Inspection on 01/12/08 for The Regency Nursing Home

This inspection was carried out on 1st 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 Regency Nursing Home 19/01/10

The Regency Nursing Home 01/12/06

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 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Regency Nursing Home St Helens Parade Southsea Portsmouth Hampshire PO4 0QJ     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: Mark Sims     Date: 0 1 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 Regency Nursing Home St Helens Parade Southsea Portsmouth Hampshire PO4 0QJ (023)92820722 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : regencynursinghome@hotmail.com Mr Michael Raven,Mrs Julia Christina Raven care home 26 Number of places (if applicable): Under 65 Over 65 26 old age, not falling within any other category Additional conditions: 0 The maximum number of service users to be accommodated is 26. The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP). Date of last inspection Brief description of the care home The Regency Nursing Home is currently registered to accommodate 26 service users under the registration categories of Older Persons (OP). 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 Care Homes for Older People Page 4 of 32 Brief description of the care home 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. 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 quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This inspection was, a Key Inspection, which is part of the regulatory programme that measures services against core National Minimum Standards. The fieldwork visit to the site of the agency was conducted over 6.5 hours, where in addition to any paperwork that required reviewing we (the Commission for Social Care Inspection) met service users, staff and management. The inspection process involved pre fieldwork activity, gathering information from a variety of sources, surveys, the Commissions database and the Annual Quality Assurance Assessment information Care Homes for Older People Page 6 of 32 provided by the service provider/manager. Despite the manager stating that surveys had been returned to the Commission, none were received in time to be included within the Report. What the care home does well: What has improved since the last inspection? What they could do better: No requirements or recommendations have been made following the inspection process. The service however, has identified via the AQAA documentation that they wish and/or intend to make the following improvements to the service over the next twelve months: Care Homes for Older People Page 8 of 32 Continue to work on our refurbishment plan with targets continuing to be set for the maintenance team to work to. Continue to work with employees in order to achieve good standards of documentation practises we hope to achieve this with the revision of the care planning system and ongoing training where applicable. Whilst working within the constraining factor of fee levels paid by local authorities we will endeavour to continue to re-invest in the business in order to maintain our good reputation and to continue to ensure we provide good value for money. 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 service tells us, via their AQAA that: We operate a good and effective administration system to ensure the smooth running of the home and its staff. Each Service user receives a comprehensive, individualised pre-admission assessment to ascertain if the Home can meet their needs. Each service user /and or relative is given the opportunity to visit the home and spend some time within the home before reaching a decision. The care records for three people were reviewed during the fieldwork visit, with their Care Homes for Older People Page 11 of 32 Evidence: care plan found to contain both professional summaries of care and details of the in house assessment completed by the manager or one of the Providers. The assessment process is designed to dovetail into the care planning process and therefore create a seamless document and audit trail, which encourages information transferences such as data recorded on the assessment can be easily copied over to the care planning document as the subject areas are the same. During our visit the manager took a call from the Local NHS Hospital regarding an assessment, the manager rang the Provider who agreed to visit the prospective client and later returned to the home with the completed assessment tool. The Provider then contacted the persons relatives and care manager to inform them that following the assessment they would be pleased to offer the person a place at the home. The manager then explained to the relatives that since they had visited the home a another larger bedroom had become available and if they agreed the home would arrange to admit their next-of-kin to this room. The latter part of this three-way conversation providing evidence to support the AQAA statement that people are encouraged to visit the home prior to making a decision on accepting the offer of accommodation. The home does not provide an intermediate care service and so this standard is not applicable. 