Inspection on 15/12/08 for The Poplars

This inspection was carried out on 15th December 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Poplars 22/02/07

The Poplars 20/02/06

The Poplars 20/08/05

The Poplars 07/03/05

The Poplars 14/09/04

The Poplars 09/03/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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 Poplars The Poplars Alsagers Bank Stoke On Trent Staffordshire ST7 8BA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Pam Grace     Date: 1 5 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 32 Information about the care home Name of care home: Address: The Poplars The Poplars Alsagers Bank Stoke On Trent Staffordshire ST7 8BA 01782721515 01782721443 rcurry@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): The Poplars Limited Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 33 Number of places (if applicable): Under 65 Over 65 3 3 33 13 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home 0 0 0 0 The Poplars is a privately owned care home registered to care for 33 older people. The home is situated in the centre of Alsagers Bank, a village community in a semi-rural setting near to Newcastle-under-Lyme. The home is on a regular bus route and there is easy access to local facilities and amenities. It is situated in a prime location that affords extensive views over open countryside and of the Cheshire plain. There are attractively laid out gardens surrounding the home with patio areas and garden seating so that service users are able to sit and enjoy the view should they so choose. There Care Homes for Older People Page 4 of 32 Brief description of the care home are parking facilities in the front of the home. The Poplars is a two-storey building with service user bedrooms situated on both the ground and first floor. The home is spacious, comfortable and well maintained. On the ground floor there are spacious and comfortably furnished lounge areas, a dining room, kitchen, reception area. At a slightly lower level off the dining room there is a training room, laundry, workshop and food store. A local GP practice, community nursing services and pharmacy provide medical and specialist services and support to the residents in the home. The proprietors of the home are also the joint registered care managers and support a team of twenty-four care workers and seven ancillary staff members. The managers provide an on-call cover throughout off duty hours by day and night. The residents have a very good rapport with both management and staff. 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: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The previous inspection for this service was 22nd February 2007. This inspection visit was an unannounced key inspection and therefore covered the core standards. The inspection took place over eight hours by two inspectors who used the National Minimum Standards for Older Persons as the basis for the inspection. Prior to the inspection, the care manager completed an Annual Quality Assurance Assessment for us. On the day of the inspection, the home was accommodating thirty two people. Care Homes for Older People Page 6 of 32 We spoke with staff, people using the service and their visiting relatives. We also examined records, carried out indirect observation of three people who use the service, and four staff on duty. Three plans of care and three staff records were examined, we also directly observed daily events. We looked at three bedrooms, two communal lounge areas, the dining areas, kitchen, and laundry. We inspected the system of medication administration and storage. Up to date information in regard to the fees charged was not available to us on the day of the inspection. The reader may wish to obtain more up to date information from the care service. What the care home does well: What has improved since the last inspection? What they could do better: Risk assessments should be kept up to date, and should include measures taken to minimise the risk. People must have their prescribed medication to ensure their health, safety and welfare. Failure to do this will put people at risk. Nutritional screening should be undertaken on admission, and subsequently on a periodic basis, a record maintained of nutrition, including weight gain or loss, and Care Homes for Older People Page 8 of 32 appropriate action taken. Consideration should be given to the layout of the chairs in the lounges, to encourage a more homely environment, which is conducive to conversation and discussion for people using the service. Consideration should be given to the choice of food available at tea time. All staff should receive Dementia Awareness training, to ensure that they are aware of the condition, and can manage the changing needs of the people using the service. Consideration should be given in regard to how feedback from quality assurance surveys is given to people using the service, their relatives and representatives. This ensures that people using the service have their say in the running of the service. Records in relation to individuals should be up to date and in good order, for the protection of people using the service. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 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 who may use the service and their representatives have the information needed to choose a home that will meet their needs. Evidence: The Annual Quality Assurance Assessment (AQAA), which was completed by the registered care manager told us: Prospective people wishing to use the service undergo a pre admission assessment. We provide information to the potential resident and their relatives. Gather information about the resident, their physical and mental condition, their care needs, their expectations and background. Providing information. In order to provide the potential resident with sufficient information to make an informed choice we do the following Provide a copy of our brochure. Provide a copy of our Statement of Purpose and Service User Guide. Provide a copy of our Residents Contract. Visits and Discussion. All the above information is useful for helping inform people about the Poplars, but written information may be of limited Care Homes for Older People Page 11 of 32 Evidence: value in conveying the reality of residential care and the people involved. For this reason we would encourage people ot visit The Poplars, have a look around, meet and have a chat with staff and other residents. Spend a day, or part of a day at The Poplars getting the feel of the place. Ask as many questions as they like about residential care in general and The Poplars in particular. Drop in at any time unannounced to what is happening. We looked at two pre admission assessments. One of these was for a person recently admitted to the home from hospital. This was comprehensive and had been undertaken by the care managers. A visit to the home had been undertaken by their relatives on their behalf, and a letter was subsequently sent to the individual confirming that their needs could be met. The Statment of Purpose and Service User Guide were readily available in individual bedrooms, and we were assured that these had been reviewed and updated for last year, although some copies seen had not been updated. This was highlighted, and feedback given to the care manager at the time. The previous report, people spoken with during this inspection, care plans examined and feedback from surveys undertaken, confirmed that people had been assessed, and had received appropriate information prior to admission. Comments received included the following, the information we received was enough, we were invited to tea, and were able to spend some time in the lounge talking to people, the staff were very welcoming. People were very helpful showing us around without an appointment and giving out information about the home. This had helped them decide if the service would be suitable for them. Surveys received and people spoken with confirmed that they had been provided with a Contract and or Terms and Conditions of Service. Individual Contracts were not examined on this occasion. Intermediate care is not provided in this home. 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. The health and personal care that people receive is based on their individual needs. Risk assessments should be kept up to date, and people must have their prescribed medication to ensure their health, safety and welfare. Failure to do this will put people at risk. Evidence: The Annual Quality Assurance Assessment document (AQAA), which was completed by the registered care manager told us : Each resident has a key worker (normally qualified to at least NVQ level 2) who will be responsble for developing a care plan, which will be regularly updated and reviewed. Residents are encouraged to make their own decisions regarding their care and life style.All residents are registered with GPs at the local health care centre, unless they would prefer to retain their own GP, and the GP is willing to visit. Short stay residents are registered on a temporary basis at the local practice. The GP visits on request and routine medical reviews are carried out on a regular basis.We work in partnership with health care professionals to ensure residents receive appropriate care. Medication is appropriately stored administered and Care Homes for Older People Page 13 of 32 Evidence: recorded and staff are trained in dealing with medicines. We carry out risk assessments on individuals to identify and minimise any threats to their health and well-being.The home has a policy that will ensure that people living at The Poplars and their relatives will be treated with dignity and sensitivity at the time of death, and that any instuction given prior to death will be carried out. We examined three care plans, a new computerised format had been introduced since our previous inspection. Care plans seen contained detailed information, for example an explanation of how staff should assist and carry out personal hygiene. All three care plans contained evidence of pre admission assessments, which had informed the care plan. There was also clear evidence of health professionals involvement, for example District Nurse and General Practitioner visits. We spoke with staff, people who use the service, and their visiting relatives. Staff spoken with could tell us exactly how each of these people were to be cared for. What those staff told us reflected what was written in individual care plans. People we spoke to told us I ask staff for what I want, and they always do their best for me, my family are made welcome here, they sort out any problems with the manager, theyve got my care plan written down for me, I know that they do their best. Visiting relatives commended the care that is undertaken by staff, one person said that the staff are very helpful here, I think that staff here are kept very busy by the demands of the residents, but the staff are smashing. We discussed the care of one person using the service, and the need for their risk assessment to be kept up