Inspection on 24/02/09 for The Depperhaugh

This inspection was carried out on 24th February 2009.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Depperhaugh The Depperhaugh Hoxne Eye Suffolk IP21 5BX     The quality rating for this care home is:   one star adequate 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: Julie Small     Date: 2 4 0 2 2 0 0 9 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. that people have said are important to them: They reflect the things 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 32 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 32 Information about the care home Name of care home: Address: The Depperhaugh The Depperhaugh Hoxne Eye Suffolk IP21 5BX 01787222227 01787222227 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Althea Healthcare Properties care home 30 Number of places (if applicable): Under 65 Over 65 0 30 dementia old age, not falling within any other category Additional conditions: 30 0 The maximum number of service users who can be accommodated is 30 The registered person may provide the following categories of service only: Care Home with Nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Dementia Code DE Old Age, not falling within any other category - Code OP Date of last inspection Brief description of the care home The Depperhaugh is a large Gothic style country house built in the 1860s. The Depperhaugh is situated in a rural setting, two miles from the village of Stradbroke, three miles from the town of Eye and seven miles from the town of Diss. It stands in pleasant landscaped gardens. The Depperhaugh can be accessed from the road through a long driveway and offers ample car parking at the front of the home. The Depperhaugh was first registered as a residential home for older people in 1987, then in 1995 it was registered as a nursing home for older people with severe mental infirmity. The home was purchased by Althea Healthcare Properties Ltd, which is part Care Homes for Older People Page 4 of 32 Brief description of the care home of Kingsley Care Homes, June 2008. The Depperhaugh is registered to accommodate up to thirty people. The fees detailed in the Service User Guide are £460 to £900 per week dependant on the accomodation and care required. Care Homes for Older People Page 5 of 32 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: one star adequate 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 unannounced inspection took place Tuesday 24th February 2009 from 10:30 to 17:40. The inspection was a key inspection, which focused on the core standards relating to older people and was undertaken by regulatory inspector Julie Small. The manager and a member of the organisations management team were present during the inspection. The requested information was provided promptly and in an open manner. Four staff members, two people that lived at the home and two relatives were spoken with. We tracked the care records of four people that lived at the home. Further records that were viewed are identified in the main body of this report, which included four staff recruitment records and training records. Care Homes for Older People Page 6 of 32 Prior to the inspection an Annual Quality Assurance Assessment (AQAA) was sent to the home and was returned to CSCI (Commission for Social Care Inspection) within the required timescale. The surveys from two relatives were also received. What the care home does well: What has improved since the last inspection? 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. Care Homes for Older People Page 8 of 32 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 32 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 32 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 that use the service can expect to be provided with information about the service that is provided at the home to help them to make decisions and to have their needs assessed before they move into the home. The home does not provide an intermediate support service. Evidence: People were provided with the information that they needed about the services that were provided at the home which enabled them to decide if the home was the right place for them in the Service Users Guide and the Statement of Purpose. Two relatives of people that lived at the home were spoken with and confirmed that they had been provided with the documents. Two relative surveys said that they were usually provided with enough information about the home to help them to make decisions. The AQAA stated we provide a service user guide prior to admission. Care Homes for Older People Page 11 of 32 Evidence: The Service Users Guide was viewed and included a summary of the service and facilities that were provided at the home, details of the terms and conditions, fees, the complaints procedure, CSCI contact details and that the last inspection report could be found in the entrance hall of the home, if people wished to read it. The Statement of Purpose was viewed and included information about Allied healthcare, the accommodation provided in the home, details of staffing and their qualifications, the vision and values in the home, how people could express their views about the service that they were provided with and the services and activities that were provided at the home. The care records of four people that lived at the home were viewed and each held a needs assessment which had been undertaken by the homes management before they moved into the home. Local authority customers also held a local authority needs assessment. The AQAA stated we do not admit new residents unless assured we can meet their assessed needs. This includes working within registration, assuring we can support their interests, choices and aspirations as well