Inspection on 27/07/06 for St Omer

This inspection was carried out on 27th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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 Omer 16/02/06

St Omer 27/09/05

St Omer 18/02/05

St Omer 12/10/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE St Omer Greenway Road Chelston Torquay Devon TQ2 6JE Lead Inspector Judy Cooper Unannounced Inspection 27th July 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address St Omer DS0000045297.V295329.R02.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. St Omer DS0000045297.V295329.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Omer Address Greenway Road Chelston Torquay Devon TQ2 6JE 01803 605336 01803 690733 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Ian Day Joanna Petrina Day Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places St Omer DS0000045297.V295329.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Two service users (named elsewhere) who are within the category DE(E) may be accommodated. 16th February 2006 Date of last inspection Brief Description of the Service: St Omer is a large detached Victorian house in a quiet residential area, registered to provide care to people aged 65 or over. The communal rooms are spacious and comfortable. Some redesigning of the home’s accommodation has resulted in there now being a large lounge and a second smaller quiet lounge. The home’s dining room has been resited within the existing conservatory. All but two of the current bedrooms are single rooms, and the majority have en suite toilet facilities. There are good views of the bay from many of the homes windows. The front door is accessed up a few steps, but there are other entrances providing level access into the home. The home has been equipped with a new shaft passenger lift and provides other disability aids, including two assisted bathrooms and a large shower room. There is a sun terrace and large, attractive gardens and parking for several cars. As part of a planned major upgrading programme, an additional extension to the home has recently been completed, which has provided four additional bedrooms, each with en suite facilities. All rooms have been completed and furnished to a high standard. An additional newly built, well equipped laundry room has also been provided within the grounds of the home, whilst a new, large wooden decked area, which is easily accessible from the newly resited dining room, has now been completed and provided with substantial outdoor furniture, which therefore allows residents an additional very pleasant, level outdoor area to sit outside on. St Omer DS0000045297.V295329.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on Thursday 27th July between 10.00a.m and 5.00p.m and on Thursday 3rd August between 10.00a.m and 2.30 p.m. Opportunity was taken to look at the general overall care given to all residents. The care provided for four residents was also followed in specific detail, from the time they were admitted to the home, which involved checking that all elements of their identified care needs were being met appropriately. A tour the premises, including the recently completed new extension, examination of some records and policies, discussions with the owners, the newly appointed manager (on the second day of the inspection), residents and staff, as well as several visitors to the home, also formed part of this inspection, whilst staff on duty were observed, in the course of undertaking their daily duties. Other information about the home, including the receipt of several completed questionnaires from residents, staff and other interested parties, has provided further feedback as to how the home performs, and all of this collated information has been used in the writing of this report. All required core standards were inspected during the course of this inspection. What the service does well: The residents remain very complimentary about the services and care, which they receive and particularly about the helpful attitude of the staff. St Omer provides a comfortable, secure and caring environment, where residents’ individuality is encouraged and upheld. Basic residents’ rights, such as dignity, respect and privacy are also firmly upheld which was confirmed by the residents themselves. St Omer DS0000045297.V295329.R02.S.doc Version 5.2 Page 6 A good range of appropriate activities and entertainment continues to be offered, which residents decide for themselves whether or not to take part in. A high standard of meals are provided. The owners have continually endeavoured to raise the environmental standards of the home since taking over ownership three years ago and this has resulted in the home providing an attractive and very pleasant environment for the residents to live in. The new, previously described, extension to the home has been completed to a high standard and the owners have ongoing plans to continue to further raise the environmental standards, ensuring that the home provides the very best accommodation for the residents. To this end new lounge furniture has been provided over the past twelve months and the ground floor of the existing extension has been redecorated. A new communal bathroom has been created on the first floor, which also incorporates a new airing cupboard. A new heating system has been installed on the first floor, comprising of three new boilers, which will allow for more consistent heating throughout the building. Additional window restrictors have been put in place to further protect residents. The now redundant chair lift (due to the installation of a passenger lift), sited on the main stairs within the home, is to be removed therefore allowing more room on the stairs There are also further plans to replace the large front sea facing windows with new double glazed units The staff team are very well trained, work well together as a team and are very able to meet the needs of the residents. The residents themselves confirmed that they feel valued and are able to easily to approach the owners and staff regarding any matter. The owners continually monitor the quality of care given within the home and quickly addresses any areas that they feel can be improved upon to enhance residents’ lives. This home maintains very good standards of care, overall, with the two outstanding requirements from the last inspection now met and only one recommendation made following this inspection. St Omer DS0000045297.V295329.R02.