementia to be cared for at the home. Separate dining, lounge and garden areas are available for this group, however at present the home is operating as one unit. This will change over a period of time, as new people are admitted and as it becomes more appropriate to have two separate areas of the home, catering for people with different needs. The registered manager is aware that the current arrangements are for a short-term period of time. What the service does well: One relative who completed a feedback survey stated; “ We knew within a few minutes of our first visit to Spindrift that this was the right place to care for our relative. It has a special feel and atmosphere, as well as providing a safe, happy, caring and homely environment for the elderly.” Spindrift retains a strong family atmosphere and is run in such a way as to make everyone feel included. The inspection gained a great deal of complimentary feedback about the staff team, managers and owners. The staff team has remained stable for some time. This means that staff, people living at the home and their relatives have built up close and positive relationships. Feedback from people living at the home and their relatives included; “staff treat everyone as an individual, respecting all their needs”, “everyone is always polite and kind,” and “we are treated with every consideration and kindness.” Spindrift Care Home DS0000064223.V336178.R01.S.doc Version 5.2 Page 7 Communication with relatives appears to be a definite strength of the home. Relatives are kept informed about important matters and consulted about any changes. Feedback about the standard of care at Spindrift included; “I live a long way from Spindrift, but I have peace of mind my relative is safe and cared for” and from another relative, “the standard of care provided is of the very highest standard. Spindrift provides an excellent service meeting all physical, psychological and pastoral needs”. The management team have placed a great deal of emphasis on pursuing qualification training for staff and Spindrift exceeds the target outlined in the National Minimum Standards of having 50 of the team qualified. Ten of the 17 care staff have achieved NVQ level 2 above. The good range of communal lounge space means that individuals can choose to be part of a larger group and join in activities or spend time alone/in small groups. One relative commented; “I like the way it has lots of small lounges, making it feel more homely.” What has improved since the last inspection? What they could do better: Although important elements of care plans are being updated or changed as needed, the full care plan should be reviewed at least every month. This will ensure that all aspects of wellbeing are considered and that nothing is missed. The risks associated with the use of bed rails need to be given more attention, with clear risk management plans in place, showing the action that is being taken to reduce the chance of harm. As well as ensuring that photographs are included in the medication record it is also recommended that any handwritten medication administration records should be checked and signed by two staff. Spindrift Care Home DS0000064223.V336178.R01.S.doc Version 5.2 Page 8 The registered manager was advised to make sure that staff who do not undertake NVQ training receive training regarding dementia and abuse as part of their basic training. 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. Spindrift Care Home DS0000064223.V336178.R01.S.doc Version 5.2 Page 9 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 Spindrift Care Home DS0000064223.V336178.R01.S.doc Version 5.2 Page 10 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 and 6 Quality in this outcome area is good. The assessment process helps to ensure that people are only admitted to Spindrift, if their needs can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The new Statement of Purpose sets out the aims and objectives of the home and gives details of the services provided. The assessment documents for two individuals recently admitted to the home were viewed. One person, recently admitted for respite care, had previously stayed at Spindrift, with a full assessment being carried out prior to that first stay. Records show that this information was reviewed and a new care plan developed. The registered manager explained that she had met with the individual and his wife to jointly put together the care plan and that the completion of a new full assessment document had not been necessary. This level of assessment is appropriate under these circumstances. Spindrift Care Home DS0000064223.V336178.R01.S.doc Version 5.2 Page 11 The other records viewed related to an individual admitted to the home for long term care. A full assessment had taken place, with information then being further developed and transferred to the care plan. Records show that each person at the home also has a moving and handling assessment and that for some people there is also a hospital discharge assessment and care programme approach documentation. The registered manager, care manager or assistant care manager, who are all experienced, carry out assessments. This would take place in hospital or in the person’s home. Information is gathered from spending time with the individual and their relatives, as well as gaining information from other professionals e.g. hospital staff. Detailed assessment information is then transferred to the care plan. People are not admitted to Spindrift Care Home solely for intermediate care. Spindrift Care Home DS0000064223.V336178.R01.S.doc Version 5.2 Page 12 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. Health and personal care needs are being met and people living at the home are treated with dignity and respect. The strengthening of risk management procedures for the use of bed rails would provide further protection. