Inspection on 03/07/07 for The Flowers

This inspection was carried out on 3rd July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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 24/06/08

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE The Flowers 3 Snape Drive Horton Bank Top Bradford West Yorkshire BD7 4LZ Lead Inspector Karen Westhead Key Unannounced Inspection 3rd July 2007 10:30a 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.V336403.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.V336403.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 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.V336403.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th July 2006 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 residents, depending on which equipment is being used. Residents 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. The current scale of fees ranges from £375 to £494 per week. The fee does not include private chiropody treatments and hairdressing. The Flowers DS0000001161.V336403.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was done by one inspector and had not been prearranged with the owner. The inspector arrived at 10.30am and left at 5.00pm. At the end of the visit the owner was told how well the home was being run and what was needed to make sure the home meets the standards. The reason for the visit was to make sure the home was being run for the benefit and well being of the residents and in line with requirements. The home was last inspected on 6th July 2006. Before the inspection information received about the home was reviewed. This included looking at the number of reported incidents and accidents, the action plan provided following the last inspection and reports from other agencies such as the fire safety officer’s report. This information was used to plan the inspection visit. A number of records were looked at which covered all aspects of the home and the care provided. All communal areas of the home were seen and some of the residents bedrooms. Most of the day was spent talking to residents, visitors, staff and the owner, to find out what it is like to live and work at The Flowers. Some visitors and residents agreed to complete questionnaires provided by the inspector during the visit. The results of these are included in the body of the report. They were all very positive and this was shared with the owner at the end of the inspection. Additional Commission for Social Care Inspection (CSCI) questionnaires and post-paid envelopes were left for residents and visitors to complete at a later date if they wish. Other visitors and residents were asked for their views and what they said to the inspector is also included in this report. What the service does well: The owner is also the manager and she invests time and money into the home to improve the environment and care provided. She works together with staff, including a business manager and assistant manager, and is involved in the day-to-day running of the home. Residents have free movement within the home and the grounds. Residents spoken to, who were able to give their views, said they feel well supported by a staff team who are caring in their day-to-day work with them. The arrangements around recreation and activities is excellent. A number of residents benefit from planned leisure activities. Residents are kept busy by The Flowers DS0000001161.V336403.R01.S.doc Version 5.2 Page 6 being offered opportunities to take part in one-to-one or group activities. Some residents help with domestic tasks in the home, with appropriate levels of staff supervision. Relatives said they were confident that any concerns or complaints would be taken seriously and be dealt with by the owner and staff team. Each resident is treated as an individual and their personalities, personal interests, cultural and religious preferences are respected by staff and their needs are met. There is good communication between staff, residents and relatives and staff members know residents well. This allows for a good continuity of care and service. The owner and staff team are extremely committed and keen to provide a good quality of life for residents living at The Flowers. The level of commitment and loyalty of staff is noticeable and staff work together as a team to make sure the home is properly run. The Flowers is homely, welcoming and comfortable. The level of cleanliness is good, the home smelt fresh. Residents were content and relaxed. There was a lot of conversation and banter between residents, visitors and staff. Staff made sure that when anyone looked unsure, bored, upset or anxious they were offered reassurance, comfort or distraction. The level of involvement with the resident was in keeping with the resident’s needs and wishes. Personal care was provided in private and staff were discreet to make sure residents dignity and self respect were maintained. Even in situations where a resident refused to move from a communal area, a screen was used to provide privacy. Residents have a choice of well-prepared and wholesome meals and are served their meals in a relaxed and friendly way. Residents have a choice of where to take their meals. In addition to this there are cold drinks and refrigerated snacks at hand for residents in places, which are easy for them to access. Policies and information is to hand for staff and ongoing supervision, staff appraisals and training courses are seen as a fundamental part of each employee’s duty. This leads to expectations being known and a good quality of care for residents. What has improved since the last inspection? Staff have continued to be trained to make sure they can fulfil their roles within the home, including attendance on courses covering food hygiene and adult protection. The Flowers DS0000001161.V336403.R01.S.doc Version 5.2 Page 7 The format of care plans is being changed to make sure they include all the necessary information in one file. The giving and recording of medication has been improved following a full audit and unannounced inspection from a CSCI pharmacy inspector on 8th May 2007. The ‘snoezelem room’ is now in use. This room