Inspection on 23/10/08 for Swallowcliffe Retirement Hotel

This inspection was carried out on 23rd October 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

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Stallcombe House

Belma

Hunters Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 26/11/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Swallowcliffe Retirement Hotel Old Beer Road Seaton Devon EX12 2PZ     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: Vivien Stephens     Date: 2 3 1 0 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 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Swallowcliffe Retirement Hotel Old Beer Road Seaton Devon EX12 2PZ 0129722629 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Judith Marion Adams Type of registration: Number of places registered: M & J Care Homes Ltd care home 30 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 30. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (Code OP) Dementia (Code DE) Mental disorder (Code MD) Date of last inspection Brief description of the care home Swallowcliffe provides accommodation with personal care up to 30 older people who may also have a physical disability and/or mental disorder or dementia. Swallowcliffe is a detached, converted property standing in large well-tended gardens overlooking the sea and approximately half a mile from the centre of Seaton. Bedroom accommodation Care Homes for Older People Page 4 of 30 Over 65 0 0 30 30 30 0 Brief description of the care home for service users is in twenty-four single and three double rooms. Three of these rooms are in a cottage a short distance from the main property, which is divided into two flats with separate entrances. The ground floor flat has a bathroom and the first floor flat has a shower room and both have a kitchenette. In the main house the bedrooms are situated on the ground and first floors. Two of these bedrooms have en suite baths and toilets and a further nine bedrooms have an en suite toilet. A stair lift provides access to the first floor landing. There are two lounges and a dining room on the ground floor. Care Homes for Older People Page 5 of 30 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: Several weeks before this inspection took place we asked the providers to complete an Annual Quality Assurance Assessment form (AAA). The completed form gave us useful information about the home and the services they provide. We also send survey forms to the home and asked them to distribute them to a random sample of people living in the home, to the staff team, and to health and social care professionals who visit the home. We received 13 surveys from people living in the home (some people received help from their friends or family to complete the form), 6 from staff, 1 from a care manager and 2 from GPs. Their responses have helped us to form the judgements we reached in this report. This inspection began at 10.15 am and finished at approximately 6.30 pm. On the day Care Homes for Older People Page 6 of 30 there were 20 people living in the home. The owners were both present and we talked to them about the way the way the home operates and their plans for the future. During this inspection we case tracked four people who live in the home. We did this by reading their care plan files to find out what information the home had gathered about each person before they moved in, and how they used this information to plan the care the person wanted. We then talked to each of the four people and two relatives who were visiting the home. We also looked at the way the home stores and administers each persons medications. We carried out a tour of the home during which we looked at a random sample of bedrooms, the toilets and bathrooms, the kitchen, laundry and the communal areas. We looked at other records the home is required to keep including the records of money held by the home on behalf of those people who do not want to hold cash in their rooms, menus and individual dietary needs, fire log book, and staff employment and training records. What the care home does well: What has improved since the last inspection? What they could do better: A new care planning system was in the process of being implemented. The way the information is presented should be improved so that staff have a quick and easy reference guide that explains clearly how the person wants to be assisted. The plans Care Homes for Older People Page 8 of 30 should not include any judgemental statements unless the person has specifically said they want it included in their care plan. The plans should be discussed and agreed with the person and if possible the person should sign to say they agree with the content of the plan. A few improvements are needed to the medicines administration records. There should be a system of accounting for any medicines that are carried forward at the end of each month (these are usually medicines that are not included in the monthly monitored dosage system). There should be clear instructions for care workers on the use of creams and lotions, and there should be a system of monitoring the effectiveness of the creams and lotions. Staff should know how to check if the persons skin condition has improved or worsened and what to do when this happens. There should be clear instructions for care staff on the use of medicines that have been prescribed on an as required basis, and for any medicines that need special instructions on how they should be administered. People would benefit from more regular organised activities to suit individual interests. The timetable of activities that has been displayed in the hallways should be updated to give correct information about regular activities provided. The level of staff who hold a nationally recognised qualification in care is below the recommended level. The home should implement a programme of training to enable all staff to gain a relevant qualification. 