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. St Omer DS0000045297.V295329.R02.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection St Omer DS0000045297.V295329.R02.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (6 is not applicable to this home) The quality in this outcome area is good. The admission process is managed appropriately with residents having had their needs assessed prior to admission. Residents and/or their next of kin/advocate are given the necessary information regarding the service so that they can make an informed decision. EVIDENCE: Since the last inspection the home has admitted some new residents. One such resident’s admission process was looked at in detail, along with the details for one other resident who had been admitted within the past twelve months, one who was admitted many years ago and one who had frequent respite stays within the home. All of these residents were spoken with during the inspection (as well as a relative of one of the residents) to ascertain their thoughts as to the admission process and the subsequent care provided. St Omer DS0000045297.V295329.R02.S.doc Version 5.2 Page 10 Two of the recent admissions to the home were able to confirm that their admissions had been undertaken in such a manner as to allow them and/or their relatives, who were choosing a home on their behalf, to be aware of what services the home could offer. The relative of the third resident also confirmed this to be the case and the fourth resident confirmed that their needs had been and continued to be met since their admission many years ago. The owner had visited one of the residents prior to admission to the home, another had come initially for a respite stay and had then decided to stay and another had been in the home for many years (prior to the owners taking over). The respite resident lives locally and often takes advantage of a respite break along with some day care, however it was pleasing to note that there were also full details as to the care that this resident would need. A very comprehensive initial assessment of need had been undertaken for each resident from which a care plan had later been drawn up. The owners have recently introduced an enhanced assessment procedure which ensures all aspects of care are discussed prior to admission to allow the owners and management to be fully aware of all of the prospective residents’ needs prior to admission. Again it was pleasing to note that, where possible, the residents and/or their advocate had been invited to be fully involved in the assessment process/care planning processes as well as the on going review process. The residents and/or their families had also been given access to necessary information including the home’s statement of purpose and service user guide, with one resident noted reading this document during the inspection. All residents are provided with a copy of the home’s own contract even if they are initially admitted with a Social Services contract and it was pleasing to not that this had been extended to those residents who had been at the home for many years. This is to ensure that all residents are aware of their rights and know what services they can expect during their stay at the home. The home does not provide intermediate care. St Omer DS0000045297.V295329.R02.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The quality in this outcome area is excellent. Residents are looked after well in respect of their health and personal care needs. Residents’ privacy and dignity is upheld and their life style choices are respected. EVIDENCE: The care plans of the four residents whose care was looked at in detail were inspected. These were very thorough and covered all required care needs as well as social and psychological needs. In each case a manual handling assessment, pressure area assessment, nutrition assessment and a general risk assessment had also been undertaken in addition to the generic care plan. Specific information relating to each resident was easily available, for example one resident was noted as being allergic to egg whites and kiwi fruit. Residents, where possible, had been fully involved in the drawing up of their care plan and continued to be involved in the regular monthly review process, signing to agree with any newly introduced measures to meet their needs. For some other residents, relatives had taken on this role. St Omer DS0000045297.V295329.R02.S.doc Version 5.2 Page 12 In all cases the management could demonstrate that they involved both residents and/or families in the drawing up and the following through of the care plans. The residents’ health care needs were being fully met, including any specialist needs. Other professionals are also asked for advice as required and there were detailed notes of any other professional intervention, contained within the individual resident’s record, of G.P and District Nurse visits. Medications were stored appropriately with a medical fridge also provided for the storage of insulin or eye drops. The administration of medication is well managed with the involved staff maintaining good records, which were seen to be up to date and with medications being only administered by experienced trained staff. Medication polices were relevant and detailed and available to all staff who have responsibility for the administration of the same. The administration of the lunchtime medication was seen during the inspection and noted to be in order. A monthly audit of medication is undertaken by the management of the home to fully ensure safe practices continue within the home, therefore protecting residents. It is envisaged that the newly appointed manager, being a registered nurse, will further review the home’s medication system to see if any further improvements