Inspection on 24/06/08 for The Flowers

This inspection was carried out on 24th 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 Flowers 03/07/07

The Flowers 06/07/06

The Flowers 21/02/06

The Flowers 08/12/04

The Flowers 14/06/04

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

CARE HOMES FOR OLDER PEOPLE The Flowers 3 Snape Drive Horton Bank Top Bradford West Yorkshire BD7 4LZ Lead Inspector Caroline Long Key Unannounced Inspection 24th June 2008 09:25 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 Flowers DS0000001161.V367114.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 Flowers DS0000001161.V367114.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Flowers Address 3 Snape Drive Horton Bank Top Bradford West Yorkshire BD7 4LZ 01274 575814 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) flowerscarehome@aol.com www.flowerscarehome.com Mrs Catherine Ruth Taylor Mrs Catherine Ruth Taylor Care Home 23 Category(ies) of Dementia - over 65 years of age (23) registration, with number of places The Flowers DS0000001161.V367114.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd July 2007 Brief Description of the Service: The Flowers is owned and managed by Catherine Taylor. It is a detached house, which has been extended and adapted. It is in a residential area and close to local shops. There is a bus route nearby. The Flowers provides care for older people with a mild to moderate dementia and other memory loss disorders. There are two shared bedrooms, all the rest are single. Some bedrooms have en-suite facilities. There are two communal areas; one is divided into a lounge/dining area with clear views of the garden. The other has recently been fitted out with sensory equipment and furniture, a variety of chairs and a sofa and is used to create a variety of environments for people, depending on which equipment is being used. People can easily move about the home, there are ramps between the different levels and a passenger lift to the first floor. There is also level access to the enclosed garden, which provides a safe and pleasant place for residents to use. There are two areas for parking. On the 24th June 2008 the scale of fees ranges from £400 to £485 per week. The fee does not include private chiropody treatments and hairdressing. A copy of the inspection report is available from the home. The Flowers DS0000001161.V367114.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. This is what we used to write this report: • • • We looked at information we have received about the home since the last key inspection. We asked for information to be sent to us before the inspection, this is called an annual quality assessment questionnaire (AQAA). We sent surveys to people living in the home and to their relatives and health professionals. Four surveys from people living at the home were returned following our visit. One inspector visited the home unannounced. This visit lasted over six hours and included talking to the staff and the business manager and the deputy manager about their work and the training they have completed, and checking some of the records, policies and procedures the home has to keep. We spent time talking with people who live in the home and five relatives who were visiting. We looked at three people’s care records to check that a plan had been formulated which helped staff provide support to people according to their needs and wishes. We focused on the key standards and what the outcomes are for people living in the home, as well as matters, which were raised at the last inspection. An expert by experience was asked to accompany the inspector during the visit to the home. An ‘expert by experience’ is a person who because of there shared experience of using services and /or ways of communicating, visits a service with the inspector to help them get a picture of what it is like to live in or use the service. During this visit they were asked to look at peoples daily life, social activities, and the environment their observations have been used in these outcome areas. • • • • • The Flowers DS0000001161.V367114.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? 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 Flowers DS0000001161.V367114.R01.S.doc Version 5.2 Page 7 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 Flowers DS0000001161.V367114.R01.S.doc Version 5.2 Page 8 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): Standard 3 only Standard 6 is not applicable. People who use the service experience excellent quality outcomes in this area People are provided with enough information and are properly assessed prior to admission so they can make sure The Flowers is the best place for them to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a Website www.flowerscarehome.com, which has good information and photographs of the service. Comments made by people’s relatives were: • ‘Moved in just before Christmas was quite happy here heather is brilliant.’ • ‘Wouldn’t wish her to be anywhere else.’ The Flowers DS0000001161.V367114.R01.S.doc Version 5.2 Page 9 Four surveys were returned from people living in the home all say they have received a contract and they did get enough information before they moved in A comment made was: • ‘Could not get a better one very happy with the home.’ In their annual assessment questionnaire the owner explains that people are encouraged to look at other providers to help to make sure this is the place they want to live, a relative confirmed this, saying: • ‘Looked around and this is the best.’ Looking at the records of a person who had recently moved into the home confirmed good practice. It contained details of their daily life and health needs, and showed the person had visited The Flowers before they had moved in. Examples of the information included were religion, daily living, social interests, nutrition, details such as they don’t like to play dominoes, and this was signed and agreed by the person moving in. The recording of personal preferences helps to makes sure people receive the service they want. Following this on the day they move into the home a temporary assessment and risk assessments were carried out. This will make sure the person is protected from risks and receives the care they need from the day the move into the home. Also the daily notes recorded that the person was introduced to other people living in the home. There was evidence also staff were provided with specialist training in order for them to provide people with the care they need an example of the training was dementia care. There was also information to show the home is constantly reviewing whether they are able to meet a persons needs. The home does not provide intermediate care. The Flowers DS0000001161.V367114.R01.S.doc Version 5.2 Page 10 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 People who use the service experience excellent quality outcomes in this area. People receive care that is delivered in a manner that respects their wishes and meets their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Generally all the relatives and one person who lived in the home made very positive comments about The Flowers examples of these were: • ‘Everyone always treated with respect and dignity.’ • ‘Wouldn’t wish them to be anywhere else.’ • ‘Brilliant really well looked after, really good when came at first always nice with her relative loves it peace of mind and knowing relative is safe.’ • ‘Home from home just what I wanted.’ • ‘Very happy it is a special place.’ • ‘Quite happy, relative seems quite happy.’ • ‘Really pleased, hands on approach touch and kiss personal contact which makes it lovely staff do care’ The Flowers DS0000001161.V367114.R01.S.doc Version 5.2 Page 11 • ‘Staff are kind and considerate staff have patience’. Three peoples’ case records were looked at in order to check that a plan had been formulated which helped staff provide support to people according to their needs and wishes. The care plans were in a booklet format and the front cover had a picture of a flower, this same picture was on the door of the persons room, they were very easy to follow and looked to be well used by the staff. They all contained plans that were comprehensive, and identified the individuals personal needs. The plans covered aspects such as daily living, catering, spiritual, religious needs, social activities and medication. They clearly described how people wanted their lifestyle to be and how their independence was promoted. They provided evidence of their involvement and making choices about their daily lives. These were supported by risk assessments, which described the possible risks to the people, and the actions the staff needed to take to minimise these risks. Both the care plans and the risk assessments had been reviewed regularly. An example of the staffs actions are, where a person had been identified as not eating a full diet, the staff had commenced weighing them regularly and started to record their fluid intake and were providing them with alternative ways of maintaining their diet such as milk shakes and finger foods. Staff were observed providing support to people in a kind and helpful manner, people were clean and dressed in co-ordinating clothes. Relatives said this was always the case. The atmosphere was calm and comfortable, people looked happy and content. A member of staff was able to explain how they use diversion methods to keep people calm. A relative described how people had memory boxes which contained personal items and photographs, and when they became upset to help calm them how staff would sit and go through them. Staff promote the rights of people to access the health care professionals that they need both within the home and in the community. In the surveys, relatives said and the records looked at all showed people do have access to the GP, the community psychiatric nurse and the dietician. A district nurse made positive comments such as everyone is looked after very well and the home will inform them of any problems, all her team say it is good. Medication is dealt with correctly. There is a drug trolley, which is kept locked when not in use. Therefore medication is kept safely. Only staff trained to give out medication do so. A sample of drugs were checked alongside the record sheets and were found to be accurate. The Flowers DS0000001161.V367114.R01.S.doc Version 5.2 Page 12 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): Standards 12, 13, 14 and 15. People who use the service experience good quality outcomes in this area. People are provided with the opportunity to have a stimulating daily life by staff. People are given a choice of nutritious drinks and meals when they request them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: When we visited we saw people sitting in comfortable easy chairs watching TV, others sitting at the dining tables eating breakfast or just enjoying