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. The principles of respect, dignity and privacy are put into practice. Evidence: The service tells us via the AQAA that: We have care plans and risk assessments in place to identify those at risk of pressure damage and what action is being taken to reduce risk. The home has risk assessments in place to identify and to take action on falls, pressure areas, malnutrition, use of bedrails. When service users are unable to manage their own healthcare, we aim to identify any health problems so that they can be dealt with from an early stage. With agreement of the service user, we work with the user, their relatives and carers Care Homes for Older People Page 13 of 32 Evidence: in partnership in order to provide the best support for the individual. Service users privacy and dignity is respected by all employees, ways to promote this is taught within training. Three service user plans were reviewed during the fieldwork visit and generally all of the plans were found to be informative documents, which were well structured and contained an indexed, which enabled the user to quickly locate the section of the plan they required. The plans are a combination of the Standex system, which is a ready made care planning process that providers can purchase; and the homes own care documents and assessment tools. The documents are individually completed, which ensures each plan produced is specific to the person it is written for and all plans are signed by the service users to acknowledge their agreement to the plan. The care files contain a page, which the staff are required to completed on a monthly basis, confirming that they have reviewed and where necessary updated the care and risk assessment plans. Risk assessments, as mentioned above are also produced on an individualised basis and cover areas where the likelihood of an injury or accident occurring exist, examples being the use of bedrails and wheelchairs. However, the bedrail assessments, whilst considering the suitability of the rail to be used and the type bed it is to be fitted to, do not adequately reflect the specific needs of the person, for example, is the resident mobile, confused or disorientated at times and therefore likely to try and climb over the bedrail, thus increasing the distance they might fall. It was also noted on one persons wheelchair risk assessment that they were being manoeuvered around the home without footplates on the chair, as their had been incidents when their limbs had become entangle with the footplate and skin flap injuries caused. However, their plan does not indicate that any consideration has been given to referring the person to an Occupational Therapy seating/wheelchair service, or that consideration of additional wheelchair features, extended footplates or back-straps that fit between the footplates, have been given. Care Homes for Older People Page 14 of 32 Evidence: This was discussed with the manager and provider during the fieldwork visit and they have given an undertaking to look into these matters. The service user plans reviewed during the visit, also contained specific health and social care records, which document the service users involvement with any professional service, General Practitioners (GPs), Opticians and Community Nurses. Peoples files also contain copies of correspondence from professional health and social care services, which confirmed outcomes of clinic visits, attendance of appointments and care management reviews. A range of health screening tools are also used by the staff to monitor peoples wellbeing, including Waterlow Score, which measure damage to skin tissues, Nutritional Assessment Tools, Incontinence Assessment Tools, Bristol Stool Scale and the Bartel Dependency Assessment. These documents, along with the other care planning records, as mentioned above, are reviewed and updated on a monthly basis or as the persons health care needs change. Equipment, to support the nursing and care staff deliver appropriate care and support, is also readily available with the look around the home enabling us to observe staff using hoisting equipment, wheelchairs, or to observe equipment stored ready for use. Information received from a Local GP provides further evidence of the homes good work in ensuring the health and welfare of the service users is being promoted, the GP stating that the home, in his opinion, was the best locally and provided excellent care and support to people. Whilst looking around the home, it was noted that in bedrooms, where people share the accommodation, screening is available to ensure privacy during the deliver of personal care and/or any health care treatments. The provider has stated that the home has a small sun lounge that can be sectioned off from the main lounge to afford privacy. The service users preferred term of address is also documented on their service user plan and the interaction between the staff and the service users and the staff and the visitors was noted to be appropriate, respectful and friendly. The review of the homes medication system established that all medications are Care Homes for Older People Page 15 of 32 Evidence: correctly held and secured. The medication administration records (MAR), were generally well maintained, although on occassions staff are entering unexplained codes into the records, when a medicine has been omitted. This was discussed with the manager, who has undertaken to address the issue with the staff team and reacquaint them with the codes, presently in use within the home. Medication stocks are kept to a minimum and records indicate that the homes medication fridge is checked on a daily basis to ensure it operates within safe and acceptable parameters. Staff observed administering medicines did so safely and appropriately, taking the medication to the service user, administering the medicine and then returning to sign the medication record. The Dataset establishes that policies are available to the staff on the control, storage, disposal, recording and administration of medicines and that the management and handling of controlled medications has been appropriate over the last twelve months with no reported concerns or issues. Each persons MAR sheet is divided off from the next by a file divider, which is affixed with a photo of the person and details of the persons known allergies. Care Homes for Older People Page 16 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 who use services are able to make choices about their life style and supported to develop their life skills. Social, educational, cultural and recreational activities could be improved to better