Inspection on 04/02/09 for Trentside Manor

This inspection was carried out on 4th February 2009.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Trentside Manor 13/02/08

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Trentside Manor Endon Road Norton Green Stoke-on-Trent Staffordshire ST6 8PA     The quality rating for this care home is:   one star adequate 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: Peter Dawson     Date: 0 4 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Trentside Manor Endon Road Norton Green Stoke-on-Trent Staffordshire ST6 8PA 01782535402 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Trentside Manor Care Ltd Name of registered manager (if applicable) Kerry Louise Rowson Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 15. The number of people accommodated with a dementia related condition will not increase above the current registration of four places until such time an additional quiet lounge/therapeutic communal area is available for use. At that time the condition will be reviewed and if the facility is confirmed as available, then the number of places for people with a dementia related condition will be increased to 15 places. The registered person may provide the following categoy of service only: Care Home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) 4 Older People (OP) 15 Date of last inspection 4 0 Over 65 0 15 care home 15 Care Homes for Older People Page 4 of 30 Brief description of the care home Trentside Manor provides care and accommodation for up to 15 older people. The home has registration to admit some people with dementia care needs and people with a physical disability. The home changed ownership in October 2007 and new registration and new Manager appointed from that date. There was a history of non-compliance with reguirements made at inspections previously but the long-standing and outstanding issues have been addressed by the new owners and Manager. The home is situated in the village of Norton Green, there is a strong community identity in the village which the home is presently taking advantage of. There are local shops, GP practice, dentist in the village which are easily accessed. Accommodation at Trenside Manor is on the ground floor only for residents. All bedrooms are for single use, only one has en-suite facilities but there are adequate bathroom and toilet areas located near to bedrooms and communal areas. There is a very pleasant large open garden area to the rear which has recently been cleared and with good access from the lounge area provides a good facility during the summer the view is onto local open fields. Care Homes for Older People Page 5 of 30 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: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The last inspection of this service was a Key Inspection, completed on 13th February 2008 The AQAA (Annual Quality Assurance Assessment) was completed and returned to us prior to the inspection as required. This is a legal document and is an annual selfassessment carried out by the providers of a service to quantify the outcomes for people using the service. Some information from that document is included in this report. The National Minimum Standards for Older People were used as the basis for assessing the outcomes for people in this inspection. Care Homes for Older People Page 6 of 30 This inspection was carried out by one inspector on one day from 08:30 - 18:00. The Registered Manager was on duty and staff on duty throughout the day were spoken with and made a valuable contribution to the inspection. There were 15 people in residence - the maximum number, all were seen and the majority spoken with together and separately. Five visitors were seen and spoken with during the day. All spoke of the high standards of care provided at Trentside Manor and the commitment of the staff. This is a small home where relationships are easily established and maintained. There was a very relaxed atmosphere, people in the service, staff and visitors engaged in a friendly, positive and relaxed way. There was open discussion about the home, the changes that have been made and the needs of the people in the service were clearly important and paramount. There was an inspection of the communal areas of the environment and a sample of bedrooms were seen. Standards were good and many areas redecorated/refurbished presenting a bright, pleasant, homely setting. Records relating to the inspection process were examined including care plans, risk assessments, medication and staffing records, staff roster, policies and procedures and other documents relevant to the outcomes assessed. There was an inspection of the physical environment including all communal areas and a sample of bedrooms. What the care home does well: What has improved since the last inspection? Redecoration of the corridor areas, lounge, dining room, bathrooms and toilet areas together with replacement of carpets and lounge furniture have vastly improved the presentation of the home. It is bright, comfortable and homely. Colour choices have been made in consultation with people who live there and there is a feeling of mutual satisfaction with the improvements made. The home have further developed the range of activities it provides, both internal and external activities. Many external visits were made during the summer of 2008, some to places of interest locally and further afield, but also people enjoyed visits to the local shops, village pub and other community facilities. This has been very successful, people now have a thirst to go out even more this year. The garden area has been cleared. This is a pleasant open area with good level access. Village community groups have donated good quality