Inspection on 12/08/08 for Stildon Brendoncare

This inspection was carried out on 12th August 2008.

CSCI found this care home to be providing an Adequate 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

Stildon Brendoncare 05/06/06

Stildon Brendoncare 19/01/06

Stildon Brendoncare 26/08/05

Stildon Brendoncare 07/12/04

Stildon Brendoncare 27/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Stildon Brendoncare Dorset Avenue East Grinstead West Sussex RH19 1PZ Lead Inspector Ed McLeod Unannounced Inspection 12th August 2008 09:30 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 Stildon Brendoncare DS0000014746.V369319.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Stildon Brendoncare DS0000014746.V369319.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stildon Brendoncare Address Dorset Avenue East Grinstead West Sussex RH19 1PZ 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) 01342 305750 01342 305758 rblatcher@brendoncare.org.uk www.brendoncare.org.uk The Brendoncare Foundation Mrs Rita Beryl Blatcher Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (0) of places Stildon Brendoncare DS0000014746.V369319.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home with Nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Old age, not falling within any other category - (OP) The maximum number of service users to be accommodated is 32. Date of last inspection 5th June 2006 Brief Description of the Service: Stildon Brendoncare is a purpose built home providing personal care and nursing care for thirty-two persons over the age of sixty-five years but has a variation to enable the admission of the following: Old age not falling within any other category (32) Physical disability (4) Physical disability over 65 years of age (4) Dementia (4) Dementia over 65 years of age (4). The accommodation comprises of thirty-two single rooms all with en-suite facilities. The accommodation is arranged on two floors each having a sitting room, dining room and two large bathrooms. The home is located within a short distance of East Grinstead town centre with its shops and leisure facilities. The home is owned by The Brendoncare Foundation for whom the responsible individual is Mr Ronald Staker. The registered manager is Mrs Rita Beryl Blatcher. The range of fees is £805 to £980 per week. Stildon Brendoncare DS0000014746.V369319.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The inspection visit was carried out by one inspector and was arranged to follow up the requirement made at the previous visit, and to assist us in assessing the home’s compliance with the key standards of the national minimum standards for care homes for older people. Planning for the visit took into account information received on the service since our previous visit, including the annual CSCI self-audit completed by the manager of the home. Our planning also took into account the views of two people living in the home and five members of staff who completed and returned CSCI survey forms before the day of our visit. On the day of the visit we were on the premises for six hours and thirty minutes, and spoke with five people living in the home, the manager, three members of staff, and a relative of someone living in the home. We sampled the individual plans of care for four people living in the home. Other records sampled included recruitment and training records for three members of staff, one volunteer, and two agency staff who had recently covered shifts in the home. We visited the main areas of the care home and four bedrooms. We observed a number of interactions between people living in the home and staff, and observed the arrangements for lunch. What the service does well: People’s needs are being assessed before admission is agreed. Clear complaints records are being maintained and people who have made a complaint are being advised in writing of the outcome within recommended timescales. The home, garden and grounds are being maintained to a good standard. Stildon Brendoncare DS0000014746.V369319.R01.S.doc Version 5.2 Page 6 Arrangements are in place for staff to receive essential training such as training in manual handling, food hygiene, and safeguarding. There is a good atmosphere in the home and staff and managers in the home are kind and helpful. What has improved since the last inspection? What they could do better: Care provision is not always ensuring the wishes and dignity of people are being respected at all times. Care plans are not always setting out in sufficient detail how the person’s care needs are to be met. There are not always enough staff on duty to ensure that safe and appropriate support is available to people living in the home. The home is not always ensuring that people working shifts who are employed by an agency are safe or competent enough to care for the people in the home. Stildon Brendoncare DS0000014746.V369319.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Stildon Brendoncare DS0000014746.V369319.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Stildon Brendoncare DS0000014746.V369319.