replaces what was previously a lounge and quiet area. It is well used by residents and allows staff to change the environment using lighting and other sensory equipment to create a range of settings either for stimulation or relaxation. Relatives said it had been a huge success and residents really liked it. The room is dedicated to the memory of a past resident and a plaque is in place to acknowledge this. What they could do better: Overall the home is run very well. Two requirements were made with regard to health and safety matters and one recommendation about the use of CCTV. • • The supply of hot water to one bathroom was not right. At the sink there was no hot water available and the temperature of the hot water from the bath tap was well over safe limits. The steps leading to the basement are immediately behind the door on the corridor. This could present a hazard, so the owner has been asked to provide a sign warning of ‘immediate steps’ to minimise risk of accidents. It is recommended that the owner look at ways to check out that the use of CCTV within the home is accepted by the residents and/or their relatives and that this does not compromise the privacy and dignity of residents and review the use of these in light of resident choice. • 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.V336403.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 Flowers DS0000001161.V336403.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): 1, 3, 4 and 5 (6 N/A) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives have enough information about the home to decide if it will meet their needs. EVIDENCE: The Statement of Purpose and Service User Guide provides enough information for residents and their relatives to make an informed choice about whether they think The Flowers might be a suitable home. The owner thought these could be produced in larger print on request, for those with poor sight. The documents describe what the home provides, what is not included in the fees, and informs people about the admission process. Three care files were looked at, including the most recently admitted resident, a resident who’s first language was not English and a resident who requires a high level of assistance from staff. The residents had had an assessment The Flowers DS0000001161.V336403.R01.S.doc Version 5.2 Page 10 before being admitted to make sure the home could meet their individual care needs. Staff work with the family and friends of residents to gain as much information as they can to make sure they capture information the resident may not be able to recall or share but could make a difference to their life in the home and this can go someway to helping the resident settle. All residents are given a contract on admission. Examples were seen where representatives or relatives had signed the contract on behalf of the resident. The contract has been written using plain language and sets out what the fee is, what the resident can expect for that fee and the terms and conditions of their stay. The Flowers DS0000001161.V336403.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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents care needs are met. Plans of care are accurate and staff know what they need to do to meet the needs of residents. EVIDENCE: Three care files were looked at in detail. The information seen gave a good insight into the needs of each person and showed any changes in the care delivery, how this if followed up and what action is being taken. For example where residents had lost weight, a nutritional assessment had been carried out showing the level of risk and what staff should do to minimise this. Care plans are being reviewed monthly; therefore any changes in care delivery are being recorded and were up to date. One resident was acting in a way, which was not appropriate. This had been picked up by staff and a plan had been put in place to make sure the resident was protected and what staff had to do to make sure other residents were not affected. The plan had been written on The Flowers DS0000001161.V336403.R01.S.doc Version 5.2 Page 12 how this should be handled, so that staff were dealing with it in a consistent and professional manner. The owner is in the process of changing the care plans to a new format, which includes additional information and will make it easier for staff to use as all the information is in one file. There is an entry on a residents daily records at least twice a day by the day and night staff. The owner talked about the care provided at The Flowers and there are clear boundaries with which the home operates. For example, when they need additional support from other agencies they know when to consult other professionals. Evidence of this was seen in residents files and examples were discussed during the course of the visit. The owner and staff in the home are committed to providing a home for life for the residents. The final stages of a residents life are seen as an important stage and wherever possible the resident will be looked after in the home with the support of district nurses, the residents doctor and relatives. The homes ‘compliments’ file containing letters and cards from relatives proves that they appreciate the work the staff do to make sure residents are cared for properly and with dignity throughout their stay at The Flowers. 