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each person has a care plan; which addresses health, personal and social care needs. Care plans for people newly admitted to the home are put into the staff communication book, for staff to read and sign, ensuring that everyone is aware of the support to be provided. Care plans include a moving and handling assessment, detailing the support or aids required. At the last inspection it was clear that care plans were being reviewed on a monthly basis or more often if needs had changed. Records viewed during this inspection showed that changes are being responded to, with elements of care plans being updated or changed as appropriate. However, the full care plan should be reviewed at Spindrift Care Home DS0000064223.V336178.R01.S.doc Version 5.2 Page 13 least every month, which is not happening at present. Temporary changes to the roles of some senior staff appear to have weakened the previously good system of reviewing care plans. Although there was no evidence to suggest that changing needs are not being responded to, a full monthly review of each persons’ support needs will ensure that all aspects of wellbeing are considered. There is a key worker system in place and the staff rota, with accompanying task list provide good directives for staff to follow each day, indicating who is supporting each person. A number of risk assessment were viewed, such as for one individual when going out of the home. The risks associated with the use of bed rails need to be given more attention. The registered manager has information available regarding the use of such equipment, however there needs to be clear risk management plans in place, showing the action that is being taken to reduce any risks associated with using bed rails. This was raised at the last inspection and although information is available and good practice, such as ensuring that the rails are covered, is being followed, this still needs to improve. Thorough risk assessments need to be put in place regarding the use of bed rails and these must be regularly reviewed as part of the care plan. Health care needs are addressed within care plans and the daily records kept by staff show that changing health needs are being monitored, with advice being sought when appropriate. Staff keep good records of all healthcare appointments, including GP and District Nurse visits. At the time of this inspection, two people were being cared for in bed. Staff were keeping clear records of food and fluid intake, plus a record of pressure care relief. The registered manager confirmed that neither of these residents had pressure sores and it was clear that the staff team are providing a good level of support to individuals who have become bed bound. A weekly exercise session is held and a chiropodist regularly visits the home. Records include an individual profile, containing basic information, including medication details. The registered manager explained that this information is taken with the person, should they have to attend hospital. The registered manager was advised to contact the Community Learning Disability Nurse to discuss problems one individual has, regarding a fear of medical examinations and healthcare appointments. A GP who was visiting the home at the time of the inspection confirmed that medical advice is followed and that when called to visit the home, there is always good information available regarding the patient and the reason for the call. Relatives and people living at the home gave a great deal of positive feedback about the standard of care at Spindrift. Comments included; “I live a long way from Spindrift, but I have peace of mind my relative is safe and cared for”, Spindrift Care Home DS0000064223.V336178.R01.S.doc Version 5.2 Page 14 “the standard of care provided is of the very highest standard. Spindrift provides an excellent service meeting all physical, psychological and pastoral needs”, and “it maintains high standards in all aspects of care – nothing ever seems to be too much trouble.” Medication is safely stored and staff who administer medication have received appropriate training. As well as signing when each individual medication is administered, the nominated staff member responsible for each medication round also signs a record to confirm responsibility for this task. The records viewed were all appropriately maintained. As recommended at the last inspection, a senior member of staff now carries out a weekly audit, checking that procedures have been followed and medication, not in pre packed cassettes, is now being dated when opened. Apart from two people recently admitted to the home, each medication sheet contained a photograph of the person. This is considered to be good practice and the registered manager explained that a problem with the printer had led to these omissions and was being dealt with. As well as ensuring that photographs are included in the medication record it is also recommended that any handwritten medication administration records are double-checked and signed by two staff. The importance of privacy and dignity is addressed with all new staff during the induction period. During the inspection staff were observed speaking kindly and sensitively to people living at the home and the atmosphere was warm and friendly. There is a small private area where people living at the home can make phone calls and people can entertain visitors in their bedroom, as was the case during this inspection. A GP who completed a feedback survey responded that staff appear caring towards individuals and that people are treated with respect, dignity and kindness. Feedback surveys from people living at the home and their relatives contained many positive comments about the personal qualities of staff, managers and the owners of Spindrift. These included; “all faiths are respected,” “all the different needs of the residents are adequately catered for, in a non judgemental and non prejudicial manner”, “staff treat everyone as an individual, respecting all their needs”, “everyone is always polite and kind,” and “we are treated with every consideration and kindness.” A relative whose parents had both stayed at Spindrift for respite care stated; “My dad passed away in Spindrift and everyone concerned from management to cleaners showed my mother and all the family so much compassion and help at this sad time.” . Spindrift Care Home DS0000064223.V336178.