Inspection on 04/11/08 for St Andrews Lodge Care Home

This inspection was carried out on 4th November 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

St Andrews Lodge Care Home 29/03/10

St Andrews Lodge Care Home 15/01/10

St Andrews Lodge Care Home 15/11/07

St Andrews Lodge Care Home 08/03/07

St Andrews Lodge Care Home 09/05/06

St Andrews Lodge Care Home 08/11/05

St Andrews Lodge Care Home 31/05/05

St Andrews Lodge Care Home 23/11/04

St Andrews Lodge Care Home 31/08/04

Similar services:

Trevayler Residential Care Home

Thornham Grove

Thistle Hill Hall

Conifer Lodge

Westwood Lodge

Egerton Lodge Care Home

Alfred Minto House Care Home

St Matthews Unit

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: St Andrews Lodge Care Home Riber Crescent Basford Nottingham NG5 1LP     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: Angela Starr     Date: 0 4 1 1 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 33 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 33 Information about the care home Name of care home: Address: St Andrews Lodge Care Home Riber Crescent Basford Nottingham NG5 1LP 01159245467 01159245485 slodge@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Timothy Mellors Type of registration: Number of places registered: Trinity Care Limited care home 80 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: No person falling under category MD(E) Mental Disorder older people over 65 years (excluding Learning Disability or Dementia) or DE(E) Dementia shall be admitted to St Andrews Lodge when there are already 80 persons of these categories/combined categories accommodated in the home The maximum number of persons to be accommodated within St Andrews Lodge is 80 To admit into St Andrews Lodge 10 service users aged between 50 - 65 years under category DE To admit into St Andrews Lodge one named service user aged 40 years under category DE To admit into St Andrews Lodge one named service user aged 45 years under category DE Date of last inspection Care Homes for Older People Page 4 of 33 Over 65 80 80 0 0 Brief description of the care home St. Andrews Lodge provides nursing care for 72 older people with Mental Illness and for those with Dementia. The registration allows for up to 10 people between the ages of 50- 65yrs to be accommodated. The purpose built home is split into two separate nursing units, Garden and Assisi, and a residential care unit, Robin. There are lounge and dining areas in each of the units which are comfortable and suitably furnished to cater for the people living there. There is a hairdressing salon in the home and the hairdresser visits twice a week. Sited in an established residential area the home has sufficient car parking and a well maintained garden. All areas of the home were accessible to service users. The fee range is from 339.39 pounds for residential care to 896.82 pounds per week, including the nurse determination fee. The Registration Certificate is prominently displayed in the entrance area of the home, together with copies of the Service User Guide, Statement of Purpose, the complaints procedure and daily menus. A copy of the last Key Inspection that took place on the 15th November 2007, can also be found in the entrance of the home and on the web site for the Commission for Social Care Inspection. Care Homes for Older People Page 5 of 33 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 focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for service users and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. We have introduced a new way of working with owners and managers. We ask them to fill in a questionnaire called an Annual Quality Assurance Assessment. This informs us about how well their service provides for the needs of the people who use it and how they intend to improve their service. We received this back from the manager within the time scale and the form was completed to a satisfactory standard. We used the information it gave us to assist with planning our visit. Care Homes for Older People Page 6 of 33 We also reviewed all the information we have received about the service since the last Key Inspection which took place on the 15th November 2007 and we considered this in planning the visit and deciding what areas to look at. The main method of Inspection we use is called case tracking which involves us selecting a number of people who use the service and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. We sent ten questionnaires called Have your say to some of the people who use the service, ten more to some relatives and a further ten to some members of staff. The responses recorded in these provided us with further evidence of the levels of satisfaction experienced by these groups of people. We spoke with five members of staff, three people who use the service and two relatives, to form an opinion about the quality of the service being provided. We read documents as part of this visit and medication was inspected to form an opinion about the health and safety of people who use the service. What the care home does well: The environment at St. Andrews has been developed in a manner that aids the orientation of the people who live there. Bedroom doors have numbers, door knockers and each is painted in a different colour to assist peoples memories. Corridors are named after Nottingham streets and have a variety of displays, such as shop fronts, flower boxes and bus stops. The hairdressing salon has a red and white striped barbers shop pole outside and pictures of hair dressing implements. The atmosphere at the home is warm and welcoming and the interaction between staff and people living at the home, is relaxed and friendly whilst remaining respectful. A relative told us The staff at St. Andrews look after and care for my relative very well. They are also there for me and anything I ask of them is always done. The care they give to us both is woderful. Another person said They care for relatives as well as the people who live there. They provide very good care and support and I have no complaints. A person living at the home told us I am very well cared for and so is my relative. The activities co-ordinators have developed an extensive range of suitable activities, based on the preferences and abilities of the people living at the home. People we spoke with told us that they enjoy going out and have recently had a bonfire and fireworks. One person told us I like the singers coming here. People experience a lifestyle that best matches their abilities, expectations