Inspection on 01/12/06 for The Regency Nursing Home

This inspection was carried out on 1st December 2006.

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 Regency Nursing Home 19/01/10

The Regency Nursing Home 01/12/08

The Regency Nursing Home 07/11/05

The Regency Nursing Home 04/05/05

The Regency Nursing Home 24/01/05

The Regency Nursing Home 27/05/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE The Regency Nursing & Residential Care Home St Helens Parade Southsea Portsmouth Hampshire PO4 OQJ Lead Inspector Ms Jan Everitt Unannounced Inspection 1 December 2006 09.30 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 Regency Nursing & Residential Care Home DS0000011523.V305816.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 Regency Nursing & Residential Care Home DS0000011523.V305816.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Regency Nursing & Residential Care Home Address St Helens Parade Southsea Portsmouth Hampshire PO4 OQJ (023) 92 820722 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) Mr Michael Raven Mrs Julia Christina Raven Mrs Hazel Adeoye Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26), Terminally ill over 65 years of age (26) of places The Regency Nursing & Residential Care Home DS0000011523.V305816.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Staffing levels apply No more than 2 beds may be used at anyone time for service users who are in need of personal care 7th November 2005 Date of last inspection Brief Description of the Service: The Regency Nursing Home is currently registered to accommodate 26 service users under the registration categories of Older Persons (OP) and Terminal Illness (TI), both categories registered in respect of 26 places. The Regency is situated along St Helens Parade, Southsea and is a short walk from the attractions of Southsea front and pier, although the amenities of the town are less readily accessible. Transportation links in and around the nursing home are good with several local providers operating buses nearby and taxis can be accessed along the front. The property is a period town house, which has been adapted to accommodate patients, offering a passenger lift to all floors and ramped access where required. The bedrooms are a mix of single and shared accommodation and communal facilities include a dining room, lounge and sun lounge. Fees : £535 - £650. These do not include the cost of personal items. The Regency Nursing & Residential Care Home DS0000011523.V305816.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection focused several key standards and various sources of evidence were considered in the formulation of judgements; records, observations and discussions with service users and staff/management. A site visit to The Regency Nursing and Residential care home, which was unannounced, took place on the 1 December 2006. This report details the results of an evaluation of the quality of the service provided by The Regency and brings together accumulated evidence of activity in the home since the last inspection on 7 November 2005. The visit to The Regency formed part of the process of the inspection of the service to measure the service against the key national minimum standards for the year 2006/7. The judgements in this report were made from evidence gathered at the visit to the home, information gathered prior to the visit; pre-inspection information submitted to the commission by the registered manager, information from the previous report, the service history correspondence, registration activity, touring the home and viewing records. Some supplementary questions were asked of the service users whose care the inspector tracked, in relation to specific data the Commission is currently collecting. A relative for one service user supported this. The results of this are documented in the main body of the report. People who use the service have been consulted with and this has been done by questionnaire surveys sent to service users, relatives, other visiting professionals including GPs, staff questionnaires and talking to service users and staff at the time of the inspection visit. Due to a number of the service user’s cognitive impairments, comment cards were not completed by them but their relatives/representative. There were twelve responses to the visiting relatives survey. Two GPs returned their comments and seven staff completed the surveys given to them by the inspector. The responses from the surveys were very positive and complimentary about the care and services delivered in the home. The Regency Nursing & Residential Care Home DS0000011523.V305816.R01.S.doc Version 5.2 Page 6 What the service does well: The standards reviewed indicated that the home is meeting its obligation to service users set out within the National Minimum Standards. Service users and relatives received information about the service before they were admitted or assessed for admission to the home. A relative spoken with confirmed that the decision to come into The Regency had been made following a visit to the home and receiving the service users guide and statement of purpose, and had proved to have been a positive choice made by she and her husband. Service users do receive and sign a contract of terms and conditions of residency in the home and scales of charges and the room occupied is stated on this contract. The manager ensures that potential service users do undergo a full and thorough assessment to ensure that their needs can be met and that the