Inspection on 12/01/09 for Warwick Park House

This inspection was carried out on 12th January 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Warwick Park House 09/01/08

Warwick Park House 05/07/07

Warwick Park House 16/08/06

Warwick Park House 09/05/06

Warwick Park House 09/08/05

Warwick Park House 26/04/05

Warwick Park House 23/02/05

Warwick Park House 15/09/04

Warwick Park House 04/03/04

Similar services:

The Vicarage

Fairfields Country Rest Home

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5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest 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: Warwick Park House 17 Butt Park Road Honicknowle Plymouth Devon PL5 3NW     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: Caroline Rowland-Lapwood     Date: 1 3 0 1 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: Warwick Park House 17 Butt Park Road Honicknowle Plymouth Devon PL5 3NW 01752772433 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Warwick Park Limited Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 50 Number of places (if applicable): Under 65 Over 65 4 10 50 dementia old age, not falling within any other category physical disability Additional conditions: 0 0 0 The Home is registered as a Care Home with Nursing for a maximum of 50 Service Users in the categories of PD(E)50, OP 10, TI 4 The home can provide care to 4 persons suffering with Dementia DE(E) named elsewhere. Date of last inspection Brief description of the care home Warwick Park Nursing home is registered to provide care, for a maximum number of fifty older people with physical frailty, disability or illnesses, who may need nursing care. Care Homes for Older People Page 4 of 30 Brief description of the care home The home is located in the Honicknowle area of Plymouth and is close to shops and near to a bus route. It is arranged on two floors with the communal lounges and dining room on the ground floor. There is level access to all parts of the home via a passenger lift and ramps. Level access is provided to a large secluded garden with a variety of seating areas. There are thirty-two single bedrooms and nine double rooms, most benefit from en suite toilet facilities. The homes service users guide and the last inspection report can be found in the entrance hall of the home and in the homes office. Car parking is available in the grounds of the home. Fees range from £337-£592.80 per week 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 quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. As part of this key inspection the manager completed an Annual Quality Assurance Assessment (AQAA), which contained general information about the home, and an assessment of what they do well and what they plan to improve upon. Before our visit we sent a number of confidential surveys to people living there, to staff and outside professionals to hear their views. We received completed surveys from 10 people living at the home. Four surveys were returned from staff and one from outside professionals. The comments and responses we received have helped us to form the Care Homes for Older People Page 6 of 30 judgments we have reached in this report. This unannounced inspection took place as part of the normal pro-gramme of inspection. The site visit was undertaken over two days, involving one whole day and a morning. As a way of judging the service overall, during our visit, we (the commission) spent time talking with people who live at Warwick Park. Most people living at the home were seen or spoken with during the course of our visit. We spoke with care and ancillary staff, visitors and the manager. We looked at the care and accommodation offered to people living at the home and observed the care and support provided by staff. We also looked at a number of records the home is required to keep, including assessment and care plan files, daily reports, staff recruitment and training records, and records of money held by the home on behalf of people living there. What the care home does well: What has improved since the last inspection? What they could do better: Six requirements and two recommendations have been made as a result of this inspection. Care plans must be consistent, providing enough specific information for staff for them Care Homes for Older People Page 8 of 30 to properly meet peoples needs. Most care plans are being reviewed regularly but not all. The management of medication must improve to ensure peoples health is not adversely affected. The home must make sure that people get the medication they are prescribed in a timely way. Systems must be in place to ensure that stocks of prescribed medicines are recorded and returned once the person is deceased. The activities at the home are adequate, however particular consideration should be given to stimulating and meaningful activities for people with dementia of those nursed in bed to ensure that individual preferences can be met. To ensure people have ample recreational stimulation their plans of care, which provide the basis for the care to be delivered, need to provide more detail about their social needs and how these will be met. Improvements are needed with regard to infection control procedures ( sluicing of bed pans). Moving & Handling practice must improve with all staff having up to date training. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good information is available to people about this service so that they know what to expect. People benefit from a good assessment process, which ensures that the home can meet their needs. Evidence: The home gives people detailed information about the services it provides. Copies of the Service Users Guide were seen in individual bedrooms. One person said they had read the statement of purpose and that it had helped them to understand what to expect at the home. Most people told us they had received enough information the home before moving in. People admitted for short term care may not receive as much information due to the nature of the admission for short stay, as sometimes it maybe an emergency admission. Two people spoke with us about their admission to the home, one told us the staff Care Homes for Older People Page 11 of 30 Evidence: were very nice from the off, and its very friendly here. We looked at three files to see how peoples care and support needs are assessed before they move in. Social services or health care professionals often make referrals to the home and information is gathered from them. The manager or head of care at the home also visit people who are considering a move to the home to get to know them, to provide information about the home, to answer any questions and to carry out an assessment. We saw that the home gathered good information about a range of individual personal and health care needs. This process helps to ensure that people are given relevant information about the service and that the home can meet peoples needs. Warwick Park does not provide intermediate care. 