Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: Tolverth House Tolverth House Long Rock Penzance Cornwall TR20 8JQ 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: Lynda Kirtland
Date: 2 1 1 0 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. the things that people have said are important to them: They reflect 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 29 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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 29 Information about the care home
Name of care home: Address: Tolverth House Tolverth House Long Rock Penzance Cornwall TR20 8JQ 01736710736 01736710736 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Vijay Enterprises Limited Type of registration: Number of places registered: care home 14 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is 14. The registered person may provide the following caregory of service only: Care home providing personal care only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP- maximum of 14 places Dementia - Code DE- maximum of 4 places Mental disorder, excluding learning disability or dementiaCode MD- maximum of 4 places Physical disability- Code PD- maximum of 1 place Date of last inspection Care Homes for Older People
Page 4 of 29 Over 65 0 0 14 0 4 4 0 1 Brief description of the care home Tolverth House is a registered home providing accommodation and personal care for up to 14 older people aged 65 years or over. Of these up to 4 may have dementia and a further 4 may have mental health care needs. The home is situated in the village of Long Rock on the outskirts of Penzance. It is close to shops and public transport routes and is set in its own grounds, slightly off the main road. It has two floors, the upper floor being accessible by stairs with a stair lift. Most of the bedrooms have en suite bathrooms. There is a spacious lounge downstairs and a separate dining room and conservatory. The registered provider lives on site and is actively involved in the management of the home. A manager who is registered with the Commission undertakes day-to-day management of the home, assisted by a team of staff. Most parts of the home are accessible to residents with physical disabilities and there are portable ramps to ensure that they can access areas that would only otherwise be accessible by steps. The upper floor is accessible via a stair lift. The new registered provider has published a statement of purpose to provide information about the home to prospective residents. Fees range from #310.00-#395.00 per week. Additional charges are made for newspapers, hairdressing, private chiropody and outings organised by the home. Care Homes for Older People Page 5 of 29 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: An inspector visited Tolverth house for a key inspection on the 21 October 2008 along with an Expert by Experience. It lasted for approximately eight hours. Information about the home received by the Commission since the previous inspection was taken into account when planning the inspection. The purpose of the inspection was to ensure that people who use the service needs are appropriately met in the home with particular regard for ensuring good outcomes for them. This involved the Expert by Experience meeting with people who use the service to discuss with them their experiences in living at the home. Their findings are incorporated in this report. Observation of the daily life and care provided occurred as well as an inspection of the homes premises and of written documents concerning the care and protection of Care Homes for Older People
Page 6 of 29 people who use the service and the ongoing management of the home. Staff were interviewed and observed in relation to their care practices and there was a discussion with the homes registered manager and registered person. Another method used was case tracking of which four people were selected. This involves examining the care notes and documents for a select number of people who use the service and following this through with interviews with them or their relatives and staff working with them. This provides a useful in-depth insight as to how their needs are being met in the home. Since the previous inspection the registered manager and registered person have worked hard to comply with the statutory requirements identified at the last inspection. This report evidences that there has been an overall improvement in the service following new management systems being put in place. People who use the service echoed that the care they received was good and were satisfied with the facilities on offer. What the care home does well: People who use the service are provided with an up to date Statement Of Purpose and Service Users Guide. These documents give the person information regarding the facilities available in the home. These are available in each residents room. Pre admission assessments occur prior to a person being admitted to the home so it can be assessed whether Tolverth house has the correct facilities to meet an individuals needs. This in turn allows the prospective service user to form a view as to if they believe the home can cater for their needs and make an informed choice about living at the home. People who use the service said that their recent admission to the home was a positive experience, as staff made them feel welcome and relieved some of their anxieties. People who use the service said that they are satisfied that their healthcare needs are being met. There are facilities to ensure that people who use the service can receive personal care in private. Medication processes are robust. The registered manager undertakes a monthly audit of medication and this has ensured that medication errors are kept to a minimum. The homes complaints policy has been expanded so that staff are provided with guidance if they receive a complaint as to the process in how to manage this. People who use the service said that they felt able to approach the registered manager if they had any concerns. The home has a range of communal facilities