meet individual expectations. Evidence: The manager states via the AQAA that: We have completely open visiting arrangements. The Home encourages users to become involved in activities and learn new skills should they wish to do so. The Home recognises the importance of the personal and social relationships that service users have and are respectful of their privacy. We liaise closely with outside transport agencies to give service users choice of services available to them. The service now employs an activities co-ordinator, who is responsible for planning Care Homes for Older People Page 17 of 32 Evidence: and delivering activities and entertainments to the residents. The service users plans, reviewed during the fieldwork visit, contain a section that documents and/or records the activities and entertainments attended by the residents at The Regency, referred to as the activities diary. The evidence provided by these records indicate, that the residents are being provided with some internal stimulation and/or opportunities to enjoy or participate in events organised by the home. The records also document when people enjoy or participate in activities externally,such as walks to and through the local park or along the seafront. No schedule of activities was observed on display around the home, whilst we had a look around and no activities were seen being delivered, although in conversation one person spoke of the musical entertainment and the manager discussed the forthcoming festive activities and visits by local groups to deliver carol concerts, etc. The homes visiting arrangements, are detailed within the service user guide and statement of purpose documentation, which the manager states, via the AQAA, she provides to all prospective residents or their representatives, copies of these documents were available within the homes entrance hallway. No visitors were spoken with during the fieldwork visit, although a number of people were observed visiting the home throughout the day. A signing in book is also maintained within the front entrance hall and this provides evidence of the numbers of people visiting the home and the varying times that these visits occur. Whilst looking around the home in the company of the manager we were able to establish that each room had been personalised by the occupant, with people using furniture, pictures, ornaments and photographs to create an individual feeling within their room. In discussion with the manager it was made clear that all bedrooms are blank canvasses when people visit with a view to moving into the home and that they are encouraged to bring with them any personal items they wish. If the person does not wish to provide or use their own furniture or fittings, etc then the service can provide the basic necessities, such as bed, chairs, table, television. The people living at the home are also supported by the service to retain control over Care Homes for Older People Page 18 of 32 Evidence: those aspects of their lives that they can,such as choice of rising and retiring time, choice of menu, activities options and where they spend their time. A visit was undertaken to the kitchen where the chef discussed the fact that the catering team comprises two cooks who share the week one working 40 hours and the second 35 hours, working from 08:00 to 18:00 to ensure the home has a cook covering from breakfast through to teatime. It was understood that presently the homes menus are being revised with the second chef having only recently commenced work at the home and having brought new ideas and concepts into the kitchen on how the service should operate. The chef on duty explained that the views of the service users are considered when revising the menus and that feedback from the service users is obtained during faceto-face contact, when completing teatime choices, a process the chefs undertake and via surveys completed by the service users. The care staff are responsible for document people breakfast and lunch options/choices, copies of the meal choice records completed for the day were seen during the visit. The chef also discussed the fact that the recent Environmental Health Office visit, had resulted in the home being rated as satisfactory for cleanliness and hygiene and that if the new hand washing facilities had been installed, following the recent kitchen refit, this would have been excellent. Food stores were considered to be good, fresh, frozen and dried goods delivered each Monday, fresh fruit is available to people if requested but not necessarily left on offer around home, as the goods often perish before being used. The chef confirmed that he had completed his food hygiene and that the second chef comes from a naval catering background, with all of his qualifications in place, the chef is also about to commence a National Vocational Qualification (NVQ) in catering. Care Homes for Older People Page 19 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 who use the service are able to express their concerns and have access to a robust, effective complaints procedure, are protected from abuse and have their rights protected. Evidence: The manager states via the AQAA that: We have a robust complaints procedure in place. We listen carefully to all complaints, concerns or suggestions and act accordingly. All staff are aware of the abuse policy and are able to act in order to protect vulnerable adults. Whilst reviewing the care plans of three service users the details of a complaint, made on behalf of the service user by their next-of-kin, was seen on a file. The records seen demonstrated that the home logged the concerns raised, undertook and investigation, provided written feedback of the outcomes and then invited the complainant to meet with the manager in order to ensure that all aspects of their concerns had been appropriately and satisfactorily addressed. Care Homes for Older People Page 20 of 32 Evidence: Details of