Inspection on 08/10/08 for Wainford House Residential Care Home

This inspection was carried out on 8th October 2008.

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

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

Wainford House Residential Care... 29/10/07

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Wainford House Residential Care Home 1-3 Saltgate Beccles Suffolk NR34 9AN     The quality rating for this care home is:   three star excellent 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: Julie Small     Date: 0 8 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 31 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 31 Information about the care home Name of care home: Address: Wainford House Residential Care Home 1-3 Saltgate Beccles Suffolk NR34 9AN 01502714975 01502711389 emma@farringtoncare.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Emma Elizabeth Mary Bye Type of registration: Number of places registered: Farrington Care Homes Ltd care home 28 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Wainford House, Saltgate is a listed town house, located in an old part of the town centre of Beccles. The building has been extended and now accommodates twentyeight older people in twenty-four single rooms and two double rooms. Twenty-one of the rooms have en-suite facilities. There are three dining rooms situated close to each other, a large lounge to the front of the building and a pleasant conservatory to the rear, which has views over the gardens and down to the river Waveney that flows nearby. The home is in close proximity to a range of local shops, churches, public houses and public transport connections. The home is owned by Farrington Care Homes Ltd from 1st June 2007. Wainford Homes UK Ltd previously owned the home. 0 0 Over 65 4 28 Care Homes for Older People Page 4 of 31 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: three star excellent 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 quality rating for this service is 3 star. This means that the people who use this service experience excellent quality outcomes. The inspection was a key inspection which focused on the care standards relating to older people and was undertaken by regulation inspector Julie Small Wednesday 8th October from 9.15 to 16.45. The report has been written using accumulated evidence gained prior to and during the inspection. The manager was present during the inspection and they provided the requested information promptly and in an open manner. During the inspection a tour of the building and observation of work practice was Care Homes for Older People Page 5 of 31 undertaken and five staff members and nine people that lived at the home were spoken with. Records that were viewed included the care plans of four people that lived at the home, four staff recruitment records, staff training records and fire safety records. Further records that were viewed are identified in the main body of this report. Prior to the inspection the AQAA (annual quality assurance assessment) and surveys to enable people to share their views of the home were sent to the home. The AQAA and one relative survey were returned to us. The manager informed us that the fees for the home ranged from 355 to 500 per week. What the care home does well: What has improved since the last inspection? 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 7 of 31 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 8 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can expect to be provided with the information that they need to enable them to make decisions about if the home is the right place for them, to be provided with a needs assessment prior to moving into the home, to have their needs met and to be provided with the terms and conditions of residency. The home does not provide and intermediate care service. Evidence: People were provided with the information that they needed to enable them to make decisions about if they wished to move into the home. The Statement of Purpose and Service Users Guide were viewed and included details about the home such as the description of the home and the environment, the homes quality policy, peoples rights, facilities and services that were provided, how peoples health care needs were met, the organisational structure which included details about the registered individual, the provider and the registered manager, staff training and qualifications, Care Homes for Older People Page 9 of 31 Evidence: fire safety, complaints and CSCI (Commission for Social Care Inspection) contact details. The CSCI details needed to be updated to show current contact details, to ensure that people were provided with the correct details should they wish to contact us. A relative survey stated that they and their relative had usually been provided with enough information about the home to help them to make decisions. People that lived at the home that were spoken with stated that they were given information about the home which they could read when they were considering moving into the home. The records of four people that lived at the home were viewed and they contained a local authority needs assessment for local authority customers and a needs assessment that was undertaken by the homes management. The homes needs assessments included the persons preferred name, daily living needs assessment, medical history, their sensory aids such as if they wore dentures, spectacles or hearing aids and the persons preferences such as their usual routines of going to bed and getting up, likes and dislikes, interests and their preferred breakfasts. The records included details of the persons individual history, such as where they had worked, where they were born, where they had lived, details about their family and their religion. The AQAA stated that they always visit potential service users in their own environment and invite them and their representative to visit the home prior to admission. Peoples records included detailed care plans which identified how peoples individual