Inspection on 12/10/06 for Tower House [Salisbury]

This inspection was carried out on 12th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Tower House [Salisbury] 03/02/06

Tower House [Salisbury] 30/08/05

Tower House [Salisbury] 07/12/04

Tower House [Salisbury] 05/08/04

Tower House [Salisbury] 08/03/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Stallcombe House

Belma

Hunters Care Centre

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

CARE HOMES FOR OLDER PEOPLE Tower House 43 Manor Road Salisbury Wiltshire SP1 1JT Lead Inspector Thomas Webber Unannounced Inspection 12th October 2006 09:00 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 Tower House DS0000028268.V315915.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. Tower House DS0000028268.V315915.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tower House Address 43 Manor Road Salisbury Wiltshire SP1 1JT 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) 01722 338395 Mrs Eileen O`Connor-Marsh Mrs Lisa Marie Mulholland Care Home 24 Category(ies) of Dementia - over 65 years of age (12), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (12), Old age, not falling within any other category (12) Tower House DS0000028268.V315915.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person must ensure that the staffing levels meet the needs of the residents at all times and do not fall below that stipulated in the Residential Forum `Care Staffing in Homes for Older People` Model. 08:00 to 14:00 Minimum of 5 care staff on duty 14:00 to 20:30 Minimum of 4 care staff on duty 20:30 to 08:00 2 waking night staff on duty with one member of care staff sleeping in each night. No more than 12 service users falling within the category of (DE(E)) may be accommodated in the extension at any one time 3rd February 2006 2. Date of last inspection Brief Description of the Service: Tower House is a private residential home registered to offer accommodation and personal care to 24 older people with a mental health disorder and/or dementia. The home has been in operation since the mid 1990s and is one of three registered care homes owned by Mrs OConnor and Mrs OConnor-Marsh. The registered manager is Mrs Mulholland. Tower House is a large detached Victorian property situated in Manor Road and is within easy walking distance of Salisbury city centre. Tower House is in close proximity to its sister homes, Dunraven and Dunraven Lodge. The premises comprise of two buildings with a linked passageway and provide sixteen single and four shared bedrooms for residents use. All residents’ bedrooms being provided with en-suite facilities. Residents bedrooms are also located on the first and second floor levels of both buildings, which are each accessed by use of a passenger lift. The home’s fees charged to residents for the care and accommodation range from £375 to £550 per week. Information about the care and services provided is available from the home, in written form, by way of its service users’ guide. CSCI inspection reports can also be seen in the home and interested people can download these directly from the CSCI website. Tower House DS0000028268.V315915.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection conducted over a period of two days on 12th and 13th October 2006 from 09:00 to 16:10 and 08:35 to 12:50 respectively. The judgements contained in this report have been made from evidence gathered before and during the inspection, which included a tour of the premises and takes into account the views and experiences of eighteen of the twenty four residents, which were sought on an individual and group basis. The views of the manager and four members of staff were also sought. The records of the four most recent residents admitted were also checked in greater detail during the inspection to ensure that they are being appropriately maintained and that their care needs are being suitably met. Twenty nine of the thirty eight Standards were also assessed on this occasion which included the examination of records, staffing, care practices, systems, policies and procedures. Feedback was provided throughout the inspection. What the service does well: Residents live in a home which is run and managed by a person who is appropriately qualified and has sufficient experience in the care setting she manages. The home ensures that there are sufficient numbers of staff on duty to meet the needs of the residents. The home creates an atmosphere where residents and staff can express and contribute to the running of the home. Staff were observed undertaking their duties in a caring, patient and attentive manner. Residents who were spoken with commented very positively about the care provided by the staff, stating that staff were very good, and they felt well cared for. Residents benefit and are supported by a staff team who continue to receive ongoing training and are appropriately supervised. Residents are supported and protected by the home’s recruitment practices. Residents live in a comfortable, safe and well-maintained environment, which meets their individual and collective needs. The home provides sufficient communal space together with bath, shower and toilet facilities. Residents have personalised their bedrooms to varying degrees and to their individual wishes. The home is maintained to a good standard being clean, tidy and comfortable and provides suitable laundry facilities to meet the needs of the residents. The health, safety and welfare of the residents and staff are being promoted and protected. Residents are confident that any complaints/concerns raised by them will be suitably dealt with and that appropriate procedures are in place to protect them from abuse. Residents who were spoken with commented that they had no complaints/concerns and felt confident that they could discuss any concerns with the management and staff of the home. Management reported that no Tower House DS0000028268.V315915.R01.S.doc Version 5.2 Page 6 complaints have been received by the home since the last inspection. However, a complaint was received and investigated by