and a spacious garden, which residents can make use of. Most people who use the service said that they are satisfied with the lifestyle the home provides. Some go out independently or with relatives and make use of the facilities in the local community. People who use the service are able to make choices over issues that are important to them. Most maintain control of their own finances or do so with the assistance of their relatives and they are able to personalise their bedrooms if they wish for example. Staff were observed to promote privacy and respect for people who use the service i.e. by knocking on bedroom doors before entering mail received unopened and access to phones in private. People who use the service commented that they felt most staff treated them with kindness and respectful. The home appears comfortable well maintained and safe so that people who use the service can enjoy attractive and homely surroundings. It was clean and tidy throughout at the time of the inspection and staff and people who use the service said that it is always kept clean. Views have been sought from people who use the service about the facilities that Tolverth house provide via the use of a questionnaire. The response they have received has been positive and people who use the service commented in the surveys that they are happy with the care they receive and could not identify areas for improvement The home manager ensures that relevant health and safety checks, such as fire Care Homes for Older People Page 8 of 29 equipment are maintained and regularly checked. What has improved since the last inspection? It was evident during this inspection that the registered manager and registered person has worked hard to improve the services that Tolverth House provide. Form the last inspection they have complied with all eight statutory requirements and nine out of the ten recommendations, which evidences the seriousness of how they approached the issues highlighted in the previous report. The improvements that have been made focus on consultation with people who use the service, documentation and implementing new management systems. Care plans have been reviewed and some were more detailed in that they guided, informed and directed staff in how to provide care in a specific way to allow consistency in care. The registered manager is aware that there is still work to do in this area and therefore a recommendation to this effect has been made. Care plans are reviewed monthly and where possible the person who uses the service is involved in this process. Any changes to the individuals care needs and what actions staff are to take to meet this changing need are now recorded. Individual risk assessments are now completed so that staff are aware of potential risks, how to minimise them for the individual and if necessary what equipment is to be used in this process for example when assisting someone to mobilise. Medication systems are robust and a recent pharmacy inspection did not identify any concerns. The registered manager has asked people who use the service about their hobbies and interests to try to be able to meet them. However it is noted that whilst the home has made a great effort to promote activities people who use the service are saying that they prefer their own company or do not wish to participate. There is ongoing discussion with People who use the service and the staff team as to if this can be progressed further. The registered manager has attended the Safeguarding Multi Disciplinary training and is cascading this training to the staff team. The registered manager has ensured that the homes recruitment and selection policy and procedure is followed in that all new staff to the home have all the relevant checks carried out prior to employment commencing. Staff have attended recent mandatory training for example infection control, manual handling and medication. Fire training is up to date. The registered manager has a over view of staff training so that she can monitor when staff training is due for renewal. The registered manager continues to review the homes policies and procedures and has introduced one for the management of people who use the service finances. The registered manager and registered provider has introduced a more comprehensive Care Homes for Older People Page 9 of 29 quality assurance process and when completed will send their findings to us. The home is maintained to a good standard. The fire risk assessment has been reviewed by a independent person and was viewed as satisfactory. What they could do better: 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 10 of 29 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 11 of 29 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. A contract of care is provided to people who use the service so that they are aware of their rights whilst resident at Tolverth House. The needs of prospective service users are assessed prior to admission so that they can be assured that the home can provide adequate care and meet their individual care needs. People who use the service are invited to meet with staff and visit the home that will assist them in making the decision about living at Tolverth house. Evidence: The homes Statement Of Purpose and Service Users guide have been updated so that they accurately reflect what services and facilities the home provides to people who use the service. People who use the service have a copy of these documents in their rooms. From case tracking new admissions to the home it is evident that prospective Service
