Inspection on 04/07/07 for Upper Mead

This inspection was carried out on 4th July 2007.

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

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

Other inspections for this house

Upper Mead 13/09/06

Upper Mead 23/01/06

Upper Mead 27/10/05

Upper Mead 23/09/04

Upper Mead 20/05/04

Upper Mead 25/11/02

Similar services:

The Shelley

Thorndene

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE Upper Mead Fabians Way Henfield West Sussex BN5 9PX Lead Inspector Mr D Bannier Unannounced Inspection 4th July 2007 09:45 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 DS0000024232.V341564.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. DS0000024232.V341564.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Upper Mead Address Fabians Way Henfield West Sussex BN5 9PX 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) 01273 492870 01273 494946 uppermead@sussexhealthcare.org Dr Shafik Hussien Sachedina Mr Shiraz Boghani Mrs Elizabeth Krandie Care Home 48 Category(ies) of Dementia - over 65 years of age (11), Old age, registration, with number not falling within any other category (37), of places Physical disability (7) DS0000024232.V341564.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Accommodation is provided in two separate units. A maximum of 48 Service Users may be accommodated. Unit one is for 11 Service Users in the category dementia, over 65 years of age - DE(E). Unit two is for 37 Service Users in the category older persons not falling within any other category (OP). Unit two may include in its number of Service Users up to seven persons in the category physical disability aged 50 years and over (PD) 13th September 2006 Date of last inspection Brief Description of the Service: Upper Mead is a care home which is registered to accommodate up to forty eight residents in the category (OP) old age, not falling within any other category. This number includes a separate unit designed to accommodate up to eleven residents over the age of 65 years who also have dementia. This number also includes up to seven residents over the age of 50 years who have physical disabilities. It provides personal and nursing care. Upper Mead is a detached two storey purpose built property which provides accommodation in shared and single bedrooms located on the ground and first floors. A vertical passenger lift provides access to all floors. A dining room and lounge are located on the ground floor. There are smaller sitting areas are located around the property. Chestnuts, the unit that accommodates residents with dementia, has its own lounge/dining room. The property is located in the village of Henfield. The fee levels range from £502 to £1297 per week. Additional charges are made for the following services: chiropody, hairdressing, dentist, optician, telephone, newspapers. The registered provider is Sussex Health Care, who have appointed Mr Shiraz Boghani to be the Responsible Individual and to supervise the overall management of the care home. The post of registered manager, who is responsible for the day to day running of the care home, is Mrs Elizabeth Kandi. DS0000024232.V341564.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection report has been written using methodologies in accordance with Inspecting For Better Lives. Some evidence used to assess standards has been gathered before this visit took place, during the visit and afterwards. For example, information has been used from the previous inspection report; comments made by residents at the time of the visit have been noted; the deputy manager has also supplied further information on request that has been considered after the visit took place. The registered provider has also completed an Annual Quality Assessment Audit (AQAA) providing information about the way the home has been run. The Commission sent out surveys entitled “Have Your Say” to residents and to relatives and friends of residents. Some comments from returned surveys have also been used. This visit was unannounced and started at 9.45 am. It took place over approximately eight hours. The inspector spoke to seven of the forty-four residents who are currently being accommodated at this care home. The inspector also spoke to the relative of a resident. This enabled to inspector to form an opinion about how it was to live there. The inspector also spoke to the chef and to the nursing staff who were on duty. They told the inspector about their jobs within the care home and the training they had received in order carry out their duties. Some records were also examined. The inspector looked at those standards that are about how new residents are admitted to the care home; how residents are cared for; the daily life and social activities provided for residents; how the care home deals with complaints and how they protect residents from abuse; the environment in which residents live; how staff are recruited and trained; and how the care home is managed. The deputy manager was available throughout the inspection and kindly assisted the inspector with his enquiries. What the service does well: The premises are kept very clean and tidy, making the home very pleasant for the residents to live there. The residents are very satisfied with the care provided. They told the inspector they are well looked after and comfortable. DS0000024232.V341564.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Senior staff, who are responsible for assessing the needs of prospective residents should be provided with further training to update or improve their skills in assessment. Assessment forms should be fully completed to ensure the care home has sufficient information about the needs of prospective residents before being admitted. DS0000024232.V341564.R01.S.doc Version 5.2 Page 7 Where possible residents should be consulted when care plans are drawn up or reviewed to ensure they reflect their wishes with regard to how they wish to have care provided to them. Care plans should include clear information about the needs of individual residents together with instructions to staff about the specific actions they should take to ensure they have been met. 