and preferences. People are enabled wherever possible to make choices and maintain control over their lives. Staff we spoke with told us We always ask people what they want to eat or what they want to do. We talk to them whilst we work with them so that they know what to expect. People receive a balanced and wholesome diet in pleasant surroundings. A nutritional analysis tool is used when planning menus to ensure that people living at St Andrews receive their recommended daily requirements. People we spoke with told us that the food is very good. People are confident that any complaints will be taken seriously and the management and staff ensure people are safeguarded from harm. Peoples financial interests are safeguarded and wherever possible, they are involved in consultation about the running of the home. The health & safety of people living at the service and staff at the home, are promoted. Sufficient staff are employed on each shift, who have undertaken training to enable Care Homes for Older People Page 8 of 33 them to do their jobs. Recruitment practices are satisfactory and provide protection from harm and abuse for the people living at the service. St Andrews provides people with a clean, homely and generally well-maintained environment. What has improved since the last inspection? What they could do better: Equality and Diversity of people living at the service is valued and taken into consideration within many aspects of their daily lives, but continued development of person centred care planning is needed and must identify individual cultural and religious diversity. Further development of the satisfaction questionnaire to enable all the people who live at the service to effectively contribute their opinions and choices and have these taken into account when decisions are made that affect them. Care Homes for Older People Page 9 of 33 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 10 of 33 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 11 of 33 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. People who wish to live at the home have their needs fully assessed to ensure their needs can be met. People are given accurate and up to date information about the service to assist them in making a decsion about their choice of home. Evidence: The manager told us in the written information he provided, We have a very comprehensive Statement of Purpose and Service User Guide. These are available in all formats to aid communication and understanding. These documents are available for all new Service Users and anyone that comes to view the home. The Service User Guide contained useful information and was written in plain language. We saw copies of this and other relevant documents, including the Care Homes for Older People Page 12 of 33 Evidence: Statement of Purpose, Complaints Procedure and a copy of the last Key Inspection on display in the entrance of the home. People who consider moving to the home are given opportunities, with their relatives, to visit, have a meal and spend time in the home to assist them in making a decsion. They may also experience an overnight stay if they wish. One relative we spoke with told us I had all the information I needed about the home before I brought my relative here. I visited and looked round and the manager answered all my questions. The written information supplied by the manager tells us, A pre-admission assessment is completed for every person admitted to the service. This is a comprehensive document and includes all activities of daily living as well as physical and mental well being. It is completed by the manager or deputy manager and is developed in association with all relevant information that is available at the time. We looked at the care plan for the last person to be admitted to the home and saw the pre-admission assessment, a copy of the Social Work assessment and clear and detailed care plans covering all areas of need. The relevant risk assessments were also present. We looked at Care Plans for two other people living at the home and they also contained thorough and detailed information to enable staff to meet their identified needs. We sent questionnaires to some peoples relatives and asked them Did you get enough information about the home to help with your decision making? Replies included, Staff were very helpful. and My daughter and I were taken round the home by the manager and found it to be very clean and bright. The staff were friendly and caring. We were very pleased with our findings. Care Homes for Older People Page 13 of 33 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. Personal and healthcare needs are assessed and provided for in a way which shows respect for the privacy and dignity of people who live at the service whilst meeting their identified needs. Evidence: The manager told us in the written information he supplied to us Qualified and senior care staff have received training for care planning and care plans are evaluated monthly. Care plans include risk assessments for the prevention of falls and for other identified areas of risk. This information also told us that people living at the home have access to all necessary areas of health care. The files of the people we case tracked contained evidence of involvement of Doctors and other professionals as their services had been required. In the care plans we looked at there were records that staff were monitoring and Care Homes for Older People Page 14 of 33 Evidence: recording all changes in peoples health and calling for medical advice when needed. The care plans we looked at contained personal preference forms that had been used to identify peoples individual needs and wishes. These showed that people had been involved as much as possible in the care planning process and relatives we spoke with on the day of the Inspection told us that they had been consulted about their relatives needs. We saw that care plans had been reviewed monthly or as changes occured and the manager told us that they are audited on a random basis. The outcomes of the random evaluations are collated and stored separately. The manager showed these to us and explained that the information they provide is used to improve the service. A named nurse system is in place, giving staff clearly defined areas of responsibility. Care staff are allocated areas within the home where they work primarily, as opposed to key working with individual people. This is to make sure that there is always someone on a shift who knows the people who live in that