garden furniture. People from the local community attend the social events arranged, forging very positive links with the village. Relatives are invited and involved in the events. Social histories are now provided for people allowing the opportunity to focus upon the past positive interests, hobbies, achievements and choices. Relatives are involved in providing this information and the response has been extremely positive and helpful in understanding and meeting the social, emotional and recreational needs of people. Bleach was previously used but has now been replaced with sanitizer, a less harmful Care Homes for Older People Page 8 of 30 option and reduces risks in the home. All staff have been provided with a copy of the General Social Care Council Codes of practice informing staff of the principles and guidelines of working in a social care setting. Planning permission has finally been approved by the local authority for an extension to the home. This will provide additional communal facilities and additional bedrooms. 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 9 of 30 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have the information they need to judge the suitability of the home and preadmission procedures and assessments ensure successful placements. Evidence: The statement of purpose required updating and this has been done. It was reviewed in April and December 2008. The Service Users Guide has been produced in a much improved, easy-read format giving details of the service provided at Trentside Manor. Some further refinement is needed to inform people of the healthcare arrangements and the specific service offered to people with dementia care needs. Advice was given about the use of some terms such as EMI and married couples. The new format was well-presented and appealing. People who are funded by local authorities have a contract. A person who funds her own care did not have a private contract with the home and this should be provided. Care Homes for Older People Page 11 of 30 Evidence: The AQAA stated We offer the choice of visiting the home before admission to see if they like the home before entering, we feel they get a true picture of what the home is really like. Several people admitted to the service in the past few months were spoken with and records seen. All had been invited to visit prior to moving in and said it was useful and helpful in knowing what to expect and reassuring them about the choices they were making. A person admitted as an emergency on the day of referral was not able to visit but both the homes own assessment and the Social Workers multi-agency assessment were completed prior to her arrival. Assessments seen were comprehensive and contained detailed information about the needs of people to be met by the service. Care Homes for Older People Page 12 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Health and personal care needs are clearly defined in care plans and met. Improvements to aspects of the medication system will ensure that people have medication as prescribed to ensure their health and safety. Evidence: A sample of care plans showed detailed information about the health and personal care needs of each person and the required actions by staff to meet those needs. Improvements in care plans were evident at the last inspection and further improvements have been made. Some plans have been re-written on the improved format giving more detailed information about the support people need. The changes were impressive. Care plans are reviewed on a monthly basis as required. Care plans seen were all person-centred. A recommendation of the last report to provide social histories for people has been actioned. Some good histories were seen containing detailed information to assist in meeting the social, emotional, recreational and personal needs of people. Care Homes for Older People Page 13 of 30 Evidence: Information relating to health care needs were clear and accurate with interventions by a range of health care professionals including GP, District Nurse, Community Psychiatric Nurse, Occupational Therapists and Physiotherapists. Referrals are made promptly where changes in the health care needs of people become evident. The home has particularly established a direct referral agreement with Physiotherapist and Occupational therapist. This was evidenced following a person being admitted without mobility who is now able to walk unassisted following input from those professionals. Her comments were I never thought I would walk again. The home is keen to use the services available to maximise health care and promote the independence of people. The AQAA stated We have used outside professional service more to improve the health needs for each individual and evidence of this was seen during the inspection. A shortfall was seen where a person had a mark, which developed into a bruise and records stated please observe, there was no later entry to clarify whether this had happened and what the outcome was. The records have been re-fortmatted to include such events and will address future similar situations. Details of diagnosed/pre-existing medical conditions were recorded and clear and interventions by health care professionals entered chronologically. All people are weighed monthly and more often if there are concerns about weight-loss. Instances of referrals to GP for nutritional supplements were also seen. There is no pressure damage in the home at this time. Several people are seen weekly by the District Nursing Service for edema, ulceration of legs. Wound care is managed by the nursing service, with specialist equipment to assist with movement and elevation. Staff follow clear instructions for care given by the District Nurses. On the