ensuring we have the skills and equipment in place. The AQAA said that they had improved the pre-admission assessment process and that this ensured that person centred care is given after admission. Care Homes for Older People Page 12 of 32 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 that use the service can expect to have their assessed needs and preferences set out in an individual care plan, to have their health care needs met, to be treated with respect and to be protected by the homes medication procedures. Evidence: The care plans of four people that lived at the home were viewed and each showed the support that they preferred and required to meet their assessed needs. The manager told us that the care plans were in the process of being updated to show a more person centred approach. The AQAA stated we have in the last 6 months moved away from following routines, custom and practice to focussing on individual choice in activities of living. Our care plans will be individual, will be written in the first person singular and will balance residents needs and aspirations and will specify what each person can do. We are building on the changes to ensure person centred care is incorporated fully into the home. The care plans that were viewed clearly showed peoples preferred routines, such as Care Homes for Older People Page 13 of 32 Evidence: what time they usually got up in the mornings and what time they preferred to go to bed, details of their health care needs, their personal care needs, regular weight checks, specific dietary requirements, manual handling, continence support and their choices at the time of death. Each care plan held risk assessments, which identified the assessed risks and methods of minimising the risks in areas such as manual handling, falls, Waterlow skin assessments and mobility. There were MUST (malnutrition universal screening tool) assessments in each persons care plan. However, only one was completed. The manager told us that the care plans were work in progress, which would be continually improved upon, and that the MUST tools had only recently been introduced and all had not yet been completed. Daily records were viewed and included staff observations of peoples well being and activities. The relative survey asked if their relatives needs were met at the home and if they were provided with the care and support that they agreed or expected. One answered always and one answered usually and one commented they took time to talk with (the person). The relatives of two people were spoken with and confirmed that their relatives needs were met at the home and that they had been consulted with about the support that their relative was provided with. One relative said that they had been consulted with regarding their relatives choices at the time of death. A comment made in a relatives survey was during (the persons) last few days, (the person) was given tender loving care. Two staff members that were spoken with stated that the care plans held the information that they needed to meet peoples needs. Peoples health needs were met and the care plans that were viewed identified the health care support that had been provided, which included chiropody and optical. It was noted that the specific foot care that one person with diabetes required had not been completed. This was pointed out to the manager and it was immediately completed. The care plans clearly showed the details of how people were supported with manual handling, which included the use of hoists and the numbers of staff required to support the person. A staff member that was spoken with stated that on the day of the inspection a nursing staff member had trained them and a colleague on the use of the slide sheets. The AQAA stated we have purchased slide sheets, handling belts and slings for the hoists. The manager told us that they had a good working relationship with the mental health team, who provided guidance and support when they requested it. People that lived at the home were protected by the homes medication procedures. The medication procedures were viewed and it was noted that they clearly explained the methods of the safe handling, storage and administration of medication. The Care Homes for Older People Page 14 of 32 Evidence: manager told us that since the organisation had taken over the home they had introduced the MDS (monitored dosage system), staff who were responsible for medication administration had been trained on the new system and a new medication trolley had been purchased. Part of the lunchtime medication administration was observed and it was noted that people were asked if they wished to take their medication, the medication was transferred from the MDS blister packs into clean pots and the MAR (medication administration records) charts were signed when the people had been observed to take their medication. The MAR charts were viewed and it was noted that there were no unexplained gaps and that the medication was accounted for. The care plans of four people that were viewed included the arrangements for the support that they required with their medication and the medication that had been prescribed to them. The staff member that was administering the medication explained the administration procedures and they confirmed that they had been provided with medication training. People that lived at the home were treated with respect and their privacy and dignity was respected. It was noted that people were clean and well dressed, which showed that care had been taken when supporting people with their personal care needs. A relative of a person that was spoken with told us that their relative was always clean and smart and that they dressed in their own clothing. The care plans that were viewed