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 and 15 Quality in this outcome area is good. Arrangements for maintaining social contacts and taking part in activities, and the good communication with relatives help to promote positive lifestyles for the people living at the home. The food is varied, good quality and enjoyed by those living at the home This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information regarding interests and preferences is gathered during the assessment period. Good information in this area was viewed. The good range of communal lounge space means that individuals can choose to be part of a larger group and join in activities or spend time alone/in small groups. A range of different activities is provided, including bingo, quizzes, exercise sessions, entertainers and films. A notice board in the dining room gives details of forthcoming events/activities. A number of church ministers regularly visit the home and people are supported to keep links with their chosen place of worship. Spindrift Care Home DS0000064223.V336178.R01.S.doc Version 5.2 Page 16 One of the residents produces a regular newsletter about life at Spindrift and praised the staff for the support she receives to achieve this and to follow her other literary interests. This individual had recently attended a course of lectures at a nearby community centre and has a French teacher who calls fortnightly. Comments from relatives feedback surveys included; ““My sister enjoys the freedom to walk out to the shops whenever she chooses,” and “always encouraging service users to try something different.” The home has its own mini bus and the regular trips out were greatly enjoyed by the people living at the home. The bus is awaiting repair and trips have not recently been taking place. One relative who completed a feedback survey stated, “ ***** misses the trips out, she enjoyed the travelling to new places and the carers always made the trips very enjoyable”. The registered manager confirmed that there are plans to re introduce these trips. During the inspection it was clear that visitors are made welcome at the home and can pop in at any time. The relatives who completed feedback comment cards all responded positively about visiting arrangements. People can entertain visitors in their bedroom, the dining room or in one of the lounges. Individuals are encouraged to handle their own financial affairs according to their wishes and capabilities. For some people a relative may take on this responsibility and make any necessary decisions. Information regarding advocacy is available. People are able to bring their own personal possessions with them to the home. Individual choices are supported, with one person keeping a budgie in her room and another keeping and looking after a budgie and goldfish in one of the lounges. Communication with relatives appears to be strength of the home. Feedback surveys completed by relatives all confirmed that they are kept informed about important matters and consulted as appropriate. Comments included; “Spindrift have always communicated any issues to us very swiftly, keeping us fully informed and providing us with regular updates where appropriate” and “good communication links”. There is a four weekly menu in place. The menus are varied and the day’s lunch menu is displayed on a board in the dining room, with an extensive list of alternatives. Staff were observed discussing alternatives with people who were unable to respond to the written menu and one person chose to have egg with chips, instead of the fish. A number of people at the home require assistance at meal times and staff provide support in a sensitive manner. The inspector enjoyed the lunch provided on the day of the visit and individuals spoken to also expressed their satisfaction. Feedback surveys from people living at the home provided many positive comments about the food, including “lovely” and “great”. One person went on to state, “On ‘Feast Days’ e.g. St David’s, St Patrick’s, St Andrew’s and St Spindrift Care Home DS0000064223.V336178.R01.S.doc Version 5.2 Page 17 George’s we have meals composed of dishes of the country.” A relative also commented that the “food is very good and varied”. Spindrift Care Home DS0000064223.V336178.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 and 18 Quality in this outcome area is good. People living at Spindrift and their relatives, have confidence that any concern would be responded to. Policies, procedures and good practice promote the protection of those living at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a complaints procedure in place. Feedback from relatives and people living at the home was extremely positive and confirms that staff and managers are approachable and will listen to any ideas or suggestions raised. Comments from relatives included; “We have always been kept fully informed by Spindrift and should we raise any queries or concerns, they have always been dealt with in a prompt and efficient manner.” The good communication with relatives is a strength of the service provided at Spindrift. Since the last inspection an anonymous concern regarding recruitment was received by the CSCI. This was promptly and appropriately addressed by the registered manager and did not have any substance to suggest that recruitment and staff management are not being properly conducted. Appropriate protection and abuse policies are in place. The whistle blowing policy is displayed on the staff notice board. The registered manager has good knowledge of the agreed protection of vulnerable adults procedures. A number of staff have in the past completed training in relation to abuse and challenging Spindrift Care Home DS0000064223.V336178.R01.S.doc Version 5.2 Page 19 behaviour. Abuse/protection is covered within NVQ programmes and the registered manager is also planning to provide a new in house training programme to address issues regarding difficult behaviour and abuse. Recruitment files show that appropriate checks are undertaken prior to staff being employed at the home. Spindrift Care Home DS0000064223.V336178.