particular area of the home. Night checks are recorded electronically and are linked to a central computer which inputs all the information about each person. Peoples night time care needs are assessed and monitored from this information and any changes that may be required are then put into the care plan. A member of staff demonstrated this system to us and told us It ensures that staff dont miss key tasks during the night and it provides accurate information for care planning. We sent ten questionnaires to relatives and carers of people living at the home. One of the questions asked was Do you feel that the home meets the needs of your relative? and of those returned to us, four said always and one said usually. One person commented Very well. We also sent ten questionnaires to people living at the home and asked Do you receive the medical support you need? The four that were returned to us all replied Always. Training records that we saw showed that all staff who administer medication have undergone training and this was up to date. Staff we spoke with explained that whilst they are doing the medication round, they wear a tabard which tells other staff members not to interrupt them. This is an aid to concentration and enables staff to focus on the task. We observed staff doing a medication round and looked at the records for the people we case tracked. These records all had a photograph of the person on them and were signed as soon as the medication had been given. Care Homes for Older People Page 15 of 33 Evidence: We looked at the storage for medication including the fridge and noted that the temperatures are checked regularly and were within the correct parameters. Controlled drugs are stored separately in a securely locked facility and the audit we did showed that the correct amounts of these drugs were present and all doses given, had double signatures. Care Homes for Older People Page 16 of 33 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 good 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 service experience a flexible lifestyle which is in accordance with their needs, abilities and preferences. Evidence: The written information provided to us by the manager said We have a wide and varied activity programme. We try to provide activities for people, based on choice, previous hobbies and their current abilities. There is a sensory room which is designed to provide stimulation for people who have limited communication or movement. We looked at the activities file and found that the range and scope of activities are well documented and a programme of activities was displayed in the reception area of the home. During the visit we observed the activity co-ordinator working with people on a one to one basis as well as in small groups. A relative we spoke with told us They always spend time with my relative on their own as they dont like joining in with others. Care Homes for Older People Page 17 of 33 Evidence: The questionnaires we sent to people asked Are there activities arranged that you can take part in? Two people said usually, one said always and the fourth said sometimes. We asked relatives Does the service support people to live the life they choose? Three people said Usually and two said Always. One person commented My relative cant really do much now but the activities staff spend time with them and talk with them. We observed the activities to be based around what is meaningful to each individual, for example, there are baskets placed in various locations around the home, containing a variety of objects for people to pick up, as they wish. We saw people walking around with items they had selected and interacting with other people and staff members. The home employs two full time activity co-ordinators who arrange activities on a daily basis. The structured activities are specific to the identified needs of the people living at the service and include, light therapy, pamper sessions, reminiscence, music, art and craft, baking, games and a variety of outings. One to one activities also take place and are tailored to meet specific needs. These include conversation, reading together, manicures etc, Entertainers are invited into the home every month and are very popular with residents and visitors. People we spoke with told us how much they enjoy listening to the singers and joining in. One person said I like the singers. They have recently had a bonfire and fish and Chip supper. People go on outings to the local pub and have recently been to the Goose Fair. Birthdays are celebrated and each month, a buffet tea is provided for all the people who have had their birthday that month. We observed people having lunch and staff were supporting people with eating and drinking in a discreet and respectful manner. A relative told us I often stay for my lunch. People we spoke with told us that they enjoy the food and have plenty to eat. Choices are offered in a variety of ways to suit peoples decsion making ability. Care Homes for Older People Page 18 of 33 Evidence: Relatives we spoke with told us that they visit the home at any time and are always made welcome. One person said that they visit their relative every morning and sometimes stay for lunch. This person told us that they used to take their relative out as much as possible but now find it too difficult. Our questionnaire asked Does the care home help your friend or relative to keep in touch with you? All five that were returned said Always and one comment said Very good. Relatives we spoke with told us that they are invited to join their loved ones for meals and also to join in activities. I came to the bonfire and enjoyed myself very much. We observed staff interacting with people and the atmosphere was cheerful. People were asked what they would like to eat and drink and assistance was offered in a discreet and respectful manner. Care Homes for Older People Page 19 of 33 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 know how to complain and are confident that any concerns would be acted upon and responded to. The people living at the service are safeguarded from harm and abuse. Evidence: The manager told us in the written information he supplied, All complaints are recorded and responded to within 28 days. The manager and all senior care staff are very approachable and will ensure complaints are dealt with quickly and efficiently. We saw the complaints procedure on display in the entrance foyer of the home. It was produced in a suitable format and clearly explained the process. It is