can be made. During the inspection it was noted that she and the home’s senior carer were in the process of re-ordering next month’s medication and were noted as being thorough and conscientious. Residents’ individuality and dignity were seen as being upheld and all residents, spoken to confirmed this to be the case, stating that staff were kind, caring and treated them with respect and understanding. An example of this involved one of the owners, during the tour of the building, indicating that one resident had hearing problems and ensuring that the resident was made fully aware of why there was to be a visit from the inspector, another involved a staff member sensitively helping a resident with feeding, only after having ensured the resident wanted this help. The other owner also ensured that another resident’s dignity was upheld, by quietly explaining to a resident why the inspector was visiting the home and ensuring that the resident was prepared to see the inspector. All bedrooms, occupied, are currently being used for single occupancy. St Omer DS0000045297.V295329.R02.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 The quality in this outcome area is excellent. Residents enjoy a peaceful, pleasant yet varied life at the home, with visitors welcomed and encouraged. Various regular informal activities are made available to help vary residents’ life at the home. Good meals continue to be provided. EVIDENCE: All residents spoken with stated that they were happy at St Omer and enjoyed living there. There is a regular programme of activities, which is displayed on the notice board. Twice a week a retired member of staff undertakes activities with residents. One day involves her working with several residents on an individual basis and the other day involves her organising a group activity. A senior carer undertakes an arts and craft session on a Friday. Other activities include a weekly exercise session, bingo, games, word games/quiz, and a “pamper” afternoon (e.g. manicure). On the first day of the inspection a quiz was being held. St Omer DS0000045297.V295329.R02.S.doc Version 5.2 Page 14 It was also noted that there is soon to be a garden party with details advertised on the homes’ notice board. Visitors are free to come and go as they wish to with the home having a visitor’s book with many entries on different days at different times. During the second day of the inspection several visitors were spoken with and all confirmed that they were made very welcome and felt they were able to visit whenever they wished, an example of the positive comments received was: “my mother receives excellent care she is safe and I have confidence in the people here”. There are regular visits from different churches, which residents can choose to be involved with if they wish. Professional musical entertainment is provided from time to time. There are also occasional trips out for groups of residents. The last recent one involved a boat trip that had been very much enjoyed by all who had participated. It was noted that the owners have sited a notice board near the entrance of the home which contains much useful information such as the St Omer news letter, NHS guide to coping in the heat, taxi numbers and other general useful information, names and addresses. Residents are able to choose how they spend their time and some choose their own company whilst others enjoy more communal living. A comment received that reflects this was “ I like my own company so don’t usually join in but can if I want”. Others stated “I’m just happy living here, I feel at home”, “ St Omer is a nice comfortable home with good food” and “I wouldn’t leave here for any amount of money!!” All of the residents consulted remain very complimentary about the standard of the meals provided, “the food is good, just like home cooking”, and the menus seen were varied with the home’s cook being totally responsible for the menus and ordering of the food. The lunch on the both days of the inspection were very appetising with the first day being beef in a red wine sauce, potatoes and sweet corn followed by home made Bakewell tart and the second day being roast beef with all the trimmings followed by fruit trifle. Special dietary needs were being met which was confirmed by the home’s weekend/relief cook who was cooking on the first day of the inspection, and the full time cook spoken with on the second day of the inspection, both of whom who has been at the home for over two years and are fully aware of the individual residents’ likes and dislikes. It was lovely to hear that the fruit and vegetables planted within the home’s gardens are being used for some meals with residents having had fresh peas form the garden on the Sunday prior to the first day of inspection. St Omer DS0000045297.V295329.R02.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The quality in this outcome area is good. Arrangements for protecting residents and responding to their concerns are satisfactory. EVIDENCE: There is a satisfactory complaints procedure, which is included in the residents’ guide, a copy of which is given to each resident. All of the residents consulted said they were confident that the home owners and/or the staff would do their best to resolve any complaint and that they would feel confident approaching the owners with any concern. The owners have recently dealt with a concern, raised since the last inspection, by an outside professional, in a thorough and professional manner with the concerns fully investigated and any necessary action put in place which has now been resolved to everyone’s satisfaction. The owners kept in contact with the Commission regarding the issue, which ensured that the Commission were fully aware of all details and action taken to help resolve the issue. St Omer DS0000045297.V295329.R02.