Care Homes for Older People Page 12 of 29 Evidence: users and their representatives are fully involved in the assessment process so that they can identify what help they need and how staff will then meet this care need. Records from relevant professionals are also gained as part of the assessment process. The manager visits prospective residents and complete a needs assessment, which takes into account the persons physical, emotional, social and diverse, needs. All the records case tracked contained needs assessment, which recorded their care needs in detail and included their views and preferences. Residents felt that the home involved them in their care arrangements. In discussion with residents they confirmed that staff lessened their anxieties when moving into Tolverth house and that this was a positive experience for them. A contract of care is provided to each person who uses the service which stipulates their terms and conditions of the placement Care Homes for Older People Page 13 of 29 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. Each person who uses the service has a care plan format, which in the main inform, guide and direct staff in the caring interventions that they need to undertake with individual people. Care plans are reviewed. There are satisfactory arrangements to ensure People who use the service have access to healthcare service. Evidence: Since the previous inspection the registered manager has developed the care plans further. Of the four care plans case tracked, one in particular informed, directed and guided staff in how to meet the persons individual needs. The other three care plans had less detail in them, however the persons dependency needs were less complex and therefore the level of care needed was written in less detail. The registered manager agreed that all care plans should direct, inform and guide staff in how to meet a persons needs consistently and stated she is reviewing all care plans to achieve this. If there are any restrictions for people who use the service to promote their well being this must be recorded in the individuals care plan. Care Homes for Older People Page 14 of 29 Evidence: Staff commented that they found these care plans to be more informative. The care plans are reviewed monthly and there was evidence that the person who uses the service or their representative participated in this. Risk assessments have been reviewed since the previous inspection and now identify the potential risk and what action should be taken to minimise the risk further. It also records what equipment, if any is needed to ensure that the person is for example transferred safely from one place to another to again minimise the risk of harm. The daily records for people who use the service summarised if care had been provided that day and also what the individual did that day i.e. if they received visitors or participated in a activity. People who use the service are registered with local GP practices. People who use the service felt that their health care needs were monitored and attention obtained promptly when needed. People who use the service are weighed regularly. The registered manager has improved the medication systems, making them more robust. Medicines are stored securely. The Monitored Dose System (MDS) is in use. The registered manager has monthly monitoring of medication to ensure that it is being received, administered and that records are accurate. A risk assessment has been completed and agreed with the pharmacist so that eye drops can be stored in the main fridge. The medication policy was satisfactory and staff who are designated to administer medication have received appropriate training. The last pharmacy audit was on 13 September 2008 and no issues were identified. It is recommended that the home gain a copy of the Safe handling of medicines in care homes guide for reference. People who use the service made positive comments on the skills and caring qualities of staff. People who use the service told the expert by experience that they felt well cared for and reported that staff delivered care sensitively, respected their privacy and dignity and listened to their concerns. People who use the service said that staff were lovely and kind. People who use the service felt safe when staff assisted them with personal care. Examples of staff providing skilled and sensitive care were observed during the inspection. Care Homes for Older People Page 15 of 29 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 the service are supported in a lifestyle, which accords as far as possible with their own expectations and preferences. People who use the service stated they are satisfied with the range of activities that takes place that meets their social, religious and recreational interests. The diet provided is varied and nutritious with attention to individual preferences. Evidence: From the discussions that the Expert by Experience had with people who use the service they felt they had control over their daily lives and were supported to make choices about their routines and activities. The majority felt that there was enough to do. The registered manager has attempted to promote activities in the home and has consulted with people who use the service to identify their hobbies so that they could then see if these could be pursued. However people who use the service told the expert by experience that there are not many activities they wish to join in with and are happy to spend time in their own company. The home has transport if people who use the service wish to go out. The registered manager said that on going consultation with people who use the service continues. Care Homes for Older People Page 16 of 29 Evidence: People who use the service reported that they found the visiting arrangements open and flexible. They felt that visitors were made welcome and choose where they meet their guests. People who use the service confirmed they have a lockable facility for small items of value. People who use the service confirmed they brought in possessions and furniture at admission by agreement with the provider. Many had personalised their bedrooms. The registered person stated that if a resident requested to lock their rooms this would be considered. People who use the service were complimentary about the quality and quantity of food provided. The registered provider continues to audit the food and seeks views from people who use the service on a regular bases in this respect. People who use the service said there is a choice of two main meals, and if residents felt unable to eat main meal