Inspection on 18/09/08 for Springfield Nursing & Residential Care Home

This inspection was carried out on 18th September 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.

Other inspections for this house

Springfield Nursing &... 25/09/07

Springfield Nursing &... 12/03/07

Springfield Nursing &... 28/11/06

Springfield Nursing &... 08/12/05

Springfield Nursing &... 15/08/05

Springfield Nursing &... 23/11/04

Springfield Nursing &... 22/06/04

Springfield Nursing &... 03/06/03

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Hillyfield Rest Home

The Maypole Nursing Centre

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Extracts from inspection reports are licensed from CQC, this page was updated on 17/12/2008.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Springfield Nursing & Residential Care Home 72 and 74 Havant Road Emsworth Hampshire PO10 7LH     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Gina Pickering     Date: 1 8 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Springfield Nursing & Residential Care Home 72 and 74 Havant Road Emsworth Hampshire PO10 7LH (01243)372445 01243431644 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Deborah Mary Powell Type of registration: Number of places registered: Springfield Health Services care home 61 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category terminally ill Additional conditions: Date of last inspection Brief description of the care home The home is owned by Springfield Health Services Ltd and is registered to accommodate up to sixty-one residents. The home is located in two houses that are separated by a quiet service road. House 72 has three floors and house 74 two floors both being accessed by stairs and a passenger lift. Both houses have communal lounges and dining areas on the ground floors for the use of residents that both allow access into well maintained garden areas. The home has sufficient toilets and bathrooms to meet the needs of the residents. The fees are based on individual need and range between 650 and 950 Britsh Pounds per week. 0 0 Over 65 61 61 Care Homes for Older People Page 4 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The inspection considered information received by the Commission since the last key inspection in September 2007. This includes information provided to us in the form of the homes Annual Quality Assurance Assessment (AQAA) in which the registered person tells us how the home has developed over the past twelve months and how they propose to continue to improve the service. We surveyed people who use the service, staff and health professionals who have input into the service. Information from these surveys has been used to inform the inspection process. We have also used information provided in the report from a professional (ISO 9001) quality audit that took place at the home on 15th and 16th September 2008. A visit was made to the service on 18th September 2008. We looked at documentation Care Homes for Older People Page 5 of 29 relating to six people living at the home. We spoke to the registered manager, six members of staff, a visiting GP and and eight people living at the home as well as looking at various documentation as part of the inspection process. What the care home does well: What has improved since the last inspection? The introduction of care group forums about wound care, infection control, and end of life care means that staff follow up to date and relevant care practice guidelines when caring and supporting people living at the home. The home continues to develop and expand the social care team. This means that social care provision at the home continues to improve with more activities and social interaction provided for people living at the home. A link resident scheme has been introduced in areas such as activities and entertainment, kitchen and food provision, gardening, health and safety and recruitment that should furthur promote the ability of people living at the home to influence the running of the home. Care Homes for Older People Page 7 of 29 A link resident scheme has been introduced giving people living at the home further opportunities to have input into the running of the home in ares such as recruitment, kitchen and food provision, the garden areas, activities and entrainment and health and safety. Changes to the complaints procedure have been made which ensure all complainants receive communication in response to the complaint made. What they could do better: 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 29 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Effective and accurate assessment procedures that include the provision of good information about the home means people can decided whether the home can meet their personal health and social care needs. Evidence: The AQAA told us about the processes that take place before a person moves into Springfield. We looked at the policies and procedures for people moving into the home as well as looking at files for six people living at the home. The home follows a comprehensive process that includes the provision of information and assessment of people wanting to move into the home. All people expressing an interest in the home are provided with a glossy brochure that includes pictures and information about the aims and objectives of the home, facilities, testimonials, risk taking and activities. Further detailed information about the home is provided in the form of the Statement of Purpose and Residents Guide. We looked at the Statement of Purpose evidencing Care Homes for Older People Page 10 of 29 Evidence: that it contains all the details as required in the Care Home Regulations 2001. The home told us that amendments have been made to the Statement of Purpose in response to a complaint received by the home. This are detailed in the complaints and protection section of this inspection report. The AQAA tells us that people living at the home have been involved in the redevelopment of the Residents Guide. We saw evidence that four people living at the home and one relative had been involved in this redevelopment of the guide. The Residents Guide details in easy to read and pictorial format the service available at the home and how to make a complaint. Both the Statement of Purpose and the Residents Guide are made available in every persons bedroom. People living at the home told us they received enough information to make a decision about wanting to move into the home. The AQAA tells us that before a person moves into the home a comprehensive assessment is made of their needs or if they are living out of the local area sufficient information is obtained from heath and social care practitioners for the home to make a decision as to whether that persons needs can be met at Springfield. In the documents we looked