last visit to this home a visiting nurse said relationships with the home were excellent. We looked at the medication system in place. Some shortfalls were identified in this important area. A requirement to record the number of tablets/doses given with variable dose medication was made - for example if the prescribed dose was for 1 or 2 tablets, the number given must be recorded. This had been completed in most instances, although paracetamol prescribed as 1 or 2 had been given but the number not recorded. A person self-medicating had been given medication for the month including cocodamol prescribed PRN (as required). She had taken the maximum dose 4 times per day and was running out of tablets. The number of tablets received at the start of the monthly medication cycle is not recorded on MAR sheets (Medication Administration Care Homes for Older People Page 14 of 30 Evidence: Records) so it was impossible to know who much medication had been taken. Records must clearly state the number of tablets received at the start of the monthly cycle including any remaining from the previous month. In this instance a medication risk assessment had been carried out relating to self-medication and included the medication being stored in a locked facility in the persons bedroom. The medication was not locked away securely at the time of this inspection. The medication risk assessment must be reviewed to ensure safe storage and also the risks involved in the person having large numbers of tablets available at any time. A count of medication is important to ensure correct and adequate administration as defined by the prescriber. It must be possible to audit the medication in use at any point in the medication cycle. This is not possible at present. A care plan recorded that a cream was prescribed for a person with leg ulcers and that she administered this herself to her legs. This was not recorded on the MAR sheet as required and therefore no record of its application made. There was some doubt about whether the person always applied the cream herself or whether this was done by staff. All staff administering medication (senior carers) have had medication training. The Manager also carries out observational and written competency tests for those administering medication. Two requirements and one recommendation are made relating to the medication shortfalls identified above. Care Homes for Older People Page 15 of 30 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 have choice and control over their lives, daily life and social activities in the home meet the needs and demands of the people living there. Evidence: Activities have developed and improved greatly over the past 18 months. A member of staff works specifically 6 hours on each of 2 days leading activities in the home. Other staff are also involved in provision of activities and many give support outside their normal working hours when external and some internal activities take place. There is a very positive committment by all staff in this area which has improved quality of life for many people. The AQAA states A lot of activities are Incorporated into the home. We ensure that residents are encouraged to participate in activities if they wish. We take people on day trips of their choice e.g. Llandudno and also to Stapeley Water gardens , Trentham Gardens, local shopping trips etc. Indoors we play bingo, dominoes, cards, painting, crafts. We provide Wildlife afternoons, sing alongs and parties. - There was evidence of the activities mentioned in discussions with people in the service, visiting relatives and photographs taken to capture the events. Care Homes for Older People Page 16 of 30 Evidence: The service now obtain social histories for each person, usually from relatives which give detailed information about their family life, interests, hobbies and activities. This is positive in providing individual and group activity programmes that people can enjoy. There are strong links with the local village community group - Norton Green Residents Association, being a small village Trentside Manor is known and considered an important part of that community. There are fund-raising and joint social events with the Association. People from the home visiting the local pub for a meal or event are known to the local people who engage very positively with them. Written comments from a visitor seen in the home included Another fantastic night, lots of fun as always Four visitors were seen during the day of the inspection. Two were relatives of a lady admitted recently and celebrated her 100th birthday at Trentside Manor. The family were very complimentary about the support given in their relative settling quickly and also the efforts made in providing a memorable day for her birthday. Other visitors seen and spoken with with visit almost daily and were equally positive about the ongoing care and support their relatives are given. They said that they were kept informed of any changes in the health or welfare of their relatives. People spoken with showed enthusiasm about the improvements in the quality of life outlined above. Now people have been on visits outside the home, their appetite for this has increased. One person said I never thought I would really see the blue skies outside again. There was evidence of chosen lifestyles being known and met. Activities are optional and people only encouraged to partake. Two people were seen in their bedrooms throughout the day, one likes to listening to talking-books obtained for her, the other spends the majority of time in her bedroom which she stated she prefers and has her own routine of watching TV. She has a special interest in sport and watches football, wrestling and other sports that she enjoys. She visits