showed the style of clothing that people preferred to wear, such as casual clothing. Staff were observed to knock on bedroom doors before entering them. Two relatives of people that lived at the home that were spoken with told us that they and their relative were always treated with respect. This was confirmed by a person who lived at the home. They were complimentary about the approach of the staff that worked at the home. The interaction between the staff and people that lived at the home was observed to be caring, respectful and professional. Care Homes for Older People Page 15 of 32 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 that use the service can expect to be supported to participate in activities that are of interest to them, to be supported to maintain the contacts of their choice and to be provided with a balanced diet. Evidence: When we arrived at the home we observed people participating in the activities provided by a visiting entertainer. They played old vinyl records from the 1940s and 1950s on an old style record player. The entertainer showed people the record sleeves and people commented that they remembered the artists. As the activity progressed people started to sing and dance to the music. People were provided with the opportunities to participate in activities that interested them. There was a notice board in the lounge which showed the daily activities that people could participate in such as pampering, ball games, singing and games such as jenga and darts. The Statement of Purpose stated that activities that were provided at the home included reminiscence therapy, film club, music and movement and reading. The AQAA stated we have a programme of activities which residents are free to participate in or not according to choice. This is tailored to individuals who may prefer Care Homes for Older People Page 16 of 32 Evidence: a more personal touch such as hand massage, foot spa, talking about family or having a local interest article read to them from a magazine or newspaper. The care plans of people that were viewed included the details of their interests and hobbies and their daily records showed when they had participated in activities at the home. A person that lived at the home was spoken with and stated that they had enjoyed the music in the morning and that there were plenty of activities that they could join in with if they chose to, such as drawing and art, talks and music. They said that they particularly enjoyed the opportunities to try something new and that they sometimes liked to chat with the people that lived at the home and the staff. They said that they chose what they wanted to do and that their choices were respected. A person that lived at the home was observed to sing along to a hymn with a staff member, which showed that they were provided with the opportunities to participate in one to one activities with staff. The care plans of four people that lived at the home were viewed and each identified the contact that they maintained with their family and friends. There were also records in the care plans which identified when family members had visited people in the home and when people had been taken out by their relatives. Two relatives that were spoken with stated that they often visited the home, that they were always felt welcome and that they were offered the opportunities to eat meals with their relative and that they were regularly offered drinks. One relative shared examples of how the staff at the home welcomed their grandchildren when visiting. The relative survey asked if they were kept informed of important issues which affected their relative. One answered always and one answered usually. The survey asked if their relative was helped to keep in touch with them. One answered usually and one said that the question was not applicable and commented I visited each week so could always ask anything I wanted to know. The menu was viewed and it was noted that people were provided with a balanced diet and that they were provided with a choice of meals and drinks. A member of the kitchen staff was spoken with and stated that if people did not want to eat what was on the menu they could request something else or they would be offered alternative choices. They told us that they were kept informed of peoples specific dietary requirements and that they ensured that the requirements were met. They showed us a batch of diabetic cakes which had recently been baked and frozen to ensure that people with diabetes were provided with the opportunities to enjoy sweet food as other people that lived at the home. They told us that when people had a birthday one of the cooks would bake a cake and they shared an example of a chocolate cake that they Care Homes for Older People Page 17 of 32 Evidence: had recently made for a persons birthday. The dining room was large, light and provided sufficient seating for people, which provided a pleasant environment to enjoy their meals in. Staff were observed to support people to eat their meals, lunch at the time of the inspection was mince beef patty, swede, potatoes and gravy with an alternative of chicken thigh. The cook was observed to be busy cooking fresh pancakes for Shrove Tuesday and staff were observed to take them to people as they were cooked to ensure that they were still hot. A staff member was observed to ask the cook if they were suitable for people with diabetes, which showed that they were aware of peoples dietary requirements. A person that lived at the home was spoken with and they said that they had enjoyed their meal. A person was spoken with and said that the food was consistently good at the home and that their choices of meal and dietary requirements were met. Care Homes for Older People Page 18 of 32 