Inspection on 17/06/08 for The Cumberland

This inspection was carried out on 17th June 2008.

CSCI found this care home to be providing an Excellent 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

The Cumberland 08/11/06

The Cumberland 23/01/06

The Cumberland 08/08/05

The Cumberland 29/03/05

The Cumberland 29/04/04

Similar services:

1 Marten Road

Daubeney House

Three Gables

Aldwick House

49 Glendale

The Springs Community

Crossways Community

Belle Vue Country House

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE The Cumberland 9-11 Beltinge Road Herne Bay Kent CT6 6DB Lead Inspector Chris Woolf Unannounced Inspection 17th June 2008 09:20 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 The Cumberland DS0000023561.V365592.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. The Cumberland DS0000023561.V365592.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Cumberland Address 9-11 Beltinge Road Herne Bay Kent CT6 6DB 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) 01227 375301 stbrelades@btconnect.com St Brelades Retirement Homes Limited Mrs Catherine Margaret Anne Chuck Care Home 29 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (27), Mental disorder, excluding learning of places disability or dementia (1) The Cumberland DS0000023561.V365592.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. People with a mental infirmity is restricted to 1 person with a d.o.b of 06/02/40 DE is restricted to one person whose date of birth is 31/01/1950 Date of last inspection 8th November 2006 Brief Description of the Service: The Cumberland is a Care Home providing personal care and accommodation for 29 people with dementia. This home only accepts female clients. It is owned by St Brelades Retirement Homes Limited, which owns another home close by. The home is located in a residential part of Herne Bay very close to the town centre with all of its amenities. The home consists of a large detached house with 15 single rooms and 7 shared rooms. There is a stair lift but some rooms are only accessible by climbing a few stairs. The front of the building is a planted patio area and there is a fenced area of garden to the rear. The current fees for the service at the time of the visit range from £403.00 to £470.00. Information on the Home’s services and the CSCI reports for prospective service users will be detailed in the Statement of Purpose and Service User Guide. The e-mail address of the home is stbrelades@btconnect.com The Cumberland DS0000023561.V365592.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 3 star. This means the people who use this service experience excellent quality outcomes Key Lines of Regulatory Assessment (KLORA) have informed the judgements made based on records viewed, observations made and written and verbal responses received. KLORA are guidelines that enable The Commission for Social Care Inspection (CSCI) to make an informed decision about each outcome area. Information for the report has been gained from various sources. These include an Annual Quality Assurance Assessment (AQAA) completed by the home; comment cards received from three health care professionals; and a site visit to the service that lasted 6 hours 40 minutes. The site visit was unannounced. This means that neither the home nor the clients knew that we were going to visit. During the site visit we (the Commission) talked with the clients. We also talked with 4 visitors to the home, a visiting health care professional, a visiting religious representative, and with most of the staff on duty. The Registered Manager was present throughout the day and made herself available to give us all of the help that we required. We observed the interactions between staff and clients, an activity taking place during the afternoon, and the lunchtime meal being served. We also looked at a variety of records including care plans, staff recruitment files, training records, medication records, complaints records, menus, and the homes quality assurance records. The people who use this service prefer to be called ‘clients’ and this is the term used to describe them throughout the report. What the service does well: The home has a clear mission statement and philosophy of care promoting holistic and individual person centred care, which takes into account each client’s diversity and equality needs. The home is clean and comfortable with a friendly and welcoming staff team. The Cumberland DS0000023561.V365592.R01.S.doc Version 5.2 Page 6 The home has strong links with both the local G.P. and the specialist Psychiatrist and Community Psychiatric Nurse. Comment cards received from health care professionals answered the question - What does the care service do well - with ‘Everything’, ‘Liase well with family, doctors and nurses; clean and safe environment; diversional therapy’, and ‘Personalised care; Privacy and dignity; and Clear documentation and instructions’. Two also added ‘One of the best homes in Herne Bay’. Professionals who visited on the day of the site visit said, “They look after them very well”, and “I can thoroughly recommend it here”. A client commented, “I’m very happy here”. To sum up we use an extract from a letter the home received after a client passed away. ‘‘All of the staff were unfailingly attentive and caring for a frail lady who ended her life in a comfortable compassionate and loving environment being looked after by people who had known her for a long time. What more could you ask’. What has improved since the last inspection? A more accessible care planning and assessment system has been introduced including better identification of risks and more holistic recording of individual needs. The home has been focusing on individual activities to give clients a sense of meaning. Environmentally, the home has improved the security of the exits and windows. A new dishwasher that washes and sanitises crockery and cutlery has been installed. The abuse and whistle blowing policies have been improved as have staff supervision and training in these subjects. More staff have completed NVQ’s, and the clinical manager has completed her Registered Managers Award. The Cumberland DS0000023561.V365592.R01.S.doc Version 5.2 Page 7 Following comments made by relatives/ visitors on last years quality assurance questionnaires some improvements have been made to staffing levels on public holidays when there are many more visitors. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Cumberland DS0000023561.V365592.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 The Cumberland DS0000023561.V365592.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): 3, & 4. Standard 6 is not applicable in this home Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Prospective clients and their representatives have the information needed to choose a home that will meet their needs. EVIDENCE: The home has good assessment processes. The AQAA confirms that All clients who are admitted to The Cumberland suffer with moderate to advanced dementia, so it is usually a relative or advocate who looks around the home. They are shown around by a senior manager who is able to answer their queries, and to give whatever advice they may need in terms of dementia The Cumberland DS0000023561.V365592.R01.S.doc Version 5.2 Page 10 care, or finances, for example. They are also given written information about dementia and a copy of the statement of purpose. Before admission to The Cumberland, a pre admission assessment is carried out wherever the prospective client is living at the time. The assessment is completed by a senior manager who collates as much information as possible from the client, relatives, and health and social care professionals, regarding all aspects of physical, psychological, therapeutic, social, diversity needs and family history. Where clients come under the Care Management scheme a copy of the joint assessment is also obtained. Visitors confirmed that one of the managers visited to carry out an assessment and that they visited the home to look round. Visitors said “xxxxx (joint manager) came out to our home”, and “We came here to have a look before choosing”. All clients have a contract. For private clients this is incorporated in the statement of purpose and for funded clients it is with the local authority. This home does not offer the facility of intermediate care, which is a specialised service with intense rehabilitation aimed at enabling clients to return to their own homes. The Cumberland DS0000023561.V365592.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): 7, 8, 9, & 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The health and personal care that clients receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: The home has recently changed their care planning to a more accessible system. Individual person centred care plans are prepared for each client based on their pre-admission assessment, and agreed with the client, their relatives and any other interested parties. Each care plan includes details of physical, mental, social, cultural and diversity needs. They also include a The Cumberland DS0000023561.V365592.R01.S.doc Version 5.2 Page 12 variety of assessment tools including monitoring nutritional needs, and promoting continence; and a variety of risk assessments including moving and handling, skin integrity, and person centred risks. A visitor commented, “They always keep me informed about her care”. The home promotes and maintains the clients health. Health care professional comment cards confirmed that individuals health care needs are always met by the care service. One added ‘Any problems, the senior carer will contact community nurses and ask to visit. A local GP visits regularly’. All visitors that we spoke with confirmed they considered that the clients health care needs are being met. One commented, “They look after her so well”. A client commented, “They look after me well”. Staff said “The nice bit is the girls are very caring towards the ladies”, and “The ladies needs are the main concern”. A Clinical Manager is employed by the home. She is a registered nurse in mental health who has also achieved her Registered Managers Award (RMA). She gives guidance and support to all carers in clinical issues and liaises with other health professionals and relatives. She has responsibility in assessing, planning and evaluating the delivery of care to the clients and in ensuring that the documentation and procedures are in place for recording clients needs and risks. Community nurses organise pressure relieving equipment, beds, and chairs to promote tissue viability. A health care professional comment card stated, ‘Staff manage skin care well. Any change in Skin condition they will refer to district nursing service for us to assess for pressure relieving equipment’. The home liaises with the continence nurse to ensure that the correct pads are supplied to maintain the comfort and dignity of those clients who need assistance to promote their continence. A chiropodist visits the home weekly. Annual optical health checks are organised for all clients who wish to be tested for sight, glaucoma and cataract development. An optician visited the home on the day