to date, it had been stated that no falls had taken place, but there was evidence to the fact that a serious fall had taken place, and that control measures had been taken in the form of the use of a pressure mat to alert staff as to when the person was out of bed. The risk assessment did not include the measures taken to minimise the risk. We also discussed the need to weigh people using the service, and to do this upon admission, one person had been weighed two weeks following admission. It is important to record a persons weight upon admission, as this establishes a base line weight, which then enables regular monitoring of the wellbeing of that person. We discussed the care of one person using the service whose behaviours were giving cause for concern. Those behaviours had affected people using the service. This behaviour and the way it was managed by staff was discussed in detail with the care managers at the time, and with the homes General Practitioner (GP). The GP agreed that a referral to the appropriate service would be beneficial, in that there needed to Care Homes for Older People Page 14 of 32 Evidence: be a behavioural management programme put in place for that individual. The General Practitioner confirmed during our visit that she visits each week, and will see any person that the home wishes. She was very complimentary about the home, which she feels is pro-active about healthcare matters, and that she receives good cooperation from staff in regard to any treatment regimes. A spot check of medication administration systems, which included controlled medication, Medication Administration Records (MAR), storage and disposal of medication, revealed that there were anomalies in regard to missing signatures from Medication Administration Records (MAR). We were informed that the medication policy is currently under review. It was not possible during the examination of those records to ascertain if the medication had been given, as the medication had commenced the day before the inspection, and was contained within 1 week blister packs. This was highlighted and discussed at the time with the care managers, it was suggested by staff that individual people could have been asleep, or had refused their medication, however, this should have been clearly recorded on the MAR sheet. Surveys said that people using the service do receive the support and care they need, this was also confirmed during our visit whilst speaking with relatives, staff and people using the service. They also said that staff listen and act upon what they say, and that they receive the medical support they need. 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 are involved in regular, organised, daytime activities and have access to the local community. Activities should be based upon a more tailored approach. The layout in the main lounge is not conducive to conversation, and people should be seated in smaller more homely groups. Evidence: The Annual Quality Assurance Assessment (AQAA) told us : We believe that just as every other phase in a persons life is important with its own joys and sorrows, a stay in the correct care home should prove no less fulfilling. People can still enjoy new stimulating experiences and relive happy memories of the past. Given security, good quality of care and company, it can be a happy and satisfying part of a persons life.We want residents to feel at home in The Poplars and to treat it as their own home, to come and go as they like. Although all the rooms are furnished people are encouraged to bring with them some of their own favourite items of furniture in order to personalise their room. Prior to coming to live at The Poplars we try to ensure individuals have sufficient information to form realistic expectations of life in a care home (see Choice of Home), during the admission procedure we will establish lifestyle preferences, social, cultural, religious and recreational interests and needs and attempt Care Homes for Older People Page 16 of 32 Evidence: to fulfil them. These will be reviewed and updated as necessary. Friends and relatives are encouraged to visit and are made welcome, we have an open door policy with no set visiting hours: However, we would expect visitors arriving before 8 am or after 10 pm to make prior arrangements.We keep in touch with local community events, with visiting choirs, school groups and trips out to events and local beauty spots.We endeavour to register all permanent residents on the electoral register. We have a mini bus with wheelchair access for outings and transport to appointments. Residents have access to their own room 24 hours a day and are therefore able to see visitors in private. An office can be made available for private interviews if necessary. Residents are able to have their own telephone installed in their room if they wish to. A pay phone is available to residents for both incoming and outgoing calls Individuals are able to decide for themselves how and where they spend the day.We have daily activities which residents are encouraged to take part in, in order to maintain existing skills and develop new ones. These include, board games, a range of large print books, art and craft work, exercise to music, walking and sitting in the garden. A number religious ministers visit. Much care and thought is given to the quality and variety of food provided, the emphasis being placed on traditional home cooked meals prepared in our modern well equiped kitchen. Special diets can be catered for. The menu rotates over a three week period. We provide