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 30 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 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are thinking about moving in can be confident that the home will assess their needs carefully and will not allow them to move in unless they are certain their needs will be met and the home is suitable. People are given plenty of information and opportunities to get to know the home before they decide to move in permanently. Evidence: The home told us in their annual quality assurance assessment (AQAA) The home has a comprehensive pre-admission/information pack available to all interested parties. The owner always makes a pre-admission visit to the home or hospital to assess needs to ensure they can be met by the home. Visits & viewings of rooms to the home are encouraged. The manger and senior carers make every effort to meet the clients during visits. All potential clients are given as much information as possible to enable Care Homes for Older People Page 11 of 30 Evidence: them to make an informed choice and we make every effort to answer all questions. For Respite care, the same information is given. All of the people who completed a survey form before this inspection told us they had received enough information about the home before they moved in to help them decide if it was the right place for them. The owners told us that everyone who pays privately for their care has received a new contract of residence since the change of ownership took place. We looked at the files of four people living in the home. Two of these people had moved in during the last six months. We looked at the way the home had assessed their needs and we found they they had gathered a good range of information covering all aspects of each persons care needs, including their likes and dislikes. We talked to the owners about the information they give to people who are thinking about moving in. We heard that they give people a range of information including the statement of purpose (a copy of this document was also seen on the table in the entrance hallway) the service user guide, a price list and a welcoming letter. A copy of the last inspection report was also seen on display on the table in the entrance hallway. Care Homes for Older People Page 12 of 30 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. People can be confident that their care needs will be met by a dedicated and caring staff team, although there are some weaknesses in the homes care planning system. Medicines are generally securely stored and safely administered, although a few improvements are needed. Evidence: We looked at the care plans files of four people who lived at Swallowcliffe. The providers were in the process of changing the care plan forms over to the same system they use in the other two homes they own. At the time of this inspection there were two different styles of care plans in use. We found that the information in the old style care plans those that were about to be replaced) was comprehensive and clearly laid out. These plans were easy to read and we could find relevant information quickly. On the other hand the information in the new care plans was not quite as comprehensive. The layout of the new plans was straightforward but those we looked at were more difficult to read than the old care plans due to the style of the wording Care Homes for Older People Page 13 of 30 Evidence: and the way they had been set out. Some information appeared to be in the wrong sections. We felt this might prevent care workers having quick and easy access to a clear set of instructions. We talked to Judith Adams about the new care plans and she told us she had already been aware of the problems and had started to look at how they could be re-worded and laid out in order to make the information clearer. While the new care plans generally set out how the person wanted to be assisted, in just a few instances judgemental statements had been made. These included statements about peoples personality, and about the likelihood of the person becoming angry. These statements suggested that the person had not been fully consulted when the plans were drawn up, and there was no discussion about the reasons why the person might become angry or behave is a particular way. We talked to Judith Adams about the importance of helping staff to work closely with each person to understand that things that might make the person angry. We discussed how care staff should work with the person when drawing up a care plan, and the person should sign the document to agree the content. One of the old style care plans we looked at included assessment forms that could be used to check if the person might be at risk of developing skin problems such as pressure sores, or if they were at risk of malnutrition. The new style care plans did not include these risk assessments. We talked to Judith Adams about the importance of being aware when a person may be at risk of problems and to know when they should seek help from the health specialists in order to introduce preventative measures. She confirmed that she had been considering alternative assessment forms they could use. We saw records to show that the home had weighed people regularly. The people we talked to during this inspection and the people who completed a survey form told us they were very happy with the way they were cared for. People praised the care staff for the care and attention given. We heard a number of examples of the dedication and