drinks. There was an atmosphere of calmness throughout the day. People were spoken to in a calm and professional manner and given time to make their views known. Magazines and books were available around the home and there were clocks in each communal room. Very few people stayed in the same place for long they were free to move around at will. In the main lounge a shelf held memory boxes (shoe box size) each clearly named and holding personal items, mostly photographs of family and friends. The purpose of these is to initiate discussions and help people reminisce about their lives and past experiences or to distract anyone who is upset. The popular activities Snoozelam room was well used, music was played and The Flowers DS0000001161.V367114.R01.S.doc Version 5.2 Page 13 some people danced. A member of staff ironed, at the same time chatting to people who moved in and out of the room, another member of staff read the local newspaper to a group of people sitting together. In the afternoon there was a game of tennis and bowls. This room was full of stimulating murals, cushions and throws in various fabrics also some soft toys which one person liked to cuddle. A flip chart had been used in the memory game of thinking of boys’ names beginning with B C and D. The staff also described how some people were taken to the theatre. The layout of the building and the garden allows people to walk around freely and select different areas to sit in. Staff see the importance of visual aids to support people and therefore there are plenty of signs in the home, which point out key areas, and plenty of things to interest them and stimulate activity and discussion. There were many visitors to the home on the day we visited, all were welcomed by staff one person told us how the home enables people to have lunch together when they visit. There is a book relatives notice board, which gave the prices of hairdressing, a description of how to recognise the staff by their uniforms. Also details of Alzheimer’s group and a notice saying welcome to a cup of tea off the tea trolley. Surveys returned by four people living in the home said there are usually activities you can take part in. One person commented they would like more outdoor activities. Comments made by relatives were mixed examples were: • ‘Always staff and some in other room with time to talk to people.’ • ‘Staff all nice talks to residents.’ • ‘Could do with more activities and staff to enable them to go out, bingo and games played and other activities sometimes their relatives joins in depends on how they feel, generally this all happens in the snooze room.’ • ‘Normally would have activities in ‘snoozalan’ room, ball darts, bingo and they do try to stimulate them. Use memory boxes when upset staff will get out and show pictures to help to calm them down.’ • ‘Sits around all day bored, nothing to do just sleep all day.’ Lunch is treated as an occasion dining tables are set with table cloths and napkins in rings, or people can choose to stay in the ‘snoozlan’ room and have lunch on their knees in a very relaxed way. Breakfast was served when the individuals wished, sometimes in their room. Lunch is sometimes soup and roll and at other times sandwiches. For mid afternoon, tea and cakes and at tea time, a cooked meal with pudding. The deputy manager explained they provide sandwiches at lunchtime and hot meal at nighttime as if given at lunchtime they found it meant people were less active in the afternoon. The Flowers DS0000001161.V367114.R01.S.doc Version 5.2 Page 14 One person was observed being helped with cereal, the staff were very patient, and there were a few biscuits on a side plate as they liked to hold one. During the morning and afternoon there is a choice of hot drinks. Throughout the day trays with jugs of fruit juice and glasses were in each of the communal rooms. A glass-fronted fridge held yoghurts and wrapped chocolate biscuits. The business manager explained the cook had recently left the home and staff had been covering for two weeks however they had a new person starting on Monday. There was evidence staff had food hygiene training , the member of staff helping in the kitchen also said she had had the training. Four people who live at the home stated they always liked the food. One commented ‘very good meal, homemade food available.’ Relative comments were: • • • • ‘Food ok fried egg sandwiches, always plenty to eat and a cup of tea and biscuit.’ ‘Have sandwiches and smoothies, menu not very varied.’ ‘Sometimes don’t wake people to eat their sandwiches.’ ‘Food good although chef left two weeks ago.’ The Flowers DS0000001161.V367114.R01.S.doc Version 5.2 Page 15 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): Standards 16 and 18. People who use this service experience good quality outcomes in this area. People who live in the home and their families can be sure that complaints are taken seriously and staff are alert to any signs of abuse. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The home has a clear complaints procedure that highlights the importance of complaining if people are not happy with the service. Which is displayed in the home, and is available on their website. Records examined showed that complaints are responded to within the correct times scales however they did not meet data protection guidelines, the business manager agreed to change this to meet the guidelines. People said they knew who to complain to and feedback from surveys confirmed that they are aware of the complaints procedure and know who to talk to if they are dissatisfied with the service. During our visit relatives said they would tell one of the managers. The home has received which have all been resolved in the last year. The commission has received two concerns, which have both been passed to the owner to investigate; the owner has investigated these and responded. Where a complaint had been made about peoples clothing there was evidence to show that this had been raised at a staff meeting. The Flowers DS0000001161.V367114.R01.S.doc Version 5.2 Page 16 Management know the course of actions to take in relation to protecting the rights of people. Staffs are aware of the need to report any allegations or suspicions of abuse to their manager. The Flowers DS0000001161.V367114.R01.S.doc Version 5.2 Page 17 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): Standard 19 and 26. People who use this service experience excellent quality outcomes in this area. People are provided with a living environment that is appropriate for their particular lifestyle and needs; it is homely, clean and well maintained. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The owner has decorated the property to provide people with dementia with an environment, which will increases their independence and stimulate them. For instance the toilet doors are all painted blue and the corridors are painted different colours. This will help people remember where their room and toilet are. The corridors were full of interest, flower motifs on all the doors, shelves with ornaments. Framed pictures of old post cards, other memorabilia and many pictures of flowers. People can also move freely around the home and the gardens, the entrance is The Flowers DS0000001161.V367114.R01.S.doc Version 5.2 Page 18 into the main lounge and dining area, which means there is always someone coming and going and saying hello to people living there. There is an emergency call system, which people can use to summon help if they are in their room. For those people who cannot use this for reasons such as memory loss, a pressure mat is positioned next to their bed so that staff are alerted to them getting out of bed during the night. This allows them to respond quickly to peoples needs. All the bedrooms have a picture of a flower on them and are individually decorated according to the flower designated to the room and have lots of personal photographs and belongings making them very attractive and homely. One person explained how their bedroom had been changed recently to a downstairs room near to the office, they said they are very happy in this new room, as they are closer to everyone. All pictures and personal items had been reinstalled. Bathrooms were well equipped, toilets convenient to communal rooms, they were like a bathroom at home. There is an enclosed sensory garden for people to use. A sunroom looked out over the secure garden, this room was popular with people who wished to be quiet. CCTV Cameras were in the home but not in people’s bedrooms on corridor and communal areas, the business manager explained this was for people’s safety and was able to show details of how they had asked the opinion of the relatives and people living in the home. All whom had said this was a good thing and protected people. There are also CCTV cameras outside the home for security reasons. At the previous inspection requirements had been made for a sign to be displayed on the basement door warning of immediate steps to minimise the risk of accidents and for the bathroom hot water taps to be within safe limits, both of these requirements had been carried out. Four relative surveys were received all said the home was always fresh and clean. All of the relatives we talked to during our visit and the people who returned the surveys said the home is always fresh and clean. When we visited we found this to be the case. The home is well maintained. Staff are employed specifically to maintain the home environment, to carry out the laundry and for the garden. When we The Flowers DS0000001161.V367114.R01.S.doc Version 5.2 Page 19 visited we were able to see how quickly they responded to any maintenance, cleaning or other health and safety issues that occurred. The Flowers DS0000001161.V367114.R01.S.doc Version 5.2 Page 20 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): Standards 27, 28, 29 and 30. People who use this service experience good outcomes in this area. Staff in the home are trained, and skilled to support people who use the service. However to make sure only suitable people are employed recruitment procedures must be more robust. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Positive comments were made about the staff by relatives such as: • ‘Staff all nice talked to residents.’ • ‘Staff are kind and considerate staff have patience.’ When we visited there were one senior and three care staff in a morning and one senior and two care staff a evening. The business manager or the owner works most days, cleaning, laundry and maintaince staff and a cook support them. The business manager explained they had recently recruited a new manager who they hope would be commencing soon. On the day we visited we were told there were twenty-one people in the home. The ancillary staff are trained to provide care if necessary and the lady who carried out the laundry explained that the priority is always peoples care needs. All of the staff said there were generally enough staff on duty and people’s needs were met. The Flowers DS0000001161.V367114.R01.S.doc Version 5.2 Page 21 Four people who returned their surveys said staff do listen and act on what they say and staff are always available when they need them. However three of the five relatives said they were occasions when they believed there was not enough staff. The business manager explained staff are always started for a probationary period first and initially complete an induction which follows the skills for care and includes mobility assistance and first aid and training by outside trainers, such as Alzheimer’s society. The home does not have a training matrix so it was difficult to identify if everyone’s training is up to date. The business manager explained they are expecting a new manager and this has been identified as their first priority However people’s certificates showed that dementia training is carried out by Bradford north mental health awareness group, Lloyds pharmacy level three, and the Alzheimer’s society. Also staff confirmed they had received both induction and training whilst working at The Flowers. The staff said they had regular staff meeting and the minutes confirmed this We looked at three staff recruitment files and found that two staff had started work before the home had received the outcome of the initial check to see if they are suitable to work with vulnerable people (Protection of Vulnerable Adults, POVA). All three had started before they had received the full police check (criminal record bureau, CRB). However all had references that were received before they started work and the business manager explained that verbal references were always sought and people are always shadowed once they commenced work. She also explained they do not like to use agency staff and have only done this when a emergency has occurred, also this was because of the delay in receiving the police checks. She agreed to make sure there procedures were more robust in the future. The Flowers DS0000001161.V367114.R01.S.doc Version 5.2 Page 22 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): People who use this service experience good outcomes in this area. The home is managed in the best interest of the people who live there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The owner has a significant amount of experience and is well thought of by her staff at The Flowers. She is supported by a deputy manager who is a registered general nurse and a business manager who takes care of staffing matters and financial arrangements. There are also plans to appoint a manager. The owner has attended a pilot course for better management in Dementia Care organised by Dementia North and has also numerous Dementia conferences and courses. The Flowers DS0000001161.V367114.R01.S.doc Version 5.2 Page 23 The outcomes of this evidence that this home is run in the best interests of the people who live there. Staff told us staff meetings and supervision occur regularly and they felt supported by the managers. People with an interest in the service and other associated professionals have been surveyed for the views on the service provided. We were able to see the responses that were very positive most gave a score of nine out of ten. An example of a comment made was: • ‘That you have the time to listen to relatives and that the standards you all keeping in the home are excellent. Cleanliness is excellent, the surroundings are pleasant and everyone maintains a sense of humour.’ Regular relative meetings are held where relatives are able to express their views. The home holds money on behalf of a number of people, transactions are recorded, for any items purchased on people’s behalf. For the benefit of the people living in the home the business manager explained they run a shop, which enables people to buy toiletries etc, however they do not issue receipts when people purchase items from the shop they log it in a book. For the protection of everyone these purchases should be track able and the owner should consider a regular audit of these accounts. There is a handyman who is responsible for maintaining and updating the health and safety records. The annual quality assurance questionnaire confirmed that equipment is maintained and serviced appropriately. A sample of the documents were seen and found to be up to date. The Flowers DS0000001161.V367114.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 3 X 4 The Flowers DS0000001161.V367114.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP29 Regulation . 19 Requirement To protect people using the service and to ensure only suitable staff are employed at the home the registered person must ensure that all staff have: • Completed a full application form and given details of previous employment. Any gaps in employment must be explored and details recorded. • Two satisfactory written references held on their personnel file. • A satisfactory CRB check in place. Where a POVA first check has been obtained there must be evidence that the staff member worked under supervision pending the receipt of the full CRB check. Timescale for action 01/08/08 The Flowers DS0000001161.V367114.R01.S.doc Version 5.2 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Flowers DS0000001161.V367114.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Flowers DS0000001161.V367114.R01.S.doc Version 5.2 Page 28 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!