a snack lunch was offered to them. They said they were satisfied with the standard of and variety of food. Each persons preferences and choices are recorded. People who use the service confirmed that lunch is a social and unrushed occasion with staff providing sensitive support in a pleasant manner. Breakfast can be taken in the dining area or in the persons room and they were very happy with the choices available. Staff knew individuals likes and dislikes. Hot and cold drinks are served between meals. The cook was aware of residents dietary needs and caters for them. The catering staff have gained the basic food and hygiene course and one has completed a course in healthy eating. It is recommended that one of the catering staff gain the intermediate food and safety certificate. A recent environmental health inspection (May 2008) was satisfactory and all appropriate records are kept. Care Homes for Older People Page 17 of 29 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. The home has a satisfactory complaints procedure that would ensure that complaints are listened to and acted upon. There are arrangements to protect people who use the service from abuse and staff are attending relevant training. The Safeguarding policy would benefit from review so that staff are fully informed of what actions they are expected to take if they suspect a person is being abused. Evidence: The complaints procedure is appropriate. The majority of people who use the service said that if they had any issues of concerns they felt able to approach the management team and believed they would be listened too. For example when there was concerns expressed regarding food provision the management team took immediate action. People who use the service are now complimentary regarding the quality and quantity of food provided. People who use the service have access to a summary of the process of how to voice concerns via the Service Users guide and posters on display. Tolverth house have received no concerns since the last inspection. They have met with health colleagues to discuss issues which are now resolved. The home has received a number of compliments recently. People who use the service said that they felt safe in the home. The registered manager has attended the Safeguarding Multi Disciplinary course and needs to ensure that the homes Safeguarding policy reflects the actions as per these guidelines to
Care Homes for Older People Page 18 of 29 Evidence: make it clearer in what actions staff must take when they are alerted to or have a suspicion of abuse. The policy needs to state that the registered person is required to notify the CSCI of all incidents of abuse, this does not constitute a referral. The registered manager agreed to action this immediately and has arranged for some staff to attend this course. Since the last inspection the registered manager has ensured that the homes recruitment procedures are robust so that new staff are recruited on the basis that they are fit and safe to work with vulnerable people in a care setting. Please refer to staffing section. Care Homes for Older People Page 19 of 29 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 home is accessible, well maintained and safe. The premises are clean and hygienic providing a pleasant environment and reducing risks to people who use the service, visitors and those who work at the care home. Evidence: The home appeared well decorated and attractively furnished. People who use the service commented that they were satisfied or happy with the accommodation provided and could not think of any areas of improvement in this area. The home appeared clean and tidy throughout at the time of the inspection and staff and people who use the service confirmed that it is kept clean. The registered manager and some of the staff have undertaken training in infection control and there are written policies and procedures in place to guide staff on how to prevent infection from spreading in the home. It is recommended that paper towels are installed in the staff toilet to promote infection control further. Staff are provided with and were observed making use of, suitable equipment to maintain hygiene in the home. Tolverth House is registered for one person with a physical disability. However there are parts of the home that are not accessible for wheelchair use. The registered manager acknowledged that if a person needs the use of a wheelchair they are unable
Care Homes for Older People Page 20 of 29 Evidence: to accommodate for this persons care needs completely and would not be able to offer them a placement at the home. The homes Statement Of Purpose has been updated to reflect this. Care Homes for Older People Page 21 of 29 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. Staffing levels ensure that there are sufficient staff on duty at all times. Recruitment policies and practices are robust so people who use the service can be sure that staff are suitable to work with vulnerable adults in a care setting. Staff training is available to assure people who use the service that they are skilled and competent to work with them. Evidence: Staff are employed in a variety of capacities for the smooth running of the home. There is one senior carer or manager on duty plus two carers during the day, in the evening this is reduced to one carer. There is one waking night member of staff plus the registered person sleeps on site. There is a manager on call system in place. There is sufficient domestic and catering staff on duty. In addition on three days of the week three carers are on duty to undertake more intimate care tasks. The registered manager believes the level of staffing levels is able to safely meet peoples needs. Rotas confirmed this level of staffing. Staff commented, echoed by people who use the service that they felt there was sufficient staff on duty. People who use the service said that staff responded to call bells promptly and spoke positively regarding staff commenting they are so kind, helpful, nothing is too much bother for them and couldnt ask for better.