admission is appropriate for the service user and the home. A service user spoken with detailed how the manager had been to see him in hospital before he came to the home. The home’s care plans are comprehensive documents, which contain good general care plans, risk assessments, wound charts and moving and handling assessments and records, and would support practices. The inspector observed that good relationships exist between the service users and the staff and they were familiar with the service users preferences and habits. Questioning in relation to the complaints policy and procedure confirmed that service users and their relatives are aware of this and would follow that procedure should they wish to make a complaint. The upkeep of the premises is good and the providers invest in a programme of re-decoration and refurbishment in all areas, which was evident as the inspector toured the home. The standard of cleanliness in the home is good. The manager and provider are committed ensuring staff are trained appropriately in all aspects of care. This is achieved by regular supervision and appraisals. Staff records confirm that training does take place appropriately. The Regency Nursing & Residential Care Home DS0000011523.V305816.R01.S.doc Version 5.2 Page 7 The manager and her staff team appear to develop good relationships with service users and their visitors, as evidenced by the comments of several people during the inspection and also relative surveys returned. People describing how they are always made to feel welcome upon arrival to the home, how they are offered a drink, and how they are kept informed of issues affecting their relative. The home has a detailed quality control system in place that measures the quality of service against the national minimum standards. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Regency Nursing & Residential Care Home DS0000011523.V305816.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 Regency Nursing & Residential Care Home DS0000011523.V305816.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 & 3. Standard 6 is not applicable to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service, and asking supplementary questions. Information about the home is given to prospective service users to enable them to make informed choices about where they wish to live. Service users are issued with a contract/ statement of terms and conditions for residency in the home. Prospective service users personal and health care needs are fully assessed prior to them going to live at the home, to ensure that the home can meet their needs. EVIDENCE: A sample of service users or/and their relative were asked questions for a CSCI survey. The service users chosen where those who had been most recently admitted to the home. Some service users were unable to respond or The Regency Nursing & Residential Care Home DS0000011523.V305816.R01.S.doc Version 5.2 Page 10 remember owing to their mental frailty but a visiting relative was able to give more accurate responses. The outcome from the survey revealed that for those who are privately funded the care home’s directory is used to identify appropriate homes in the chosen area. One relative reported that there is not a great deal of choice in the Portsmouth area. She then visited several homes in the area, one being The Regency, and reported to be ‘immediately impressed with the environment and atmosphere of the home’. At this time she was given the Statement of Purpose and the service user guide to support the decision-making about which home to choose. For other service users, a care needs assessment is undertaken by a social worker. This is then referred on to an appropriately registered home for them to undertake an assessment. One relative commented that she had received ‘excellent’ input from the social worker when looking for a home and that the provider’s ‘input was invaluable’. Contracts/terms and conditions of residency were evidenced in some of the service user’s files. The ones not signed were those for service users who were more recently admitted and the four-week period for either party to change their minds had not expired. The contracts seen by the inspector identified the room to be occupied by the service user, the fees per week and how these fees are broken down between nursing and social care. Two service users spoken with were aware of the fees they were paying but one other reported to ‘have no idea’, another saying ‘I know it is pretty high’. The provider reported to the inspector that if fees increase or if there is any change in the contract she writes personally to all service users/relatives to inform them of the change. Pre-admission visits are agreed with the prospective service user and all assessments are signed and dated by the assessing staff member. The manager or/and the provider undertake pre-admission assessments in the service users current environment. The majority of service users have been admitted to the home from a hospital. The inspector tracked four service users care notes that included the three service users selected for a survey. The care notes evidenced that a comprehensive assessment is undertaken and includes all aspects of personal, emotional, psychological and health care needs. This assessment process is used in the decision-making about the suitability of a placement. A service user spoken to confirmed that she had been visited by the manager in her own home before coming to the home and had received all the information about