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Inspection on 04/09/06 for The Sands Nursing & Retirement Home

Also see our care home review for The Sands Nursing & Retirement Home for more information

This inspection was carried out on 4th September 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The inspection was conducted in a very friendly and cooperative manner and all the residents were very happy to tell the inspector about their home. Those spoken to said how happy they were living at The Sands. The atmosphere was very relaxed and staff and residents got on well together. During the visit, the inspector spoke to and observed a number of residents who all appeared to be very comfortable and relaxed in their surroundings. Several residents were cared for in bed on the nursing floors. They were well cared for and the inspector observed the staff caring for them with respect and dignity. There was progress charts kept on them so that care provided could be monitored. These included fluid chart and a chart to record when a resident has been turned to prevent pressure sores. The residents who responded to the written survey and those consulted during the inspection were very complimentary about the quality and variety of meals provided at the home. Great satisfaction was expressed about the standard of meals and choices on offer during each mealtime. A written pre admission assessment (Indicator of Dependency Form) is done to ensure that residents admitted to the home are provided with care to meet all their needs. This form covers all areas of needs such as personal care, communication, mobility, personal and medical history and other areas to meet the needs of the residents The manager and the staff have a good awareness of equality and diversity and said that they treat everyone as equals and respect people`s different ways and habits. A formal policy on Equality and Diversity needs to be produced. Following advice form the inspector, the manager has already downloaded information on this subject from the CSCI website. Although the manager has overall responsibility for the home, each of the nursing floors is managed by a qualified nurse and the residential floor by a senior carer. This enables residents to have direct access to someone in charge on each floor. The manager and her deputy visit all the floors when they are on duty to speak to the residents and the staff. They also work on the floors on when required. A receptionist is employed during peak times to answer the telephone and welcome visitors at the home. The staff benefit from a good standard of training. It was also pleasing to note that the home continue to meet the national target in NVQ training, with 60% of carers holding the qualification at level 2 or above. The staff were observed to be polite and respectful when talking and caring for the residents.

What has improved since the last inspection?

Several areas of the home have been decorated. The manager said that it is the policy of the home to have an ongoing programme of decorating and carpet replacement in all areas of the home. The small kitchens on each floor have been upgraded with new units, toasters, kettles and food warming facilities The staffing level has been increased by having a member of staff to float between the floors to help during peak times. More nurses have been employed to meet the requirement for more qualified nurses. The receptionist is to help the manager by becoming her personal assistant and training coordinator.

What the care home could do better:

The manager needs to produce a policy on Equality and Diversity and arrange training on the subject for all staff.

CARE HOMES FOR OLDER PEOPLE The Sands Nursing & Retirement Home 390 Marine Road East Morecambe Lancashire LA4 5AU Lead Inspector Mr Ajam Auckburally Unannounced Inspection 4th September 2006 10:00 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 Sands Nursing & Retirement Home DS0000006159.V302965.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 Sands Nursing & Retirement Home DS0000006159.V302965.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Sands Nursing & Retirement Home Address 390 Marine Road East Morecambe Lancashire LA4 5AU 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) 01524 400300 01524 410284 Victoria & Thornton Court Limited Mr Robert Wilson, Ms Maureen Mackay Mrs Lisann Christine Smith Care Home 80 Category(ies) of Old age, not falling within any other category registration, with number (80) of places The Sands Nursing & Retirement Home DS0000006159.V302965.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home shall employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 9th February 2006 Date of last inspection Brief Description of the Service: The Sands is a purpose built care home which also provides nursing care and is known as a Care Home with Nursing. The home is situated on Marine Road in Morecambe and faces the sea front. The building has five floors and residents are accommodated on the ground, first, second and third floors. A passenger lift is available for access to all the floors. The central kitchen, the laundry, the manager’s office and the administrative section of the home are situated on the fourth floor. A total of 80 residents can be accommodated at any one time. The ground floor is for people who do not require nursing care (residential). The first floor has recently been changed to take residents who need nursing care. Currently this floor has a mixed of both nursing and residential residents. The change will mean that the first floor will eventually be all nursing. Residents who are classed as residential have agreed to remain on this floor or move to the residential floor when there is a vacancy. The second and third floors are for people requiring nursing care. Each floor has its own lounge, dining room and kitchenette. All the bedrooms are single rooms and all except four have an ensuite facility. The home is staffed around the clock to meet the needs of all the residents. Nursing staff are employed to meet the needs of residents who need nursing care. There were 79 residents staying at the home at the time of the inspection. Current weekly fees are between £390 and £603 depending whether residential The Sands Nursing & Retirement Home DS0000006159.V302965.R01.S.doc Version 5.2 Page 5 or nursing care is provided. The residents pay for additional extras like hairdressing, private chiropody and newspapers. The Sands Nursing & Retirement Home DS0000006159.V302965.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. Under IBL (Inspecting for Better Lives) The Sands was assessed as requiring a statutory key visit (inspection) between April 2006 and March 2007. An unannounced key site visit was carried out on 4th September 2006 followed by another visit on 7th September to complete the inspection. The two-day inspection took a total of 8.5 hours. The inspection was carried out against the National Minimum Standards for Older People. The inspection despite being an unannounced one was carried out in a friendly atmosphere and with the full cooperation of the manager, the staff and the residents. During the inspection, some records were looked at and several residents and staff were spoken to. The residents were very positive about the care they receive and the way the staff treat them. Evidence about the inspection was gathered firstly by sending out a questionnaire for the manager of the home to complete and return. The completed questionnaire gave information about several areas such as staffing, checks that the home has made about the safety and maintenance of the building, information about residents and other useful information. Questionnaires are also sent to residents, the families and the staff. Sixteen residents and two relatives returned their completed forms. When they were analysed, they showed that everybody was happy with the quality of care provided and the facilities at the home. The same inspector has been inspecting The Sands for a number of years and has seen good progress made in the care of the residents and the facilities provided. There were 79 residents living at the home at the time of the inspection and there were an adequate number of qualified nurses, care staff, and other ancillary staff on duty. Two managers and the catering staff were also on duty. The number of staff on duty was well within the minimum level recommended. The staff were observed to be polite and attentive when talking and dealing with the residents. The Sands Nursing & Retirement Home DS0000006159.V302965.R01.S.doc Version 5.2 Page 7 What the service does well: The inspection was conducted in a very friendly and cooperative manner and all the residents were very happy to tell the inspector about their home. Those spoken to said how happy they were living at The Sands. The atmosphere was very relaxed and staff and residents got on well together. During the visit, the inspector spoke to and observed a number of residents who all appeared to be very comfortable and relaxed in their surroundings. Several residents were cared for in bed on the nursing floors. They were well cared for and the inspector observed the staff caring for them with respect and dignity. There was progress charts kept on them so that care provided could be monitored. These included fluid chart and a chart to record when a resident has been turned to prevent pressure sores. The residents who responded to the written survey and those consulted during the inspection were very complimentary about the quality and variety of meals provided at the home. Great satisfaction was expressed about the standard of meals and choices on offer during each mealtime. A written pre admission assessment (Indicator of Dependency Form) is done to ensure that residents admitted to the home are provided with care to meet all their needs. This form covers all areas of needs such as personal care, communication, mobility, personal and medical history and other areas to meet the needs of the residents The manager and the staff have a good awareness of equality and diversity and said that they treat everyone as equals and respect people’s different ways and habits. A formal policy on Equality and Diversity needs to be produced. Following advice form the inspector, the manager has already downloaded information on this subject from the CSCI website. Although the manager has overall responsibility for the home, each of the nursing floors is managed by a qualified nurse and the residential floor by a senior carer. This enables residents to have direct access to someone in charge on each floor. The Sands Nursing & Retirement Home DS0000006159.V302965.R01.S.doc Version 5.2 Page 8 The manager and her deputy visit all