kindness of the care staff. Two GPs who completed survey forms praised the standard of care. Comments included Caring and well organised, and There has been a marked improvement at Swallowcliffe and the standard of care appears good. There was also a letter from the District Nursing team on display in the hallway praising the home for the high standard of care provided. A care manager told us The staff I have met show genuine respect and friendship towards my service users, while supporting them to reach their optimum quality of Care Homes for Older People Page 14 of 30 Evidence: life. We heard that people have received check ups and treatment from dentists, opticians, and chiropodists when required. We looked at the way the home administered creams and lotions. We heard that the home usually has administration charts for creams and lotions in peoples rooms. We suggested that instructions on how and where the creams should be administered should be included in the care plans, along with instructions on how the staff should monitor the persons skin condition and the actions they should taken if the condition changes. Most of the people we met appeared neat and tidy. People had attractive hair styles and some of the women had polished and neatly manicured nails that demonstrated the care the staff had taken to help people look and feel good. However, one person had a stain on their jumper. We heard that this person had previously taken great care with their appearance and had loved nice clothes, make up and jewellery. We talked to Judith Adams about how this information could be included in the care plan and how care workers could be given instructions to take special care to make sure this person always wore clean clothing. We looked at the way the home handles peoples medicines. The home had recently changed pharmacy and were happy with the service provided by the new pharmacy. Medicines were provided in monthly monitored dosage packs. We found the medicines were stored securely. A new medicines trolley had been ordered and Judith Adams said she hoped this would make the storage and administration process easier. Special secure storage was provided for controlled drugs and medicines that needed to be kept cool. Records of medicines that had been received into the home and administered were generally very well maintained. However, there were no records of the medicines that had been carried forward each month. This meant that there was no audit system to check the stocks of medicines that were not supplied in the monthly monitored dosage packs. This was discussed with Judith Adams and she assured us this would be carried out in future. The new care plans included a list of medicines that the person was on when they moved into the home. We talked to Judith Adams about the need to keep this list updated or to simply refer to the current medicines administration record. Care Homes for Older People Page 15 of 30 Evidence: The care plans did not explain how medicines that had been prescribed on an as required basis. We talked to Judith Adams about the importance of setting this information out in the care plans and/or in the medicines administration records so that care workers knew when to offer these medicines. Some care workers have had training on the safe administration of medicines in the past. The home was just about to begin a new programme of staff training that will include training for all care workers on this subject. The home had a brief policy on the safe administration of medicines. The policy did not cover all aspects of medicine receipt, storage, administration and disposal. We advised Judith Adams to make sure the policy was in line with current good practice guidance. Care Homes for Older People Page 16 of 30 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 are generally contented with daily life at Swallowcliffe although some people would benefit from more regular organised activities to suit individual interests. People receive a nutritious and balanced diet to suit their tastes and dietary needs. Evidence: We looked at daily life in the home and the activities people enjoy. People told us in the completed surveys that they had enjoyed outings in the homes minibus, regular musical entertainments, and during the summer there had been cream teas and barbeques in the garden. They had also had visits from the Donkey Sanctuary. However, a few people had indicated in the survey forms completed before this inspection that at times they would like more activities to be provided. In the hallway we saw a programme of activities on display. We heard that they did not always manage to keep to this programme. The care plans we looked at explained some of the things people liked to do. However, there was no evidence of how the home had used this information to plan a programme of regular activities to suit all individuals. Judith Adams said she had tried to recruit an activities organiser but so far Care Homes for Older People Page 17 of 30 Evidence: had not found the right person for this post. In the meantime the staff had done their best to offer activities most days. On the day of this inspection we saw a member of staff sitting with a person in the afternoon doing board games. The home told us in their AQAA, No restrictions are given to relatives visiting providing it is convenient with the sus (at the sus request mealtimes are asked to be avoided). Advocates are encouraged to get involved in social events and take their loved ones out on visits. Relatives are always warmly welcomed by staff and are made to feel comfortable. Activities take place 3 to 4 times a week and sometimes more often. We have regular visits from a singer who caters for our elderly client group