the home but ‘her son had taken care of all the arrangements’. A relative spoken with stated that she had been present when The Regency Nursing & Residential Care Home DS0000011523.V305816.R01.S.doc Version 5.2 Page 11 the home had assessed her husband in hospital and that she had provided much of the information. The manager reported that social care needs assessments are not consistently received from the social workers and that she does have to chase up information from them. The Regency Nursing & Residential Care Home DS0000011523.V305816.R01.S.doc Version 5.2 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service and looking at records. The matron/manager has introduced a comprehensive and individualised careplanning package for service users. The health and social care needs of service users are appropriately met and documented. The home’s approach to the management and storage of service users’ medications was robust and secure. Service users are treated with respect and their right to privacy upheld. EVIDENCE: A sample of care plans and service users documents were viewed. Each contained pre-admission assessments from which care plans are instigated, patient specific information such as photos for identification purposes and daily records. The Regency Nursing & Residential Care Home DS0000011523.V305816.R01.S.doc Version 5.2 Page 13 Full risk assessments are undertaken for health and safety and include moving and handling, the use of bed rails and documentation to support the use of these. Nutritional and tissue viability risk assessments were also undertaken on service users. The care plans are thorough and cover all aspects of health and social care and this includes any need for psychiatric support from a psychiatrist and a community psychiatric nurses. The level of detail within each plan was felt generally to be good, and there was evidence that the plans were being regularly reviewed and updated, and that the service users or their representatives were involved in the reviewing process. The inspector observed that the visiting GP documents details in the care plans of his visit and the outcome. The inspector observed that other visiting professionals also record their visits. Comment survey cards received from the two GPs who visit the home, were very positive and they both stated that they considered the care in the home to be of a high standard and that the care given to those terminally ill is ‘very good’. The daily records were quite detailed. The inspector did discuss with the manager that staff should avoid using terminology in the daily records, such as ‘cooperative’ and ‘demanding’, to describe how a service user was reacting that day. The inspector observed on the tour of the home that fluid and food charts are maintained for those who have been assessed of being at risk. These records were noted to be regularly recorded and indicated the response of the service user if they refused diet and fluids. The home’s medication system was audited as part of the inspection process. The home has robust systems in place for the management of service users’ medication and were found to be well organised with clear, structured systems for ordering and receiving medications into the home. The return of medication is now undertaken by an approved waste disposal organisation with which the home has a contract. The storage area for the medication is within the large nursing office and holds a specific fridge for storing medications below room temperature. The medication is dispensed as part of a Monitored Dosage System (MDS), supplied by the local pharmacist, from which the manager reports, the home receives good support. Medication Administration Records (MAR) sheets were viewed and found to be completed accordingly. Copies of medication policies and procedures are held at the beginning of the MAR sheets files. There is also a record of a homely remedies programme agreed with a local General Practitioner. This enables some basic medications The Regency Nursing & Residential Care Home DS0000011523.V305816.R01.S.doc Version 5.2 Page 14 to be given, on a limited dosage arrangement, without an underpinning prescription being generated. The inspector observed that service users preferences as to their daily activities of living are documented as part of the assessment process. The inspector observed that service users were not being rushed to get out of bed and a number reported to enjoy having a ‘lie in’. Staff were observed to be knocking on doors before entering service users’ rooms and generally there was a good rapport between staff and service users, with carers being over heard giving service users choice and respecting their wishes. Service users, who were spoken with, praised the staff highly and considered them ‘wonderful’ and it was obvious to the inspector that they were familiar with the service user’s needs. Comments from relatives returned on the survey comment cards also confirm that they think the staff give high standards of care consistently and they show ‘kindness and compassion’. End of life care is also documented in the care plans and if appropriate service users’ choice of how they wish to be cared for following death is also recorded. The home liaises with the local hospice for training and support if they should be caring for a terminally sick person. The pre-inspection information and training records demonstrate that a number of staff have undertaken a bereavement course and the home follows the Liverpool Care Pathway