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 that use the service can expect that their complaints will be listened to and acted upon and to be protected from abuse. Evidence: The complaints procedure was viewed and detailed how people could complain about the service that they were provided with and the methods of how their complaints would be acted upon. People were provided with a summary of the complaints procedure in the Service Users Guide and it was displayed on the wall in the entrance hall to the home. Two relative surveys stated that they knew how to make a complaint and that their concerns wee always acted upon appropriately. Two relatives of people that lived at the home were spoken with and they confirmed that they had been made aware of the complaints procedure when their relative moved into the home and one stated that they had been given a copy of the procedure for their reference. Two staff members that were spoken with were aware of the homes complaints procedure and actions that they should take if a person wished to make a complaint about the service that they were provided with. The complaints book was viewed and it was noted that the nature of complaints were clearly recorded and actions taken as a result of the complaint were identified. The Care Homes for Older People Page 19 of 32 Evidence: AQAA stated that there had been three complaints made and CSCI were aware of them and the outcomes. The manager told us that there was one complaint which was in the process of being investigated. The AQAA stated we are honest about our actions, shortfalls any acts of omission. We try to deal with concerns and issues as they arise and respond appropriately. It was noted that there were no records of compliments that had been received at the home. The manager told us that they had received compliments and that they had not yet developed a system for recording them and agreed that they would ensure that they were recorded. The AQAA stated that there had been no safeguarding referrals made in the last twelve months and CSCI had not been made aware of any. Two staff members that were spoken with were aware of the safeguarding and whistle blowing procedures. Staff training records that were viewed showed that the staff were provided with safeguarding training July 2009. Care Homes for Older People Page 20 of 32 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can expect to be provided with a clean home to live in, they cannot expect that the home is well maintained, however, plans for the redecoration of the ground floor are in the process of being undertaken. People cannot be assured that they are safeguarded from cross contamination by the homes infection control procedures regarding the cleaning of commodes. Evidence: The grounds to the home were attractive and well maintained and the decor and furnishings of the home were in keeping with the homes period and the home was clean and there were no offensive odours. However, it was noted that there were some areas of the home which required redecoration and refurbishment. The paint on the dado rail in the lounge was chipped, the wallpaper in the hall near to the kitchen and in two bedrooms was peeling, there was a hole in the upholstery of the chair lift, the baths were old and stained and the chairs in the lounge were faded and stained. The areas in need of updating were not a safety risk to people that lived at the home. The manager told us that bedrooms had been redecorated as people had moved out and quotes had been obtained for the redecoration and re carpeting of the ground floor. The AQAA stated vacant bedrooms have been upgraded and furniture replaced. The overall environment is being reviewed to effectively meet the needs of residents. Care Homes for Older People Page 21 of 32 Evidence: The manager told us that they were considering areas of the home which they could make more accessible for people with dementia, for example signs for bedrooms and the dining room. The laundry was viewed and it was noted that it was a very small area which provided one washing machine and one drying machine. A staff member told us that the previous owners to the home sent out the bed linen to an external laundry and that the bed linen was currently laundered in the home. The manager was spoken with about the size of the laundry and if it was sufficient to meet the needs of thirty people. The manager reported that there had been no issues that had arisen with the laundry and that they managed it well. It was noted that there was no evidence, such as a large amount of dirty laundry, to suggest that they did not manage the laundry appropriately. However, this may be an issue if the washing machine were to break. There was no provision of dirty and clean areas in the laundry, whilst there were hand washing facilities it was noted that the sink was discoloured with a white film on the surface. A member of the organisations management team looked at the sink and said that it appeared that it had been marked by water and detergent and if it was wiped it would be clean. A staff member that was spoken with was asked what the arrangements for cleaning commodes were and they said I have no idea. The manager was asked about the methods for cleaning commodes, which they initially said that they thought that it was done by the night staff by jet wash outside of the home, which was confirmed by another staff member. We had stated that this was not appropriate infection control procedures, the manager told us that there was a sluice facility one of the first floor bathrooms, however, this could not be located by the manager at the time of the inspection. A staff member explained the night staff undertook the tasks of cleaning commodes and that they were cleaned