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are confident the 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 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. EVIDENCE: We received the home’s annual CSCI self-assessment questionnaire (the Stildon Brendoncare DS0000014746.V369319.R01.S.doc Version 5.2 Page 10 AQAA) which told us that the person’s needs are assessed before admission to ensure that the home are able to meet those needs. During our visit we looked at admission assessments for four people living in the home and found that needs were being assessed before admission is agreed. Mrs Blatcher told us during our visit that the home discuss verbally with the person or their representative if their needs can be met in the home, but at present this is not recorded in the home’s records. The AQAA tells us that the resident’s welcome pack, statement of purpose and service user’s guide, which provide information on the service, have been updated to assist people to make an informed choice about where to live. The AQAA tells us that prospective Service users are invited to visit the home with their relative or representative to assist them in making their choice. We are also told in the AQAA that people can opt for a four week trial period before they decide if they wish to live there. Stildon Brendoncare DS0000014746.V369319.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People’s personal and social care needs are not being fully recorded and 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, people manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. EVIDENCE: At the previous inspection we found that not all the needs identified were recorded on the person’s care plan, and that care plans were not always setting out the actions needed by staff to meet the needs. Stildon Brendoncare DS0000014746.V369319.R01.S.doc Version 5.2 Page 12 A requirement was therefore made at the previous inspection that the registered person ensures that a written plan is completed as to how the resident’s needs in respect of health and welfare are to be met. During our visit we looked at the care plans for four people living in the home. In the home’s annual CSCI quality self-audit assessment (the AQAA) the manager Mrs Blatcher has told us that the person’s individual needs are discussed with them or their advocate and set out in their care plan which is agreed, signed, and reviewed. During our visit Mrs Blatcher told us that care planning is being improved by staff undertaking training in care planning, and by each person having a key nurse or key carer to better ensure the care they need is provided. Mrs Blatcher also told us that staff sit down with the person to go through their care plan, and that care plans have become more detailed and specific to the individual person. On some of the care plans we looked at, we found that how the person wished their personal care to be provided was not being recorded in the care plan. For example, one person told us that she preferred to eat in her room, but we found that this was not recorded on her care plan and on the day of our visit she was taken by staff to eat in the dining room. The person’s care plan states that she is to receive a pureed food diet, and that she needs her meat cut up. The person told us that they don’t need to receive a pureed food diet, but do need assistance to cut up food and eat. The care plan had therefore not been updated to reflect her eating needs and where she wishes to have her meals. During the lunch serving we observed that this person was taken to the dining room to eat, and was presented with a meal which she was attempting with difficulty to cut up and eat. We also observed that she became tired out with the effort and stopped eating. Subsequent to this staff came and assisted her with eating. One relative we spoke to said that the continence needs of her husband were not always being regularly attended to, and we found that the care plan for her husband was not providing guidance for staff on how his continence care is to be provided – for example, how often his continence pads should be changed. One person we spoke to said she prefers to keep to her room. Her Stildon Brendoncare DS0000014746.V369319.R01.S.doc Version 5.2 Page 13 care plan states that she can become isolated, and needs reassurance when anxious. She is severely disabled, and is limited in the social contact that she herself can initiate. She said no staff spend time sitting talking with her. We discussed this with the manager. The manager said that the activities organiser has spent time talking to the person about her social needs. We noted that the care plan was not clearly setting out how the person’s social needs would be met, which in turn was not assisting to reduce the person’s anxiety and isolation. The care plan for one person we talked to tells us there needs to be daily checks to ensure they are not developing pressure areas. The person told us she has “no problem” with pressure areas. We noted that the care plan has not been updated accordingly. One person we spoke to said she doesn’t wish to receive help from male carers, and when a male carer came to assist her with her personal care recently she let him know that she would like a female carer instead and this was arranged. We noted that the person’s care plan had not been updated to reflect that their wish was to receive personal care from female carers only. These examples given to us by people living in the home indicate that care planning is not always ensuring their wishes and dignity are being respected at all times. A requirement has been made concerning the need for more detailed care plans. The AQAA tells us that all residents have a choice of GP or can maintain their own GP if they previously lived in the local area. We received two CSCI survey forms completed by people living in the home, one of whom said “the medical support is very efficient and well organised”. People we talked to indicated that their health care needs were being met. Records we looked at indicated that people are accessing GPs and community nurses. Care records we looked at indicated that one person’s diabetes, and one person’s long-term infection were being appropriately managed. We looked at the arrangements in place for one person living in the home to manage their own medication, and we noted that this had been assessed appropriately. Stildon Brendoncare DS0000014746.V369319.R01.S.doc Version 5.2 Page 14 We found there to be appropriate arrangements for the storage of medication. We looked at two sets of records for the administration of medicines and found that arrangements for recording were being followed. Stildon Brendoncare DS0000014746.V369319.