and from the local donkeys at Branscombe. Impromptu barbecues on the patio area overlooking the sea. We looked at the menus and found out how the cook makes sure each person receives a meal they enjoy that meets their dietary needs. We heard that the staff know each persons likes and dislikes and will offer an alternative if the person does not like the main meal on offer. The cook has worked at the home for a number of years and knows each person and their dietary needs. We saw evidence to show that the menus had been discussed at a recent Residents Meeting and the menus had been adjusted to reflect the suggestions and comments made. All of the people we talked to said the standard of meals was very good. We were told that since the new owners have taken over everyone living in the home has chosen to have their breakfast in the dining room rather than in their bedrooms. Since the last inspection the kitchen has been completely refitted. The Environmental Health Officer visited the home the day before this inspection and we were able to see their report that showed that standards were now very good, although a washbasin was needed. We heard this was about to be installed in the near future. Care Homes for Older People Page 18 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that any concerns or complaints they have will be listened to and acted upon promptly. The risk of harm or abuse has been reduced by good recruitment practices, and well trained and vigilant staff and management team. Evidence: Since the new owners took over Swallowcliffe no complaints or concerns have been received by the Commission and no complaints have been received by the home. The owners told us in their AQAA, We are open about complaints and residents are encouraged to voice their concerns, which are always taken seriously. Every person has been given a copy of the homes complaints procedure in the information they received before they moved in. People who completed a survey form and those we spoke to on the day of this inspection told us they knew how to make a complaint. They said they knew who to talk to if they had any concerns and felt confident that they would be listened to, and the matter would be investigated and addressed appropriately. Comments included The staff are always ready to listen and I always speak to person-in-charge. On the table in the entrance hall we saw a complaints and concerns book in which people have been invited to write any issues they have had. We talked to Judith Care Homes for Older People Page 19 of 30 Evidence: Adams about the possibility some people may not want to record a concern or complaint in a book that other people might read, and suggested they should have other recording methods for complaints for those people who may want a complaint to be dealt with confidentially. We heard that the owners live on the premises and are fully involved in the day-to-day running of the home. They said they talk to people every day and hoped that people felt able to raise any issues with them so that they could sort them out quickly. They said they welcomed constructive criticism. All of the staff have received training on the protection of vulnerable adults. The home has followed safe recruitment procedures that reduce the risk of harm or abuse. Care Homes for Older People Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a warm, safe and comfortable home. A programme of redecoration and refurbishment is steadily raising the standard of the accommodation throughout the home and those areas already upgraded are now bright, modern and stylish. Evidence: During this inspection we carried out a tour of the building. We looked at a random selection of bedrooms, the bathrooms and toilets, the lounges and dining room, and the kitchen. We saw some of the improvements the owners have made since they took over the home. These included an electrical upgrade, freshly painted exterior doors, complete kitchen refurbishment, and the complete redecoration and refurbishment of four bedrooms. Some of the people who completed a survey form before this inspection told us they thought the environment had improved under the new ownership. People have been encouraged to bring items of furniture, pictures and personal effects to make their bedrooms feel homely. The new owners told us about their plans to complete the redecoration and upgrading of the home that had been started by previous owners of the home. At this inspection we saw that many areas have improved significantly but a few bedrooms and some Care Homes for Older People Page 21 of 30 Evidence: bathrooms and toilets were still in need of redecoration and updating. The gardens were neat and tidy and attractively laid out with places to sit during warm weather. We were told that there are plans to repaint the outside of the house in the spring of 2009. We found that all areas of the home appeared clean and tidy. The owners told us they had doubled the amount of cleaning hours since they had taken over the home. They have a maintenance and repairs book in which any repairs that are necessary are listed then signed off when completed. Care Homes for Older People Page 22 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are cared for by a stable and committed staff team, although the level of qualified staff is low. Evidence: On the day of this inspection there were 20 people living in the home. No-one was seriously ill or needing a high level of care. When we arrived both of the owners were present. There were three care assistants on duty plus the cook. Routines were carried out during the day in a timely way and the staff appeared relaxed and cheerful. In the last year staff turnover has been low. Most of care staff have been at