the floors when they are on duty to speak to the residents and the staff. They also work on the floors on when required. A receptionist is employed during peak times to answer the telephone and welcome visitors at the home. The staff benefit from a good standard of training. It was also pleasing to note that the home continue to meet the national target in NVQ training, with 60 of carers holding the qualification at level 2 or above. The staff were observed to be polite and respectful when talking and caring for the residents. What has improved since the last inspection? What they could do better: The manager needs to produce a policy on Equality and Diversity and arrange training on the subject for all staff. The Sands Nursing & Retirement Home DS0000006159.V302965.R01.S.doc Version 5.2 Page 9 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 Sands Nursing & Retirement Home DS0000006159.V302965.R01.S.doc Version 5.2 Page 10 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 Sands Nursing & Retirement Home DS0000006159.V302965.R01.S.doc Version 5.2 Page 11 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): 3&6 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Procedures to give residents adequate information before choosing the home are excellent. EVIDENCE: The records of admission of the last resident admitted to the home were examined. The manager said that in this instance, information was obtained from the relatives who visited the home on behalf of the resident. A member of the management team always visits prospective residents who are unable to visit the Sands, either in their own home or in hospital before admission. The manager said this helps with introduction as well giving and gaining information. The brochure contains information about the care, the facilities, the staffing, the complaint procedure and other useful information. The Sands Nursing & Retirement Home DS0000006159.V302965.R01.S.doc Version 5.2 Page 12 A copy of the last inspection report is given to all new residents. Prospective residents or their families are encouraged to visit the home and spend as much time as they need before making a decision. A written pre admission assessment is done at this stage to ensure that the staff of the home can meet the assessed needs. A form (Indicator Of Dependency) is used to record information under the heading of: personal care, nursing needs, mobility, eating, communication and several more areas relevant to the care of the resident. Bedrooms are allocated according to vacant rooms and often there is only one to choose from. However, room can be changed when there is a vacancy. The staff said that they are given as much information about the new residents as possible so that they can provide tailor-made care. Several residents spoken to said that their families have chosen well for them and that they liked living at the Sands. They said that they can do what they want and that the staff provide assistance and help when required. The manager said that referrals from residents of an ethnic background would be welcomed. She said that research would be carried out, for example if the home was unsure how to meet cultural, religious and dietary needs of people from a different country or culture. The residents said that the staff are very good and that nothing is too much trouble for them. It was noticed on the completed pre inspection questionnaire that the turnover of residents at the home was quite high. The number of deaths since the last inspection was 27. The manager explained that the home can take 80 residents and many of the admissions have been for short-term care. The manager said that the high number of deaths is because people being admitted to the nursing part of the home are very poorly when they arrived. The home does not provide intermediate care. The Sands Nursing & Retirement Home DS0000006159.V302965.R01.S.doc Version 5.2 Page 13 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. There are good practices to meet residents’ health and personal care needs. EVIDENCE: Four residents, one of whom being the last one admitted to the home were case tracked. This means that four residents were selected by the inspector and the care they receive examined closely. Their assessments and care plans were examined and they were spoken to. The records show that detailed written information about the residents has been recorded. These include an assessment to identify the needs of the residents and also a care plan which shows how the needs were being met. The Sands Nursing & Retirement Home DS0000006159.V302965.R01.S.doc Version 5.2 Page 14 The physical assessment covers; personal hygiene, mobility, hearing, vision and other areas. The care plans give details of how the assessed needs are met. For example, if someone needed help with personal hygiene, the record will show that this person needs staff to wash and dress her. On the nursing floors, the care plans are used more because treatments are provided on an ongoing basis. For instance, the care plans examined by the inspector show that fluid, feeding and personal hygiene charts are used to record and monitor residents’ progress. The care plans for people with nursing input are reviewed on a daily basis to meet their needs. The care plans for people who do not need nursing care are reviewed monthly or as required to meet their changing