Inspection on 04/11/08 for Stobars Hall

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

Stobars Hall 23/01/07

Stobars Hall 31/01/06

Stobars Hall 03/08/05

Stobars Hall 25/01/05

Stobars Hall 31/10/04

Stobars Hall 04/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Clover House

Langrigg House

Parkside

Dystlegh Grange

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: Stobars Hall Stobars Hall Kirkby Stephen Cumbria CA17 4HD     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: Marian Whittam     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 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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 28 Information about the care home Name of care home: Address: Stobars Hall Stobars Hall Kirkby Stephen Cumbria CA17 4HD 01768371291 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) The Franklyn Group Ltd Type of registration: Number of places registered: care home 38 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia learning disability old age, not falling within any other category physical disability Additional conditions: The home is registered for a maximum of 38 service users to include: up to 37 service users in the category of OP (Older people, not falling within any other category) up to 7 service users in the category of DE(E) (Dementia over 65 years of age) 1 person over 18 years of age with a learning disability (LD) and a physical disability (PD). The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection Brief description of the care home Stobars Hall is a residential care home registered with the Commission for Social Care Inspection to provide accommodation for up to thirty-eight people, seven of whom Care Homes for Older People Page 4 of 28 Over 65 7 0 37 0 0 1 0 1 Brief description of the care home may have dementia. Stobars Hall is owned and carried on by The Franklyn Group Ltd. Stobars Hall is a large period property on the outskirts of Kirkby Stephen set in large attractive and well kept grounds. The home is a detached two-storey building which has been adapted for use as a residential care home. Accommodation for residents is provided in the form of twenty-four single bedrooms and seven double rooms which two people can choose to share. All the bedrooms have a private bathroom equipped with a bath or shower, toilet and wash hand basin. There are appropriate toilets close to all areas used by residents and the home provides assisted bathing facilities. Shared space is provided in the form of two smoke free sitting rooms and a dining room. The home has passenger lifts and a stair lift to assist residents to access accommodation on the first floor of the property. There is a pleasant patio area with level access and seating for residents at the front of the property. Stobars Hall provides accommodation to residents referred by the local social services department and to individuals who purchase their care privately. The home offers respite care when accommodation is available. The service makes information avaialable to people through its Statement of Purpose and service user guide. There are additional charges for personal toiletries, hairdressing and newspapers and magazines people may want. Care Homes for Older People Page 5 of 28 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 quality rating for this service is 2 stars. This means the people who use this service experience good outcomes The site visit to Stobars Hall forms part of a key inspection. It took place on 24th November 2008 and we (The Commission for Social Care Inspection, CSCI) were in the home for 5 hours. Information about the service was gathered in different ways. An Annual Quality assurance Assessment (AQAA) was completed by the manager. The AQAA is a self assessment and a data set that is completed annually by all providers of registered services. This gives us information about how they believe they are meeting outcomes for people using the service. It also gives statistical information about the Care Homes for Older People Page 6 of 28 service and trends and patterns in social care. We looked at the service history. We spoke with people living in the home and the staff and acting manager during the visit. We made observations of staff practices and interactions during the visit. Completed questionnaire survey forms done by people living in the home and staff working there. During the visit we spent time talking with people living there about their experiences of life in the home. We looked at a sample of care planning documents and assessments to see if the level of care being provided met peoples individual needs. We made a tour of the building to examine and assess the environment standards and any improvements. Staff personnel and training files were examined and a selection of records required by regulation. We assessed the handling of medication through examination of relevant documents, the storage facilities and through talking with the residents, acting manager and other staff. Fees for this service range from three hundred and eighty pounds to five hundred and ninety five pounds. What the care home does well: What has improved since the last inspection? Since the last key inspection the service has met the good practice recommendations made at the last visit. More resources and thought have been put into providing a broader range of activities and support to people. The service now has a carer who works on recreation and personal support 2 days a week and the service plans for 1 to 1 support more using available staff levels. This allows greater choice and a more individualised approach and is in response to what residents have been telling the manager they want. The service has been making improvements to the home and has employed a full time maintenance and gardening person to ensure maintenance is kept up to date and the extensive grounds tidy. The service is looking at ways it can make more use of the grounds that will involve the people living there in projects. The outside paths have been made safer and in better condition so people can feel confident and safe when using them. To improve access the service is making a ramp for one room and improvements have been made to provide en suite showers and replace private bathrooms making it easier for people to use them. The service has purchased new furniture for the lounge to suit peoples needs and replaced some of the carpets that were getting worn. The service continues to add to the number of profiling beds it has to meet individual needs. Since the last inspection the service has been making sure that there are regular Care Homes for Older People Page 8 of 28 recorded meetings with residents and amongst all the staff groups to allow for feedback and opinions to be expressed. To make them more accessible all the documents in use are now stored securely on the ground floor rather than on the upper floors. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 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 10 of 28 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. Peoples needs had been assessed before they had come to live in the home to help make sure that the home could meet their needs and relevant information about the service is provided to help people make an informed choice about living there. Evidence: Information is available to prospective residents and their families in the combined Statement of Purpose and service user guide that are specific to the home and the services it offers. This information helps people to make an informed choice about living there. The documents and other general local information are on display in the foyer. The documents contain a previous inspection report but this was an old report not the last one and we recommend that the service makes sure a copy of the last inspection report is easily available in the home. Letters on display from residents and families give their views on the service. Care Homes for Older People Page 11 of 28 Evidence: Survey responses from people living there and conversations with them during the visit indicated that people felt they had been given enough information about the service, had contracts and had been able to visit before they came to live there. Some people told us they had previously come in for respite or a holiday and had got to know the staff and service that way. We looked at four pre admission assessments in detail in peoples care plans and found that people coming to live there had their personal, health and social care needs fully assessed before the service offered them a place. The assessments we looked at contained sufficient information to begin to develop a care plan from. This information helps ensure that staff have enough information to be aware of the level of care each person needs and wants. People had only been admitted following an assessment and the service has a six week trial period when people come in followed by a review. This helps make sure that the home is meeting their needs and that they are happy with service and are settling in. People told us that the manager had visited them at home and when they came in the staff had been helpful and had supported them as they got used to living there. People can visit and look around the home and speak with staff and other residents if they wish. If the manager knows they are going to visit they arrange for a staff member to assist and show them around. The service does not offer intermediate care. Care Homes for Older People Page 12 of 28 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. The health, social and personal care that people using this service receive is based on their individual needs and preferences. Privacy, dignity and personal choices are being respected to promote their independence and choice. Evidence: All people living in the home have a plan of care developed with them based on initial assessments and risk assessments setting out health, personal and social care needs and these are being regularly reviewed and updated with changes. We looked at four peoples care plans in detail and these were clearly set out and easy to follow. The care plans gave individualised information including on a persons mobility, diet, health care needs and their social and religious preferences and expectations. Appropriate risk assessments for skin care were in place and appropriate equipment to prevent pressure sores for those at risk was seen in use. Effective nutritional screening is in place and peoples weight is monitored and recorded and action taken if needed. Care plans showed that where needed specialist services had been used to support peoples health care needs. This included the speech and language therapist to assess Care Homes for Older People Page 13 of 28 Evidence: swallowing ability for one person where it was needed. Visits from doctors, district nurses and specialised services, such as opticians, dentists, occupational therapist and speech and language therapists are recorded with the outcomes and actions needed. People living in the home told us that they saw their doctors as they needed and in private and also the chiropodist as they needed. The surveys we received from residents also supports this. One person commented that, Everyone is very kind, patient and helpful and If you tell them you need a doctor they heed it. People we spoke with and survey responses indicated that people felt staff and management listened to what they had to say and supported them to make choices in their daily life. We talked with members of care staff and from what they told us it was evident they knew the people living there well and their individual needs and preferences and spoke about them in a way that respected their individuality. What staff and residents told us also indicated that overall peoples particular wishes and individual preferences are being recognised and respected. Our observations during the visit, records of care and our conversations with people living there indicated that they are treated as individuals with flexible routines and their privacy respected. One person told us that The girls are very good, very understanding,helpful and polite. Speaking to residents and staff it was clear that care is focused on the individual although care plans do not