the homes complaints procedure is contained within the statement of purpose and service users guide documentation, which is made available to people within the home and on admission. The dataset, which forms part of the AQAA documentation, establishes the existence of the homes complaints and concerns procedure and that this was last reviewed in the September of 2008. The dataset also contains information about the homes complaints activity over the last twelve months: No of complaints: 0 No of complaints upheld 0. Percentage of complaints responded to within 28 days: N/A. No of complaints pending an outcome: 0. This information would appear to be inaccurate, as the records seen on the care file indicate that the complaint discussed above was received on the 04th January 2008 and resolved by the 10th January 2008. However, despite the clerical anomaly, the homes complaints process appears to operating effectively. The dataset also indicates that policies on the protection of service users are in place, Safeguarding adults and the prevention of abuse and Disclosure of abuse and bad practice, both policies updated in the September of 2008. The dataset establishes that over the last twelve months no safeguarding referrals have been made to the Local Authority, a statement support by a review of our database. During the visit the manager produced copies of the homes training records, maintained for each employ, which demonstrated that staff have completed safeguarding training, this corroborating the information contained within the AQAA. Care Homes for Older People Page 21 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 manager states via the AQAA that: We ensure that the environment is well maintained and offers service users a homely and safe place in which to live. The care home is maintained appropriately to reduce the risk of infection and cross infection. Toilet and bathing facilities are available to meet the needs of the service users as set out in National Minimum Standards (NMS). We undertook a look around the home in the company of the manager. The building is in a good state of repair, well decorated and furnished to a good standard throughout all communal areas. Several residents bedrooms were visited during our look around, each room was found to provide ample living space, en-suite facility in some cases, and screening if Care Homes for Older People Page 22 of 32 Evidence: the room was shared. All rooms had been furnished according to the occupants own design and wishes and personal items used to individualise their space. The communal facilities are spacious, light and well furnished areas of the home, which offer the service users the opportunity to socialise and be entertained. The dining room is not large enough to accommodate all of the existing residents in one sitting; however, as some people require assistance when eating and drinking this is presently not and issue, as these people can be supported in the lounge or their bedrooms if required. Throughout the tour of the home no offensive odours were detected, with the premises noted to be clean and fresh. Communal toilets and bathrooms were noted to contain liquid soaps, paper-towels and bins for the disposal of waste. All chemicals were stored in accordance with the Control Of Substances Hazardous to Health (COSHH) regulations. A review of the homes duty rosters established that there is a dedicated domestic team employed at the home, members of this team were observed working around the home during the fieldwork visit. The laundry is located within the main building and where the staff/home are responsible for laundering residents clothing and returning this to the client room the clothes are labelled to reduce the possibility of lose or the item being returned to the wrong person. The dataset makes clear that the staff have access to policies and procedure on: Communicable diseases and infection control, Control of substances hazardous to health, Disposal of clinical waste and Health and safety (Health and Safety at Work Act 1974), all of these policies and procedures reviewed in the September of 2008. Care Homes for Older People Page 23 of 32 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience 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 provided 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 manager tells us via the AQAA that: All staff working within the home complete mandatory training applicable to their role within the company, for example, Protection of Vulnerable Adults (POVA), manual handling, infection control, fire safety. Nurses working within the home are suitably registered with the appropriate body. As an organisation we recruit in a fair and open way ensuring we employ the right people. We undertake a robust recruitment process and carry out various checks on possible employees, for example, Criminal Records Bureau (CRB), POVA, references, employment history. In addition to their comprehensive Induction Programme, all staff receive the encouragement and support to undertake further training particularly in National Vocational Qualifications (NVQ) and health related subjects e.g. palliative care, nutrition, manual handling. Care Homes for Older People Page 24 of 32 Evidence: Copies of the homes duty roster were seen during the fieldwork visit and indicated that staff are employed in the disciplines care and nursing staff, domestic and ancillary staff, maintenance and activities co-ordination. The roster establishes that there are, on average six staff on the morning and afternoon shifts and at nights this drops to one team leader and two care staff. Observations made throughout the day tended to support the fact that sufficient staff are employed at the home and that the needs of the service users were being meet, with nursing staff, care staff, domestic, maintenance and catering staff all seen around the home during the fieldwork visit. The individual