Care Homes for Older People Page 22 of 29 Evidence: From inspecting recently recruited staff records it was evident that the registered manager has ensured that all checks are now completed as per the Care Standards Act requirements. Therefore practises are sufficiently robust so that staff are recruited fairly and on the basis that they are suitable to work with vulnerable people in a care setting. Under fifty percent of care staff have achieved a minimum of NVQ at level 2. It is acknowledged that since the last inspection the registered manager has recruited new staff and they have not gained this qualification. The registered manager stated that new staff members would be asked to undertake this qualification. Staff confirmed that there has been training in the last year for example medication, moving and handling and infection control. The registered manager has introduced an overall training programme for all staff at the home so that she is able to monitor what training is needed and when refresher courses need to be organised. Care Homes for Older People Page 23 of 29 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 homes manager is registered with the Commission so that People who use the service can be confident that the home is in safe hands. People who use the service and staff are able to contribute their views to the ongoing improvement and development of the service. There are satisfactory systems in place to ensure that the home is a safe place to live and work in. The homes policies and procedures are reviewed so that staff are aware of what is expected of them, and that relevant legislation is being adhered too. Formal recorded supervision of staff needs to be evidenced so that there is accountability for staff working at the home. Evidence: The homes manager is registered with the Commission and demonstrated her fitness to be in charge of a care home. She has completed her Registered Managers Award. The registered manager is in active day to day charge of the home. Staff and People who use the service commented positively about the registered manager and all stated they felt able to approach her if they had any concerns. The registered person lives on
Care Homes for Older People Page 24 of 29 Evidence: site and is also involved in the day-to-day management of the home. The registered person completed the Annual Quality Assurance Assessment (AQAA) which assisted with this inspection process. In addition the registered provider and registered manager have worked hard to address the requirements and recommendations identified at the previous inspection, which reflects how seriously they want to improve the service that they provide plus work with us. They are in the process of completing this years quality assurance process which they shared with us. Feedback from people who use the service and staff were gained. The overall findings were that all were satisfied with the care provided, level of activities, staffing skills, complaints process and environment. Two health questionnaires were also received and one quoted as a professional you are given a friendly service. Information is relayed in a confidential manner. The care home appears clean and tidy. Another responded by saying flexible, able to meet the needs of confused clients with moderate behavioural problems. The registered manager is aware that when a overview of the quality assurance is completed that she sends a copy of her findings with any actions that she aims to take to us. Most of the current residents manage their own financial affairs or do this with the assistance of their relatives or representatives. The registered persons do not act as agents or appointees for the majority of People who use the service. The home has implemented an up to date policy and procedure in the management of residents money so that all staff are aware of how to manage this process. Records of money kept on behalf of a resident tallied with paperwork kept. New staff said that their induction training consisted of working alongside more experienced staff. The registered manager is aiming to implement a new induction process. The registered manager acknowledged that formal supervision of staff is outstanding and knows this must occur so that staff have opportunities to reflect on and develop their practice. Staff however did state that they could speak with the registered manager at anytime if they had any issues. Staff and People who use the service said that they feel safe in the home. It appears to be well maintained. Staff have undertaken training in fire safety awareness, which is up-to-date and there is always someone qualified in first aid on duty. There are clear records of accidents to People who use the service and staff so that potential risks and hazards can be monitored. The homes policies and procedures are being reviewed to ensure they accurately inform staff of their accountability and the homes expectations of them.
Care Homes for Older People Page 25 of 29 Care Homes for Older People Page 26 of 29 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 27 of 29 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 1 7 Individual Care plans should be developed further so that all inform, guide and direct staff in what caring interventions are to be provided to meet a persons individuals needs. The homes adult protection policy needs to be reviewed which follows the Multi Agency Safeguarding guidance so that the staff team are aware of what the process is if a allegation of abuse is made Paper towels should be installed in the staff toilets to promote infection control systems further. 50 of the staff team should achieve a minimum of NVQ level 2 as per the national minimum standards guidelines All staff should receive a minimum of six formal recorded supervisions per year to ensure that there is a opportunity to reflect on their work practice and review their training needs. 2 18 3 4 5 26 28 36 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) 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. Care Homes for Older People Page 29 of 29 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