Swallowcliffe for more than two years. We looked at the recruitment files of two staff recruited in the last year and one file of a person who was in the process of being recruited. We found the home had followed good practice by obtaining two satisfactory references and a criminal records bureau (CRB) check before the new staff were confirmed in post. Records showed that new staff have completed a comprehensive induction at the start of their employment. Care Homes for Older People Page 23 of 30 Evidence: The new owners have compiled a record of the training staff had completed and these records showed that the staff had received training on health and safety topics in the past but some of these were due to be updated. All staff have received training in food hygiene, fire, manual handling, first aid and the protection of vulnerable adults (POVA). We were told that the home had just agreed with a training company to provide the updated training necessary. The home employed 11 care staff at the time of this inspection. Of these, only 2 staff held a nationally recognised qualifications known as NVQ. This is well below the recommended level of 50 . The owners told us in their AQAA that all staff are encouraged to attain at least NVQ level 2. Care Homes for Older People Page 24 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed. People who live in the home, their families, and the staff team are invited to voice their opinions so that the standard of services are continually improved. Potential risks to peoples health and safety are minimised by regular checks and maintenance, staff training, and good policies and procedures. Evidence: The new owners are experienced operators of care homes and have two other homes in the Somerset area. Judith Adams is one of the owners and is also the registered manager. She works at Swallowcliffe full time and has over thirty years experience of caring for people. Some of the people who completed a survey before this inspection praised the new owners for the improvements they have made to the home since they took over. One Care Homes for Older People Page 25 of 30 Evidence: member of staff commented My manager is in constant communication both visibly and verbally. Another member of staff told us they were Well supported. Another member of staff said In the short time the present owners have been in control I have noticed they get involved more with the residents for cream teas, BBQs and outings. They do appear to be totally professional people. A GP said the home is Caring. Well organised. The home uses various systems for checking the quality of the service they provide including surveys, residents and staff meetings, and by talking to people individually and inviting their comments. We looked at the way the home looks after cash on behalf of those people who do not want to hold cash in their rooms. Judith Adams said lockable storage can be provided in bedrooms if people request this. Cash is held in separate wallets and all transactions have been recorded and balances regularly checked. A second signature has been obtained to witness the transaction. We checked the balance of one wallet chosen at random and found the balance was correct. We looked at the health and safety procedures in the home. The owners told us in their AQAA they have a range of policies and procedures in place on health and safety topics. All staff have received some training on health and safety topics in the past but some of these are now due to be updated. The owners have arranged for a specialist training company to deliver a programme of training on all health and safety topics including fire safety. The home had records of regular maintenance of all equipment. Fire safety equipment has been checked by a member of staff but there was a period when some checks had not been carried out. A new log book had been obtained and the owners had begun to ensure that all checks were being carried out regularly once again. Care Homes for Older People Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 30 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 7 The new care plans that are being introduced to the home should be written a way that staff will be able to read and follow them easily. Information should be placed in the most appropriate sections. The care plans should not include judgemental statements unless these have been discussed and agreed with the person the plan is written about. The care plans should be signed and agreed by the person they relate to. Staff should have easy access to information and instructions on how and when medicines that have been prescribed on an as required basis should be administered. Staff should be given written information on how, where when and why creams and lotions should be administered. The home should have a method of monitoring skin condition and checking the effectiveness of creams and lotions and there should be instructions on what to do if the condition worsens or improves. The home should provide an alternative method of recording complaints and concerns that people can use if they wish to retain confidentiality. The owners should continue their programme of upgrading, redecorating and refurbishing the home to bring all areas including toilets and bathrooms up to a good standard. Page 28 of 30 2 9 3 16 4 19 Care Homes for Older People 5 28 The home should have a minimum of 50 trained members of care staff who hold a nationally recognised qualification such as NVQ level 2 or equivalent. All staff should receive regular training and updates on all health and safety related topics. Care Homes for Older People Page 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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