needs. The residents and their families are involved in this exercise. The residents said that they are very well looked after by a team of very good staff. They were very positive about the staff and the management of the home. They described the home as being very good. Sixteen survey cards were received back from the residents and they were all positive about the staff and the care they receive. Two survey cards were received back from relatives. They both had positive comments about the home. The daughter of one resident was visiting at the time of the inspection. She said that her mother is well cared for and that the staff are very good. The inspector observed a very relaxed and friendly atmosphere in the home. There were good interactions between the staff and the residents. To meet the needs of residents who need support when walking along the corridors, handrails have been fitted on the walls. All of the toilets have been fitted with grab rails to help those residents with poor balance and mobility. A passenger lift is available to access all the floors. The lift is on the small side and is constant use. Some of the baths and showers have easy access and facilities to help residents who are disabled. Bath hoists are available to assist residents with getting in and out of the bath. All the residents are white British, but the manager said if a resident from a minority group was to be admitted to the home, she will obtain as much The Sands Nursing & Retirement Home DS0000006159.V302965.R01.S.doc Version 5.2 Page 15 information as possible by researching this group to meet care, cultural and dietary needs. Resident’s health care needs are met by involving health care professionals. GP’s, district nurses and chiropodist visit when required. The medications of two residents were audit trailed and were found to be correct. Residents who are able and willing can keep and administer their own medications. The home is sensitive to the needs of all the residents and does everything to help them remain as independent as possible. The staff said that their job is to work with the residents and meet all their needs. They said that they have very good relationships with all the residents. They were observed talking and helping the residents with respect and dignity. The Sands Nursing & Retirement Home DS0000006159.V302965.R01.S.doc Version 5.2 Page 16 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. There are good practices to meet the social and personal needs of the residents. EVIDENCE: The manager said that residents are encouraged to remain as independent as they want and able to. The residents said that they can do what they want and join in organised activities that they liked. Residents were observed doing their own things. Some were in the lounges and others were in their rooms. They said that they are able to remain as independent as they want or able to. They said that staff are helpful and will provide assistance when required. The Sands Nursing & Retirement Home DS0000006159.V302965.R01.S.doc Version 5.2 Page 17 Several residents said that they like to stay in their rooms for most of the day. Some of them would join the others in the dining room at meal times, whilst some would eat in their rooms. An activity organiser is employed to do a variety of activities to suit the different needs of the residents. Activities include bingo, soft ball games, art and craft. Families and friends of residents are encouraged to visit when they want. Some of the residents said that their relatives take them out regularly. The inspector observed a member of staff sitting in the lounge and talking to the residents. The manager said that when there is a social event, residents from all floors are encouraged to join in. The staff said that they assist the residents to do what they like. The staff said that they try and meet residents’ individual needs. They said that if residents wanted to go for a walk or do something, they would try to oblige. The residents said that they do what they want and that the staff are very helpful and would assist them when required. The residents said that the food is very good and that they are offered choices at all mealtimes. On the day of the inspection, the choices for lunch were steak pudding or tuna sandwiches. A choice of potatoes and vegetables were also offered. Meals are cooked in the main kitchen and transported in heated trolleys to the different floors. Meals are served in the dining rooms on each floor. Tea making facilities is available in the small kitchen in the dining rooms. Residents are encouraged to eat with others in the dining rooms, but may eat in their rooms if they prefer. There is a good choice of food to choose from at breakfast and teatime and including a hot meal. Hot drinks are served at regular times in the day, but residents can ask for one when they want. The Sands Nursing & Retirement Home DS0000006159.V302965.R01.S.doc Version 5.2 Page 18 A resident who likes to drink a lot of tea is provided with a flask of hot tea for her to use in her room. Crabmeat has been provided for one resident who likes it on her sandwiches. Fruit bowls are available in each lounge and residents can help themselves to the fruit freely. Records of meals served examined show that a good variety of meals are offered to the residents. The chef said that within reasons, he would cater for