always make clear the persons inclusion and expectations in planning their care. We discussed this with the managing director who was present during much of the visit. We recommended that the service looked at ways of making its documentation and recording more person centered making clear expectations and individual goals. This way staff will not be relying too much on passing on verbal information. We looked at the handling of medication, records and practices and found there are established systems for managing medicines in the home. Staff kept accurate records and those administering had received training to make sure they were competent to do so. There were systems in place for ordering and disposal of medication and safe storage. Records we looked at were accurate and up to date and signed by those administering. Some medication records did not have photographs of residents to aid safe administration. We discussed this with staff who were aware some were missing and the deputy manager was currently updating this. We spoke with some people who administered their own medication and had secure facilities for storing this. People are supported to do this and the risks assessed and this helps to promote their independence. We found that controlled drugs are safely stored and recorded in a controlled drugs register. The service asks people and families about their wishes at the end of life and records personal wishes and preferences on this. Records show some staff have attended Care Homes for Older People Page 14 of 28 Evidence: training on care of the dying. Staff we spoke with expressed an understanding of the importance of end of life care and how they worked with the district nurse so people could be cared for as they wanted at this time. Care Homes for Older People Page 15 of 28 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 who use this service are able to make their own choices about their lifestyle and are supported to maintain their interests and independence. Evidence: Peoples care plans and assessments contained some information about social and recreational interests and there were activities preferences in place. There were no personal profiles or pen pictures with backgrounds, significant events, people and occupations and we recommend that this should be developed. This background information can help in supporting people with achieving goals and activities that reflect their individual lifestyles and are meaningful to them as individuals as well as in group activities. A member of staff takes responsibility for organising and making sure activities go ahead as planned and the services has been putting more resources into activities. We looked at care plans and records of activities and spoke with people living there about the things they did. The people we spoke to were well aware of what activities were going on and information was provided on the activities programme. During the visit several people were enjoying a weekly quiz club led by a staff member. Other regular organised activities people could take part in included exercise sessions, yoga and hand care and bingo. The hairdresser visits each week and we saw Care Homes for Older People Page 16 of 28 Evidence: some people using this service during the visit. The service has also introduced a bi weekly head and foot massage session for people who want this. Some people we spoke to preferred not to take part in organised activities although some of these had attended the bi weekly musical entertainments and demonstrations. People told us about a presentation given recently from the owl centre, that many had enjoyed. We spoke with a small group of residents in one lounge who were doing jig saw puzzles which they liked to do and books and board games were easily available for people. The home encourages family and friends to visit and several people told us they go out regularly with family and friends or 1 to 1 trips out with staff to local shops and the tea rooms. The service has a company car for residents use as well. There is a key worker system in operation to support people. Twice a week staff doing activities help people to tidy and arrange their rooms if they want to and this also allows staff to see if there are any personal things people need. People are being supported to follow their own religious faiths and there are services provided by both the Church of England and the Methodist church as well as weekly visits from the Roman Catholic priest. The local Parish magazine is available in the home for local news and events people may wish to attend or support. We spoke with the cook about menus and dietary requirements and the cook was going around asking people what they wanted for meals from the menu choices. People told us this was usual and that they could make special requests that the cook would make for them. This was evident for one person who had particular dietary preferences that the cook tried to meet for them. People can take their meals where they wish and we observed a couple taking their lunch in one dining area. The meal was well presented and the couple told us that they had enjoyed the 3 courses. Some people chose to have a aperitif before their meal. The dining areas were attractively furnished and some people had tables in their bedrooms where they could take their meals. People we spoke to said they enjoyed their meals. One person said the food was excellent and plenty of variety, varied vegetables and salads another said that theyenjoyed a good dinner and that staff would always make them a sandwich in the evening. The service received a 5 star rating from the Environmental Health Departments last inspection. Care Homes for Older People Page 17 of 28 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. There is an accessible complaints procedure in the home and procedures and training in place on safeguarding vulnerable adults. People who use this service are able to express their concerns knowing they will be listened to and acted upon. Evidence: There are procedures in place for dealing with complaints and concerns including a system for logging and investigating. The procedure is on