of the site visit. Clients who need to attend hospital whether for a routine appointment or as a result of an urgent admission are always accompanied by a carer day or night and they support the client for as long as they are needed. Advice is sought when necessary from speech therapist or a dietician. The dentist who was visiting the home retired recently but the home has now been able to organise registration of all clients with a local dentist who offers domiciliary visits. In order to provide more robust clinical support the home has a medical contract with a GP practice and a doctor visits weekly to give general medical guidance and support. She also reviews the medication and general health of those clients registered with her surgery on a regular basis. Clients are welcome to select their own GP, and the home liaises with whichever practice the client is registered with. All medical examinations are conducted in the privacy of the clients room. A doctor who visited on the day of the site visit The Cumberland DS0000023561.V365592.R01.S.doc Version 5.2 Page 13 had only positive comments to make about the home. He said, “We visit weekly but they always call us out if needed in between”. Following the appointment of a new Consultant Psychiatrist he now runs a clinic at The Cumberland every three months accompanied by a Community Psychiatric Nurse (CPN). All clients on medication specifically for their mental health are now reviewed and evaluated at these reviews and this is documented in their records. The home uses the Boots monitored dosage system of medication. Receipt, storage, administration, recording, and disposal of medication all meet with the requirements of the Royal Pharmaceutical Society. All staff who administer medication have received appropriate training. The home has robust medication policies including Homely Remedies and PRN protocols and risk assessments are in place for self-medication if and when this is appropriate. We observed that clients are treated with respect by the staff; their dignity is upheld, and their privacy is respected. The AQAA states, ‘The conduct of the staff in respecting clients privacy, dignity and in promoting choices in their daily lives is enshrined in The Cumberlands mission statement, philosophy of care, staff descriptions, staff inductions and in all aspect of staff training. They are evaluated on their understanding of these principles and ability to express this in their interaction with the clients’. A health care professional comment card stated, ‘When attending to dressings residents are always taken out of the lounge and taken to somewhere private’.All visitors confirmed that the clients privacy and dignity are upheld. A visitor said, “She is always nice and tidy”, and a member of staff said, “Privacy and dignity is maintained at all times”. The Cumberland DS0000023561.V365592.R01.S.doc Version 5.2 Page 14 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 excellent. This judgement has been made using available evidence including a visit to this service. Clients are able to make choices about their life style. Social, cultural and recreational activities meet individual clients expectations. Clients receive a balanced and nutritious diet EVIDENCE: Clients living in the home are encouraged to maintain an active life, within the confines of their illness, and to participate in a variety of activities. The homes AQAA says, ‘Our aim is to make clients, their families and vistors to feel welcome and at home. Clients are encouraged to be useful and engaged with their environment, and to have genuine choice over their daily lives. Clients are provided with opportunities to engage in purposeful activity and to make constructive use of their time. Through positive approval and praise they gain a sense of achievement with their efforts, and feel they have made a recognised and valued contribution’. A ‘life history’ is obtained from clients and The Cumberland DS0000023561.V365592.R01.S.doc Version 5.2 Page 15 their families and documented. This helps staff to understand the individual their interests and aids reminiscence. The home has group activities such as entertainment shows, musical exercises, coach outings and religious services. Some individuals enjoy helping with folding laundry, dusting and polishing, gardening and baking. On the day of the site visit clients were observed folding laundry, and also enjoying a cake making session and eating the cakes they had made. Manicures and hairdressing are also available and enhance clients sense of well being. The home provides current magazines, daily newspapers. And a range of CDs in addition to radios and television. Two members of staff have recently attended NAPA (National Association for Providers of Activities for Older People) training and are now working with the manager on providing a revised activities programme for the home. A visitors commented, “xxx used to go for pottery classes and on outings but she is not really able to now”. A member of staff said, “They are getting more activities nowadays. A couple of the staff have recently done activities training”. Staff confirmed that activities include Coach trips, musical exercises, balloons, colouring, manicures, music, and dancing and walks to town with tea or coffee in a cafe. The religious beliefs of many clients are important to them and regular monthly services are held by the Church of England and Catholic clergy. Families sometimes participate in the services. Clergy will also visit clients individually, particularly if they are unwell. On the day of the site visit an Anglican