for terminally ill residents. The Regency Nursing & Residential Care Home DS0000011523.V305816.R01.S.doc Version 5.2 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has recently employed an activities co-ordinator (part-time) to oversee the activities and entertainments for service users. Service users are supported and encouraged to maintain contact with family and friends and the local community. Service users are supported to exercise choice and control over their daily lives. The home serves a wholesome appealing diet with choices at each mealtime. EVIDENCE: The home has recently employed an activities coordinator who works three days a week and at the time of this visit was on an induction programme to the home. The Regency Nursing & Residential Care Home DS0000011523.V305816.R01.S.doc Version 5.2 Page 16 The inspector could not evidence a structures programme of activities but did observe that there were collages around the room that service users had recently made. The manager reported that ‘crafty moments’ attend the home fortnightly and undertake craft activities for those who wish to participate. The inspector could not evidence social history information about the service users and the co-ordinator intends to gather this information gradually from the service users and their relatives. One service user was observed to be reading and others viewing the television. The inspector spoke to a number of service users, one commenting that she did do the activities but she really enjoyed ‘being idle’. Those spoken to consider their recreational needs were being met. The inspector noted that the lady service users were well manicured and that the hairdresser visits the home weekly. The visitor’s book evidenced that a number of visitors do attend the home daily. A service user reported to the inspector that his wife visited him daily. The inspector had the opportunity to speak with her on this occasion. She reported to be very happy with the home in general and was always made welcome at the home. The inspector received a good response from the relatives’ survey. Every survey commented that they were always made welcome at the home, one commenting that ‘they do not like you to visit the home at mealtimes and before 10.00 in the morning.’ The home documents, as part of the assessment, service users’ preferences and choices about how they wish to live their daily lives. The inspector observed that this was documented in care plans, together with the service users’ preferences to what they liked to eat. Those service users spoken with reported that they can ‘please themselves and can choose to join in or not’. The inspector observed staff respecting service users choices during the day in where they chose to sit and spend their time and take their meals. The home has a four-week menu cycle. A sample of menus accompanied the pre-inspection documentation and were varied and nutritious with choices offered at every mealtime and also indicated which were special diets. On the day of this visit fish and chips were on the menu. This was apparently a favourite with a number of service users. Most service users had chosen this menu for their lunch. The cook reported that she is aware of service users’ likes and dislikes and that an alternative menu or choice is available at every meal. The inspector observed that there was no menu for the day displayed detailing what was the main meal and alternative. The menu displayed on the The Regency Nursing & Residential Care Home DS0000011523.V305816.R01.S.doc Version 5.2 Page 17 tables was one from the previous two days. This was discussed with the manager, who reported that it was unusual for this to happen. The inspector observed the lunchtime meal. The service users reported that it was ‘enjoyable’ and that the food was generally good. The menus are created by the cook and the provider with the service users likes and dislikes taken into consideration. The Environmental Health Officer had inspected the kitchen in November 06 and the inspector viewed the written report. The stated outcome of the visit was that the kitchen was of a good standard and no recommendations were made. Nutritional assessments are undertaken on service users and weights are recorded regularly. Care plans were evidenced for those assessed as at risk. The Regency Nursing & Residential Care Home DS0000011523.V305816.R01.S.doc Version 5.2 Page 18 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home operates a complaints process, which includes records of complaints received and actions taken to address issues identified. Service users and relatives are aware of the complaints process. Service users are protected from abuse. EVIDENCE: The home has a complaints procedure in place. A copy of this is included in the Statement of Purpose and service user guide. There is a copy of this procedure displayed on the wall. Survey comment cards received by the CSCI from relatives indicated that they were aware of the procedure. Service users spoken to said if they were unhappy about something they would talk to the staff or manager about it or their relatives would speak to the manager. Service users commented that the manager was ‘very approachable’. Questions asked of the service users were part of a CSCI survey. The Regency Nursing & Residential Care Home DS0000011523.V305816.R01.S.doc Version 5.2 Page 19 There have been two complaints in the past year. Both were satisfactorily resolved following investigations undertaken by the manager. The home