the Commission. The complaint related to five separate issues relating to care practices, record keeping and staff cover. The investigation found no evidence to support the complaint. The home provides residents with a range of activities as well as the opportunity to pursue their own interests to meet their social, recreational and religious needs. Residents maintain contact with their families, friends and relatives in accordance with their preferences. Residents, within their capabilities, can exercise personal autonomy and choice and receive a varied, appealing and balanced diet. Residents who were spoken with commented very favourably about the quality and quantity of food provided, confirming that they receive plenty and that alternatives are available to meet their preferences. Care plans and accompanying risk assessments have been established for all residents to ensure that their care needs are being appropriately met. Residents’ health care needs are also being suitably met. Residents’ privacy and dignity are respected at all times. Residents are assessed by the home, prior to admission, to ensure that it can meet their needs. Prospective residents and their families are provided with the opportunity to visit and assess the quality, facilities and suitability of the home. Residents are provided with either a copy of the home’s written contract or placing authority’s terms and conditions so that they are aware of the services being provided to them. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Tower House DS0000028268.V315915.R01.S.doc Version 5.2 Page 7 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 Tower House DS0000028268.V315915.R01.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 5 and 6 This judgement has been made using available evidence including a visit to this service. Residents are assessed by the home, prior to admission, to ensure that it can meet their needs. Prospective residents and their families are provided with the opportunity to visit and assess the quality, facilities and suitability of the home. Residents are provided with either a copy of the home’s written contract or placing authority’s terms and conditions so that they are aware of the services being provided to them. Quality in this outcome area is excellent. EVIDENCE: Residents who are privately funded are provided with a copy of the home’s contract. However, where residents are funded by social services, they would be provided with a copy of the relevant local authority’s statement of terms and conditions. All residents have been issued with written contracts and evidence was available to confirm that a signed contract had been established for the four residents most recently admitted to the home. Tower House DS0000028268.V315915.R01.S.doc Version 5.2 Page 9 The home, as part of its admission process, obtains copies of the care programme approach and other relevant documentation prior to admission in respect to any prospective resident. In addition, the home also undertakes its own assessment. Evidence was available to confirm that both processes had been achieved in respect to all four of the most recent admissions prior to their placements being agreed. Evidence was also available to show that the home had confirmed in writing that the home could meet the residents’ needs based on their assessments and were happy to offer them a place. Prospective residents and their families can make as many introductory visits to the home, as they wish, to assess the quality, facilities and suitability of it. This process is evident in the home’s admissions policy. Evidence was available to confirm that two of the four most recent admissions had made a pre-visit to the home whereas the families of the other two residents visited the home. The home does not provide intermediate care therefore this Standard is not applicable. Tower House DS0000028268.V315915.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 This judgement has been made using available evidence including a visit to this service. Care plans and accompanying risk assessments have been established for all residents to ensure that their care needs are being appropriately met. Residents’ health care needs are also being suitably met. Residents’ privacy and dignity are respected at all times. Quality in this outcome area is excellent. EVIDENCE: All residents are provided with care plans which identify their areas of needs and strengths. Residents’ care plans seen were detailed, well written and informative. Evidence was also available to confirm that they had been reviewed and updated on a monthly basis. Short-term care plans had also been established detailing specific goals being worked towards. Residents’ care plans will be updated and reviewed every six months or more frequently where changes occur. Risk assessments have also been established and reviewed on at least a six monthly basis. Residents are registered with one of five surgeries within the Salisbury area. Where residents are admittedly locally, they would maintain their own GP Tower House DS0000028268.V315915.R01.S.doc Version 5.2 Page 11 unless they choose otherwise. Residents tend to visit the surgery for any appointments with the support of staff unless they are too frail to do so. Appointments are also made for residents in respect to other health services such as chiropodist, optician and dentist. Domiciliary visits to the home are available for optician and chiropody treatment whereas residents are required to attend the dental practice for any appointments. Written evidence was available within residents’ care plans, daily case notes and Doctors’ notes held by the home to confirm that their health care needs are being met. The home has established its own medication procedure as well as having obtained the Boots monitored dosage procedure. The manager reported that none of the residents have been deemed capable of managing their own medication. However, two residents maintain control over their inhalers but even these are used under staff supervision. Staff administer residents’ medication