communion service was held and this was attended by 17 of the clients. The presiding minister said, “We always pray for the home and the staff”. Clients are encouraged to maintain contact with their family and friends. During the summer months there are also monthly outings organised. Visitor comments included, “Oh yes, I am always made welcome, they all know me”, “I come twice a week and am always offered a cup of tea or coffee”, and “They are everso good to me”. The clients are offered choices in all aspects of their daily life, as far as their cognitive impairment allows. Staff confirmed that choices include food with alternatives always being available, what they wish to do, newspapers and magazines, if they wish to watch TV, whether to sit in their own room or in one of the communal rooms, whether they want to listen to the radio/CD, what they wear, and where they eat their meals. The home provides a varied balanced and nutritious diet with choices always available Current special diets include soft diet, diabetic, vegetarian, and low calorie. Healthy eating is encouraged. Clients comments included, “Lunch was very good”, “I like the food”, and “The food is very good”. Visitors said, “I had Christmas dinner here it was very nice”, and “The food is good”. Staff comments included, “Its lovely”, “It always smells nice”. “Its variable”, and The Cumberland DS0000023561.V365592.R01.S.doc Version 5.2 Page 16 “They get good meals, a good selection, fruit and yoghourts are always on offer, and they have chocolates in the afternoons”. The Cumberland DS0000023561.V365592.R01.S.doc Version 5.2 Page 17 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): 16, & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Clients and their representatives are able to express their concerns, and have access to a robust, effective complaints procedure. Clients are protected from abuse. EVIDENCE: The home has a robust Complaints Procedure and copies are incorporated in The Statement of Purpose and Service Users Guide, and displayed in the hallway. A record is kept of all complaints made and includes details of any investigation and action taken. Even minor incidents or complaints are documented. The home say they aim to deal with any small issues before they become of major concern to anyone, and regard such comments in a positive way to improve services to the clients. 4 complaints were received in the previous 12 month period and all were resolved within 28 days. A client said, “Everything is in order”, and a visitor commented, “The management is ever so good, I only have to mention anything and its done”. The Cumberland DS0000023561.V365592.R01.S.doc Version 5.2 Page 18 Clients in the home are protected from abuse. The home has clear and accessible abuse and whistleblowing policies in place. No member of staff starts work in the home until a satisfactory check of the Protection of Vulnerable Adults register has been received. All new staff receive training on abuse, protection of vulnerable adults, and whistle blowing during their induction. Since the last inspection there have been no incidents referred to the Protection of Vulnerable Adults team. The Cumberland DS0000023561.V365592.R01.S.doc Version 5.2 Page 19 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): 19, 20, 24, & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables clients to live in a safe, clean, and comfortable environment. Planned maintenance will enhance the environment for the benefit of the clients. EVIDENCE: The Cumberland is a large detached house. It is well located for access to the town, seafront, and local facilities. The home gained 1st place in the medical section of the ‘Herne Bay in Bloom’ competition in 2007 and are awaiting the The Cumberland DS0000023561.V365592.R01.S.doc Version 5.2 Page 20 results of the 2008 competition. Some of the décor is looking a little tired at the present time. There is a programme of routine maintenance and renewal in place and the manager has identified where improvements are needed and is prioritising the works commencing with replacing the lino in the communal toilets and in the communal areas. The rooms in the home are set out over 3 floors and a mezzanine. There are 3 stair lifts available to reach the majority of the upper rooms but some rooms are only accessible by climbing a few stairs. These rooms are therefore are only used by more mobile clients. The home operates a ‘no smoking policy’. The homes AQAA indicates that improvements made since the last inspection include, better security of the exits; building of an attractive secondary barrier to the back of the home; improved security of windows so that that the restraints are more robust; and installation of a new commercial dishwasher that washes and sanitises crockery and cutlery. There are a variety of communal areas for sitting and dining giving clients a choice of where they sit and who they sit with. All of the communal areas are comfortable and homely. The home has a variety of both single and double bedrooms available, some with en suite facilities. Where a room is shared screening is provided to ensure privacy for personal care. Lockable facilities are available for rooms where required. Rooms are personalized to meet the needs of the individual client. When clients wish they are encouraged to bring in their own furniture to make their rooms even more homely and to give them more of a sense of belonging and ownership. A client commented, “My room is nice”. A health care professional comment card stated, ‘I believe that an effort is made to make residents bedrooms individual