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. Some ares of care planning and issues around privacy need further work, in order to promote the safety and well being of people living at the home. Some medication practice could put people living at the home at risk. Evidence: People living at the home told us they always or usually receive the care they need. One person told us they are really good, very kind and there is no where else I would rather be other than my own home. Other comments included I am happy enough and get all I need. We spoke with one relative who was generally pleased with the care her father was receiving, she said they all seem very nice. Each person living at the home has their own care plan which is kept in their bedroom. We looked at four care plans to help us judge how care is planned and delivered. Three of the four care plans had been completed well and gave good information to staff about peoples abilities and assistance needed to complete the daily activities of living. Some described peoples preferences and some included a social history which details Care Homes for Older People Page 13 of 30 Evidence: the persons life before moving into the home, including their occupation and family members. It is important information which provides staff with the understanding of who the person really is. One care plan we looked at stated that the person was diabetic, blood sugar levels had been recorded in the plan but there was no clear instruction for staff of how to actually care for the person in relation to their diabetes. Another care plan stated that the individual who often was nursed in bed should have 800-100mls of fluid per day however this man was asleep most of the day and drinks were just left out of his reach and not recorded on the fluid chart. His television was on very loud but there was no indication in the care plan that this was what he liked to listen to or watch. Not all care plans had been reviewed monthly. Care plans kept in the bedrooms contained personal information some of which is confidential to the individual, this is a breach of confidentiality. We saw that moving & handling assessments and plans had been completed and we saw most staff using appropriate moving & handling techniques when needed. However, one person described to us how he had stumbled that morning when being assisted by one member of staff from the chair, as he had been unable to stand without the help of two carers, his plan clearly stated needs two people to transfer. Also we saw another member of staff pulling a man in a reclining chair to the lounge while his feet were dragging along the floor, this is poor practice and could have resulted in the person being injured. Staff said they had had Moving & Handling training, the staff training records showed that some updates were overdue ( see standard 38). Staff told us they were always or usually given up to date information about peoples needs. One staff member told us the care plans have all the information in and we have handover every day Generally staff spoken with had a good knowledge of peoples care and support needs and their individual abilities and personalities. People living at the home told us they usually or always receive the medical support they need. Visiting health professionals said that the care service usually seeks advice and acts upon it to manage and improve individuals health care needs. Records showed that outside professionals visit people regularly, for example GP, chiropodist,and other specialists. People are also supported to attend out patient clinics. People prone to pressure sores have the necessary equipment to help reduce risk (specialist beds and cushions). Medication is kept in two locked trolleys, one on each floor and the controlled drugs are stored securely in a locked cupboard in the medication room. We looked at the Care Homes for Older People Page 14 of 30 Evidence: drug cupboards and we found some medication ( controlled drugs and creams stored in the fridge) that should have been returned, records had not been changed to show the medication was no longer in use and the person was deceased. Medication administration charts were correctly completed there were no gaps and the appropriate codes had been used when medication had not been given. The Registered Nurses on duty were still undertaking The 8AM medication round (one on each floor) at 10AM this process ( on the first floor) finished at 11.45AM We were told this is usual as they are sometimes needed to help carers with tasks whilst giving out the medication. We were told some medication is given by the night staff, (antibiotics and some pain relief). All the people we spoke with living at the home commented on the kind and friendly approach of the staff; people told us staff are lovely, they are so helpful, nothing is too much trouble and they are lovely girls. During our visit we saw staff interacting with the people that live there in a warm and friendly manner often having time to have a joke with the people living there too. Staff were seen to be respectful when delivering care or dealing with requests. Peoples personal care is well attended to, which promotes their dignity and improves their feeling of self worth. People were dressed in their own clothes and were well groomed; attention to their personal care was good. 