but do not do so unless they have achieved appropriate training. Evidence was also available to confirm that a large proportion of staff have achieved such training. The home uses two separate systems: one in the old building and the other in the new building being respectively the Boots and the Alliance monitored dosage systems. Examination of residents’ drug sheets showed that these are being appropriately initialled for medication administered. Appropriate systems are also in place for the receipt and return of unwanted medicines. Staff are instructed during their induction period about their conduct towards residents. Residents who require assistance with regard to their personal hygiene/care receive this in complete privacy. Screens are provided where residents share a bedroom. Staff assistance is also provided to residents who require help in choosing their clothes. Staff use residents’ preferred form of address and this is recorded in their respective care plans. Residents have access to a cordless telephone, which they can use in private and no charges are made for any outgoing calls. Residents’ mail is given directly to them unopened, although staff will assist residents to understand the contents of their mail if required. Staff also request to be informed where the correspondence relates to any appointments. Locks are fitted to all bathroom and toilets doors and where residents require some assistance, staff ensure that the door is shut and their privacy and dignity is maintained. Tower House DS0000028268.V315915.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 This judgement has been made using available evidence including a visit to this service. The home provides residents with a range of activities as well as the opportunity to pursue their own interests to meet their social, recreational and religious needs. Residents maintain contact with their families, friends and relatives in accordance with their preferences. Residents, within their capabilities, can exercise personal autonomy and choice. Residents receive a varied, appealing and balanced diet. Quality in this outcome area is good. EVIDENCE: Residents can choose where and how to spend their time including pursuing their individual interests. Residents can also choose when to get up and go to bed. Since the last inspection and with the opening of the new unit, the home has implemented an activity programme. Residents from both units can choose to join in the activities available which tend to take place in the new unit. Most of the residents from the new unit have chosen to participate in the range of activities on offer. Two residents from the home are capable of going out on their own whilst others are accompanied by staff. Staff take residents out shopping on a one to one basis as well as for regular walks, weather permitting. Some residents also go out with their families when they visit. The hairdresser visits the home on a weekly basis and the mobile library also now attends the home where residents choose their own books. A Church of Tower House DS0000028268.V315915.R01.S.doc Version 5.2 Page 13 England service is held within the home on a monthly basis and communion is provided separately for Catholic residents. One resident also attends St Marks church. The home has an open policy regarding visiting hours and residents choose whom and where to see any visitors, either in their bedrooms or in the various communal areas. Tea making facilities are available and can be used during such visits. There are a number of indicators to show that residents can exercise personal autonomy and choice according to their capabilities. Residents can bring items of furniture and personal possessions to make their bedrooms more homely, they can choose where to spend their time, where to eat, and when to get up and go to bed. All residents require support when out. Residents’ families or solicitors primarily deal with their finances, although some residents maintain control over their own money. A satisfactory and varied menu is in operation, which provides a choice at breakfast with set meals at lunch and teatime. However, alternatives are provided for these meals, if required, to meet the residents’ individual preferences. A cook is employed to undertake the main cooking duties, although staff occasionally undertake this role. Residents are encouraged to eat their meals in the various dining rooms within the home, although they could choose to eat their meals in their bedrooms, if they wished. On the day of the inspection four residents in the new extension of the home had their breakfast in their bedrooms. Drinks are also available to residents at other set times of the day and staff facilitate this. A kitchenette is available in both parts of the home for this purpose. Meals tend to be at set times, although some flexibility is available, if required. Residents who were spoken with commented very favourably about the quality and quantity of food provided, confirming that they receive plenty and that alternatives are available to meet their preferences. Breakfast was observed in the new part of the building where staff were on hand to provide assistance and support where necessary. Residents ate their breakfast in a relaxed and congenial setting. Tower House DS0000028268.V315915.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 This judgement has been made using available evidence including a visit to this service. Residents are confident that any complaints/concerns raised by them will be suitably dealt with and appropriate procedures are in place to protect the residents from abuse. Quality in this outcome area is good. EVIDENCE: The home has established an appropriate written complaints procedure and all residents have been provided with a copy. Residents who were spoken with commented that they had no complaints/concerns and felt confident that they could discuss any concerns with the management and staff of the home. Management reported that no complaints have been received by the home since the last inspection. However, a complaint was received and investigated by the Commission. The complaint related to five separate issues relating to care practices, record keeping and staff cover. The investigation found no evidence to support the complaint. The home has robust procedures in place for responding to suspicion or evidence of abuse and these include a Whistle Blowing procedure. Copies of the shortened version of the Swindon and Wiltshire Vulnerable Adults Procedures, which are in line with the Department of Health guidance “No Secrets”, have been distributed to all staff. Staff who were spoken with confirmed that they have received training in this area. The issue of abuse is also covered during the induction of new staff. Tower House DS0000028268.V315915.