to that resident’. The home has robust infection control procedures in place. The AQAA states, ‘In place is an Otex laundry system that is effective at eliminating Clostridium difficile and MRSA organisms using ozone rather than thermal treatments and this is effective on all its wash programmes. This eliminates the risk of infection from all washes and not just from foul or infected laundry cycle. All towels and flannels are washed after single use and most clothing is washed on a daily basis’ . All teams of staff are trained in COSSH and have their own copies of policies on health and safety which they are evaluated on. Visitors commented, “Its always clean and not really any odours”, and “It does not smell”. Staff said, “It’s always kept clean”, “There are always cleaners around”, and “They keep the carpets cleaned regularly and the toilets are always cleaned regularly as well”. The Cumberland DS0000023561.V365592.R01.S.doc Version 5.2 Page 21 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): 27, 28, 29, & 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to support the clients, and to support the smooth running of the service. EVIDENCE: Sufficient staff are employed on duty to meet the needs of the clients, with additional staff on duty at peak times of activity during the day. Trainee junior carers under 18years work under supervision in a support role only. Domestic and catering staff are employed in sufficient numbers to ensure that standards relating to food, meals and nutrition are fully met, and that the home is maintained in a clean and hygienic state. The homes AQAA states ‘Last years relative questionnaire showed that some relatives felt there were not enough staff on duty at the weekend (despite the staffing levels being exactly the same as in the week). At weekends, particularly on Sundays, on Mothers day, at Easter, or if there is a birthday party with a big family gathering, there are many more visitors. I have now increased the weekend staffing levels during The Cumberland DS0000023561.V365592.R01.S.doc Version 5.2 Page 22 these periods to enable the atmosphere to be more relaxed without the staff feeling under pressure’. Visitors confirmed that they considered there are always sufficient staff on duty and that the staff appear competent at their jobs. A health care professional said, “There are always lots of staff”. All of the staff spoken to confirmed that there are sufficient staff on duty to meet the needs of the clients. The head of training, who has the responsibility for coordinating the NVQ (National Vocational Qualification) candidates for the home, has achieved NVQ level 4 in care and the RMA (Registered Managers Award). Currently 82 of the care staff either hold or are working towards NVQ at Level 2 or above, with a high level having already achieved NVQ 3. The clinical manager is a registered nurse in mental health and has also achieved her RMA. Several of the senior staff are also NVQ assessors. Staff said, “I have NVQ 3 and am going to start Level 4”, “I am just doing NVQ 3”, “I have got a B.Tec. National Diploma in Health Studies”, and “I have my Level 4 and RMA”. Catering staff are also encouraged to undertake their NVQ’s and the cook on duty confirmed that she has an NVQ 2 in catering. The home has robust recruitment procedures based on equal opportunities and the protection of the clients. No new member of staff is employed until a satisfactory check of the Protection of Vulnerable Adults Register and two satisfactory references have been received. All staff are issued with a Statement of Terms and Conditions, a copy of the General Social Care Council Code of Conduct, and a copy of the homes whistleblowing policy. An enhanced Criminal Records Bureau and POVA check is also undertaken prior to appointment for ancillary staff such as hairdressers and musical exercise therapist. The Cumberland is a single sex home for elderly ladies with dementia who come from a wide range of social backgrounds. The homes AQAA says, ‘All the care staff are female because the work involves meeting the personal hygiene needs of the clients and their privacy and dignity are paramount. Employment of female only carers in this environment complies with the regulations under the sex discrimination act’. It also states, ‘Staff come from a wide range of social backgrounds, and a few are also from ethnic minority groups and other faiths. At the Cumberland staff are recruited for their skills and other criteria which are not based on discriminatory or prejudicial factors relating to age, gender (except carers), sexual orientation, religion, race or disability and this is part of our recruitment policy’. Staff working in the home are trained to be competent in their role. The Head of Training and the Trainer/Administrator oversee the induction and ongoing certified training programmes of staff. All staff receive induction training to Skills for Care specifications when they first start working at the home and this includes mandatory training. Mandatory training is updated regularly although at present some certificates have lapsed. This was discussed during the site visit of the other home and a The Cumberland DS0000023561.V365592.R01.S.doc Version 5.2 Page 23 planned programme to update all training has already been put in place. All staff have either received or are in the process of doing training in dementia. All staff spoken to confirmed that they have done dementia training. All staff who administer medication have received training, one said, “I have done the medication training”. A client said, “The staff are nice”. A