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. The drugs held were checked alongside the record sheets and were found to be accurate. The pharmacy inspector had carried out an unannounced inspection on 8th May 2007 and gave advice and said what needed to be done so that the home was meeting regulations. This has now been carried out. None of the current residents deal with their own medication. There are routine reviews of medication and staff were knowledgeable about what medication was held and what it was being used for. A recent letter from the doctors, who residents are registered with, was passed to CSCI for information. It was decided to share this with the owner. This is a matter which the owner will take up with the surgery. Evidence was seen in the home that the issues in the letter were an ongoing matter and the owner had had a meeting with the doctors in 2005 and copies of letters to and from the doctors surgery were seen on file. Residents are seen in private when the doctor visits. Staff accompany residents to give the doctor up to date information regarding their conditions and to discuss any changes in medication or treatment. There was written evidence of contact with district nurses, dentists and other health professionals. Comments from residents showed they were very satisfied and content with the care provided. The Flowers DS0000001161.V336403.R01.S.doc Version 5.2 Page 13 It was clear during conversations with staff that they take an interest in the well being of each resident and try to provide them with a good quality of life. Some areas of good practice were seen, for example the way in which staff approached residents to attend to their personal care needs and those needing encouragement to eat and drink. This was done in a professional and discrete way. The Flowers DS0000001161.V336403.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): 12, 13, 14 and 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Resident’s lifestyle in the home matches their expectations and they are helped to exercise choice and control over their lives as much as possible. EVIDENCE: Relatives said staff were very good at keeping residents occupied and active. They said there is a lot of activities to keep them entertained, and that they were not made to join in with games and other activities if they didn’t want to. This was also noted on some of the care plans seen. Residents were seen engaging in a wide range of activities throughout the visit, including one to one attention and small group activities. For example, staff read out loud from the local paper to residents who were sat in the dining room. Later in the day residents were encouraged to join in a music session and given time to assemble. Organised activities are advertised in the home. For example posters were up giving details about a forthcoming trip to the pub and the date an entertainer was coming. The Flowers DS0000001161.V336403.R01.S.doc Version 5.2 Page 15 The home has a volunteer who comes on a regular basis to serve drinks and sit with residents to do group activities or to talk to them. The volunteer used to visit her own relatives in the home and continues to visit as an acknowledgement of the support her relatives got when they were at The Flowers. Memory boxes had been created and were displayed around the home. These are made up of old photographs and things which residents used to use when they were younger. The purpose of these is to initiate discussions and help residents reminisce about their lives and past experiences. One example was seen where a member of staff used one of the displays to distract a resident who was upset. The discussion about the display was effective. Staff said they made good use of the local facilities and that the home was part of the local community. Arrangements for dining are good. The main meal of the day is served at teatime, with a lighter meal at lunchtime. All residents are offered a cooked breakfast. The menus seen offered variety and alternatives. Staff are aware of the different preferred tastes of residents and this is included in the menu planning. Two residents like food which is traditional to them and arrangements are in place to make sure they have the opportunity to have this. The staff are aware of the need to make sure residents are given plenty of fluids and jugs of juice were seen in different parts of the home for residents to help themselves to or for staff to provide them. Requests for hot drinks were responded to in addition to the regular tea breaks residents had. Those handling food have received the appropriate training. Staff were attentive to residents at meal times. Examples of good practice was seen when residents were given additional support to eat and drink. The kitchen was clean, tidy and well organised. Records of cleaning schedules, food delivery, serving temperatures and fridge temperatures are kept. The cook prepares the main meal of the day. Residents have a choice whether they are cared for by male or female staff. For example, some residents prefer not to have their personal care needs dealt with by a female. This is respected and male staff are available to assist. Some residents and relatives shared their views about the home: • • • • • • I like it here. Yes, I know the manager, she’s the owner. I talk to her and she sorts things out for my mother. I’ve enjoyed it here since coming. The food is good. I get what I want to eat, if I don’t like something they know what I like. My mum doesn’t have to join in the games if she doesn’t want to. DS0000001161.V336403.R01.S.doc Version 5.2 Page 16 The Flowers • • • • • This is a loving home. There is a positive atmosphere. This is the best home around this area. We are happy with the care. The staff know the needs of the residents. Five questionnaires were completed, two by residents (with the help of a relative) and three by visitors. All the responses were positive and showed that they were satisfied with all aspects of the home and the care provided. Some residents, who were not able to talk about their experiences, showed they recognised the owner and staff in their responses to them and that they felt safe in their presence. There was a warmth and kindness in the way staff spoke to residents who were experiencing difficulties or needed guidance. There was an atmosphere of calmness throughout the day. Staff said they are not under pressure to meet tight timescales and routines. There was an emphasis on making sure residents were comfortable. Staff did not walk past residents without acknowledging them. If residents were looking ‘lost’ or unsure staff picked up on this straight away. Residents were spoken to in a calm and professional manner and given time to make their views known irrespective if they were able to talk or not. The layout of the building allows residents to walk around freely and select different areas to sit in. Staff see the importance of visual aids to support residents 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. Staff hold residents meetings and use a variety of methods to engage residents who have some memory impairment or dementia in discussion. All accidents and incidents in the home are being recorded properly. The Flowers DS0000001161.V336403.