breakfast, dinner and tea, morning coffee, afternoon tea and evening drinks/supper. Surveys received from people using the service confirmed that there are activities arranged by the home that they can take part in. Most people surveyed also said that they enjoyed the meals at the home, however, two comments received said that the teatime menu was repetitive. This was discussed with the cook during the inspection, suggestions for some variety in the teatime menu were put forward. Comments received included the following we sometimes play dominoes or bingo, but excursions on the homes mini bus are now very infrequent. Lunchtime hot meals are usually quite good, but evening tea lacks variety and is very repetitive.Dad is not able to join in with many activities, but enjoys the music. Dad found it difficult to swallow lumps of food, the staff were very understanding and thought of a way to overcome this, he is now improving. Good food, home cooked.Breakfast and teatime menu could be better, needs more variation. Activities are usually undertaken between 1.30 and 3.30pm, they included art, crafts, puzzles, discussion groups, reminiscence groups, 1:1 conversation, and outings when the weather permitted. There was a large and new flat screen television in the main lounge. We spoke with people who use the service and their visiting relatives about their daily Care Homes for Older People Page 17 of 32 Evidence: life, activities, and their outings. They confirmed their involvement in the activities organised by the home, which people said were limited, according to the time that staff had to spend on activities. We saw letters and cards which had been sent in by peoples relatives and friends, commending and thanking the managers and staff for their commitment, care and support. The home has a long lounge area, and a smaller quieter lounge area, which are used by the people using the service, their visitors and friends. Visitors can also be seen in private if people so wish. We noted during our visit that people using the service were seated in lines down either side of the lounges, and were close together, making it difficult for people to talk to specific people whilst they were standing. When visitors arrived, they needed to seek vacant chairs and squeeze into the space. Smaller groups of people, in a semi circle or circle would be more conducive and homely, and would encourage conversation. We spoke with people whilst they were sitting in the lounge areas, they said that they didnt have clear views of everyone, and that being in a long lounge meant that their view of the television was affected, depending upon where they sat. Other comments received were in relation to how busy the staff were, and how the staff treated them, especially making their Christmas so enjoyable. Sherry and Mince pies were being served during this discussion. We were shown activities assessments which had been undertaken for people using the service, these were brief and in some cases were not comprehensive enough. More information was needed, particularly for people who have poor short term memory, in those instances we suggested that a family member could assist with the assessment. The Activities book confirmed and evidenced that activities were being undertaken, however, there were some gaps noted, which was reportedly because a particular activity might have been re-scheduled, or not run on that day. Staff spoken with about activities also said that it was sometimes difficult to encourage people to join in. Bedrooms seen evidenced that people can bring in their own furnishings and personal effects. Visitors and relatives spoken with confirmed that within reason they can visit at any reasonable time. 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 using the service have their rights protected, are protected from all forms of abuse, are able to express their concerns, and have access to a good complaints procedure. Evidence: The Annual Quality Assurance Assessment (AQAA) told us : We ensure that all residents have a copy of our complaints procedure on admission and that a copy is easily accessible in their care plan and in the front hallway of the home. From the outset residents and their relatives are encouraged to openly discuss problems concerns or suggestions with senior members of staff or the proprietors at any time (see admission letter and complaints procedure). Staff and proprietors talk informally with residents and, where appropriate, their relatives, monitoring residents well being on a day by day basis, and foster a relationship of trust and openness. All staff employed are subject to the normal checks including POVA and CRB. All care staff receive induction training in the protection of vulnerable adults. This includes the definitions of a vulnerable adult and elderly abuse and information on recognising abuse and the actions taken if abuse is witnessed or suspected. We have a clear policy on restraint that all care staff are familiar with. Care is taken to ensure all residents have someone, other than an employee of The Poplars to promote their interests. Where attorneys have been appointed we keep details on file. Care Homes for Older People Page 19 of 32 Evidence: The service told us that it had received no complaints since our last visit. The complaints policy is on display in the reception area of the home for people to access. We saw from responses to our surveys that people are aware of whom to make complaints to. Comments received included, I have no complaints at present but I would talk to a