the communal areas for meals and stays as and when she wishes. All people asked said that they were highly satisfied with the choice, quantity and quality of food summarised in written feedback to us prior to the inspection that stated We always have a choice and they will do me something else if I dont like whats on the menu, the food is excellent Care Homes for Older People Page 17 of 30 Care Homes for Older People Page 18 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are aware of the procedures for making complaints. Greater awareness of Safeguarding procedures will improve the protection of people using the service. Evidence: At the time of the last inspection the new Safeguarding procedures were not generally known or available in the home. A requirement was made to obtain a copy of the Safeguarding procedures from the local authority and ensure that staff had updated training in this important area. A copy of the Staffordshire and Stoke on Trent Multi-agency Safeguarding procedures has been obtained. There has been some training for staff in Abuse Awareness at the local college - around half the staff received this training. Another course is being sourced to provide training for remaining staff. Since the last inspection the service has made a Safeguarding referral to the local authority concerning possible financial abuse. This referral should have been made sooner, there was no recording of events surrounding the matter and poor communication of concerns within the home. The matter was ultimately investigated by the police. The importance of staff recording and reporting suspected abuse must be improved by means of greater awareness and training. Early referral of any suspicions are essential. Care Homes for Older People Page 19 of 30 Evidence: There is a complaints procedure in place with a copy in the Service Users Guide, that all people have a copy of. Additionally there is a copy in the home for visitors. No complaints have been received by the home or by us since the last inspection. There is also a facility for people to make comments anonymously about the service if they wish. People using the service, in written feedback to us said that they were aware of the procedures and what actions to take if they had any complaints. Care Homes for Older People Page 20 of 30 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. People live in a pleasant, comfortable, safe surroundings with good facilities that they enjoy. Evidence: The AQAA states We have a clean, tidy and fresh smelling home, that has recently been decorated to make it more appealing and a warm place to live in. Gardens have started to have a make-over to improve the appeal, be more inviting and make them safer for residents. The environment is inviting and is a home from home. Improvements to the environment have continued since the last inspection. The hallways, lounge and dining room have been redecorated, people in the service choosing the colour schemes - the result is a bright, appealing, warm and comfortable domestic setting. New lounge chairs have been provided throughout the lounge areas. The corridor areas have been re carpeted. All toilets with the exception of one have been upgraded and bathrooms have been redecorated. some bedrooms have been redecorated and new furniture provided. All bedrooms seen were well personalised. The result is a further improvement in the overall presentation of the home. There are 2 assisted bathrooms but no shower facility at present. One person and her family did express a preference for a shower. Plans have recently been approved by Care Homes for Older People Page 21 of 30 Evidence: the local authority and will provide an extension that will incorporate additional communal facilities, including a shower room and additional bedrooms. A requirement of the last report to substitute bleach with sanitizer to reduce the risk to people in the home has been done. Data sheets for all COSHH (Control of Substances Harmful to Health) items used have been obtained. Alginate (degradable) red bags are now used to separate incontinent laundry. We noticed that disposable gloves and aprons had been located throughout the building to facilitate good infection control practice. Standards of hygiene throughout the home were high, there were no malodours. Random tests of hot water outlets in bathrooms showed that two exceeded the safe limit of 43C. Regular weekly checks of the system are carried out and recorded - the two outlets mentioned were recorded at 46C previously, but no action had been taken to reduce the temperature to a safe limit. The garden area at the rear, with good level access, has been cleared and being developed to use as a safe and pleasant area for people to sit and use during the summer months. Good seating has been provided by the local community groups. This also provides an excellent open view from the large lounge area of the home. Several people, including visitors commented very positively about the improvements that have been made to the home. Care Homes for Older People Page 22 of 30 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. People are supported by staff who are committed, well trained and have the skills to meet their needs. Evidence: The home remains fully occupied with 15 people. Staffing levels are 3:2:2 throughout the three 24 hour shift periods, plus the Manager who works during the week. This is satisfactory for the dependency levels of the current resident group which is low medium level. Additionally there are catering, housekeeping and maintenance staff. Two requirements were made at the last inspection relating to staffing outcomes. They were: The planned outstanding training for staff should be completed within 3 months and all staff