assessed needs were to be met. Peoples records that were viewed included the terms and conditions of residency and for local authority customers, a local authority placement contract which was signed by a council staff member, the homes manager and the person or their representative. Care Homes for Older People Page 10 of 31 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can expect to have methods of meeting their assessed needs identified in a care plan, to have their health needs met, to be treated with respect and to be protected by the homes medication procedures. Evidence: The care plans of four people that lived at the home were viewed, which detailed how their assessed needs, health care needs and diverse needs, such as with communication and religious worship, were met. The care plans identified the step by step support that people required and preferred in their day to day living needs, which included their personal care and their preferred times of getting up in the morning and going to bed. Each care plan identified the areas of personal care that people could attend to independently and the documents stated that peoples independence should be encouraged. Daily records that were viewed identified the support that people had been provided with and observations of their well being or activities each day. Two care plans that were viewed included areas of peoples specific diverse needs that Care Homes for Older People Page 11 of 31 Evidence: were highlighted for staff members particular attention, such as how a person preferred and needed to dress and undress due to restricted mobility of one arm and how staff should communicate with a person who was profoundly deaf. The care plan of one person identified areas of deaf culture and how the person may seemed abrupt and that this was due to their communication differences. One persons care plan identified that they had requested that they be supported by female staff when they were assisted with their personal care needs. The four care plans that were viewed clearly identified peoples choices with regards to their chosen religious worship. The care plans were updated regularly to show peoples changing needs and preferences. Peoples records that were viewed included a care plan agreement which was signed by the person or their representative to show that they had been consulted with about the support that they were provided with. Staff that were spoken with confirmed that the care plans included the detail that they required to meet peoples assessed needs. Staff showed a good knowledge in peoples individual needs and the support that they required. People that were spoken with reported that they felt that their needs were met at the home and that the staff were available when they needed them. During the inspection staff were observed to be attentive to peoples needs. A relative survey stated that they felt that their relatives needs were usually met and that their relative was usually provided with the support that they agreed or expected. The survey stated treat all the residents with great respect and help all to the best of their ability. Peoples care plans clearly identified peoples wishes at the time of death, which included their funeral arrangements. A person that was spoken with said that they had arranged their funeral and that they had spoken with staff about their wishes. The records of four people that lived at the home included detailed risk assessments which identified the risks of their daily living and methods of minimising the risks. The risk assessments included areas of mobility, falls and pressure areas. The records of two people included waterlow skin assessments, which identified that they were at high risk of pressure areas and methods of minimising the risks which included the use of pressure relieving aids such as a cushion and mattress. Methods of assisting people with their mobility were clearly identified in peoples records, such as the mobility aids that they used. During the inspection two staff members were observed to support a person from an arm chair to a wheelchair. They used a stand aid and it was noted that the manual handling was undertaken in a appropriate manner. The staff members spoke to the person throughout and asked if Care Homes for Older People Page 12 of 31 Evidence: they were comfortable. Peoples health care needs were met and the care plans that were viewed included records and outcomes of support that they had been provided with by health professionals such as a doctor, district nurse or chiropodist. The care plans identified the support that each person should be provided with, such as with allergies, their mental health and continence. Peoples weight was regularly monitored through regular weight checks. A person that was spoken with reported that the staff supported them to make a doctors appointment if they needed one and that they received regular support from a district nurse. A person stated that they had been supported by staff in their condition and that staff assisted them with their eye drops, they stated they are lovely and gentle. Staff were observed to remind a person to stop itching their legs and asked them how they felt, they stated that they would assist them in making a doctors appointment if they required one. Peoples care plans that were viewed identified the arrangements for support that people required with their medication administration, for example if they were supported by staff or if they administered their medication independently. The care plans each held a medication profile and a medical history. People were protected by the homes medication procedures and practices. The homes local pharmacy undertook a quarterly medication audit, in which areas for improvement were identified and how the home had actioned concerns, such as improvements in staff training and with the storage of medication. The medication audits were viewed and identified that the storage of homely medication had improved and that seven staff had attended a distance learning course on the