every taste. He said that he is able to cook food to suit ethnic needs and if he did not know how, he will try and find out. The chef said that he attends monthly residents’ meetings and listens to what they have to say about food and would provide any reasonable food requested. . The Sands Nursing & Retirement Home DS0000006159.V302965.R01.S.doc Version 5.2 Page 19 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. There are robust policies on complaints and abuse for the protection of the residents. EVIDENCE: We received a complaint in July 2006 from the Social Services Department that a member of staff who was working at the home has had a conviction for theft and that she was struck off the Midwife and Nursing Register for misconduct. A visit was made to the home to investigate the complaint. It was discovered that the said staff has been working at the home for 3 years and that she was on the bank staff. The person in charge said that the staff declared her conviction and upon a judgement made by the management of the home, it was decided to employ her. The staff did not declare that she was struck off from the Nursing Register. The manager said that the member of staff has been a good staff and was liked by the residents and the other staff. She said that there has been no reason to suspect her of any wrong doing. The Sands Nursing & Retirement Home DS0000006159.V302965.R01.S.doc Version 5.2 Page 20 During this inspection, the issue was discussed and the manager said that the staff member will not be used again and that they have tightened their procedures to ensure that more thorough check are carried out before employing new staff. The home has a robust procedure for dealing with complaints. All complaints and incidents are recorded on a form. The last complaint recorded was dealt with promptly and to the satisfaction of the complainant. Written information about how and who to complain to is given to residents or their families. The residents said that if they had any complaints, they would speak to the manager and have every confidence that their concerns would be dealt with. The manager said that the management team is always available to speak to the residents or their families. The person in charge visits all the floors to speak to residents and staff on a daily basis. The manager said that this allows for problems and concerns to be sorted out as they appear. There are systems in place for staff to report any incident of abuse either by staff themselves or by families. All the residents appeared to be safe and free from harm, neglect and abuse. Staff were observed treating the residents with respect and dignity. The staff spoken to were aware of different types of abuse. One member of staff spoken to was able to describe abuse as being physical, emotional and financial. Several staff have attended a course on abuse awareness. The Sands Nursing & Retirement Home DS0000006159.V302965.R01.S.doc Version 5.2 Page 21 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. There are procedures in place to provide residents with a safe and clean home. EVIDENCE: A tour of the building was carried out and all the communal areas were found to be clean and tidy. With the permissions of the residents, several bedrooms were visited. They were found to be clean. The residents who were occupying some of these bedrooms said that the domestic staff comes in everyday to tidy and clean their rooms. They said that they do not have to leave their rooms if they don’t want whilst cleaning is being done. The domestic staff spoken to said that she has had training on the use of cleaning materials and infection control. The Sands Nursing & Retirement Home DS0000006159.V302965.R01.S.doc Version 5.2 Page 22 She was seen using a trolley to keep all her cleaning materials and said that she never leaves it unattended. The manager said that there is a rolling a programme of maintenance and carpets are changed when necessary. The policy of the home is to decorate and change carpets in empty rooms before new residents are admitted. The residents said that they feel safe living at the home and that their rooms are well maintained. There are policies and procedures regarding the handling of cleaning materials and infection control. Some staff have attended courses on the control of infections. The residents’ general comments were that the home is beautiful, clean and homely. The management of the home has made great effort in providing aids and adaptations to help residents with physical disabilities. Handrails have been fitted alongside the corridors to help residents with mobility. There are grab rails fitted to some of the toilets to help residents who are disabled. There are a selection of different baths and showers to enable residents to have a choice which one they want to use. A passenger lift, albeit on the small side is available for the residents to use independently if they wish. A team of domestic staff is employed to do the cleaning and a handyman is also employed for maintenance. The home was found to be free from hazards and the residents said that they can get around the home safely. The Sands Nursing & Retirement Home DS0000006159.V302965.R01.S.doc Version 5.2 Page 23 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. There are good procedures to provide a good calibre of staff to care for the residents. EVIDENCE: The