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. DS0000024232.V341564.R01.S.doc Version 5.2 Page 8 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 DS0000024232.V341564.R01.S.doc Version 5.2 Page 9 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): 3 and 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The care needs of prospective residents are not always fully assessed before admission. Upper Mead does not provide intermediate care. EVIDENCE: The names of four residents, who had been admitted on a permanent basis, were identified for case tracking purposes. The inspector spoke to each of them and also looked through the care records of each resident. The inspector also spoke to other residents who were not part of the case tracking exercise. Residents said that they were satisfied with the care and services provided to them. One resident said, “ I moved here because my son lives nearby. He can DS0000024232.V341564.R01.S.doc Version 5.2 Page 10 visit me and I can visit him.” Another resident said, “I think this is a nicely run place.” A relative, who was visiting at the same time as the inspector said, “I was impressed when I visited to look around the care home before my relative moved in, and after 18 months I am still impressed.” Records seen showed that the provider has designed a form for residents’ care needs to be assessed before admission. The inspector examined the record of a resident who had been admitted recently and noted that the form had not been completed fully. Despite this the resident had been admitted. This means a full assessment of the resident’s needs had not been carried out so that it could be determined if the care home can meet their needs. Indeed the inspector was made aware that there were some problems with providing for the needs of the resident, particularly whilst in bed. It is recommended that staff who are responsible for carrying assessments of prospective residents receive further training to update or improve their skills. This will ensure the necessary information is recorded in order to confirm whether or not the care home can meet the resident’s identified needs. Following discussions about the needs of identified residents, staff on duty were able to demonstrate they were fully briefed about the care required by three of the four residents identified and what was expected of them. Staff told the inspector what they do to provide care for the fourth resident. As the assessment record is incomplete it was not possible to determine if this is appropriate and meets the resident’s needs. DS0000024232.V341564.R01.S.doc Version 5.2 Page 11 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff do not always have appropriate information to ensure they are able to meet residents’ needs. The registered provider has ensured residents’ health care needs have been fully met. The registered provider has ensured residents are protected by the home’s policies and procedures for dealing with medicines. Current care practices have ensured residents feel they are treated with respect and their right to privacy has been upheld. EVIDENCE: DS0000024232.V341564.R01.S.doc Version 5.2 Page 12 Each care record seen included a form entitled Personal Profile (A Day in My Life). The profile goes through a day and identifies what the resident needs. Headings include washing, using the bath, using the shower, using the toilet, getting dressed, getting around the home, teeth care, gum care, tongue care, lip care, hair care, nail care, breakfast, rest of my morning, medication, lunch, afternoon, supper, evening. Each area of need consists of two sheets of paper, the first identifies the above headings and the second includes a risk assessment related to that heading. The directions recorded for staff to follow included general statements such as “encourage” or “support” the resident but did not include details specific to the individual needs of the resident, nor did they include details of the individual wishes or preferences of the resident with regard to how they wanted care to be provided to them. Two residents returned surveys. One resident confirmed that they always received the care they required, whilst the second resident confirmed they usually receive the care they require. From this the inspector concluded that, care plans have been drawn up from the information gathered when residents’ needs were assessed. However care plans seen did not include appropriate information and instructions which staff are expected to follow to ensure identified needs are met. The deputy manager informed the inspector that, at present care plans were being reviewed with the registered provider. It is expected that comments made during this inspection about the current shortfalls are taken into account during this process. The home’s visiting GP was visiting on the same day and agreed to speak to the inspector. He confirmed he had spoken to the inspector about his concerns at the last inspection. One concern was that there were communication difficulties with the staff, particularly when talking on the telephone with the trained nurses about the medical needs of residents. The doctor noted that there has been a marked improvement in this area. In the past the care home appeared to be chaotic when he visited. But today, he noted the trained nurse on duty has conducted his visit in an effective and efficient manner. In conclusion the doctor confirmed that has no concerns about the quality of nursing care provided and, in his opinion, there have been sufficient staff on duty to provide the care required. He believes Upper Mead is a lot more settled then it was. Overall he feels happier about this care home than he was. The home’s dispensing pharmacist was also visiting on the same day to monitor practices. She also agreed to speak to the inspector. The pharmacist had just completed her inspection and confirmed she had no concerns in this area. She informed the inspector that, “Overall practices are very good. The staff are risk aware and are keen to get things right. Regarding communication