safe handling of medication, which was confirmed in the staff training records that were viewed and staff members that were spoken with. The most recent audit identified that the stocks storage for medication exceeded 25 degrees in summer months and the methods for minimising the risks were in the process of being identified. The manager was spoken with and reported that they were hoping that they would be provided with a second medication trolley to store stocks of medication or they were considering changes of the doors to the cupboard. MDS (monitored dosage system) blister packs were stored in a secured medication trolley and stocks of medication was stored in a secure cupboard, which contained the secured controlled medication cabinet and homely medication. Medication that required refrigeration was stored in a refrigerator for which regular temperature checks were made. The home had procedures for the safe handling, storage and administration of medication, homely medication and self administration. Care Homes for Older People Page 13 of 31 Evidence: MAR (medication administration records) charts were viewed and they included each persons photograph and their prescribed medication. The charts had been signed by staff when they had administered the medication and codes had been used to identify when medication had not been administered, such as if the person had refused their medication or if they were not at the home. The lunchtime medication administration round was observed and a staff member clearly explained the procedures for medication administration. People were assisted with their medication one at a time and the staff member signed the MAR charts when they had observed people taking their medication. People were treated with respect and their privacy was respected. People that were spoken with reported that staff always spoken to them respectfully and that staff always knocked on their bedroom doors and waited to be invited in before entering. One person stated I like living here, I like the staff and the residents. Staff spoken with reported that they were aware that they should treat people with respect at all times and they stated that some people preferred a laugh and a joke and that some people preferred a more formal approach. They stated that they treated people in the way that they preferred. A domestic staff member was spoken with and reported that they always ensured that they communicated with people when they cleaned their bedrooms, they stated that it would be rude to go into their bedroom and not speak to them. The maintenance staff member was spoken with and reported that they were responsible to check the maintenance of the home, they stated that they were always aware of ensuring that people were respected and that their privacy was respected when they wished to view their bedroom. They said I do know that their bedrooms are their domain. We sat in the lounge for the majority of the inspection and staff were observed to interact with people that lived at the home in a friendly and professional manner. There were some examples of good practice that we observed during the inspection, which confirmed that people were treated with respect and that their dignity and privacy was respected. A person had woken from a morning nap and staff asked if they were comfortable and offered a cushion to make them more comfortable. A staff member had noted that a persons leg was wet and was told that they had just spilled a drink onto their leg (which was not hot). The staff member supported the person to move from the public area and did not draw attention to the fact that their leg was wet. A person was going into the communal toilet and a staff member quietly reminded them to close the door before they started to undress. Care Homes for Older People Page 14 of 31 Evidence: The AQAA stated we promote independence of the individual and assist them to maintain this where necessary, privacy and dignity being an utmost priority. Care Homes for Older People Page 15 of 31 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 can expect to be provided with a programme of activities which are of interest to them, to be supported to maintain contacts, to be supported to make choices in their lives and to be provided with a balanced and nutritious diet. Evidence: People that were spoken with reported that they were provided with the opportunity to participate in activities that were of interest to them. A person explained that they participated in activities on a daily basis, which they enjoyed. Two people listed the programme of activities for the week of the inspection, which included a quiz, darts, bingo and a visiting entertainer, who visited the home on a weekly basis. A person said that they particularly enjoyed the visiting entertainers, when they could enjoy a good sing song. A person stated that they were able to go out to the shops, library and church without staff assistance, which they said that they enjoyed. A person said that if they wanted anything from the shops a staff member would get it for them if they were unable to go out themselves. A person said that members of a local church visited the home regularly for praise and worship. The care plans of four people that lived at the home were viewed and each identified Care Homes for Older People Page 16 of 31 Evidence: their interests and if they had stated an interest in participating in the provided activities and their chosen religious worship. The care plans identified if people wished to have a newspaper and the days that they chose to have it. The activities book was viewed, which explained the type of activity that was provided, who had participated and comments on their well being during the activity. There was a large selection of books in the home that people could read if they chose to. The manager was spoken with and reported that they provided an activities coordinator each week day afternoon apart from Thursday when a visiting entertainer attended the home. They stated that the home had a fête during the summer