also included in the Service User Guide. The manager also told us We have a log for recording complaints and all relating documents are maintained in this file. We looked at the complaints log and saw that three complaints had been entered since the last Key Inspection. Two were about medication issues and there was a clear record of the subsequent investigation and resolution. The third was about a persons diet and again, clear recording showed us that this had been thoroughly investigated and the outcome was that it was unsubstantiated. Care Homes for Older People Page 20 of 33 Evidence: The written information provided told us We complete monthly audits of complaints and evaluate the results in order to improve our service. All staff have received training in Safeguarding Adults and Whistle Blowing. Since the last Key Inspection three Safeguarding Alerts have been made to the local authority. These have been investigated and concluded in a satisfactory manner. Safeguarding Adults is a process of identifying and reporting suspected or potential abuse of vulnerable people and provides a framework of consistency to protect those individuals who are at risk. Whistle Blowing is a means for staff to feel supported to report anything of concern that they may witness. The five staff we spoke with all demonstrated a clear understanding of both Safeguarding Adults and Whistle Blowing. The training matrix confirmed that all staff have received this training within the last year. We sent out questionnaires to some people living at the home. We asked Do you know how to make a complaint? Of the four that were returned, three said Yes and one said No. We also sent questionnaires to relatives and of the five returned, all said Yes. We also asked relatives Has the care service responded appropriatley if you or the person using the service has raised concerns about their care? Three said Always and two said Usually. We spoke with a relative who told us I would not hesitate to complain if I needed to and I am confident that my views would be listened to and acted upon. Since the last Key Inspection, we have received one complaint. We saw that this had been satisfactorily resolved and the outcome had been shared with the complainant. Care Homes for Older People Page 21 of 33 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 live in a clean, safe and comfortable home which is well maintained and designed to meet their needs. Evidence: The written information provided to us by the manager told us St. Andrews has a stimulating environment which is achieved in part by the use of murals on walls depicting different scenes. All the bathrooms have different calming murals which are generally of a water scene. This has been found to encourage some people to communicate verbally with staff in a relaxed manner, whilst bathing. We completed a partial tour of the home and found all areas to be clean, hygienic and warm. We observed that the home is light and airy and is decorated in a manner to aid orientation of the people living there. An example is the hairdressing salon, which has a striped barbers pole outside. Bedroom doors are painted different colours and each has a door knocker fitted. People we spoke with told us that they like the way the corridors are painted and they find it easy to recognise their own bedrooms. Care Homes for Older People Page 22 of 33 Evidence: We saw that the laundry was well organised and is in operation every day, run by staff who are employed solely to undertake this work. People we spoke with told us that they are happy with the laundry provision and on the rare occasions things are lost, the manager replaces them or refunds money to cover the purchasing of a replacement. The laundry staff ensure that garments are clearly labelled with peoples names in order to avoid loss. A relative told us My relatives coat was missing and could not be found. The manager gave me the money for a replacement straight away. The dining rooms had murals depicting cafe scenes and were set out in a way that allows staff to assist people with eating in a discreet manner. We observed people having lunch and being assisted where necessary. Staff were offering this support in a calm and relaxed manner enabling the person to enjoy their meal. We looked at some bedrooms and saw that people had their personal belongings with them, including items of furniture and photographs. Most of the rooms had electric profile beds which are designed for comfort and accessibility and have integral wooden rails that may be used for reasons of safety. A maintenance person is employed on a full time basis and all his tasks are recorded electronically. He checks all equipment monthly and enters the information into a system which then prompts the next task and helps to eliminate oversight of routine tasks. We looked at the communication log for staff to record any problems they may identify and saw that this is checked daily by the maintenance person who undertakes any tasks required and signs when they have been completed. Staff we spoke with confirmed that they use this communication log and any requested tasks are dealt with as quickly as possible. In our questionnaires, we asked people Is the home clean and fresh? Of the four returned to us, three said Always and one said Usually. The information provided by the manager told us, All staff within the building work very hard to provide a well maintained, clean, comfortable and homely environment for the people that live at the home. Care Homes for Older People Page 23 of 33 Evidence: One person we spoke with said Its lovely I like my bedroom and my beds comfy Care Homes for Older People Page 24 of 33 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported and protected from harm by well trained staff in sufficient numbers to meet their needs. Evidence: The written information provided by the manager tells us, We have a thorough recruitment procedure and all staff have two references, a satisfactory Criminal Record Bureau and Protection of Vulnerable Adults check in place. Our staff group varies in age and experience providing a balanced work force. We always ensure there are enough staff on shift to meet the needs of the residents. We have a very comprehensive training programme and offer training which is specific to the needs of the people who live at the home. All staff receive regular supervision and annual appraisal. We saw the training records of three members of staff and this showed us that they have undertaken a variety of training, which