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 and 26 Quality in this outcome area is good. The home is clean, comfortable and well maintained, providing a homely environment for the people living there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since that last inspection the registration status of the home has changed and Spindrift is now able to admit people who have dementia. Separate dining, lounge and garden areas are available for this group, however at present the home is operating as one unit. This will change over a period of time, as new people are admitted and as it becomes more appropriate to have two separate areas of the home, catering for people with different needs. In order to prepare for these changes a number of doors have been fitted with keypads and an alarm has been fitted to one of the doors to the garden. These safety features are necessary for the protection of individuals with dementia. The fire safety officer has agreed these changes. Spindrift Care Home DS0000064223.V336178.R01.S.doc Version 5.2 Page 21 The home is very close to Lytham town centre, providing excellent access to a range of community facilities and services. The majority of bedrooms are single; however there are two double bedrooms available for people who may choose to share a room. The good range of communal space, including a small conservatory, means that individuals can choose to join in activities or spend time alone/in smaller groups. One relative commented on a feedback survey; “I like the way it has lots of small lounges, making it feel more homely.” There is an ongoing programme of redecoration and refurbishment within the home. Since the last inspection some areas of the home have been refurbished, including a bathroom, one of the lounges and a number of the bedrooms. A full time maintenance worker is employed, who carries out all minor repairs and decoration. An individual living at the home praised staff for responding quickly when she reported a maintenance problem; “I put in a request to management for the washbasin in the loo between my room and the next to be attended to as it was leaking. That was at 9 30 am. Just after 12 noon it was mended.” The home has a well-organised laundry room, with a staff member employed solely for these duties. A cleaner is employed and night staff also carry out some domestic duties. The home has an infection control policy to guide staff in their work and the majority have also completed training in this area. Spindrift Care Home DS0000064223.V336178.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 and 30 Quality in this outcome area is good. The stable, consistent, capable, caring and in the main, qualified staff team, work well to meet the needs of those living at Spindrift. Good recruitment and staff training arrangements help to promote the safety of people living at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the day and evening there are four care staff on duty, plus at least one of the management team. During the night there are two staff on working duty plus a member of the management team on call, available for emergencies. A housekeeper, cleaner and maintenance worker are also employed. At present the home does not have a dedicated cook, with one the senior staff preparing meals, however the registered manager confirmed that this is under review. During the inspection one person, resting in her room, had cause to use the call bell, available in each room, and staff were very quick to respond and attend to her. Spindrift has placed a great deal of emphasis on pursuing qualification training for staff and exceeds the target outlined in the National Minimum Standards of having 50 of the team qualified. Ten of the 17 care staff have achieved NVQ level 2 above. At present one person is working towards the level 2 award, one Spindrift Care Home DS0000064223.V336178.R01.S.doc Version 5.2 Page 23 working towards the level 4 award and a member of the team is engaged in nursing studies. The staff team has remained stable for some time, with no new staff being been appointed since the last inspection. This continuity has resulted in staff and people living at the home building up close and positive relationships, reflected in the many complimentary comments about staff being received via the feedback surveys. Examination of recruitment records shows that good procedures are being followed. A completed application form, two references and appropriate Criminal Records Bureau disclosures were available on the file viewed. A training matrix clearly shows the training completed by each member of staff. The basic core training includes moving and handling, health and safety, first aid, food hygiene, infection control and medication. Training appears well organised and the majority of staff have completed all of the basic courses plus training regarding challenging behaviour and alzheimers. Some staff have completed abuse/protection training, which is also covered in NVQ programmes. The registered manager is planning in house training regarding dementia, abuse and difficult behaviour. The registered manager was advised to ensure that the new in house programme is achieved, to make sure that staff who do not undertake NVQ training receive training regarding dementia and abuse as part of their basic training. Feedback from a relative included; “all the care staff seem very well trained and motivated. They obviously ‘care’ for the people they look after.” Spindrift Care Home DS0000064223.V336178.