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 The quality in this outcome area is good. Additional upgrading of the home’s environment has resulted in St Omer presenting as very comfortable, clean and well maintained whilst providing a safe standard of accommodation for the residents. EVIDENCE: The tour of the home confirmed that an extensive upgrading programme of the home continues to take place. Some redesigning of the home’s accommodation has resulted in there now being a large communal lounge as well as a large second quiet lounge. The home’s dining room has been resited within the conservatory, which residents stated they liked and staff felt was more appropriate as there was more room between tables. All but two of the bedrooms are single rooms, and the majority have en suite toilet facilities. All are currently being used for single occupancy St Omer DS0000045297.V295329.R02.S.doc Version 5.2 Page 17 There are excellent views of the bay from many of the homes windows and many rooms on the ground floor have French windows. The home is now equipped with a new shaft passenger lift whilst other disability aids, including two assisted bathrooms and a large shower room are also available to aid those with mobility problems. There is a sun terrace, a new wooden decked area and large, very attractive gardens for residents’ use. The new extension to the home, of four additional en-suite bedrooms, has been completed to a high standard and the owners have ongoing plans to continue to further raise the environmental standards, ensuring that the home provides the very best accommodation for the residents. The owners are currently waiting for the final building completion certificate, following some discussions with the local fire and rescue service in connection with the home’s fire external escape being completed to the required standard. Residents’ bedrooms throughout the home have been personalised as desired and residents bring in personal items with them if they wish to. The owners stated that the home would provide a suitable lock, if requested by a resident, although they are not always provided as standard on admission (except in the recently created extension). New lounge furniture has been provided over the past twelve months and the ground floor of the already existing extension has been redecorated. A new communal bathroom has been created on the first floor, which also incorporates a new airing cupboard. A new heating system, consisting of three boilers, has been installed on the first floor, which will allow for more consistent heating throughout the building. Additional window restrictors have been put in place on the first floor. The now redundant chair lift (due to the installation of a passenger lift) sited on the main stairs within the home is soon to be removed. There are also plans to replace the large front sea facing windows with double glazed units The lounge and dining areas provide adequate communal space and are well appointed and were being well used during the days of the inspection. The owners are maintaining the day to day home’s fire precautions in line with the requirements of the local fire department with the home’s fire records seen. The fire department last visited on the 22/04/05 and the home was noted, at this point, as complying with the requirements of the fire department. The home presented, overall, as clean, bright, welcoming and pleasant. The home maintains suitable infection control measures, including necessary staff training, which protects residents from the spread of any infections. On the second day of the inspection it was noted that a new dispenser of hand gel disinfectant had been provided at the entrance to the home for use by visitors to the home to help protect both residents and visitors. All staff also carry individual disinfectant hand gel dispensers. An additional newly built well equipped laundry room has also been provided within the grounds of the home, which provides laundry equipment that is fully able to meet the needs of the residents at the home. St Omer DS0000045297.V295329.R02.S.doc Version 5.2 Page 18 St Omer DS0000045297.V295329.R02.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 The quality in this outcome area is good. The home’s recruitment programme is in order and protects residents by the appointment of suitable staff. Staff at the home are well trained and supported, and employed in sufficient numbers to meet the residents’ needs at all times. EVIDENCE: On the day of inspection there were twenty-three residents in the home. Staffing rotas inspected evidenced that there are sufficient staff on duty to care for the residents at all times and it was noted that staff had sufficient time to spend with the residents. There are four carers on duty each morning, afternoon and evening/night until 10.00p.m when there are two carers until 11.00p.m. From 11.00p.m. until 6.00a.m there is one carer and one sleep in staff member until 6.00am when there are two waking staff on duty. At 8.00am it reverts to 4 staff on duty. Additionally there is a daily home’s cook, daily cleaner and the management of the home are also additional to the care staff numbers. Staff spoken to felt that there were adequate staff numbers employed to allow them to both care and spend social time with residents. All residents, spoken to confirmed that the staff care for them well and respect their dignity and privacy. St Omer DS0000045297.V295329.R02.S.doc Version 5.2 Page 20 Resident feedback contained such comments as: “staff are friendly and helpful”, “I can tell them anything”, “When I am upset they always come to help me” and “they always come when I call”. Training is provided regularly by an employee of the home who has responsibility for training and who provides regular statutory training such as moving and handling, protection of vulnerable adults, food hygiene and a specific course designed to raise the staffs’ awareness and understanding generally regarding the issues surrounding the needs of the elderly. Staff confirmed that they have received this training and that they have additionally either undertaken NVQ training or were in the process of doing so. Currently seven staff members have achieved NVQ level three in care and five staff members are working towards NVQ level two in care. Induction training takes place for any new staff member. This level of training ensures that staff are both appropriately