visiting health care professional said, “They are very caring people”. A visiting health care professional comment card said, ‘The staff appear to be experienced (Trained and untrained)’. General comments from staff include, “I like it here”, “It’s a nice working atmosphere”, “Communication is good”, and “I’m quite happy, I like it, its busy”. The Cumberland DS0000023561.V365592.R01.S.doc Version 5.2 Page 24 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): 31, 32, 33, 35, & 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect, and has effective quality assurance systems. The health, safety and welfare of clients and staff is promoted and protected EVIDENCE: The Registered Manager of the home has 30 years of experience of supporting clients with dementia and has been manager at The Cumberland since 1980. The Cumberland DS0000023561.V365592.R01.S.doc Version 5.2 Page 25 She is working towards completing her RMA, and has now completed all of the evidence ready for assessment. She is supported by an established management team of a co-manager who is a registered general and mental health nurse, a clinical manager who is a registered mental health nurse and who has recently completed her Registered Managers Award (RMA), a training manager who has an NVQ level 4 in care and RMA, and many other senior carers who have achieved NVQ level 3 in care. A client said, “She (the manager) is very kind to us”. Staff commented, “You can always go and tell Cathy anything”, and “Cathy is very approachable”. A visitor said, “The management are always helpful”. The manager was late in submitting the homes AQAA to us. However, when received, it was very comprehensive and contained all of the information that we required. The home has also developed their own quality assurance systems. Quality Questionnaires are circulated annually to clients’ advocates and issues raised are evaluated and appropriate actions are taken. The homes AQAA states ‘Feedback is sought from relatives and visitors about services provided through anonymous user satisfaction questionnaires and through individual discussions with clients as well as evidence from their records. Together with feedback from staff meetings and staff discussions we are constantly striving to improve the quality of the services provided to the clients and this is achieved by careful planning, reviewing any actions and evaluating the outcomes and this can be evidenced in clients care plans’. Regular audits are undertaken on staffing, occupancy, food hygiene, risk assessments and trends i.e. complaints. Line management meetings and staff meetings are held as required. The home is a member of the Care Homes Association and holds Investors in People accreditation. Comments observed in the homes compliments book included, ‘A big thank you to everyone who looked after mum…… She was settled & happy at The Cumberland. We were very touched with the care you gave mum at the end …’, ‘Words cannot express how grateful we are to you and the staff. Xxx care over the last four years was much appreciated (as well as the care bestowed on our father xxx when he visited the home. Many thanks to you all for the compassion shown to us all during mums last hours’, and ‘Thank you for the part you and your staff played in her care. We really appreciate it’. Visitors spoken to on the day of the site visit said, “She is quite happy here”, and “She is well looked after”. The only client monies held by the home are small amounts of ‘pocket money’ for those clients who like to have some cash to hand. Accounts for such items as chiropody and hairdressing are paid by the home and invoiced to the client’s representative. The homes AQAA says ‘Due to the clients severe cognitive impairment all clients have an appointed agent/advocate usually a relative or solicitor who manages the financial affairs of the clients. No-one at The Cumberland is directly involved in the financial affairs of the clients but the manager can advise relatives on setting up an enduring/ lasting power of attorney or acting as receiver through the public guardianship service. The Cumberland DS0000023561.V365592.R01.S.doc Version 5.2 Page 26 Records and receipts are provided for the safekeeping of money and valuables on behalf of clients and there are secure facilities for the safekeeping of money and valuables on behalf of clients’. The health, safety and welfare of staff and residents is protected. All equipment is safe and regularly maintained. Accidents are properly recorded. Staff are trained in the mandatory health and safety related subjects. There were some shortfalls in this training but this is now being actively addressed. All staff receive induction training which cover safe working practices. Environmental and care risk assessments are in place. All radiators are covered to protect the clients. The home is secure, there are keypad entries to the external doors, and window security has improved during the last year. The Cumberland DS0000023561.V365592.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 4 X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X 3 X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 3 The Cumberland DS0000023561.V365592.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP31 Good Practice Recommendations The registered manager should complete her qualification course The Cumberland DS0000023561.V365592.R01.S.doc Version 5.2 Page 29 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 The Cumberland DS0000023561.V365592.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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