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23, 24 and 26 This judgement has been made using available evidence including a visit to this service. Residents live in a comfortable, safe and well-maintained environment, which meets their individual and collective needs. The home provides sufficient communal space together with bath, shower and toilet facilities. Residents have personalised their bedrooms to varying degrees but to their individual wishes. The home is maintained to a good standard being clean, tidy and comfortable and provides suitable laundry facilities to meet the needs of the residents. Quality in this outcome area is good. EVIDENCE: Since the last inspection a new extension has been built to the rear of the existing building and a link has also been created between both buildings, although the residents do not use this. The extension has meant that the home has doubled in size and the number of residents that can now be accommodated. The home provides residents with a safe, comfortable, wellmaintained environment which is furnished to a good standard. The premises provide sufficient heating, lighting and ventilation. The proprietor has Tower House DS0000028268.V315915.R01.S.doc Version 5.2 Page 16 established an ongoing maintenance programme for the renewal of its fabric and decoration of the home. The home provides sufficient communal space to meet the collective and individual needs of the residents accommodated. The old part of the home provides a communal lounge to the front of the property with a dining room/sitting area to the rear, which provides tea-making facilities. A seating area is also available within the main entrance hall. The new extension provides two large lounge/dining areas. These facilities are homely, well maintained and furnished to a good standard. The home has a non-smoking policy and therefore any residents admitted who wish to smoke must do so outside. However, there is a large paved area to the front of the property with table and chairs to facilitate the smokers as well as providing a general seating area for all residents. There is also a small grassed area to the rear of the new extension. The kitchen facilities have been relocated to the lower ground floor which services both parts of the building. The home provides sufficient bathroom and toilet facilities to meet the needs of the residents and these are located within close proximity to residents’ bedrooms and the communal areas. In addition, all residents’ bedrooms are provided with en-suite facilities. The premises provide sixteen single and four shared bedrooms for residents use with all bedrooms being provided with en-suite facilities. Residents bedrooms are located on the first and second floors of the home. These are accessed by use of a passenger lift in each building. Residents’ bedrooms are suitably furnished and they can bring limited items of furniture and personal possessions to make their bedrooms more homely. Residents have personalised their bedrooms to varying degrees but to their individual wishes. Residents’ bedroom doors to the new extension have been fitted with appropriate locks, whereas locks have not been fitted to the residents’ bedroom doors in the old part of the building. However, locks could be fitted to these at the request of residents. All residents are provided with a lockable storage space within their bedrooms. Residents stated that they were happy with their bedrooms and that these are kept clean and tidy. The home continues to be maintained to a good standard being comfortable, clean and tidy. The laundry facilities have been relocated to the lower ground floor, as part of the new extension, and provide suitable facilities to meet the needs of the home. Care staff undertake the washing duties in the mornings, however, the manager will provide hands on care if necessary to fill any gap when the care staff are undertaking this task. The domestics undertake the ironing duties in the afternoons. Residents’ clothing is labelled to ensure that their clothing is suitably returned and residents spoke positively about the laundry arrangements in place. Tower House DS0000028268.V315915.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 This judgement has been made using available evidence including a visit to this service. The home ensures that there are sufficient numbers of staff on duty to meet the needs of the residents. Residents benefit and are supported by a staff team who continue to receive ongoing training. Residents are supported and protected by the home’s recruitment practices. Quality in this outcome area is excellent. EVIDENCE: The deployment of staff ensures that there is a minimum of five members of care staff on duty in the mornings and four in the afternoons and evenings. At night there are two members of waking night staff with one care member of staff sleeping in. The above staffing levels exclude those hours worked by the manager. Four domestic staff and a cook are also employed. Staff were observed undertaking their duties in a caring, patient and attentive manner. Residents who were spoken with commented very positively about the care provided by the staff, stating that staff were very good, and they felt well cared for. Four newly appointed staff files were checked and these showed that the home is following appropriate recruitment practices. These