and that the people that lived at the home had decided what they wished to spend the proceeds on. They had agreed to have a range of visiting entertainers and a buffet meal. The AQAA stated that they had improved in the last twelve months by purchase and implementation of activity equipment, 5 day per week activity programme. During part of the inspection we sat in the lounge with the people that lived at the home. On the morning of the inspection people were observed to read books, listen to music and chat with each other and with staff. From 13.30 to 15.30 people were observed to participate in a quiz, for which there was a prize for the person who answered the most questions correctly. Fifteen people participated in the quiz and there was lots of laughter and chatting about the questions, answers and peoples memories of certain subjects. A staff member was observed to sit next to a person that could not participate in the quiz and chatted about what was going on, which showed that people were not excluded from the fun due to their abilities. During the inspection people were observed to enjoy visits from their family and friends. Staff were observed to interact with visitors in a friendly, welcoming and professional manner. People that were spoken with reported that their family and friends were always welcomed into the home. A relative survey stated that staff at the home always supported their relative to keep in touch with them and that they were always kept up to date with important issues that affected their relative. The survey commented have a good relationship with members of staff. The care plans of four people that lived at the home that were viewed clearly identified the contacts that people chose to maintain. Four care plans that were viewed clearly identified peoples preferences with regards to how they lived their lives and the support that they were provided with. For example a person had chosen to be supported by one gender of staff with their personal care and a person had chosen not to be involved with religious worship. The daily records that were viewed showed how peoples choices were sought and met by staff on a daily basis. People that were spoken with reported that their choices were listened to and Care Homes for Older People Page 17 of 31 Evidence: they felt that the staff always did their best to ensure that their choices were met. During the inspection staff were observed to ask people what they wanted to do during the day, such as what they wanted to drink and eat, where they wished to be in the home and if they wished to participate in the activity. The AQAA stated that the home respect residents choices at all times regarding decisions about how they choose to conduct their lives. A relative survey stated that people were always supported to live the life they chose. The homes menu was viewed and it was noted that people were provided with a balanced and nutritious diet. People that were spoken with said that the food was very good and they listed the things that they particularly enjoyed to eat. One person was asked about the quality of the food at the home and they replied ooh gorgeous. A person was asked if they were provided with enough food to eat and replied that there was sometimes too much. People stated that they were provided with a choice of meals and that if they did not want what was on the menu they were provided with their chosen meal. A kitchen assistant was spoken with and confirmed that people could choose what they wanted to eat, they said that they were informed of peoples specific dietary requirements by the manager and that the kitchen staff often spoke to people about their likes and dislikes. The care plans of four people were viewed and clearly identified peoples food preferences and their specific dietary requirements. Lunch during the inspection was lamb casserole and fresh vegetables or quiche salad and followed by a fresh fruit salad. The meal smelled and looked appetising and it was noted that people did not leave much on their plates. People were observed to be offered a selection of hot and cold drinks and biscuits throughout the day. Care Homes for Older People Page 18 of 31 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can expect that their complaints are acted upon and that they are protected from abuse. Evidence: People can expect to have their complaints listened to and acted upon. People that were spoken with reported that they were aware of how to make a complaint or raise concerns about the support that they were provided with. However, they stated that they had not felt the need to complain and that they were happy with the support that they were provided with at the home. They were provided with a summary of the complaints procedure in the Statement of Purpose and Service Users Guide. The complaints procedure was viewed and detailed the homes arrangements for dealing with complaints in a timely manner. The AQAA stated that they provided an open policy providing information to all regarding their rights to the complaints procedure. There had been no complaints received by the home since the last inspection. The manager stated that one complaint had been received by the providers from a neighbour of the home. The manager explained that the complaint had been made regarding the noise from the laundry during the night. The manager had responded by ensuring that the laundry was only used during the day. A notice was posted in the office which explained to staff that they must not use the washing machines during the night. Care Homes for Older People Page 19 of 31 Evidence: We viewed lots of thank you cards and letters which had been sent to the home from the relatives of people that had lived at the home, thanking them for the care and support that the home had provided. The manager was spoken with and stated that they would amend the complaints book to include the compliments that had been made about the home. There had been no safeguarding referrals made since the last inspection. Staff spoken with were aware of