issues, the staff deal with this very well. They are very careful with regard to the names of drugs.” The pharmacist informed the inspector that she does not provide staff training for this care home. The registered provider has its own trainer; the pharmacist liaises with this person where necessary. In DS0000024232.V341564.R01.S.doc Version 5.2 Page 13 conclusion, the pharmacist told the inspector, “I have no concerns regarding medication practices. There is a good standard of administration and recording.” As a result of this the inspector decided it was not necessary to examine records on this occasion. The inspector spoke to several residents and one relative during the course of the inspection. Comments made about the care afforded to them were positive. “One resident said, The staff are very good, they treat you very well.” Another resident said, I have no problem with the staff. They treat me with respect and ensure my dignity is maintained.” A relative told the inspector, I am very happy with the care provided for my mother.” From this, and following direct observations of care practices, the inspector concluded that staff treat residents with respect and ensure their dignity is maintained. DS0000024232.V341564.R01.S.doc Version 5.2 Page 14 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social and recreational interests and needs. Residents maintain contact with family and friends Residents receive a wholesome appealing balanced diet. EVIDENCE: Residents’ social, and recreational interests have been recorded in individual care plans. Residents spoken to have confirmed they enjoyed the programme of activities provided at Silver Court. A programme of activities were displayed on the residents’ notice board and included bingo, movement to music therapy, craft group, singalong sessions and quizzes. One relative told the inspector, “I DS0000024232.V341564.R01.S.doc Version 5.2 Page 15 can visit Mum often. There is always something going on when I visit.” A resident told the inspector that it was their birthday recently and commented, “They baked me a huge birthday cake. The staff came into my room to sing to me “Happy Birthday”. They did me very proud!” On the day of his visit the inspector noted that, during the afternoon, a quiz session was taking place in the dining room. A group of approximately 10 residents were taking part. The deputy manager informed the inspector that residents who have dementia also take part in the activities provided. Televisions and music centres have been provided in lounges. Some residents have also bought televisions for their own rooms. There is also equipment available for residents to play board games such as scrabble and dominoes. A bookshelf in a small library area was well stocked with paperbacks, audio tapes and large print books for residents’ use. A mobile library visits the care home regularly to change the selection available. Information supplied by the registered provider confirmed that “An activity programme is available; there are different activities daily; regular outings are organised; religious services offered twice a week.” Visitors are welcomed to Upper Mead. One resident told the inspector, “My family live about 10 minutes away. They can visit me often.” Another resident said, “My youngest son lives nearby. He can visit me and I can go to visit him to take part in family events and parties. Upper Mead is convenient for this.” A relative of a resident told the inspector, “I am always made welcome when I visit my mother.” The inspector noted that the lunchtime meal was a choice between roast pork or braised lamb and mint sauce, roast and mashed potatoes, cabbage and swede, followed by pineapple with meringues and cream. The inspector was advised that there are two sittings at lunchtime. At 12.15pm those resident who need help with eating have their meal, whilst the other residents have their meal at 1pm. The inspector joined the residents in the dining room at 1pm. The inspector observed the main meal being served, which looked very appetising. From menus seen the inspector concluded that residents have been provided with a varied, wholesome and balanced diet. Comments made about the food were varied. One resident said, “The food is quite bland but I can understand how difficult it must be to cook for large numbers with different tastes.” Other residents said, “The food is very nice,” and “The food is very good and appetising.” Another resident commented, “The food is sometimes better than others. They could have a bit more variation, but it can’t be easy with the amount of people they have to cook for.” Of the surveys returned by residents, one resident said they always like the meals provided, whilst the other resident said they usually like the meals provided. DS0000024232.V341564.R01.S.doc Version 5.2 Page 16 During the last inspection two areas of concern were raised. There was not enough room in the refrigerators provided for sandwiches, which had been prepared for the suppertime meal, to be appropriately stored. The chef showed the inspector that a new refrigerator had been purchased. In addition, dry stores, such as cereals were stored directly on the floor. At the last inspection, the inspector noted a catering size bag of cereal had been opened and the contents had spilled on the floor. It was noted, on this occasion, the registered provider has supplied wooden palettes to ensure all such foodstuffs are not stored directly on the floor. The chef also confirmed that this means the requirements made by an Environmental Health Officer had now been met. DS0000024232.V341564.R01.S.doc Version 5.2 Page 17 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives know that their complaints will be listened to, taken seriously, acted upon. The registered provider has ensured that residents are protected from abuse. EVIDENCE: A written complaint procedure was on display. This clearly identified who residents, or their relatives should speak to if they wished to make a complaint. The procedure also set out the steps any investigation would go through and the timescales by which the complainant would be