at we saw that everyone had an assessment of needs performed before they moved into the home, or if they moved in from out of the local area there was information provided from health and social care professionals along with details completed in the pre admission assessment form from telephone conversations held with such people. The assessment process includes details about communication, oral hygiene, nutrition, sensory, mobility, elimination, washing and dressing, sleeping, skin integrity, and medication needs. Also included in the assessment process are details about the persons feelings about moving into a care home, their mental capacity and a mini mental score assessment. The home has a policy of not admitting anyone if they score below a certain level in the mini mental test; this is because the home is not registered to admit people with dementia or mental health needs. Written evidence is included in the assessment process that the home has informed the persons relative and /or representative whether the home is suitable for the person to move into and details about visits made to the home and trial periods of residency at the home. Care Homes for Older People Page 11 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Effective care planning processes involving the person living in the home, their representatives and all staff at the home mean that people living at the home receive the support and care they need in the way they like. People living at the home have their health care needs met by a workforce that has a good understanding of health care issues, by effective monitoring and prompt referral to health care professionals when needed. Good medication practices protects the welfare of people living at the home. Evidence: The AQAA told us improvements made in the past twelve months with regard to the health and wellbeing of people living at the home include the continued development of the PAL (Pool Activity Level - a professionally developed process of care planning that recognises the ability to take part in and perform activities is essential to a persons wellbeing) of care planning, annual training about dementia, for those administering medications the safe management and administration of medications and the development of care group forums. Care Homes for Older People Page 12 of 29 Evidence: As part of the inspection process we looked at six care plans for people living at the care home. Care plans are developed to detail peoples capabilities and limitations and the action to be taken to maintain or improve their capabilities. Examples of this include cutting food up so a person can continue to be independent at meal times, comprehensive details about personal care abilities so a person can maintain independence in their personal care as much as they are able and good details about how a person with expressive communication problems can express their opinions and needs so care staff act in a way that allows the person time to communicate. Staff told us they have access to the care plans and refer to them to ensue they provide care and support in the manner preferred by the person living at the home. Staff also told us that care plans are reviewed and updated monthly or more frequently if required. We noted that the care plans we looked at had been reviewed monthly, with details about the actions required to meet changing needs of the person being documented in the care plan. Discussion with people living at the home and staff members indicates that peoples wishes as documented are adhered to. A complaint had been received by us in the past twelve months and referred to the registered providers for investigation detailing that a person living at the home had not had their care plan reviewed and amended to reflect their current needs. The home evidenced that this complaint has been fully investigated and steps have been taken to ensure this does not happen again. The team of trained nurses and senior carers working at the home facilitate the health care of people living at the home. The home uses professionally recognised tools for monitoring health care needs of people living at the home including assessments of nutritional needs, risk of developing pressure ulcers, mental wellbeing and moving and handling assessments. Information from these is incorporated into the care planing documents. The care plans document contact people have with GPs and other health care professionals. Instruction from doctors is recorded on the doctors notes of the care plans as well as being incorporated into the care plan and medication administration sheet if needed. Comments from three GPs indicate a high level of satisfaction with the health care provision at the home. Comments include all round competence, the home is a very good, caring efficient home and the home is brilliant. The AQAA informed us that one of the ways in which the home is improving the provision of health care to people is by the implementation of care group forums for infection control, end of life care and wound care. This has so far resulted in improved communication, care plans and liaison with specialist nurse about wound care and the planned implementation the Liverpool Care Pathway for people in the end stages of Care Homes for Older People Page 13 of 29 Evidence: their life. This along with the provision of good training indicates the home is continually looking for ways to improve the provision of health and personal care at the home by sourcing relevant and up to date care practice guidelines to follow. Throughout the inspection information was obtained indicating the privacy and dignity of people living at the home is promoted and protected. Care plans detail peoples wishes about personal care. Staff members were seen talking with and assisting people at the home in a friendly and pleasant manner. No breaches of privacy were observed. The use of the PAL format of care planning results in staff having a good understanding about the individuals background, beliefs and previous life experiences which enables staff to understand the person as an individual. This assists staff in providing personal and health care in a manner that promotes the dignity of the individual person. Medication was checked in one of the houses and is well managed. Medication is stored in a locked trolley and a locked cupboard. Administration records are fully completed and there is a records of medication received, administered and destroyed. Controlled drugs are stored in a separate locked cabinet that complies with the Misuse of Drugs (Safe Storage) Regulations 1971 and a controlled drugs register is maintained. Regular checks of medication stock are undertaken to ensure medication is not over ordered. There is a medication fridge available, with temperature checks taken daily. According