display in the home and is in the statement of purpose and service user guide. In the last year the service has had 3 complaints, all resolved within 28 days and investigated and dealt with using the services own procedure. We (The Commission for Social Care Inspection) have not received any complaints about this service. We spoke with residents who told us they knew who to make a complaint to if they had one but they saw the manager or deputy most days and would talk to them about anything first. People living there told us they had confidence in the management to deal with any concerns they raised. Survey responses indicated that generally people knew how to make a complaint, although one person told us, So far I have never needed to make a complaint and another said They always listen to what I want so I have never needed to complain. The service has its own internal procedures on Protecting Vulnerable Adults (POVA), Care Homes for Older People Page 18 of 28 Evidence: safeguarding residents and reporting abuse and they provided these for us to examine. In the last year there have not been any safeguarding adults referrals made to social services. Training is given to staff on safeguarding and the staff we spoke to confirmed this and were clear about what procedures they would follow if they had any suspicions of abuse occurring. Staff survey responses also supported this. The service does not deal with any residents personal finances and encourages and supports people to handle their own affairs or with family and legal representatives. Procedures are in place regarding peoples financial affairs and expenses incurred are invoiced to individuals or their representatives. Care Homes for Older People Page 19 of 28 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. Residents enjoy a comfortable, safe and homely living environment. The premises are maintained to provide an environment that suits the needs and expectations of the people living there. Evidence: There is regular planned maintenance of the home and the grounds and the standard of decoration is consistently good throughout. The service now employs a full time maintenance person who also attends to the grounds. There is an ongoing programme of refurbishment of rooms and the services policy is always to redecorate a room when it is vacated after a period of time. There are records of the maintenance and testing of equipment and service agreements. All areas used by residents have accessible call bell systems and these are tested. The home is warm and well furnished with a variety of communal areas for people to use. The lounges are well furnished in a style that suits the life styles and needs of the people living there. The home is a converted period property and many communal and bedrooms retain the original features giving it a homely appearance and there are extensive views over the surrounding countryside from private and communal rooms. People have been able to bring in their own possessions and personalise their rooms according to their taste and preferences. The bedrooms are different in shape and size Care Homes for Older People Page 20 of 28 Evidence: and features and some are like bed sitting rooms making them all individual and different. There are 3 lounge areas and a dining room for people to use. One lounge is used predominantly by the people on the EMI unit although they are free to mix with other residents as well. We found the home to be clean and tidy and there were no unpleasant lingering odours. Resident surveys and comments during the visit indicated that was generally the case. There are weekly meetings with the housekeeping and maintenance staff to allow for planning and prioritising what needs to be done. All the bedrooms have either en suite bathroom facilities or private bathrooms for their own use and the service has been putting in more en suite showers. There are bathing aids in use and some people have brought in their own aids that they prefer to use. At present there is only one double occupancy room at the request of the married couple using it. The home has a laundry away from resident areas entered using a key pad for safety. The domestic and care staff attend to laundry and the night staff take care of ironing. Residents told us that generally their laundry is done quickly and returned to them. The service has infection control procedures that they provided for us to examine and appropriate washing machines. Care Homes for Older People Page 21 of 28 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. Staff are trained and experienced to meet the needs of people living there. The numbers and deployment of staff on duty and on the rotas are sufficient to meet the assessed needs of the people living there at the current levels of occupancy and dependency. Evidence: We examined staff rotas, observed staff deployment during the visit and spoke to residents and staff about staffing in the home. Records and responses indicated that the service had a largely stable staff group with a range of skills and experience to provide a consistently good standard of care for people living there. There were sufficient staff on duty day and night to meet the needs of people at the current levels of occupancy and dependency. Staff numbers are generally greatest during the busier morning period and there is always a senior member of staff on day shift. The organisation has identified that there have been times when staff levels have been affected by the difficulty of recruiting in a rural area. This can affect 1 to 1 support time but the service has been proactive and tried to reduce the effect by supporting residents to plan days out when the staff levels allow and by involving residents when staff go shopping so they can visit the shops and local tea rooms of their choice at the same time. The management team are still actively recruiting and also looking at ways to help retain the staff they have to provide a consistent service to people. We Care Homes for Older People Page 22 of 28 Evidence: discussed with the management team the need to ensure staff levels are monitored and adjusted as occupancy and dependency