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability 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. EVIDENCE: Stildon Brendoncare DS0000014746.V369319.R01.S.doc Version 5.2 Page 16 The AQAA tells us that the home has two activity co-ordinators who provide and assist in a wide variety of activities, entertainment and social interaction. Activities displayed on the notice board in the home on the day of our visit were games, socials, reminiscence, films, and exercise. We are told in the AQAA that monthly multi-denominational services are open for anyone to attend. The AQAA tells us that a league of friends meets regularly and arranges various outings and entertainment both inside and outside the home, and that they produce a regular news letter to keep residents informed of forthcoming events. The AQAA tells us that improvements to the service have included providing a wider range of activities and encouraging more participation. One person we talked to said that people come along to sing, play piano, and that staff ask what entertainment they would like. She said that someone had requested the “Dambusters” DVD and this was arranged. We talked about activities with the manager, and we were advised that no activities are usually arranged during the mornings or at weekends. We are told in the AQAA that each person living in the home has an individual well being programme about the goals they wish to achieve. The AQAA tells us that nutritious well balanced meals which are freshly prepared and cooked are provided. People living in the home told us that a menu is brought round every week, and so people tick their meal choice on a form. We observed a lunch sitting where the main choices were sausage pie or vegetable lasagne. We noted that two people had opted for an alternative to the menus, one of whom had an egg salad and the other person had a baked potato. A number of people had opted to have their lunch in their rooms, and staff were taking covered plates of food on trays to the people in their rooms. The meal was relaxed and unhurried for most people in the home, and people Stildon Brendoncare DS0000014746.V369319.R01.S.doc Version 5.2 Page 17 who needed assistance with eating were receiving this. As discussed in the previous section there was one person for whom the meal was not relaxed and they had to wait for the assistance which they needed, and we will discuss this further in the staffing section of this report. There was a mixed response from people we talked to about the food – some said they enjoyed the meals, others said improvements could be made. Stildon Brendoncare DS0000014746.V369319.R01.S.doc Version 5.2 Page 18 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. If people have concerns about their care, they or other 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. EVIDENCE: The AQAA tells us that complaints are being recorded and investigated and areas for improvement are reviewed. We looked at the complaints record during our visit, and complaints concerning staffing levels will be discussed in the staffing section of this report. We observed that clear complaints records are being maintained and people who have made a complaint are being advised in writing of the outcome within recommended timescales. Stildon Brendoncare DS0000014746.V369319.R01.S.doc Version 5.2 Page 19 We received two CSCI survey forms completed by people living in the home, who told us that they knew how to complain and who to complain to. The manager tells us in the AQAA that there have been no safeguarding issues in the home in the past 12 months. Training records we looked at indicated that staff are undertaking training in how to safeguard vulnerable people. The home has a copy of the updated local guidance for safeguarding vulnerable people, and Mrs Blatcher told us she had attended training on the new guidance and procedures. Stildon Brendoncare DS0000014746.V369319.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People stay in a 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 rooms feels like their own, it is comfortable and they feel safe when they use it. EVIDENCE: Stildon Brendoncare DS0000014746.V369319.R01.S.doc Version 5.2 Page 21 We visited all the communal areas in the home and four bedrooms. The home, garden and grounds are being maintained to a good standard. Improvements to the premises since our previous visit have included better recording and monitoring of home maintenance and the provision of a memorial garden close to the sitting room. The idea of the memorial garden was suggested by people living in the home and their families. This garden has a water feature chosen by residents and includes raised flower beds for residents and their families to tend. Garden furniture has also been purchased for