notified of the outcome. Whilst the inspector did not examine the complaint record, information supplied by the registered provider confirmed that thirteen complaints had been received in the last 12 months, all of which had been resolved within 28 days of receipt. Surveys returned by two residents confirmed they knew how to make a complaint. One resident told the inspector, “If I needed to make a complaint I would speak to the manager. I haven’t made a complaint, but I would do if it was really important.” Another DS0000024232.V341564.R01.S.doc Version 5.2 Page 18 resident said, “ I would speak to Elizabeth, who is the head. But. I can’t think of anything to complain about!” A relative said, “If I had to complain I would probably go to the office.” Information supplied by the registered provider stated that, “This home is good at listening, especially to any concerns and complaints. They would be fairly treated and handled.” According to records seen training provided to all staff includes training in Adult Protection procedures. Some staff have recently had sessions to update their knowledge and understanding. It was also noted that the registered provider has a copy of the Adult Protection procedures published by West Sussex Local Authority. Staff on duty, who were spoken to, were able to tell the inspector about different types of abuse and to whom they should report any instance they may find. DS0000024232.V341564.R01.S.doc Version 5.2 Page 19 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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe, well-maintained environment. The home is clean, pleasant and hygienic EVIDENCE: The inspector toured the premises accompanied by the deputy manager. It was noted the premises were very clean, tidy and well maintained. The inspector viewed a number of bedrooms, the lounge and the dining room. These were very clean and tidy, and well maintained. Residents have been able to personalise their own rooms by bringing small items of furniture, pictures, ornaments and family photographs. One resident said, “I am very happy here. I have an extremely nice view from my window.” Another resident said, “I DS0000024232.V341564.R01.S.doc Version 5.2 Page 20 have a nice room, which is kept very clean. I am quite happy with the laundry service.” Information supplied by the registered provider prior to the visit indicated that the premises has been visited by the Fire Officer and Environmental Health officer to ensure it is safe and meets requirements in terms of fire safety and health and safety regulations. The registered provider has also confirmed that any shortfalls identified have been rectified. Equipment such as gas installations, electrical wiring and equipment have been regularly checked and maintained to ensure they are safe to use. As mentioned previously, those issues raised at the last inspection, which were also identified by the Environmental Health Officer, have been addressed. Another refrigerator has been purchased and wooden palettes in the larder have been provided on which dry foods can be stored. Several bathrooms and WC’s seen were clean and maintained to a good standard of hygiene. Some bathrooms have been fitted with bathing aids to assist residents in getting in and out of baths. Toilets seen have also been equipped with appropriate aids such as toilet seats and grab rails to assist residents. According to training records staff have been provided training in such subjects as food hygiene, infection control and health and safety. Staff on duty, who were spoken to confirmed the training they had received. DS0000024232.V341564.R01.S.doc Version 5.2 Page 21 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered provider has ensured there are adequate staffing levels to ensure residents’ needs are met by the numbers and skills mix of staff. The registered provider has ensured residents are in safe hands at all times. The registered provider has ensured residents are supported and protected by the home’s recruitment policy and practices. The registered provider has ensured staff are trained and competent to do their jobs. EVIDENCE: On the day of the inspection, the inspector noted that two trained nurses were on duty supported by a team of eight nursing assistants, and a third trained nurse. The inspector was informed that, at the beginning of their shift staff are allocated to work either upstairs or downstairs, or on Chestnuts Unit, working DS0000024232.V341564.R01.S.doc Version 5.2 Page 22 with residents who have dementia. In addition there were house keeping and catering staff to ensure the premises are kept clean and residents are provided with cooked meals, snacks and drinks throughout the day. According to the staff rota there are three trained nurses supported by a team of at least six nursing assistants from 7.30am to 1.45 pm each day. From 1.45pm to 7.45pm each day there are three trained nurses supported by six nursing assistants. The inspector concluded there were sufficient trained nurses, care assistants and ancillary staff to meet the needs of residents accommodated. This also ensures staff are in safe hands at all times. Two residents, who returned surveys said that staff are sometimes available when needed. A relative of a resident told the inspector, “I am very happy with the care provided to my mother.” A resident commented, “The staff are very good, they treat me well.” Another resident told the inspector, “Staff don’t have enough pagers. If I don’t get an answer after half an hour, which has occasionally happened, I am able to press the emergency bell.” The inspector examined the records of three staff recruited since the last inspection. Records seen were well maintained and were up to date. The information seen included references, criminal records checks and evidence which confirmed the identity of the member of staff. The inspector concluded that the manner in which staff are recruited ensures appropriate checks are carried out to confirm the applicant is appropriate to work with vulnerable residents. Residents spoken to confirmed they feel safe and are satisfied with the quality of