levels change to ensure effective staffing levels are always maintained. People we spoke with told us the staff were very pleasant people and always listen to what I want and that it was a good service and most particular about fire alarm tests. People told us that staff came quickly when they rang their bells and that there were staff available when they needed them. Staff we spoke to said they enjoyed their work and showed enthusiasm for it when they discussed it and said they felt valued by the organisation they worked for. We could see that staff had a good rapport with the people living there. There was sufficient domestic cover and a housekeeper to keep the home clean and fresh with two cooks covering the week and 2 kitchen assistants to help them. There are recruitment procedures in place and these are being followed. We examined recruitment records and spoke with staff and found the system to be effective. The service has made all necessary Criminal record Bureau (CRB) checks, Protection of Vulnerable Adult (POVA) checks and taken up references before people start work in the home. Staff have job descriptions to help them in fulfilling their roles. The service encourages staff to undertake a range of training and develop their skills and 50 per cent of staff of care staff have completed the NVQ level 2 qualification in care. All staff have had induction training and from speaking with them and from their survey responses the indication was that they felt most areas were well covered. The service records the training staff have done and records any training needs. Training needs are discussed and decided upon at formal supervision. Training dates and updates needed are recorded then, so people do not get overlooked. Staff confirmed that they had received their mandatory training. Several staff had undertaken other relevant courses including care of the dying. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are able to put forward their views on the service and the home is being run in the best interests of the people living there. Evidence: The person appointed to register as manager with CSCI has just handed in their notice and they were not in the home at the time of the visit. The organisation has acted quickly and already begun the process of recruitment for this post to appoint a suitable person to manage the home. In the interim the deputy manager has taken over the daily management duties. The deputy is an experienced carer with many years experience caring and supporting older people. As a result of the designated manager leaving suddenly some documentation was not easily at hand but the management team were able to forward the information and records we asked for quickly. The service does hold regular residents meetings and keeps records of the issues discussed and feedback on the service. There were records of the providers visits to Care Homes for Older People Page 24 of 28 Evidence: the service and of their speaking to people living there to get their views. Staff have regular meetings and these are recorded covering issues such as medication issues, individuals needs and updates for staff. We observed the staff handover where staff discussed any issues that had arisen during their shift. The housekeeping, catering and maintenance staff have their own meeting to discuss relevant issues and priorities. The service also carries out an annual review of its policies and procedures so they can be updated in light of changes in legislation and good practice. Residents, families and health professionals are asked for their views using periodic surveys which are on file. This has not been done this year by the manager and the management team are aware that this needs to be done to continue to get feedback on the effectiveness of their service and are addressing this. This approach helps enable people to influence the way the service is being run. From resident surveys, talking with them in the home and records of meetings and observation there was evidence of an open and inclusive atmosphere in the home. The service also uses audits to monitor the quality of systems including care plans and medication. There is a planned development and budgetary plan in place for the service. There are financial procedures in place and being followed. The service does not keep individuals monies or act on their behalf in financial matters. People living there or their representatives are invoiced monthly for any expenses they incur. People are encouraged to control their own money if they wish and are able to do so, otherwise families or legal representatives assist them. We looked at records of accidents and incidents and records of servicing and testing of equipment and facilities. Records of tests and maintenance indicate the service has annual service contracts for equipment, up to date fire training for staff and that the servicing and testing of emergency equipment and appliances is being done to promote residents health and safety. This included, water temperature testing, portable electrical appliances, weekly fire alarm testing and emergency lighting. Care Homes for Older People Page 25 of 28 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 26 of 28 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 1 1 The manager should make sure that a copy of the most recent inspection record is available in the home for residents and prospective residents to see to make sure they have up to date information about the service. The service should consider developing more person centered care planning records, so peoples individual goals and expectations are recorded and made clear and staff do not rely too much on verbal information. The service should consider developing pen pictures/personal profiles with individuals to help make sure that people are supported to achieve personal goals and have activities that reflect their lifestyles and are meaningful to them as individuals. 2 7 3 12 Care Homes for Older People Page 27 of 28 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 © (2009) 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. 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