has the local adult protection policy and procedure, which they follow if allegations of abuse occur. All members of staff have received training on this and also the whistle blowing policy for reporting any incidence of abuse. Staff surveys returned to CSCI along with staff spoken with at the time of the visit, demonstrated that staff are aware of the procedures and how they would report any incidence or suspicion of abuse to service users. All staff are made aware of the abuse procedures and what constitutes abuse during their induction programme and this is part of the NVQ level 2 training. Staff are supervised six to eight times a year and there was evidence in the staff records to support this. The Regency Nursing & Residential Care Home DS0000011523.V305816.R01.S.doc Version 5.2 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a safe and well-maintained environment that is comfortable and clean. EVIDENCE: The inspector toured the home. The home is very well maintained and the providers have a programme of improvement and redecoration as an ongoing process. Each room is redecorated at it becomes vacant and new carpets and soft furnishings are installed. New double glazed windows have been fitted to the front bay windows, which have excellent views of the Solent and Isle of Wight. The rooms are very The Regency Nursing & Residential Care Home DS0000011523.V305816.R01.S.doc Version 5.2 Page 21 comfortable and have been decorated pleasantly and service users have personalised their own rooms with their belongings. Service users do have the choice to bring with them items of personal furniture for their rooms, which some have chosen to do. Service users spoken with said they were very pleased with their rooms and one relative reported that on her first visit to the home it looked well maintained and the general atmosphere of the home was good and this had supported her choice of home for her husband. At the time of this visit the two offices were in the process of being redecorated and refurbished. The laundry areas, of which there are two, are small and enclosed and the manager reported that these are to have air conditioning fitted imminently. The manager reported that the providers are very responsive to her requests for equipment, fixtures and fittings. The inspector observed that there were a number of hoists being used and 80 of the beds had pressure-relieving mattresses in place. The home was very clean and there was no offensive odours detected. The home has a separate housekeeping staff who maintain high standards of cleanliness around the home. Cleaning chemicals were observed to be handled correctly and were either with the housekeeper using them or stored in a locked environment. The home has an infection control policy in place. The manager reported that she consulted with the Public Health Advisor about a recent outbreak of viral gastroenteritis, which affected a large number of the staff and service users. This was contained with the support of the Public Health Advisors and by following the infection control procedures. The inspector observed that hand-washing facilities are available in all areas of the home and it was observed that staff were wearing gloves and aprons appropriately. There was evidence in the induction programme and training records that staff do receive training on infection control. The Regency Nursing & Residential Care Home DS0000011523.V305816.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The numbers and skill mix of the staff are sufficient to meet service users’ needs. Staff are trained and competent to do their jobs and therefore service users are in safe hands at all times. The recruitment processes and practices of the home are robust and support and protect service users. EVIDENCE: The inspector viewed the staff rotas. It was established with the manager that there are sufficient staff on duty to meet the needs of the service users. She discussed the recent correspondence with the CSCI about numbers of registered nurses on duty throughout the day. It has been decided by the providers that a trained nurse be replaced with an extra carer in the mornings. • • 1 trained nurse and 7 carers am shift. 1 trained nurse and 5 carers pm shift. DS0000011523.V305816.R01.S.doc Version 5.2 Page 23 The Regency Nursing & Residential Care Home • 1 trained nurse on nights with 2 carers. In addition to this the provider is available most days and the registered manager is in the home Monday to Friday. A separate housekeeping staff of two undertake the cleaning and laundry during the week, with one housekeeper on Saturday and Sunday. The staff also undertake a certain amount of the laundry work. Service users spoken with did report the staff work hard but did not relay any concerns that there were not sufficient on duty. Two of the twelve relatives’ survey comment cards returned to the CSCI reported that they did not consider sufficient staff were on duty at the weekends. Rotas demonstrated that the same amounts of care staff are on duty throughout the seven-day period, but housekeeping staff are reduced to one. The proprietor and manager continue to be committed to staff training and development, providing access to both core training such as moving and handling, first aid, fire safety, etc. as well as specific training events such as National Vocational Qualifications (NVQ). Currently of the twenty-four care staff employed over 50 hold the NVQ level 2 qualification. The management retain a record of the training