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, 17 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The level of staff understanding gives assurance that complaints will be taken seriously and service users will be protected from abuse. EVIDENCE: The home had dealt with five complaints over the last 12 months and all information is kept in a file, including the outcome. All the matters had been resolved to the complainants satisfaction and in some cases the complainant had complemented the home on the way the matter had been handled. Residents and relatives said they knew how to complain and who they could talk to if they felt unhappy. The owner has completed a course on adult protection and staff spoken to on the day said they had received training and were familiar with the procedure. The home has an adult protection policy. A recent letter from the doctors, who residents are registered with, was passed to CSCI for information. It was decided to share this with the owner. This is a matter which the owner will take up with the surgery. Evidence was seen in the home that the issues in the letter were an ongoing matter and the owner The Flowers DS0000001161.V336403.R01.S.doc Version 5.2 Page 18 had had a meeting with the doctors in 2005 and copies of letters to and from the doctors surgery were seen on file. The Flowers DS0000001161.V336403.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, 21, 22, 23, 24, 25 and 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The standard of decoration and maintenance of the home is very good. Two minor matters were brought to the owners attention, these will be dealt with without delay. EVIDENCE: The layout of the home suits the residents living at The Flowers. Most of the residents are fully mobile and there is level access into the home and garden, which residents can use freely. There is a passenger lift to the first floor and hoists, grab rails and raised seats are fitted to baths and toilets as required. There is a mobile hoist for staff to The Flowers DS0000001161.V336403.R01.S.doc Version 5.2 Page 20 use if necessary and they confirmed they had received training in the use of this. Communal areas and bedrooms, which were seen, are well furnished and provide a comfortable setting for residents. The completion of the ‘snoezelem’ has been well received by residents. This area is used to create different settings for residents. Murals on the wall are in keeping with the intended purpose and create a visual focus for residents. This room was full of items of interest, which residents could pick up and touch freely. The television is not switched on through habit. Residents in the television lounge were asked whether they wanted it on, whether they preferred a DVD or music playing. It was clear that the music and television were used at the request of the residents in this area and music was played at a volume which meant residents not wanting to watch it could still converse with each other or their visitors. Residents were offered comfortable seating in the communal areas and foot stools and cushions were in ample supply. The décor in the home is good and there is a theme of flowers throughout the home. Residents seemed to like this and relatives thought the idea helped to enhance the calm and homely environment the owner tried to achieve. Residents are encouraged to bring cherished items of furniture and things they associate with family and home into The Flowers with them. This can help a resident settle better and means they have familiar things around them, which can be comforting. Infection control is well managed. The level of cleanliness in the home was good throughout. The home smelt fresh and staff were attentive to the personal care needs of residents. This was done in an efficient yet discrete way. All laundry is dealt with in house. The washer has a special cycle which takes care of soiled linen. The laundry is in the basement. A new system of collecting and returning personal items of laundry to residents had been introduced and was said to be working well. New hanging rails had been purchased to make sure residents clothing, when ironed, was returned to their room without creases. There are CCTV cameras outside the home for security reasons. There are also monitors inside. These are in corridors and entrances to communal areas. These are not used to intrude on the daily lives of the residents, but to increase observation of residents and maximise their independence. The reasons for their primary use were explored with the owner. Continued use needs to be reviewed to make sure it does not impinge on the rights of The Flowers DS0000001161.V336403.R01.S.doc Version 5.2 Page 21 residents to privacy and dignity. This is made as a recommendation for the owner to consider. There is an emergency call system, which residents can use to summon help if they are in their room. For those residents 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 check on the resident. The alarm system was tested during the visit. The staff member who responded to the call cancelled the bell by visiting the room. This means calls cannot be cancelled unless a member of staff goes into the residents bedroom from where the call was activated. The response time was good. There was nothing said to indicate that residents were left for long periods if they needed assistance. The steps leading to the basement are immediately behind a door. A sign warning of this needs to be displayed to minimise the risk of an accident. However, a digital lock means only staff can access this area. One bathroom, which is kept locked when not in use, had two problems on the day of the inspection. The hot water coming out of the bath tap exceeded the safe limit and there is risk of scalding and there was no hot water to the sink. The owner agreed to address these matters. Information