trained and consequently able to provide suitable care for the residents at the home. Staff on duty were spoken with and it was evident that they took pride in their role and felt that ensuring residents had a good quality of life, irrespective of need or diversity, was the most important part of their role. The staff felt they worked well together as a team and were all there to provide the best care possible for the residents. The home maintains a mostly stable staff group. Changes that have occurred have been mostly on the night shift. This overall staff stability allows residents to feel secure and confident of the carers’ ability to care for them in respect of the fact that the residents are aware that the staff are familiar with their needs. Since the last inspection the owner has appointed four new staff members. All of these staff records were inspected and it was noted that an adequate recruitment programme had been carried out which had included the receipt of an application form, at least one written reference each (with verbal ones received in respect of the second with written ones due to follow) and in two instances the receipt of an enhanced CRB disclosure (the other two were in the process of being obtained, as the two staff members concerned were from overseas and the owners had not been able to apply for their CRB disclosure until the two staff members had got a permanent address in the U.K). These staff files did however, have all relevant documents from the staff member’s country of origin and both of the staff members, along with other staff on duty, were spoken with during the inspection. From these conversations and from discussion with the residents it was evidenced that all staff, including the newly appointed staff, were considered to be kind and caring. Other staff members were also able to confirm that they had undergone a full and robust selection process. One of the care staff members appointed is currently under the recommended age of eighteen, however it has been agreed by the CSCI that, due to her past experience of caring and the fact that the owners will support her in her role and with her training towards achieving her NVQ level two in care, that this carer can continue in her caring role. St Omer DS0000045297.V295329.R02.S.doc Version 5.2 Page 21 St Omer DS0000045297.V295329.R02.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 The quality in this outcome area is good. The management of the home provides the necessary support to staff and residents to ensure the home is well run and managed. Excellent quality auditing takes place to ensure that the home is run in the best interests of the residents. The home provides a safe, secure environment where residents’ safety and well being is maintained. EVIDENCE: The newly appointed manager is a qualified Registered General Nurse with previous experience of working with the elderly. She has only recently commenced at the home on July 17th 2006 but is already liked by both staff and residents. St Omer DS0000045297.V295329.R02.S.doc Version 5.2 Page 23 During the second day of the inspection her professionalism in dealing with a visiting G.P was noted, as was her quiet and gentle approach to residents. Records inspected were up to date, concise and contained appropriate information. The residents or the residents’ families/advocates mostly deal with any financial matter although the home does hold small amounts as requested by residents or their families. There were detailed records in respect of these. The owner has developed a structured quality management system, which incorporates audits at weekly, monthly, quarterly and annual intervals. Regular meetings continue with the residents, staff (separate for night staff) and management, with minutes of these meetings available. The results of this quality auditing is then used to inform the owners as to how best the home can further improve its service to residents in general. Comments noted from this years in-house questionnaires include: “Staff do a first rate job”, “I can’t find a thing wrong”, “The new lift is great”, “and the new dining room is good”. There is both a development plan for the home for 2006 and another for how the owners intend for the service to develop. Staff spoken to confirmed that they felt very comfortable approaching the owners for any support and that the new manager also seemed knowledgeable and approachable. Staff also confirmed that the owners are available daily in the home and “oncall” at other times. The owners stated that they had begun to build up a good relationship with the new manager and between them were looking at ways of further enhancing the general day to day running of the home to ensure it continues to be run in the best interests of the residents. General discussion took place, at the inspection, in respect of the owners considering applying for the category that will allow the home to care for those residents that may be experiencing age related confusion/memory loss. The home has previously been granted two individual exemptions in respect of caring for two residents already falling into this category. The owners will now gather information that will allow them to present an application to provide care for more such residents in the future. Residents’ health and safety continues to be maintained within the home to a satisfactory level and the owners comply with required health and safety legislation as necessary. St Omer DS0000045297.V295329.R02.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 4 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 4 x 3 x x 3 St Omer DS0000045297.V295329.R02.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP31 Good Practice Recommendations Additional training should be provided for the newly registered manager to ensure she meets the qualifications required. This includes obtaining an NVQ level four in management. St Omer DS0000045297.V295329.R02.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI St Omer DS0000045297.V295329.R02.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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