senior on duty if I was unhappy, I would ask the one in charge, I tell my daughter. The major problem is the tracking of ones clothes, underwear and nightwear are always missing although every item is labeled. More care and attention is required when returning these items from the laundry. If one has no one that calls and checks their clothing on a regular basis, they must have problems or wear someone elses. This was discussed with the care manager, and thought to be because new staff members dont always know which clothing belongs to which person. Labeling is always encouraged, but relatives dont always label new clothing, and labels do need replacing from time to time on items that have been washed several times. During our visit we were told by a person using the service that they were fed up with the noise and the behavior of one of the other people using the service. This was highlighted and discussed with the care managers at the time. The services AQAA document tells us the home has updated the Safeguarding vulnerable adults policy. We spoke to staff about safeguarding and their role in keeping people safe from harm. Staff said they understand their role, and their responsibilities in relation to this. At present their is no restraint being used in the home. Staff confirmed that they do not use restraint of any kind in the course of their duties. We looked at three recruitment files , and spoke with those staff members as part of our case tracking process. We did this to see if the home is fulfilling its obligation in completing safety checks against the Protection of Vulnerable Adults (POVA) list and Criminal Records Bureau disclosures. The service must do this to prevent unsuitable people from working with vulnerable adults. We found that checks against the POVA list, and CRBs were confirmed. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the home enables people who use the service to live in a safe, well maintained and comfortable environment, which encourages independence. Evidence: The Annual Quality Assurance Assessment (AQAA) told us: Our aim continues to be to provide and maintain a warm friendly informal and secure environment in which people living at The Poplars can feel at ease and be able to pursue a lifestyle that suits them. The Poplars was formerly the vicarage to St Johns Church in Asagers Bank. It stands in its own private gardens and enjoys some of the finest views in Staffordshire over the Cheshire plain to the Welsh hills. The home is quietly tucked away just off the high street of Alsagers Bank, approximately 3 miles north west of Newcastle Under Lyme. Regular bus servcies to Newcastle, Hanley and surrounding villages, pass the end of our drive, and there is a pub all walking distance of The Poplars. The Poplars opened as Private Care Home for ten Older People in August 1984. Since then the property has been extended and updated in several phases so that now up to thirtythree people can live in what is mostly purpose built accommodation. Currently there are: Fifteen single ground floor bedrooms, eleven of which have en-suite wcs. Sixteen single first floor bedrooms, fourteen of which have en-suite wcs. One double first floor bedroom with en-suite wc. Large main lounge, with two smaller lounges on the ground Care Homes for Older People Page 21 of 32 Evidence: floor. Main and small dining rooms on the ground floor. The property and its garden are maintained to a high standard by a rolling programme of redecoration, and refurbishment. The layout of the builiding allows access by residents to all lounges, dining rooms, bathrooms, toilets and bedrooms. Ramps are provided outside to give access to the gardens and the large patio to the rear of the property where impressive views to the north, west and south can be enjoyed. Bathrooms and toilets are adapted to suit residents needs, including specialist baths and shower. Adequate storage areas distributed around the home. Modern well equipped kitchen. Modern laundry with ozone disinfection system. The building and grounds were seen to be safe and well maintained. A maintenance person had been appointed since the previous inspection. This ensures that routine safety checks and maintenance of the building are undertaken, and keeps people safe. Communal areas were clean and comfortably furnished. They were well used by people using the service and their visitors and or relatives. Bedrooms seen had been personalised and adapted to suit the individual. Aids and adaptations were in use around the home, for example raised toilet seats, walking frames, wheelchairs and walking sticks. The kitchen and laundry areas were clean and tidy. All equipment was in good working order. Infection control measures were in place, ensuring the health and safety of the people using the service. The AQAA and records seen during our visit confirmed to us that health and safety checks had been undertaken. Surveys received from people using the service confirmed that the home is always kept clean and tidy. One person said that this is to a high standard. Care Homes for Older People Page 22 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service, in line with their terms and conditions, and to support the smooth running of the service. Evidence: The Annual Quality Assurance Assessment told us: The proprietors of The Poplars are joint registered care managers and operate the home with a team of (currently) twenty three care staff, two cooks, two domestics, one gardener handyman and one cleaner with special responsibility for kitchen and laundry. Six