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. Routines are flexible and opportunities for social activities have improved. People enjoy a balanced diet which takes into account the likes and dislikes of individuals. People benefit from contact with their family and friends, which is encouraged and supported by the home. Evidence: Peoples preferred daily routine is respected, staff are aware of favored times for getting up and going to bed etc. We spoke with several people about the routines at the home, people told us that the routines were flexible and suited their needs. Comments included, There are no restrictions here I have lots of freedom and there is no strict routine and No-one tells me what to do. We asked people about the social activities provided at home. People returning surveys to us had different things to say. Two people said there were always activities available for them to take part in; three said this was usually the case and one person said this was sometimes the case. Since the last inspection the manager has recruited a full time member of staff to help Care Homes for Older People Page 16 of 30 Evidence: improve peoples social opportunities and improve the activities. A pro gramme of activities has also been established, for example, regular bingo and other games, some reminiscence and trips out. People told us about some of the things they enjoyed doing, one person told us how he had always wanted to visit the Naval dockyard in Plymouth and the staff had enabled him to do this, he had a wonderful experience and said it was really great; Other people told us they enjoyed the bingo and musical events. In some care plans, but not all, we saw that information has been collected about each persons past life, their social interests and the activities they have taken part in before coming to live at Warwick Park. For those people that are able to express their choice this information is being used in a positive way to find them activities they may enjoy. However, for others who are less able to participate, little or no information was gathered and activities or one to one interaction was inadequate. The home provides a welcoming and friendly approach when relatives and friends visit. We saw that visitors were invited to have a meal with their relative if they chose to. Surveys from relatives showed that they were always kept up to date with changes. One relative wrote, The home always keeps me up to date with any medical problems, and another wrote, they are very good they always let me know. One relative told us, We can come and go as we please. We are always welcome. Five of the six people responding with surveys felt that staff listened and acted on what they said, ensuring that people have the opportunity to exercise some choice and control in their daily lives. One person told us, Staff always respond to my requests. Surveys showed that most people were happy with the food at the home. Some comments included The food has been very good so far, Good quality food but we are given too much! . People returning surveys and those spoken with told us there was always an alternative offered if they did not like or want the main the meal. Special diets are catered for. We spoke with the catering staff, who were aware of individual needs, and likes and dislikes. We saw people had fresh drinks available during the day. Care Homes for Older People Page 17 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples views and complaints are generally listened to and acted upon. People feel safe and well cared for. Staff are aware of the procedure to follow to protect people from abuse or harm but some would benefit from up to date training. Evidence: Five of the six people responding to our survey were aware of the homes complaints procedure and knew who to speak with should they have any concerns. Most people we met and spoke with during our visit were also aware of whom to speak with about concerns or worries. One person told us, I would see one if the nurses if I had a problem, another said, I would talk to Karen if I was worried and another said, You can talk with the staff. We looked at how the home records complaints and the action they take to respond to peoples concerns. Records were clear about the outcome of complaints and records relating to the most recent complaint were available. The Commission has received three complaints about the home, two were unsubstantiated and one was unresolved. People living at Warwick Park told us they were well cared for, that they felt safe there and that staff treated them with respect. The manager told most staff had had training in the protection of vulnerable adults. However, he was aware that this needed updating and said staff had been booked onto the next available course. All staff spoken with told us they had received adult protection training but some could not Care Homes for Older People Page 18 of 30 Evidence: remember when, all demonstrated a clear understanding of their responsibilities to report any concerns. Care Homes for Older People Page 19 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. Warwick park generally provides a safe, clean and comfortable home with a good standard of furnishings, which offers a pleasant environment for people to live in. Evidence: The home has car parking facilities and pleasant gardens to the rear of the home. The main entrance is provided with information and an administration person is able to greet and open the door to people arriving at the home. Secure locks to the doors are provided for the safety of the people living there. Communal areas consist of two lounges, a dining room and an eating area within the second smaller lounge. A television is on in the main lounge during the course of the day. Carpets in the reception areas and main corridors and dining room have all been replaced since the last inspection. Some bedrooms carpets are now in need of replacing, information received ion the AQAA tells us that this is being planned for the near future. Bedrooms are available on the ground and the first floor of the home. A passenger lift serves the first floor of the home. People living here were happy with accommodation provided. People are encouraged Care Homes for Older People Page 20 of 30 Evidence: to personalize their private bedrooms with their own furniture, and other items such as pictures and photographs. The staff member in charge of cleaning was spoken to on both days of the inspection. The home was found to be clean and a good supply of aprons and gloves are available to staff to use to prevent the spread