number of staff on duty has been maintained to a good level to meet the needs of the residents. At the time of the inspection, there were 2 managers and 40 other staff including, nurses, care assistants, catering and other ancillary staff on duty. Staff rotas checked showed that the staffing is well within the recommended level for the number of residents at the home The same staff usually work on the same floor to ensure continuity. It was obvious that the staff knew the residents well and that there was a good rapport between them. The staff and residents were seen talking and laughing. The Sands Nursing & Retirement Home DS0000006159.V302965.R01.S.doc Version 5.2 Page 24 The manager said that when there is a shortage of staff, agency staff are used. She said that she tries and use permanent staff to fill any gaps and only use agency staff as a last resort. The manager demonstrated a good understanding of the procedures to be followed when selecting and recruiting staff. The management team has produced a well written recruitment policy for its staff. A member of the management team is always involved in the recruitment of new staff. When there is a vacancy for a job, it is advertised locally and interested parties are given application forms to complete. From information received, prospective staff are selected for interviews. Once a new staff has been selected, two written references are taken and POVA (Protection Of Vulnerable Adults) and CRB (Criminal Records Bureau) checks are done. No staff starts work until satisfactory checks have been done. The staff files examined show that appropriate checks had been carried out before offers of employment were made. Such checks included CRB (Criminal Records Bureau) checks and a POVA (Protection Of Vulnerable Adults) check. Once a new member of staff starts work at the home, she undertakes an induction training programme involving orientation of the home, meeting residents and staff. Training also include, Fire Procedures, Moving and Handling and many other relevant courses Training records show that the staff at the home have attended several courses. These include: Abuse, Moving and Handling, First Aid, Dementia, Medications, etc. Staff spoken to said that they treat all the residents with respect and accept any difference people may have. CSCI (Commission for Social Care Inspection) recommends that at least 50 of care staff achieved NVQ (National Vocational Qualification) level 2. The percentage of care staff at the Sands with this qualification is 60 and is commendable. The staff spoken to said that they enjoy working at the home very much. They said that the management is very supportive and listens to what they have to say. The residents said that the staff are marvellous and will do anything for them. There were good interactions between the residents and the staff. They all appeared to be happy and content. The Sands Nursing & Retirement Home DS0000006159.V302965.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. There is a good management team running the home for the benefit of the residents. EVIDENCE: The Sands is managed on a day-to-day basis by the registered manager Mrs Lisann Smith. She is a qualified nurse. She is supported by a deputy manager who is also a qualified nurse and other senior nurses and senior care staff. The home is owned by a company called Victoria and Thornton Court Ltd. Mr Robert Wilson and Miss Maureen Mackay are the directors of the company. The Sands Nursing & Retirement Home DS0000006159.V302965.R01.S.doc Version 5.2 Page 26 The manager said that the home has an open door policy and that residents and staff are always welcome to come and have a chat. Residents and or their families are encouraged to deal with their own finances. Most of the fees due to the home are paid for by direct debit arrangements. Where the home, keeps money on behalf of residents, appropriate records are kept. The inspector had the full cooperation of the manager, the staff and the residents during the inspection. The manager said that she has daily contact with the residents and will deal with any concerns they may have straight away. The inspection was carried out in a friendly environment and residents and staff said that the Sands is a very good home. The managers from other homes within the company visit the Sands regularly and once a month completes a Regulation 26 form. This form is completed to ensure that owners who do not work at the home on a daily basis either himself or herself or a representative looks at all areas of the home and leaves a written report. A copy of the report is also sent to CSCI. The Sands Nursing & Retirement Home DS0000006159.V302965.R01.S.doc Version 5.2 Page 27 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 X X 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 The Sands Nursing & Retirement Home DS0000006159.V302965.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? 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 OP32 Good Practice Recommendations The manager should produce a policy on Equality and Diversity. The Sands Nursing & Retirement Home DS0000006159.V302965.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 Sands Nursing & Retirement Home DS0000006159.V302965.R01.S.doc Version 5.2 Page 30 - 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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