of the care staff are designated as senior carers. Of the twenty three care staff six have NVQ level 2 in care, two have NVQ level 3 in care, two have NVQ level 4 in care and Registered Managers Award, four have other professional qualifications. We currently have eight member of staff studying for NVQs, one at level 4, five at level 3 and 2 at level 2. All staff complete an application form, provide two references, are interviewed and subjected to POVA and CRB checks prior to confirmation of employment. New staff undergo an induction training program that includes the principles of care, elderly abuse, infection control, health and safety and manual handling. Care staff are familiar with the contents of the General Social Care Councils Codes of Practice and the implications for the quality of and accountability for their work. The development of skills, knowledge and attitudes towards the care of older people is considered essential Care Homes for Older People Page 23 of 32 Evidence: to the success of The Poplars. The supervision of staff and their development is carried out by the proprietors/care managers and senior staff members. This supervision consists of monitoring day to day performance of individual members of staff and more formal sessions including tutorials, discussions and training which is recorded.The number of care staff hours provided at The Poplars exceeds those calculated to be necessary to meet the needs of our residents using the formula contained in the Residential Forum publication Care Staffing In Care Homes. The service has a good recruitment procedure that meets statutory requirements and the National Minimum Standards (NMS). The procedure is followed in practice and there is accurate recording at all stages of the proces. The staff rota evidenced that staffing levels had been maintained. Agency staff are not used, as existing staff members cover for colleagues absences either due to sickness, holidays or training. Staff interviewed confirmed that they had received appropriate training, including adult protection, fire, first aid, moving and handling, food hygiene. Individual training records and Certificates evidenced that these courses had been undertaken. One training record was not available for us to examine, this was because the staff member had needed the record for her National Vocational Qualification (NVQ) evidence. We discussed with staff the needs of people with dementia, particularly in relation to people who had been resident at the service for some years, and had developed poor short term memory needs. Staff spoken with confirmed that they had not received any training in relation to Dementia Awareness. We recommended that all staff should receive this training, to ensure that staff are aware of the condition, and can manage the changing needs of the people using the service. Staff spoken with confirmed that they had attended staff meetings, and could recall the date of their previous meeting. We were also shown notes taken from that meeting, which was held in October 2008. Supervision was undertaken informally with staff, on a daily basis. Staff confirmed their system of handover, and instructions and support given to them to enable the smooth day to day running of the service. This supervision consists of monitoring the day to day performance of staff, and involves more formal sessions, including tutorials, discussions, and training, which is recorded. Surveys received from people using the service confirmed that staff listen and act on what they say, and staff are available when you need them, comments included, they do as much as they can, my relative really likes it a lot. Care Homes for Older People Page 24 of 32 Care Homes for Older People Page 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home is based on openness and respect. Feedback from quality assurance surveys undertaken, should be documented. Evidence: The Annual Quality Assurance Assessment (AQAA) told us: The Poplars is owned by the joint care managers Sylvia and Robert Curry who have managed the home since August 1984. When we opened The Poplars we had a clear set of aims and values in mind, which in the light of experience we still consider to be valid and worthwhile, and hope that all members of staff who work here are able to understand and promote in their day to day work. Our work as managers of The Poplars is founded on three beliefs: 1.That for most older people choosing to give up their home and all that goes with it, to move into residential care is a very difficult decision. It is not a decision that should be taken lightly or one that should be rushed, its impact should never be underestimated. 2. That although residential care can never replace a persons home, choosing to live in a residential home should prove to be an enjoyable and enriching Care Homes for Older People Page 26 of 32 Evidence: experience, somewhere where older people can enjoy first class care and accommodation, together with good food and company, with the freedom to come and go as they please without the day to day burden of coping on their own. 3. Coming to live in a residential care home with a group of other people, does not diminish an individual as a human being in any way! Each person will have their own opinions, character and expectations of life within a residential care home. It is our job to be aware of these factors and respond to them sensitively.Between us we feel we have the experience and formal qualifications (Ph.D. M.A. [Gerontology] B.Ed.