in peoples en suite facilities and included the use of detergent and disposable dry wipes. The homes detailed infection control procedure was viewed and clearly showed the good practice methods for ensuring that cross contamination was minimised in areas such as cleaning commodes and body spillages. A member of the organisations management team was spoken with by telephone following the inspection and they confirmed that there was a sluicing facility in the home where commodes were disinfected. However, this was not identified in the homes infection control procedures. During the inspection staff were observed to use good infection control procedures which included wearing disposable aprons when working with food and disposable Care Homes for Older People Page 22 of 32 Evidence: aprons and gloves when supporting people with their personal care. Around the home there were bottles of alcohol hand cleanser for the use of staff, visitors and people that lived at the home and it was noted that all bathrooms provided hand wash liquid and disposable paper towels to ensure that all people in the home could wash their hands effectively to minimise the risk of cross infection. Care Homes for Older People Page 23 of 32 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 can expect to be supported by adequate numbers of staff that are appropriately qualified. They cannot expect to be protected by the homes recruitment procedures and that staff are appropriately inducted into their job roles. Evidence: The needs of people that lived at the home were met by adequate staff numbers. A member of the organisations management team stated that they regularly checked the staffing arrangements on the Department of Health staffing forum. There were no staff vacancies at the home. The manager told us that the management arrangements at the home were that there was one nursing staff on each shift throughout the twenty four hour period. Five care assistants on the morning shift 07:00 to 14:00 and on the afternoon shift 14:00 to 21:00 and two waking night care assistants during the night shift 21:00 to 08:00. A handover meeting at each changes of shift was held and the manager told us that there was always a staff member available to attend to peoples needs at these times. There was a cook, kitchen assistant and either one or two domestic staff members seven days a week. Three maintenance staff worked at the home. During the inspection it was noted that staff were attentive to the needs of people and Care Homes for Older People Page 24 of 32 Evidence: that call bells were answered promptly. The manager worked Monday to Friday 08:00 to 17:00, the manager stated that they also undertook spot checks on the home and had arrived at the home 06:00 the day before the inspection. The manager told us that an administration assistant had been employed at the home and that they were waiting for their satisfactory CRB (Criminal Records Bureau) check and that they were in the process of obtaining an activities support staff member who would coach staff in the activities provision for people. The home had met the target of a minimum of 50 of care staff to have achieved a minimum of NVQ (National Vocational Qualification) level 2 by 2005 as identified in the National Minimum Standards relating to older people. The AQAA said that there were twenty two permanent care workers and thirteen had achieved an NVQ level 2 and stated care and ancillary staff are gaining underpinning knowledge through their NVQs. The training records of two staff members who had started working at the home January 2009 were viewed and each contained a training certificate for continence support. There was no evidence to show that they had been provided with an induction which met with the Skills for Care Common Induction Standards. The manager told us that all newly appointed staff were provided with an induction course and that they would ensure that evidence of the induction course would be included in the staff records. The training records of a further two staff members were viewed and they held training certificates which included person centred support, safeguarding, manual handling, fire safety and incontinence. They did not include evidence that they had undertaken an appropriate induction course. Two staff members were spoken with and one stated that they were currently working on their induction course and that a nursing staff member had trained them and a colleague in the use of slide sheets on the day of the inspection. The staff members said that they had been provided with training courses such as manual handling, safeguarding, incontinence and that they were attending a dementia training course in March 2009. The manager was spoken with and stated that a dementia course was due to be undertaken by the staff team and that they were in the process of organising a diabetes training course. They also stated that it had been identified that the manual handling training should be updated and this was in the process of being planned. A member of the management team of the organisation said that a group of staff would Care Homes for Older People Page 25 of 32 Evidence: be attending a Mulberry House manual handling trainers course and then they would roll it out to the staff team. They said that they had attended the training and that it was good quality. The AQAA stated training provision is being stepped up. The manager was spoken with about the training records that were maintained in the home and how it may be beneficial to keep a record of the training and the dates of the training that the staff group had been provided with, which may provide a system of identifying when updates were required and if there were any gaps in the training provision for individual