should be given copies of the GSCC codes of conduct. These requirements have been met. The staffing matrix showed that courses in Dementia Care, medication, and first aid had been arranged during 2008. Some staff have not completed training in Health & Safety but awaiting dates for the planned training. Some further training in Safeguarding is also needed as mentioned earlier in this report. All staff have now been given copies of the GSCC Codes of Conduct. All staff have obtained the NVQ 2 certificate and the majority are involved in or completing NVQ 3. Care Homes for Older People Page 23 of 30 Evidence: A sample of staff files were seen. All had either POVA (Protection of Vulnerable Adults) or CRB (Criminal Records Bureau) checks prior to commencing work. We saw that only one reference had been obtained for a person previously working as an apprentice in the home. That was provided by the placing college but was not dated and addressed To whom it may concern. Individualised, personal references should be obtained prior to employment. The home were unable to find a second character reference that had apparently been sought. We noticed also that an employment contract had not been provided for a person employed for the past 6 months. Records showed that staff were regularly supervised and had annual appraisals. All staff on duty were spoken with and made a positive contribution to the inspection. Many are quite long-serving. Flexibility of work routines is good, some people working between day and night care, catering, activities and housekeeping. We noticed that there was positive engagement between staff and people in the service with an open and friendly approach. This evidenced the comments made by people who spoke highly about staff and the commitment to their care. Care Homes for Older People Page 24 of 30 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 home is well run and managed in the best interests of the people living there. Evidence: This home changed ownership, with a new Registered Manager on 19/10/07. The Registered Manager provides an open and inclusive atmosphere and takes a positive lead in the home. She has a daily presence in the home during the week that includes 2 days working on the rota for care. She is enthusiastic about the changes being made and it is important that staff are included and feel that they have contributed to the very positive changes made during that time in the delivery of care. In written feedback to us from a relative prior to the inspection someone said The home is much improved with a very active hands-on manager and good staff The Manager has completed the NVQ4 in care and presently studying NVQ4 in Care Homes for Older People Page 25 of 30 Evidence: Management to complete the required Registered Managers Award. There are regular staff meetings. Residents Meetings and occasional Relatives meetings are held on an as required basis. The views of people in the service and visitors are sought on a daily basis. Visitors seen during the inspection said that their views were sought, they were well received into the home that had a friendly, homely atmosphere. There is a weekly and also monthly visit by the providers, who clearly monitor the operation of the home. Although the required monthly visits are made by the providers under Regulation 26 of the Care Home Regulations, a report is not completed and made available in the home. This is important to record the events and progress being made and must be available to the Manager and to us. We noticed that the homes policies and procedures were last reviewed in January 2007 - prior to the change of ownership. It is important that these are reviewed by the Manager annually. Care planning documentation has improved considerably and there have been improvements in quality of life for people in extending the internal and external activities of the home. Positive relationships have been established with the local community. Improvements are sought in areas of Safeguarding people and the safe administration of medication. Care Homes for Older People Page 26 of 30 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 30 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 1 9 13 Risk assessments for self28/02/2009 administration of medication must be reviewed and medication stored securely. This will ensure people are protected against the misuse and potential harm of medication. 2 9 13 The amount of medication 28/02/2009 received must be entered on MAR sheets to provide a running balance and ensure audit of the system This will ensure people have the medication prescribed to maintain their health. 3 25 13 Hot water outlets in resident 28/02/2009 areas must not exceed the safe limit of 43C and actions taken if exceeded. This will ensure people are not at risk of possible scalding. Care Homes for Older People Page 28 of 30 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 2 People who are self-funding must have written contracts with the home. This will ensure they are aware of their rights. The number of tablets given must be recorded where variable dose medication is prescribed. This will ensure people have the correct medication prescribed for them The importance of staff recording and reporting potential abuse must be improved by means of training and greater awareness. Providers/representatives must prepare a written report following their monthly visits and must be left in the home as required in Regulation 26(4) & (5) 2 9 3 18 4 38 Care Homes for Older People Page 29 of 30 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 © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 30 of 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. 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!