provided by the home confirms that all equipment and services are checked regularly and there are contracts in place for this. The Flowers DS0000001161.V336403.R01.S.doc Version 5.2 Page 22 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are competent to look after the residents. The manager works alongside staff and offers good leadership and guidance. EVIDENCE: The information provided before the inspection showed that seven members of staff had left within the last twelve months. None of the reasons made it necessary for them to be dismissed or disciplined. The recruitment files of two new staff members were seen and all the necessary pre employment checks had been made to make sure they were suitable to work with the vulnerable people. Staff are responsible for reading all procedures and staff instructions and they sign to say they have read these. Two staff members are provided at all times during the night and three at any other time. This includes a senior member of staff and at times the owner, assistant manager and business manager. The care staff are supported by a team of domestic, catering and maintenance staff. The owner works closely The Flowers DS0000001161.V336403.R01.S.doc Version 5.2 Page 23 with staff in the home and takes a serious interest in the well being of the residents and how the home is run. There are suitable on call arrangements. Staff training is provided and an up to date list of the training done so far was provided. Staff said they had attended courses in the past, including dementia awareness, induction, food hygiene, moving and handling and medication administration. Many of the staff have been trained to national vocational levels including level 2, 3 and 4. This is a recognised qualification which all staff involved in the care sector should have. Induction training is comprehensive so this gives staff with little experience a good base line of information on which to develop. Those with experience are taken through the type of home The Flowers is and what the owner expects for residents and what outcomes they are trying to achieve. Staff meetings are held. The minutes of the most recent meetings were seen, including seniors meetings. Staff roles are detailed and all staff have a contract setting out their job description. This means they know what is expected of them and what their role involves. Staff said they enjoyed their jobs and that The Flowers was a nice place to work. They said they were given leadership and guidance when they needed it and had enough time to spend with residents during their working day. Designated time is scheduled into their shift which is to be spent with residents. This means other necessary tasks do not interfere with the need for residents to be given devoted time for recreation, activities or one to one attention. The Flowers DS0000001161.V336403.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, 35, 36, 37 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed and run in the best interests of residents. EVIDENCE: The owner has a significant amount of experience and is well thought of by her staff and the residents living at The Flowers. Since the last inspection the role of the assistant manager has been developed and it is intended that she will increase her qualifications to a recognised level. The owner has also appointed a business manager to take care of staffing matters and financial arrangements, which she supervises. The Flowers DS0000001161.V336403.R01.S.doc Version 5.2 Page 25 Staff confirmed they discuss their work, practices and training needs with a senior member of staff at regular intervals. They said they found the owner and other senior staff approachable and easy to get on with. Supervision records were available but not seen during this visit. The owner uses a system of safeguarding residents money which is transparent and easy to follow. Relatives leave a small amount of money to be used for anything the resident may require. Any expenditure incurred is recorded and a monthly account is provided for relatives which details what the money has been used for. This system makes sure residents are protected from financial abuse. Money is kept in one of two safes in the home and access is restricted. All records are kept in a locked filing cabinets in the office or staff working area when not being used. Residents’ looked well cared for and attention had been given to their appearance and grooming. Health and safety in the home is well organised. The maintenance staff have been trained in health and safety and records are kept of the routine checks made in house. There are two requirements with regard to health and safety to make sure the risk of scalding or accidents are minimised i.e. a sign is needed to the door leading to the basement to warn of the immediate steps and hot water coming out of taps must not exceed safe limits. The Flowers DS0000001161.V336403.R01.S.doc Version 5.2 Page 26 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 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 3 2 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X 3 3 3 3 The Flowers DS0000001161.V336403.R01.S.doc Version 5.2 Page 27 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 OP19 Regulation 13(4) Requirement The registered person must make sure there is a sign displayed on the basement door warning of immediate steps to minimise the risk of accidents. The registered person must make sure that hot water is available to residents and the temperature of this must be within safe limits. Timescale for action 05/08/07 2 OP21 13(4) and 23(2)(j) 05/08/07 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 OP20 Good Practice Recommendations The registered person should consider ways of checking out that the use of CCTV within the home is accepted by the residents and/or their relatives and that this does not compromise the privacy and dignity of residents and review the use of these in light of resident choice. The Flowers DS0000001161.V336403.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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. 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