care provided. Records of training provided were also examined and demonstrated that training for all staff has included mandatory training such as fire safety, food hygiene, adult protection and health and safety. Care staff have also received training in infection control and understanding dementia. It also demonstrated that trained nurses have received additional training with regard to dementia, catheter care, infection control and staff supervision. According to information provided before the inspection took place, nine nursing assistants hold the National Vocational Qualification (NVQ) in Care at Level 2 or above, whilst six nursing assistants are working towards the same award. One resident, who has complex care needs, told the inspector, “The staff know what they need to do to provide the care I need.” According to information supplied by the registered provider, the areas that this care home does well are, “Diverse workforce. Team spirit. Retention of 90 of staff. Staff/personal development encouraged.” The doctor who visits this care home regularly, had noted during the last inspection that there had been a large turnover in the staff team. It was the doctor’s opinion that this has as much improved. He also thought that morale has improved and there is a better continuity in the staff team. In conclusion DS0000024232.V341564.R01.S.doc Version 5.2 Page 23 the doctor confirmed that has no concerns about the quality of nursing care provided and, in his opinion, there have been sufficient staff on duty to provide the care required. He believes Upper Mead is a lot more settled then it was. Overall he feels happier about the care provided at this care home than he was. DS0000024232.V341564.R01.S.doc Version 5.2 Page 24 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, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered provider has taken appropriate action to ensure Compton House is being well managed. The home is being run in the best interests of the residents. Residents’ families handle financial affairs on their behalf. The registered provider has taken appropriate action to ensure the health, safety and welfare of residents and of staff. DS0000024232.V341564.R01.S.doc Version 5.2 Page 25 EVIDENCE: The registered manager for Upper Mead is Mrs Elizabeth Kandi. Mrs Kandi has demonstrated her fitness to manage Upper Mead through the process of registering with the Commission. During the last inspection, it was noted that residents able to express an opinion stated that they were happy with the way the home was run and that they are happy here. However, fewer staff expressed this opinion. At this inspection the inspector noted a positive atmosphere at the care home and amongst the staff team. Staff who were spoken to were able to talk about the needs of residents in an appropriate and professional manner. The local doctor who visits this care home regularly, had noted during the last inspection that there had been a large turnover in the staff team. It was the doctor’s opinion that this has as much improved. He also thought that morale has improved and there is a better continuity in the staff team. The registered manager has ensured regular staff meetings with the trained nurses and with the care staff are carried out in order to provide an appropriate means of communicating with them. Minutes of such meetings were seen and demonstrated that they are used to discuss the needs of residents and the best way of caring for them. Staff are also provided with an opportunity to raise and discuss any matters they may have concerns about. Staff are also receiving regular supervision and are being provided with regular opportunities to take part in a variety of training sessions to improve their skills and understanding in providing care to residents with complex needs. According to information supplied by the registered provider areas that Upper Mead does well include, “Involving residents and staff in planning of the running of the home. Staff training.” Reports of monthly visits to the care home carried out by a representative of the registered provider were available for inspection. The inspector examined the most recent report, which demonstrated that the visit included discussions with residents, staff on duty and examining selection of records. Information supplied by registered provider confirms that, “The head office sends out satisfaction questionnaires; resident and relatives meetings take place regularly; a suggestion book has been made available to residents and families.” The registered provider has identified that, as a result of consultations, improvements made to the service include, refurbishment to the lift; re carpeting of the care home; a review of meals provided; the provision of an in house dentist, physiotherapist and optician. The administrator informed the inspector that the care home does not handle residents’ money. The resident or their family are expected to handle this. DS0000024232.V341564.R01.S.doc Version 5.2 Page 26 The premises have been well maintained, ensuring a safe environment in which residents can live and staff can work. The registered provider has supplied information that indicates equipment such as boilers, other gas installations and electrical equipment have been regularly serviced and maintained. Residents have told the inspector that they are very satisfied with the accommodation and services provided. According to training records staff have been provided training in such subjects as moving and handling, food hygiene, infection control, health and safety. Staff on duty, who were spoken to confirmed the training they had received. DS0000024232.V341564.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 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 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X N/A X X 3 DS0000024232.V341564.R01.S.doc Version 5.2 Page 28 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations DS0000024232.V341564.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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. 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