the memorial garden. Several residents we spoke to were pleased with the creation of the garden and that it is easily accessed from the communal areas of the house. The home has been decorated and furnished to a high standard. Bedrooms we visited had been personalised by the person living in them, and people had found different ways to make the room their own. There is a sitting room and dining area on each of the two floors. Some people were choosing to make use of the sitting rooms, and other people were choosing not to. The home has hoisting equipment and assisted baths. We noted that bath temperature records sampled indicated temperatures of between 36 and 38 degrees. We hand tested the water in a running bath, the temperature of which seemed close to the temperatures being recorded. The AQAA tells us that the home have two maintenance staff, and that staff have a quick and easy system for reporting matters for maintenance. We visited the laundry room and found it to be clean and suitably equipped. We received two CSCI survey forms completed by people living in the home, who told us that the home is always clean and fresh. All areas of the home we visited during our visit were odour free and clean. Stildon Brendoncare DS0000014746.V369319.R01.S.doc Version 5.2 Page 22 Stildon Brendoncare DS0000014746.V369319.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The provider needs to review staffing levels to ensure people have safe and appropriate support and that there are enough competent staff on duty at all times as people’s needs are not always being met. There is a need for the provider to ensure people can have confidence in the staff at the home by ensuring checks have been done on all staff working in the home to make sure that they are suitable to care for them. People are cared for by staff who get the relevant training and support from their managers. EVIDENCE: During our visit Mrs Blatcher told us that staff records and staff training have been improved, and that arrangements for regular staff supervision are becoming established. Stildon Brendoncare DS0000014746.V369319.R01.S.doc Version 5.2 Page 24 Mrs Blatcher advised us that five care staff and two nursing staff are on the rota for each morning shift, and four care staff and one nursing staff are on the rota for each afternoon shift. Mrs Blatcher has advised us in a letter subsequent to our visit that staffing levels had been recently reviewed at the time of our visit, and that managers can evidence where an increase in needs in the home has resulted in more staff being provided. We received five CSCI surveys completed by members of staff, some of whom believed there were enough staff to meet people’s needs and some who did not. Two staff told us there were “always” enough staff, one said there was “usually” enough, one said there were “sometimes” enough and one said there were “never” enough staff to meet the individual needs of all the people who use the service. We spoke to a relative during our visit who told us that there are now two carers in the evening on the nursing floor, which she believed were not enough to assist people to bed and therefore the evening meal “gets rushed”. Concerns about staffing levels and staff being able to attend to care needs in good time are noted in the records of three complaints received by the home since our previous visit. One person living in the home we talked to said that staff “often walk off in the middle of something (providing care) saying they’ll come back but don’t”. She said she didn’t know why staff went off, she thought it might be to attend to someone else. One relative we spoke to during our visit said her husband was sometimes put to bed without a blanket, and she said she believed this was because carers were “hard pressed” and “rushing at night”. A requirement has been made concerning staffing levels. We received CSCI survey forms completed by five members of staff, all of whom said they had criminal records bureau checks carried out before they commenced work in the home. We looked at recruitment records for one volunteer and three permanent staff working in the home, and found that references and checks were in place before they commenced work in the home. Stildon Brendoncare DS0000014746.V369319.R01.S.doc Version 5.2 Page 25 We found that four shifts by temporary (agency) staff had been worked in the home between the 4th August 2008 and 10th August 2008, but that the home had not obtained from the agency confirmation of the checks and training records for either of the two agency staff who had worked those shifts. We discussed this with the manager Mrs Blatcher who told us that this information for agency staff who had worked previous shifts in the home had been obtained, but that the agency providing the two staff covering the four most recent shifts had not provided this information. During our visit Mrs Blatcher contacted the agency concerned, and told us they had said they did not usually provide this information. Mrs Blatcher told us that no more agency staff were booked to cover shifts until 15/8/08, and that agency shifts would be cancelled unless the required information had been provided by the agency before the start of the person’s first shift. An immediate requirement was made that temporary (agency) staff should not be employed without written confirmation of the checks undertaken and training completed by the temporary member of staff. In the AQAA the manager tells us that of 20 care staff employed, 15 staff have achieved the national