staff members. The manager said that they were in the process of developing record keeping systems and that this would improve when their administration assistant had started work. The recruitment records of four staff members were viewed and two held the required information to show that the appropriate checks had been made to safeguard people. They included CRB checks, POVA (protection of vulnerable adults) first checks, identification and two written references. There was a record of an interview which had been undertaken by the manager and a staff member in one staff record which showed an area of good practice following the receipt of their CRB check. The records of two staff did not include evidence that a CRB and POVA first check had been undertaken. The member of the organisations management team contacted their head office and they said that the head office was going to send the information to the home. This had not been received by the end of the inspection and we agreed that it would be acceptable for the information to be sent to us by fax and that they would telephone us to advise that the information was being sent. We were telephoned Friday 27th January 2009 by the member of the organisations management team who advised us that the two staff members had been provided with a police check from their country of origin and that a CRB check and POVA first check had not been applied for. They stated that they had taken actions to address the issue and that POVA first and CRB checks had now been applied for and that the two staff members would not be working at the home until the POVA first check was received. Care Homes for Older People Page 26 of 32 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that use the service can expect to live in a home which is managed in their best interests. They cannot be assured that their health and safety is fully protected. Evidence: A manager had been employed at the home since October 2008. The manager was spoken with and told us that they had a nursing qualification and that they were working of an NVQ Leadership and Management course. They had not yet made a registered manager application with us and they stated that they would be making the application as soon as. People were consulted with about the service that they were provided with in care review meetings and in monthly Regulation 26 visits. A Regulation 26 visit report was viewed which had been undertaken January 2009 and showed that people that lived at the home, visitors to the home and staff were spoken with about their views about the service that they were provided with. The manager said that the organisation does Care Homes for Older People Page 27 of 32 Evidence: undertake regular satisfaction questionnaires, however, this had not yet been provided at the home because they were a new service. Two relatives of people that lived at the home were spoken with and said that they were consulted with about the care that was provided to their relative and that they could approach the management at the home or staff for information or to share their concerns. The manager told us that they did not handle the finances of the people that lived at the home and that all transactions were invoiced to their representatives. The home had a fire safety risk assessment. The records of regular fire safety checks were viewed, which ensured that the risks to people in case of a fire were minimised. The fire procedure was displayed around the home. The Safer Food and Better Business records were viewed in the kitchen and showed that cleaning and regular fridge and freezer temperature checks were undertaken. The radiators in the home were covered to minimise the risks of burns to people. A hoist on the first floor landing was looked at and it was noted that it held a sticker which stated that it had been checked January 2009 and the next check was due July 09, which showed that it was safe to use. The records of hot water temperature checks were viewed, which showed that people were safeguarded against scalds. The electrical appliance check had been booked for two weeks time. There was an identified risk regarding the homes infection control procedures for the cleaning of commodes, which is discussed in the environment section of this report. A further risk was identified regarding the staff recruitment checks that were undertaken at the home to ensure that people were safeguarded by the homes recruitment procedures and this is discussed in the staffing section of this report. Care Homes for Older People Page 28 of 32 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 29 of 32 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 1 26 13 Procedures must be in place to ensure that commodes are appropriately cleaned. To minimise the risk of cross contamination. 15/03/2009 2 29 19 Satisfactory Criminal 15/03/2009 Records Bureau and/or POVA first checks must be in place before a worker starts to work at the home. To ensure that workers are fit to work at the home and that vulnerable adults are safeguarded by the homes recruitment procedures and processes. 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 30 It is recommended that the training records be improved to show where workers have been provided with training, to identify when updates are required and if there are any Page 30 of 32 Care Homes for Older People gaps in the workers training. 2 30 It is recommended that evidence that workers are undertaking or have been provided with an appropriate induction course be included in their training records. Care Homes for Older People Page 31 of 32 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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. 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