include obtaining a full employment history, two satisfactory written references and satisfactory Criminal Record Bureau enhanced checks. However, the home was advised to obtain a police check and a reference from the last employer in respect to the overseas member of staff via the employment agency. Where this Tower House DS0000028268.V315915.R01.S.doc Version 5.2 Page 18 documentation is already available, it must be translated into English. The advice was provided to further improve the existing good practice maintained by the home. Evidence was available in the staff files to confirm that the newly appointed members of staff had completed the home’s induction training programme, which is normally completed within six to eight weeks. On completion of this programme staff would undertake the various mandatory training courses as well as being considered for the National Vocational Qualification level 2 in Care. A training matrix has been established by the home for easy monitoring of training undertaken as well as training due to be completed by staff. A training plan has also been established for each member of staff which identifies the training already achieved and any future goals. At the time of the inspection, the home had achieved approximately 57 of staff being trained in NVQ. A further nine staff should achieved the NVQ level 2 in Care award by the end of March 2007 and a further seven in NVQ level 3 in Care by the same date. Clearly the home is working very hard to achieve a trained workforce by 2007. The home continues to ensure that staff attend and update their knowledge through training and this was confirmed by staff who were spoken with. Tower House DS0000028268.V315915.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 35, 36 and 38 This judgement has been made using available evidence including a visit to this service. Residents live in a home which is run and managed by a person who is appropriately qualified and has sufficient experience in the care setting. The home creates an atmosphere where residents and staff can express and contribute to the running of the home. Residents benefit from a staff team who are appropriately supervised. The health, safety and welfare of the residents and staff are being promoted and protected. Quality in this outcome area is good. EVIDENCE: The manager has appropriate management and supervisory experience in the relevant care setting she manages. She has sucessfully completed the NVQ level 4 and the Registered Managers’ Award as well as being an NVQ Assessor and has undertaken periodic training to update her skills and knowledge, which includes some Dementia Awareness. Tower House DS0000028268.V315915.R01.S.doc Version 5.2 Page 20 Discussions with staff and residents indicated that there is an open, positive and inclusive atmosphere within the home where the manager communicates with a clear sense of direction and leadership. Staff feel able to contribute ideas and suggestions pertaining to the running of the home. Regular staff meetings and daily hand over meetings have been established which ensure that staff are kept fully up to date. Staff commented that management are very approachable and they are happy with the level of support provided. Staff morale is good and staff commented that they work well as a team and they are happy with the training opportunities available to them. Likewise, residents feel able to discuss any issues or concerns with the management and/or staff and feel these would be suitably dealt with. Residents’ meetings have been established which are held every three months and provides them with a forum to discuss any issues pertaining to the running of the home. Residents also have the opportunity to discuss individual issues through the key worker system established. The manager reported that the home does not deal with residents’ finances as these are dealt with by members of the residents’ families or their appointees, therefore this Standard is not applicable. There are a range of mechanisms in place for the manager to both brief and receive feedback from staff in order to monitor the standard of care and services provided to the residents. These include regular staff meetings and both formal and informal staff supervision. Staff who were spoken with confirmed that they receive formal supervision and they are happy with the level of support available. Staff files checked also confirmed that staff were in receipt of regular supervision. Management ensures that there are safe working practices within the home and these comply with the relevant legislation. Risk assessments have been established to ensure a safe working environment. All bedroom windows from the first floor upwards are fitted with window restrictors. Written evidence was available to show that appropriate servicing, tests, checks, drills and instruction to staff are being carried out in respect to fire prevention. A tour of the premises did not identify any health and safety issues. Staff continue to undertake the various mandatory training which includes health and safety training. Tower House DS0000028268.V315915.R01.S.doc Version 5.2 Page 21 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 3 4 X 4 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 4 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 4 4 X 3 3 X 3 STAFFING Standard No Score 27 4 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 X X N/A 3 X 3 Tower House DS0000028268.V315915.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP29 Good Practice Recommendations The registered individuals should strongly consider obtaining a police check and a reference from the last employer in respect to the overseas member of staff recently employed Tower House DS0000028268.V315915.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB National Enquiry Line: 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 © 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 Tower House DS0000028268.V315915.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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