(Hons.), not only to deal with all practical and administrative aspects of running a care home, but have the enthusiasm, commitment and skills to achieve our objectives of running the home for the benefit of those living here. We recognise that this can only be done if our team of senior carers, carers and other staff are well motivated, trained and rewarded. We see it as our responsibility to supervise and train staff to ensure they are competent, caring, well motivated and possess the appropriate skills and knowledge to perform their allotted tasks. Our approach to this reflects the informal and open ethos of the home. We have accounting procedures and support in place to ensure that financial viability is monitored and safeguarded.Policies, contracts, agreements, statement of purpose and service users guide and records are in place to safeguard the interest of residents. This includes training programs for staff. Policies and procedures have been established and implemented in order to ensure our obligations under Health and Safety legislation are met. The Annual Quality Assurance Assessment (AQAA) was well completed and returned to us on time by the registered care manager/provider. All sections of the AQAA were completed and the information gave us a good picture of the current situation with the service. The AQAA told us about the areas where they still need to improve, and the ways in which they are planning to achieve this. We are kept informed via Regulation 37 Notifications of incidents in the home which affect the people using the service. This helps to ensure the safety of individuals using the service. There had been no complaints and Safeguarding referrals made to us since the previous inspection. Staff recruitment files evidenced that a good system is in place for the recruitment of new staff. The environment is safe for people and staff because appropriate health and safety practices are in place. Some consideration should be given in regard to the layout of the lounge areas, and encouraging people to be in small groups, which would be more homely, and would stimulate and be conducive to conversation and activities. Care Homes for Older People Page 27 of 32 Evidence: Care plans and pre-admission assessments were in place, but there was a shortfall in the consistency of recording. Risk assessments should be kept up to date, and should iinclude the measures taken to minimise the risk. Thus ensuring the safety of the people using the service. A spot check of medication systems, which included controlled medication, Medication Administration Records (MAR), storage and disposal of medication, revealed that there was a shortfall in regard to missing signatures from MAR records. The registered care manager/provider has delegated more responsibility to senior carers, key workers, and two members of staff now hold a Registered Managers Award. Staff spoken with understood their role and responsibilities, and showed a commitment to caring for the people using the service. We were told in the AQAA that the registered manager/provider had reviewed records, policies and procedures in the light of new legislation and current good practice. However, we were unable to evidence this during our visit, as the provider was on leave, and the records needed were stored on computer and not available to us. We were told that the provider had sent out quality assurance surveys in 2008. We were shown those surveys, but did not find evidence that the information received had been collated and shared with people using the service, their relatives and the staff team. We did not spot check peoples finances on this occasion. This will be monitored at the next inspection. Relatives and people using the service were complimentary of the staff and management and positive comments were received in regard to the commitment, care and support that they and their relatives received. Comment cards and letters received by the service since our previous inspection confirmed this. 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 1 9 13 The registered person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. Gaps noted in the MAR sheets signatures 15/01/2009 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 Risk assessments within individual care plans, should be up to date, and records should clearly reflect the preventative measures taken to minimise that risk. Nutritional screening should be undertaken on admission, and subsequently on a periodic basis, a record maintained of nutrition, including weight gain or loss, and appropriate action taken. Consideration should be given to the layout of the chairs in the lounges, to encourage a more homely environment, which is conducive to conversation and discussion for people using the service. 2 8 3 12 Care Homes for Older People Page 30 of 32 4 5 15 30 Consideration should be given to the choice of food available at tea time. All staff should receive Dementia Awareness training, to ensure that they are aware of the condition, and can manage the changing needs of the people using the service. Consideration should be given in regard to how feedback from quality assurance surveys is given to people using the service, their relatives and representatives. This ensures that people using the service have their say in the running of the service. Records in relation to individuals should be up to date and in good order, for the protection of people using the service. 6 33 7 37 Care Homes for Older People Page 31 of 32 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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