their roles and responsibilities with regards to safeguarding people that lived at the home and whistle blowing. Staff were advised of their roles and responsibilities by the homes safeguarding policies and procedures. The training records that were viewed showed that they had been provided with safeguarding training. The AQAA stated that they ensured that people were safeguarded by following procedure for protection from abuse and that they had updated procedure for staff in the event of suspicion or allegation of abuse in the last twelve months. The care plans of two people were viewed and clearly identified methods of ensuring that they were safeguarded, which included the support that people were provided with to ensure that they did not neglect themselves by not eating. Care Homes for Older People Page 20 of 31 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 can expect to live in a safe, clean and well maintained environment. Evidence: People were provided with a comfortable, clean and well maintained environment to live in. A tour of the building was undertaken and it was noted that the home was clean and attractively furnished. The manager was spoken with and reported that the communal lounge had been provided with a new carpet and chairs. The AQAA stated we provide a warm, comfortable, homely environment for our residents and improvements that they had made in the last twelve months were re-carpeted lounge, reception and several bedrooms, purchased new lounge chairs and replaced several beds. There were no offensive odours in the home and the manager reported the actions that they had taken to eliminate the offensive odour which was noted during the last key inspection, which included the provision of a new bed and carpet. Peoples bedrooms were clean and attractively furnished and their personal memorabilia reflected their individuality. People that were spoken with reported that they felt that the home was comfortable, was always warm enough and that the home was always clean. A domestic staff member was spoken with and was aware of their roles and Care Homes for Older People Page 21 of 31 Evidence: responsibilities with regards to keeping the home clean and tidy and with infection control. Care staff that were spoken with were aware of the homes infection control procedures. Staff were observed to demonstrate good infection control procedures which included wearing protective aprons and disposable gloves and washing their hands when working with food and supporting people with personal care. The AQAA stated that ten staff had been provided with infection control training, which was confirmed by training records that were viewed. The AQAA stated that hand gels are available at entrances and carried by all staff. It was noted that the laundry, kitchen and communal toilets and bathrooms provided suitable hand washing facilities, which included hand wash liquid and disposable hand drying towels, which minimised the risks of cross infection. The laundry was viewed and it was clean and contained washing machines that provided suitable washing programmes to safeguard people from cross infection. Care Homes for Older People Page 22 of 31 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 can expect to be supported by staff who are trained and competent to do their jobs and that they are protected by the homes recruitment procedures Evidence: People were safeguarded by the homes recruitment procedures. The recruitment records of four staff members were viewed and each held evidence that the required checks had been made which included a CRB (Criminal Records Bureau) checks, two written references, a health declaration and details of their work history. The staff rota was viewed and it was noted that people were provided with support throughout the twenty four hours of each day. The staffing cover for the home included the morning shift from 7.30 to 13.30 there were four carers including a senior staff member, the afternoon shift from 13.30 to 16.30 there were three care staff including a senior staff member and the activities staff member, the evening shift from 16.30 to 20.30 there were three care staff including a senior and the night shift from 20.30 to 7.30 there were three staff including a senior. There was further staffing support from the kitchen staff, maintenance staff and domestic staff. The AQAA stated the home provided a full compliment of locally based staff. Staff numbers have been increased, hours increased for ancillary staff. Care Homes for Older People Page 23 of 31 Evidence: Staff spoken with reported that they felt that there were sufficient staff on duty to meet the needs of the people that lived at the home. People that lived at the home that were spoken with stated that they felt that there was always enough staff working at the home, that the staff were available when they needed them and that call bells were always answered promptly. They were complimentary about the staff that worked at the home and comments included they are lovely and the staff are very good and always do their best. Staff were observed to be attentive to peoples needs and requests throughout the inspection and it was noted that the interaction between staff and people that lived at the home was friendly and professional. People were supported by a staff team that were appropriately qualified. The home had met the target of 50 of staff to have achieved a minimum of NVQ (National Vocational Qualification) level 2 in care by 2005 which was identified in the National Minimum Standards relating to older people. The AQAA stated that there were eighteen care staff that worked at the home and ten had achieved a minimum of NVQ level 2 in care and five staff members were working towards their qualification. The manager stated that a senior staff member was working towards their NVQ level 4 and another senior carer was working on their NVQ level 3 and that in the last twelve months two carers had been promoted to senior carers, which showed that staff were provided with the opportunity to progress and