training files of two staff were reviewed during our visit to the home. These records are maintained within the office and should be updated by the staff as and when they complete a training event/course, although the evidence indicated that some recently completed training events had not been entered into the files. Certificates for courses completed are also retained by the management team and also provided by the management team who undertake in house training on Moving & Handling, as one of the Providers and a senior employee have completed Moving & Handling train the trainer courses. The provider has also purchased a number of training DVDs AND the most recent purchase covers fire safety. In conversations with staff it was established that training opportunities are good and that annually they are put through their mandatory courses, a statement supported by the advertised courses within the staff room. Information taken from the dataset and confirmed with the manager, indicates that currently the home employs twenty-eight nursing and care staff. Eleven of the twenty care staff has completed a National Vocational Qualification (NVQ) at level 2 or above and this provides the home with a rate of 55 of its care staff possessing an NVQ at level 2 or above. The dataset also establishes that a recruitment and selection strategy/procedure exists to support the manager when employing new staff. It also indicates that all of the people commencing work within the home over the last Care Homes for Older People Page 25 of 32 Evidence: twelve months have undergone satisfactory pre-employment checks. On reviewing the files of the three most recently recruited staff all of the required checks were in place, Criminal Records Bureau (CRB) checks, Protection Of Vulnerable Adults (POVA) checks and two references. The files also contained completed application forms, work permits, health declarations, photographs of the employee, interview summaries, personal information, information used to support the CRB application process and for qualified staff confirmation of the right to practice, a pin number check with the Nursing and Midwifery Council. Care Homes for Older People Page 26 of 32 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience 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, has effective quality assurance systems developed by a qualified, competent manager. Evidence: It has been established at previous inspections that: The registered manager is a registered general nurse and has had many years experience with care of the elderly. She has gained her Registered Managers Award (RMA), the providers have also undertaken this qualification and successfully completed it. The AQAA supports our earlier findings and states: The Manager and Proprietors all have above average experience and skills in a care setting and each holds either the RMA or Diploma in Management Award. The evidence throughout the report indicates that the home is being well run, although one or two issues, as mentioned in the report, were brought to the managers Care Homes for Older People Page 27 of 32 Evidence: attention and will require some action or addressing on her or the providers part. The homes approach to quality assurance is reasonably good, with questionnaires or comment cards made available to people on a variety of issues, such as the food consumed within the home, as discussed by the chef and the general performance of the home and the service delivered. The evidence from the questionnaires returned is that people generally have little by way of negative comments to make and praised the home for being clean, tidy and well maintained, for having a reasonable activities programme and for the attitude of the staff. Records seen within the management office provide evidence of monitoring visits being undertaken by the providers, in accordance with Regulation 26 of the Care Homes Regulations. Staff are being provided with supervision and appraisal opportunities, as evidenced by the completed feedback sheets on their files and team meetings are arranged and delivered, as required. 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. As an alternative arrangement to holding monies for service users the home offers a tick system, whereby the home will purchase items for a service user or pay for services and then recoup the money at the end of the month by invoice. People may choose not to settle this account immediately, however the providers have established an upper limit beyond which a persons debt is not allowed to exceed. Receipts for all purchases are obtained and made available to the families upon request and the account balance sheets maintained by the providers list all incomings and out goings on the tick system. The look around the home identified no immediate health and safety issues and the environmental risk assessments consider both potential areas of harm and how these can be managed. The presence of the maintenance person means that any immediate hazard or risks can be addressed without delay, whilst routine maintenance is undertaken to ensure Care Homes for Older People Page 28 of 32 Evidence: the environment remains fit for purpose and safe. The manager tells us, via the AQAA and dataset information that health and safety policies and procedures are made available to the staff and that domestic appliances and personal equipment is regularly maintained and serviced. Health and safety training is being made available to staff, the training records providing evidence of the courses attended, whilst the AQAA indicates that infection control training is completed by all staff and food hygiene by all catering staff. Care Homes for Older People Page 29 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 30 of 32 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 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. 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