to the records the temperature of the fridge is kept at a safe level for the storage of medications. The home completes an assessment with all people who live at the home about their ability to manage their own medication. The majority of people are either not able or unwilling to manage their own medication. People have lockable storage in their room where they can keep their medication. Staff records indicate that those staff administering medications have recent relevant training about the safe management and administration of medications. Care Homes for Older People Page 14 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are able to enjoy a full and stimulating life style with a variety of activities to chose from and are able to maintain contact with family and friends. Excellent use of assessment processes means that staff are able to support people to exercise choice and control over their life. People living at the home benefit from a choice and variety of food at meal times with meal times being an enjoyable social occasion. Evidence: The AQAA told us the social care team known as Canaries have the responsibility for coordinating activities and social life for people living at the home. The social care team is led by a social care coordinator who has extensive experience in supporting people with dementia, learning disabilities and mental health needs. Assessments are made regularly of the well being and social profiles of people living at the home with the use of tools from recognised professional specialist bodies such as the Bradford Dementia Group and Jackie Pool Associates. Information gathered from these assessments allows for a large variety of activities and social events to be arranged that will interest people living at the home. A monthly programme of activities is Care Homes for Older People Page 15 of 29 Evidence: provided to everyone living at the home. Examples of activities include cooking, art and craft activities, trips out, reminiscence sessions, tea and parlour games and music activities. There is a member of the social care team on duty in each house Monday to Friday from 8.30am till at least 4.30pm. The coordinator told us they try to provide a service seven days a week and into the evening. The rota for the week of our visit detailed that for two evenings that week there was a social care worker on duty till 6.30pm and for two other evenings till 8pm, but unfortunately due to annual leave there were no social care workers rostered for the weekend. However it was explained to us that activities still happen at the weekend because all members of staff have received training and support to be be able to promote activities at the home and easy to use packs have been made so all staff members can facilitate activities with people living at the home. Whilst visiting the home we observed activities such as general quizzes, music activities and reminiscence about make and do in the war years were occurring across both of the houses. People joining in with these activities spoke of how much they enjoyed them and enjoyed the time to socialise with others living at the home. People living at the home told us there are always things happening at the home they can take part in if they wish. They gave examples of trips out to local pubs and gardens, cooking, sing a longs and craft activities and spoke enthusiastically about activities provided. They also told us if they make a suggestion about something they would like to do the social care team will try to provide them with that activity. Some people told us in surveys that because of their poor physical wellbeing they are unable to take part in activities arranged. We discussed this with staff members and the social care coordinator and looked at records belonging to people living at the home. It is evident that although some people might not join in with large group activities, whether this is from personal choice or physical wellbeing constraints, one to one activities take part every day with a member of the social care team visiting people in their own rooms, chatting with them, listening to music or partaking on other activities. Records are kept of all activities that people take part om whether group or individual activities and regular assessments are made about the persons wellbeing and their response to activities. From these assessments decisions between the individual and the social care team are made as whether to offer alternative activities. The AQAA told us there are no restrictions on the times people living at the home can receive visitors. This was confirmed in conversations that we had with people living at the home. The visitors record book detailed that people visit at varying times of the day. Throughout the visit people were observed being able to make decisions about their daily life, whether choosing to take part in activities, choosing the meal they want or Care Homes for Older People Page 16 of 29 Evidence: making choices about where to send their time whether to socialise in the communal areas or spend time in their own company in their private bedrooms. The work done by the social care team in developing informative social profiles, assessments of people living at the home and relevant training for staff has resulted in staff having a good understanding about how to facilitate people to make choices. This results in people living at the home being able to confidently exercise their choices. The home has developed a link resident scheme with the intention that this scheme will further promote choice for people living at the home. A number of people living at the home have been recruited to posts such as gardening, kitchen, activities, health and safety and recruitment link residents. With the support of the social care team the link residents for the various areas are able to represent the other people living at the home and influence management and running decisions regarding these area. During our visit we observed a meal time in one of the houses. It was explained by the social care coordinator that meal times are considered an important social event in the home. By the development of detailed social profiles the social care team encourage people to sit in groups where they believe common interests and backgrounds will promote the development of friendships. A member of the social care team is always on the dining room at meal times to facilitate conversations between people and to assist people who have difficulties with feeding themselves. During our visit we saw various sizes of groups sitting with each other ate the meal time taking part in general conversations. We noted a range of meals being provided at lunch time. These included home made meat pie and vegetables, a variety of salads, curry and rice, casserole and vegetables and fish and vegetables. All people we had conversations with told us they always have a choice of food at meal times and if there is something specific they wish to have it is generally provided. The social care team along with the link resident for the kitchen are in the process of revising the menus to ensure everybodys wishes regarding meals are incorporated into the plan. Example of requests for meals includes people living at the home asking to have rabbit on the menu which was provided and one person living at the home only likes to have fish and vegetables at meal times and this is always provided. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this 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 who live in the home are confident that complaints are taken seriously and responded to promptly. People who use the service are protected from the effects of abuse by a staff team that has a good understanding about safeguarding procedures. Evidence: The AQAA told us people who live in the home and their relatives are made aware of the complaints procedure by discussion during the initial assessment process, in documentation such as the residents guide and because the procedure is displayed in the home. People who live in the home told us in surveys that they know who address any concerns and complaints to and are confident that complaints will be responded to in a an appropriate manner. This was confirmed in conversations that we had with people living at the home during our visit. Staff told us in surveys they know how to respond to any complaints or concerns received. They said I would immediately try to resolve the issue and inform matron ( the registered manager) of the issue. They also told us if they were unable to resolve the problem they would immediately refer it to matron ( the registered manager) or whoever was in charge of the home at that particular time. The AQAA told us that the home has received five complaints in the last twelve months, four of which were responded to within the 28-day time scale. We have received two complaints about the service in the past twelve months which we had Care Homes for Older People Page 18 of 29 Evidence: referred to the registered persons to investigate using the homes complaints procedure. We looked at the complaints log book that included details about the two complaints we had referred for the home to investigate. There are clear details about all complaints received, the action taken to resolve the complaint and action taken as a result to prevent similar circumstances happening again. Examples of these include the addition to the complaint procedure that all correspondence to a complainant must be sent by registered post after complainant did not receive the response sent to him and changes being made to the Statement of Purpose after a complaint detailed that the description of the service provided was unclear in some aspects of clinical procedures available at the home The AQAA told us that all staff members have received training about safeguarding adult procedures and about the mental capacity act. Training records evidence that staff have undertaken this training. Discussion with staff evidenced they have a good understanding about different types of abuse and the action to take should they suspect abusive incidents have occurred. The manager also demonstrated in conversation a good understanding about safeguarding procedures. There have been no safeguarding referrals made in the past twelve months. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this 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 who use the service benefit from living in a safe and comfortable environment, which is suitably furnished and maintained. Evidence: As part of the inspection a tour was made of the environment looking at a sample of bedrooms, bathing facilities, all communal areas, the kitchen and the laundry. The decor of the home has been chosen with guidance from dementia care experts to promote ease for identifying areas of the home for people living there. Bedrooms are personalised to varying degrees with personal objects such as small items of furniture, pictures and ornaments. A shaft lift enables people to access all floors of both homes. There are sufficient bathing and toileting facilities for people living at the home. Policies and procedures are in place about hygiene practices and the control of infection. A team of housekeepers are responsible for the cleaning of the home. During our visit the home was observed to be clean and tidy with no offensive odours. People who live at the home told us in surveys the home is always clean and fresh. The homes laundering facilities are on the ground floor in house 72. The laundry is equipped with machines that are suitable for washing soiled items and there are dedicated laundry staff. The laundry floors and walls are easily cleanable, and the position of laundry and good laundry practices reduce the risks of cross infection for Care Homes for Older People Page 20 of 29 Evidence: dirty laundry. There are hand washing facilities in the toilets, bathrooms, laundry and kitchen. there are also hand disinfectant gel dispensers in communal areas of the home to enhance the infection control practices at the home. Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Excellent staff development and training provision ensure that people living at the home are cared and supported by a highly skilled and knowledgeable workforce in suitable numbers. Robust recruitment procedures mean that people living at the home are supported and cared for by staff suitable to work in the caring profession. Evidence: A staff rota displayed at the home details who and it what capacity, such as housekeeping, kitchen, care, social care staff is on duty at any one time. Surveys from staff and people living at the home told us there is usually sufficient staff on duty at any one time to meet the needs of people living at the home. Care staff tell us that with the introduction of the social care team they now have more time to spend supporting people living at the home with personal and health care needs as well as being able to make tine to sit and talk with people living at the home. Observation during our visit showed that care staff as well as the social care team have time to sit and talk with people living at the home and call bells were answered promptly indicating there was a sufficient number of staff on duty at that time. We looked at a sample of staff files. These evidenced good recruitment practices are followed ensuring that no one commences employment at the home prior to written references being received and CRB (Criminal Record Bureaux) and POVA ( Protection Care Homes for Older People Page 22 of 29 Evidence: of Vulnerable Adults list) information being obtained. These