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, 33, 35 and 38 Quality in this outcome area is good. The home is run in the best interests of those living there, with relatives and other interested parties having opportunities to air their views of the service provided. Policies, procedures, staff training and good practice promote the health and safety of people living at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has worked at the home for many years and is also a director of the provider company. Qualifications include the Registered Managers Award, NVQ level 4 in Care and the NVQ assessors’ award. The management team also includes a number of senior care staff with specific Spindrift Care Home DS0000064223.V336178.R01.S.doc Version 5.2 Page 25 areas of responsibility. The inspector met with two members of care staff, who confirmed that managers are approachable, good training is provided and regular staff meetings take place, with one being planned for the following week. The home appears to be well managed; however during the inspection some information was hard to find. The registered manager is advised to review storage arrangements and how information is organised, within the main office. A number of internal and external quality monitoring systems are in place. Spindrift has achieved the Investors in People award. Questionnaires are usually sent to relatives, GP’s and District Nurses at least once per year, however due to the registration changes at the home and the need to consult specifically about these changes, quality monitoring questionnaires have not been distributed recently. The registered manager confirmed that this process, which is vital for gaining feedback about the service, would recommence. As part of the planning for changing the registration status of Spindrift, good consultation took place. Discussions were held with those living at Spindrift and all relatives were written to. Health and social care professionals were also contacted and two consultation events were arranged, inviting any interested party to attend and ask any questions about the proposed changes. Some community nurses did attend to gain further information. Relatives preferred to speak individually with the managers, as and when they visited the home. The general response was favourable, as a number of people currently living at the home have a degree of dementia and relatives felt that the changes would have a positive impact. A few of the people currently living at the home do not want to move rooms (as part of the longer term plan to have two separate units) and this request is being honoured. Feedback surveys completed by relatives and people living at the home provided a lot of positive information regarding staff and managers being approachable and praising the general communication within the home, particularly communication with relatives. This open and inclusive atmosphere means that ideas can be put forward and any issues quickly resolved. Comments from relatives included; “Any worries are dealt with a.s.a.p. and always reported back. Either through a phone call, letter or email.” One person living at Spindrift wrote, “We have a residents committee, chaired by a resident, and the minutes are typed and passed around the home”. For other people, feedback is gained via more informal methods, such as during day-to-day chats with the registered manager. The responsible individual for the provider company undertakes monthly monitoring visits at the home and sends copies of the reports to the CSCI, as required by regulation. Spindrift Care Home DS0000064223.V336178.R01.S.doc Version 5.2 Page 26 People are encouraged to manage their own finances or for some individuals a relative will take on this responsibility. The registered manager holds spending money in safekeeping for three people at the home and acts as the Court of Protection receiver for one of these individuals. The records of income and expenditure for these people were viewed and clearly show details of all income and expenditure. The cash held for one individual was checked and balanced with the record sheet. A safe is available for the secure keeping of any cash. The home has a system of invoicing each person or nominated relative for incidental expenditure such as hairdressing costs. The pre inspection information completed by the registered manager confirms that maintenance checks take place. The gas and central heating were checked in March 2007 and there is an electrical wiring safety certificate available. Equipment such as the lift and stair lift are regularly maintained. Records regarding, checking electrical equipment, testing water temperatures, fire alarm tests and fire drills were forwarded to the inspector following the visit. The core-training programme addresses health and safety topics such as moving and handling. Risk assessments are in place, addressing work practices such as using equipment, working at height, use of computers and use of laundry and kitchen equipment. Records of any accidents are kept. Spindrift Care Home DS0000064223.V336178.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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Spindrift Care Home DS0000064223.V336178.R01.S.doc Version 5.2 Page 28 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 OP7 Regulation 13 Requirement Thorough risk assessments for the use of bed rails must be carried out and regularly reviewed. (not met from pervious inspection) Timescale for action 30/05/07 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. Refer to Standard OP7 OP9 Good Practice Recommendations Care plans should be fully reviewed at least every month. All handwritten medication administration records should be checked and signed by two people. Spindrift Care Home DS0000064223.V336178.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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 Spindrift Care Home DS0000064223.V336178.R01.S.doc Version 5.2 Page 30 - 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. 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