vocational qualification (NVQ) in care at least to level 2, and that 3 staff are presently undertaking NVQ training. The AQAA tells us that the training coordinator ensures that all staff are made aware when their mandatory training needs to be updated and keeps records of all training undertaken. We spoke to the training co-ordinator and looked at the training records for three members of staff. We found that arrangements were in place for staff to receive essential training such as training in manual handling, food hygiene, and safeguarding. The CSCI survey forms completed by five members of staff tell us that their induction training prepared them well for doing their job, and that they are receiving regular training and management support. Stildon Brendoncare DS0000014746.V369319.R01.S.doc Version 5.2 Page 26 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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. EVIDENCE: Stildon Brendoncare DS0000014746.V369319.R01.S.doc Version 5.2 Page 27 Mrs Blatcher was registered as manager for the service on 22/10/07. During our visit Mrs Blatcher told us that she has continued to update her training in areas such diversity, health and safety, and local safeguarding procedures. People living in the home and relatives we talked to said there was a good atmosphere in the home and that staff and managers in the home are kind and helpful. The manager tells us in the AQAA that a Health and Safety working group has been started, and monthly staff meetings now take place. The manager discussed with us some improvements which had been made further to comments made in residents’ meetings – for example, people asked for a garden area nearer to the lounge to be provided and this has now been completed. At the previous inspection we found that although the home provides appraisals, job chats, group discussions and reflective practice to support staff, staff told us they did not have one to one sessions of supervision where they can discuss any confidential matters. We suggested that the provider review this matter. In the AQAA the manager tells us that training in supervision and appraisals has been commenced, and that a team leader is undertaking to improve staff supervisions. During our visit Mrs Blatcher told us that each member of staff has an allocated supervisor, and that appraisals for staff are being carried out, with 70 of staff having had their annual appraisal. The manager tells us in the AQAA that the home is seeking to complete appraisals for all staff and to increase the number of staff supervisions and clinical supervisions undertaken. Mrs Blatcher told us that senior staff have all completed supervision and appraisal training and group supervision training. We looked at arrangements for holding small amounts of money on behalf of people living in the home, and found that appropriate records are being made and the person’s money is held securely and separately. Stildon Brendoncare DS0000014746.V369319.R01.S.doc Version 5.2 Page 28 We are told in the AQAA that regular monitoring checks are being carried out in the home, and that managers ensure that accidents and incidents are being recorded and followed up appropriately. The manager tells us in the AQAA that equipment services and tests carried out in the past year have included those on portable electrical equipment, stair lifts, hoists, fire equipment and the heating system. In the AQAA the manager tells us that 80 of staff have undertaken training in infection control. Stildon Brendoncare DS0000014746.V369319.R01.S.doc Version 5.2 Page 29 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 4 3 3 X 3 3 3 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 3 Stildon Brendoncare DS0000014746.V369319.R01.S.doc Version 5.2 Page 30 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. 1. Standard OP7 Regulation 15 Requirement The registered person shall ensure that a written plan which addresses all the care needs, including the social care needs of the person, is completed. The care plan shall advise how the person’s health and welfare are to be met, and should include how the person wishes their care to be provided. The care plan shall be regularly reviewed and discussed with the person receiving the care and/or their representative, so that they can have a say in how the care is provided. Timescale for action 22/12/08 2. OP27 18.1 The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of service users ensure that at all times suitably qualified, competent and experienced persons are working in the care home in such DS0000014746.V369319.R01.S.doc 22/12/08 Stildon Brendoncare Version 5.2 Page 31 numbers as are appropriate for the health and welfare of service users. 3. OP29 19(2)(4) and Schedule 2 paragraph s 1 to 7 Where a person is employed by a 14/08/08 person other than the service provider, the service provider shall not allow them to work in the care home unless the employer has confirmed in writing to the registered person the information required under this regulation. This is to assist the home in making a judgement on whether the agency member of staff is safe and trained enough to care for people in the home. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Stildon Brendoncare DS0000014746.V369319.R01.S.doc Version 5.2 Page 32 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Stildon Brendoncare DS0000014746.V369319.R01.S.doc Version 5.2 Page 33 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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