enables them to meet the needs of the people who live at St Andrews, in an appropriate and safe manner. This training includes, moving and handling, dementia awareness, food hygiene and fire safety as well as more specialist areas such as pressure area care and infection Care Homes for Older People Page 25 of 33 Evidence: control. Appropriate training has also been provided for staff who administer medication and those who are responsible for developing care plans. The training matrix that we saw showed that all the staff have access to a wide variety of training and that mandatory training is up to date. This record also shows us that over seventy per cent of the staff have achieved National Vocational Qualifications. We spoke with five members of staff, including an activities co-ordinator and a person employed as a domestic. All said that they had a formal interview and all the necessary checks were in place before they commenced work. The staff files we saw contained all the evidence to support this. Staff we spoke with all confirmed that they have regular supervision and feel that it is a useful and supportive process. We asked them Do you think the people living here are safe?. All said Yes and when asked about Safeguarding Adults, were able to demonstrate a good understanding of this. They all said that they feel the home is well run. We observed a medication round being done and there were sufficient numbers of staff on duty to allow the person to complete the round without interruption. In the questionnaires we sent out to relatives, we asked, Do the staff have the right skills and experience to look after people properly? Of the five that were returned, three said Always and two said Usually. One person told us, The staff at St. Andrews look after and care for my relative very well and are always there for me. Anything I ask of them is always done and the care they give to us both is wonderful. The questionnaires sent to people living at the home asked, Do the staff listen and act on what you say? All replied Yes. We also asked, Are the staff available when you need them? and all replied Always. The home is divided into three areas, Garden, Assisi and Robin. We observed people being supported in a relaxed and unhurried manner, indicating that there are sufficient numbers of staff employed in these areas to meet the needs of the people living there. Staff we spoke with told us that they would benefit from having more staff on duty because they would be able to spend more time with individual people, but they confirmed that there are enough people to meet everyones needs. Care Homes for Older People Page 26 of 33 Evidence: Relatives told us The staff are great. There is always someone around to help you. There is an activities co-ordinator every day and a maintenance person is employed on a full time basis. Care Homes for Older People Page 27 of 33 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. The home is well managed and is being run in the best interests of the people who live there. Evidence: The Annual Quality Assurance Assessment was completed in a satisfactory manner and was returned to us within the required timescale. It told us that St. Andrews benefits from having an experienced manager who has achieved the registered managers award. The manager is full time in the role and has two deputies, allowing managerial cover every day and enabling the manager to concentrate on areas of the service that require oversight and improvement. There is administrative support and a receptionist is employed on a part time basis to assist with the day to day operations of the home. Care Homes for Older People Page 28 of 33 Evidence: The Annual Quality Assurance Assessment tells us that the manager is responsible for carrying out monthly audits in a number of areas including Health and Safety. This is part of an in house Quality Monitoring system which looks at each area of the service in relation to the standards as set down in the National Minimum Standards. We looked at the audits completed by the manager in relation to medication, Health and Safety, Care Planning and admissions to the home. These were comprehensive and informative, and indicated to us that the manager is well informed about the service that is being provided to people. The audits we looked at regarding the health, safety and welfare of people living at the home provided us with evidence that the management promote this and protect people. Health and Safety is also promoted through staff training and the training matrix showed us that all the staff employed at the home have completed this within the last year. The audits completed by the manager are part of the quality monitoring system which is in place. This is further supported by information provided by people living at the home, their relatives and staff who complete questionnaires. These are then evaluated and issues that are identified are looked at and remedied where possible. The documentation shown to us by the manager was comprehensive and clearly showed that peoples opinions and comments are considered and taken into account, enabling the home to run in the best interests of the people who live there. In the questionnaires sent to relatives we asked, What do you feel the care home does well? One person said They care for the relatives with love and support, as well as the people living there. When asked How do you think the care home can improve? a person told us This is a good home and in my opinion needs little improvement. Relatives we spoke with told us they attend regular meeting and feel well informed about issues relating to the home. People living at the service also said they can attend meetings but some choose not to. The staff we spoke with told us that they feel well supported by the manager and deputies, they have regular staff meetings and feel encouraged to attend and take part in any discussions. They also told us that they believe the home is well run and the people who live there are safe. We looked at the arrangements for handling peoples monies and found the records to be well maintained and accurate. Care Homes for Older People Page 29 of 33 Care Homes for Older People Page 30 of 33 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 31 of 33 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 32 of 33 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. 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. Care Homes for Older People Page 33 of 33 - 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!