develop in their work roles. Training records that were viewed identified that staff were provided with training to inform them of how to meet the needs of the people that lived at the home. Training that was provided included Skills for Care Common Induction Standards induction, medication, infection control, food hygiene, health and safety, first aid, moving and handling, challenging behaviour, safeguarding, dementia and dying, death and bereavement. Staff had also undertaken distance learning courses in the last twelve months, which included the safe handling of medication, infection control, dementia awareness, food safety, occupational health and safety and health and nutrition. The manager was spoken with and reported that the provider had forwarded a selection of training DVDs since the last inspection. During the inspection the manager had signed up to attend the train the trainer manual handling and risk assessor training for November 2008, which they stated would increase their ability and confidence to deliver the DVD training to staff. Staff spoken with reported that they felt that they were well trained to do their job, however, they stated that they did not feel that the DVD training for manual handling was sufficient for newly recruited staff members. They stated that they felt that they needed the opportunity to attend formal training which provided them with the opportunity to practice with manual handling equipment. The manager and a senior staff member agreed that they would ensure that staff were appropriately trained and identify their concerns to the provider if they Care Homes for Older People Page 24 of 31 Evidence: and the staff team felt that the DVD training was insufficient. Care Homes for Older People Page 25 of 31 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. People can expect to live in a home that is managed by a person that is fit to be in charge, that the home is run in their best interests and that their health, safety and welfare is promoted and protected. Evidence: The home was managed by a person who was fit to be in charge and they had proved fit during the CSCI (Commission for Social Care Inspection) registered manager application process. Since the last inspection the manager had registered on and was working toward the NVQ level 4 care leadership and management qualification. During the inspection the manager had signed on for the train the trainer manual handling and risk assessor training for November 2008. They explained that they felt that the training would assist them in the training delivery for staff that work at the home. Staff and people that lived at the home that were spoken with were complimentary about the manager and the management style in the home. A person that lived at the home stated that the manager was approachable and always listened to what they Care Homes for Older People Page 26 of 31 Evidence: said. A staff member stated that they felt that they could speak to the manager about their work role and that the manager always supported them if they had concerns. The AQAA stated that they do well by good record keeping, manager provides open, inclusive presence in the home. Since the last inspection the monthly Regulation 26 visit reports were present at the home, which showed that the responsible individual regularly monitored the running of the home and they had spoken with the people that lived at the home regarding their views and experiences of living at Wainford House. People were provided the opportunity to express their views about the home in quality assurance satisfaction questionnaires. The questionnaires had been provided to people January 2008 and seventeen had been completed by visitors to the home, eighteen had been completed by people that lived at the home and fifteen had been completed by staff members. The manager was spoken with and explained the actions that they would take if they had received concerns about the service that was provided in the questionnaires. During the inspection it was noted that CSCI surveys were present in the entrance hall to the home, for people to help themselves to, if they wished to comment on their experiences of the home. Peoples health, safety and welfare was promoted and protected. The home provided clear procedures for the safeguarding of peoples finances. The records three peoples finances were viewed and they clearly recorded the incomings and outgoings of monies and the receipts for peoples spending. The actual money was checked with the records and it was noted that the records were accurate. The maintenance book was viewed and it clearly showed the identified need for repairs and when they had been completed in a timely manner. The maintenance person was spoken with and reported that they regularly checked the building to ensure that there were no hazards and to check that the home was well maintained. During the inspection the maintenance person was observed to undertake water temperature checks and the records of the checks were viewed. The fire safety records were viewed and it was noted that fire safety checks were undertaken on a weekly basis. Regular fire drills and instruction were undertaken to ensure that people that lived at the home, visitors and staff were aware of actions that should be taken in the event of a fire. The home provided a clear fire safety procedure, a fire evacuation plan and a fire risk assessment. The homes environmental risk assessments were viewed which identified the possible risks in the home and methods of minimising the risks in the home. The risk Care Homes for Older People Page 27 of 31 Evidence: assessments covered areas such as slips and trips, manual handling, COSHH (control of substances hazardous to health), infection control, first aid and burns. Care Homes for Older People Page 28 of 31 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 29 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 30 of 31 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 31 of 31 - 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!