undertaken and completed by staff and a training matrix system is used to track dates when courses are due for renewal and update. Staffs’ other training needs are identified at supervision and appraisal and the inspector evidenced this in staff training records. Staff spoken with at the time of this visit told the inspector that they have access to various training appertaining to their jobs and are supported and encouraged to take up the training. The training is fully funded by the provider. At the time of this visit the two administration offices were being refurbished and the manager’s office was not accessible because a carpet was being fitted. The inspector was therefore unable to view a sample of recruitment files. The recruitment and selection of staff process was discussed with the manager who advised the inspector that advertisements are mainly placed in local papers and that all applicants are interviewed before appointment. She also confirmed that the home has a generally low turnover of staff and that new posts are created only when someone decides to leave or is dismissed. Staff were also spoken with about how they were recruited and they described the process and confirmed that the home has robust recruitment practices in place. The Regency Nursing & Residential Care Home DS0000011523.V305816.R01.S.doc Version 5.2 Page 24 Taking into account the history of the home and past information from the previous reports the inspector made the judgement that the recruitment process is robust. The Regency Nursing & Residential Care Home DS0000011523.V305816.R01.S.doc Version 5.2 Page 25 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Registered Manager holds both an appropriate professional and managerial qualification The home has an effective quality monitoring system and gains the views of those who use the service to measure the home’s success in meeting the aims and objectives and the statement of purpose. Service users interests are safeguarded. The health and welfare of the service users and staff are promoted. The Regency Nursing & Residential Care Home DS0000011523.V305816.R01.S.doc Version 5.2 Page 26 EVIDENCE: The registered manager is a registered general nurse and has had many years experience with care of the elderly. She has gained her Registered Manager’s Award (RMA). The provider has also undertaken this qualification and successfully completed it. The proprietors have purchased a quality auditing system produced by the ‘Nursing Homes Association’ (NHA), which is used annually to benchmark the home’s performance against the ‘National Minimum Standards’. In addition to this largely paperwork based system, the proprietors also regularly look to canvass the opinions of both service users and visitors on the performance of the home and the service delivered. The inspector received twelve survey comment cards from relatives who generally stated they were very satisfied with the care and services that their relative is receiving. Three surveys were returned from service users and they also made complimentary remarks about the home. One service user commenting that ‘it is a lovely well run care home who really do look after you and bring out the best in you’. One relative commented ‘the difference in my mother since she has been at the home is amazing’. The manager reported that she monitors the cleanliness of the home daily. The day-to-day maintenance in the home is recorded in a book, which the manager views regularly. The manager does not record her daily auditing of the MAR sheets but does sign the care plans as evidence that these are audited at intervals. The manager reported that it is the policy of the home not to become involved in the management of service users’ monies, although where a person wishes to retain control of their own financial arrangements every effort to support them is given. An inventory is maintained of any furniture that service users bring to the home that is kept in the service user’s notes. The inspector viewed the fire logbook and this demonstrated that all checks on the system have been undertaken at the appropriate intervals. Staff fire training was also recorded in this log. A sample of servicing certificates was viewed and information gathered in the pre-inspection information demonstrated that the home has maintained regular servicing of all equipment and systems. The Regency Nursing & Residential Care Home DS0000011523.V305816.R01.S.doc Version 5.2 Page 27 The home can demonstrate through records that the staff have appropriate training and updates on health and safety issues. The Regency Nursing & Residential Care Home DS0000011523.V305816.R01.S.doc Version 5.2 Page 28 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 3 3 X X 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 The Regency Nursing & Residential Care Home DS0000011523.V305816.R01.S.doc Version 5.2 Page 29 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP12 Good Practice Recommendations It is recommended that the newly appointed activities organiser compose social life histories of the service users to enable her to plan and support their recreational needs appropriately taking into account their current mental capacity. The Regency Nursing & Residential Care Home DS0000011523.V305816.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Regency Nursing & Residential Care Home DS0000011523.V305816.R01.S.doc Version 5.2 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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