processes protect the welfare of those living at the home. Staff surveys confirmed that checks such as references and CRB were obtained prior to them commencing employment at the home. As part of the development of link residents, one person living at the home has volunteered to be part of the recruitment panel. This person has already taken part in the recruitment of a social care worker, during which support was provided by the social care coordinator. Staff records also contain copies of certificates for course attended and qualifications obtained. The manager maintains a training matrix that clearly identifies the training staff have had and what training they need to update. Structured training about the care of people with dementia is now provided to all staff working at the home. The home is not registered to admit people with dementia but the manager told us that many of the people living at the home develop some degree of memory problems or dementia type illnesses so she believes all staff must be equipped with the skills to recognise changes in a persons mental capabilities and have the skills and knowledge to provide care and support for them. Non care staff such housekeepers, kitchen staff and administrative staff also undertake training about dementia, health and safety, infection control and general care issues to help them understand the care environment they are working in. An administrative member of staff told us although I work on the administrative team I am still given training relating to the mental capacity act, moving and handling, dementia etc. This helps to understand the residents needs more and also to enable me to communicate with them. Staff receive training about how to provide meaningful activities for people living at the home. This means that there is always opportunity for people living in the home to engage in purposeful activities no matter who is on duty at the time. Staff told us that training is frequently provided and if they or the manager identifies a training need it is quickly provided. One carer told us he was provided with training about bereavement care when he had highlighted it a training need in a supervision session. During our visit to the home seventeen staff members were undertaking moving and handling up date training in two separate sessions. Staff told us in surveys that their induction programme covered what they needed to know to begin supporting and caring people at the home. The manager confirmed the induction programme complies with Skills for Care common induction standards. We saw a copy of the induction programme used by the home to confirm this. The AQAA told us that 81 of care staff have NVQ level 2 or above in care, with further staff undertaking NVQ in care studies. The duty rota for the week we did our visit detailed three care staff were attending NVQ training that week. Care Homes for Older People Page 23 of 29 Care Homes for Older People Page 24 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this 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 live in a home that is effectively managed to improve outcomes for them and involves people living at the home in the running of the home. Good health and safety practices protect all people at the home. Evidence: The registered manager has been in post for approximately twelve years. Her qualifications include NVQ level 5 in operational management and MSc in Gerontological practice and she regularly undertakes regular training to keep her skills up to date. For example she is planning to undertake as a minimum a diploma in dementia care in the next twelve months. She demonstrates a commitment to improve the service provided at the home to achieve improved outcomes for people living at the home. Examples of this include the investment and development of the social care team which means that people living at the home can lead a full and stimulating lifestyle, the provision of training structured to the needs of staff and the needs of people living at the home ensuring that all staff have the relevant skills and knowledge Care Homes for Older People Page 25 of 29 Evidence: to support people living at the home and the development of the Link Resident schemes. The home has a comprehensive quality assurance system in place, which includes the use of professional external organisations including ISO 9001 and Investors in People to assess their auditing processes. An inspection from both these organisations had taken place two days before our visit and the copy of the report that the manager showed us detiled many many positive aspects of the management of the home. Surveys are completed of people living in the home, their relatives and staff. The results of surveys are collated and used to plan improvement to address the issues raised. The development of link resident scheme has further introduced ways in which people living at the home can influence the running of the home. The manager reports that the homes directors visit two or three times each week and complete monthly reports on how the home is running and any actions they feel are necessary. The home looks after cash for some people, although no accounts are operated on peoples behalf. Accurate records are kpet of this money which means people liuving at the home can access their money when they want and know exactly how much money they have at any one time. The manager reported in the AQAA that regular checks and servicing are completed on the fire alarm and fire fighting equipment, electrical systems, portable electrical equipment, lifts, hoists and gas appliances. We looked at a sample of service certificates evidencing that services and equipment are maintained at manufacturers recommended intervals. This protects the wellbeing of all people at the home. We looked at the fire log book. This details that fire safety checks and staff training is carried out in line with Fire and Rescue Services regulations and that a comprehensive fire risk assessment is completed annually. Health and safety policies and procedures are in place. Staff records detail they receive training about all aspects of health and safety including moving and handling, fire safety, the control of substances hazardous to health, infection control and food hygiene for those handling food. Staff files evidence that each member of staff has an annual risk assessment completed regarding their working practices and the environment in which they work. Action such as training or the provision of equipment is taken to ensure their safety and the safety of the people they are caring for. Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 28 of 29 Helpline: 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 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. 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