of infection. There is a team of five Cleaners to cover the home seven days a week, four of whom have obtained an NVQ qualification. We saw staff using the bathroom on the ground floor of the home for a person who needed a hoist to allow her to bath safely. Staff were kind and caring when helping this person. However due to the size and layout of the bathroom the person had to be hoisted in the corridor and pushed into the bathroom. Whilst every attempt was made to promote the dignity of this person the procedure was inappropriate and alternative should be considered. The home has no dedicated sluice facility only a macerator for disposable commode pans. Staff described how they sluice and clean commode pans; as there is no sluicing facility at the home this is done is any sink available usually in the large bathrooms. This could pose a considerable risk to health and hygiene. The laundry is well equipped, clean and well organized. A red bag system is used for any soiled laundry ensuring staff are protected. People spoken with said they were very satisfied with the laundry service provided and that their clothes were taken care of and always nicely pressed and returned in good condition. All maintenance records are up to date and evidence the regular servicing of equipment in the home. Care Homes for Older People Page 21 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. Staffing levels are generally sufficient to ensure that peoples needs are met in a timely way. People benefit from having experienced, competent and friendly staff who have a good understanding of their needs. People are protected by the robust recruitment practice followed at the home. Evidence: People returning surveys to us told us that staff were always available when needed. During our visit people told us, I dont usually have to wait too long for attention, Staff are usually around when you need them, They are pretty good. Staff spoken with told us there usually enough staff on duty. One staff member told us, We usually manage between us OK but it can be difficult when people go off sick other staff members confirmed this. People living at the home were generally very happy with staff attitude and approach, We received many positive comments, including, They are mostly friendly and happy, Staff are friendly, and really good, the girls are brilliant, they are very kind. We looked at the files of three members of staff included the most newly recruited to Care Homes for Older People Page 22 of 30 Evidence: ensure that the home operates a robust recruitment procedure, which protects people. These contained all the required documentation including satisfactory police checks to ensure that people living at the home are protected from unsuitable staff. Staff surveys showed that they were well supported when they first started working at the home. We were told that the induction provided covered everything they needed to know. Staff spoken with during our visit said they felt well supported and that good training opportunities were available to them. Records at the home show that new staff receive a structured induction. However, the training record showed that many of the existing staff have training that it overdue, the manager said he was aware of this and planned to address the issue. We were told that over half of care staff had achieved a nationally recognized care qualification (NVQ 2 or above) to ensure that staff are competent to meet peoples general care needs. A number of staff have attended a one-day course relating to dementia care, and some staff have attended a training session about the Liverpool Care Pathway ( this was happening on the day of the inspection). The manager is trying to organize other training sessions like this to support staff in their role. Staff told us that they were not expected to care for people outside of their area of expertise. Care Homes for Older People Page 23 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is generally well managed by the Registered Manager. There are good arrangements in place to involve people in the running of the home. Good systems ensure that peoples personal monies are correctly managed. Health and safety is generally well managed but some staff need up-dated training to ensure that good practice is maintained. Evidence: The home has a full time registered manager and a head of care both these senior staff members are qualified nurses. A deputy matron is also employed to support the management team. An administrator has responsibility for supporting the home with paper work requirements to include for example drawing up the contracts of care for the people in the home. Two directors of the Company undertake the responsible individual role and visit the Care Homes for Older People Page 24 of 30 Evidence: home very regularly. One of the directors was at the home on both days of the inspection. A quality audit of the whole of the home was undertaken last year, and most recently an audit of the care plans. It is planned that questionnaires will be sent out in the near future to people living at the home to seek their thoughts about the food provided. Regular meetings are held for people living at the home to discuss any changes or seek suggestions about how the home may improve. Procedures for managing any finances of the people in the home are in place. People are encouraged and able to manage their finances should they so wish with a safe storage facility provision provided. Where this is not possible the home is able to offer support and hold money in safe keeping if required. A random audit confirmed that finances were being held correctly with an incoming and outgoing balance. Currently staff are not receiving regular supervision which should covers all aspects of practice, career development and the philosophy of care in the home. The manager told us that this was planned to begin in the near future. Moving & Handling training is provided by the home. However, some staff training in this area has lapsed and two incidents of poor manual handling practice were identified at the inspection. This must be addressed so that people living at the home are appropriately cared for by competently trained staff. Fire safety is generally well managed, for example fire equipment such as fire extinguishers and fire alarm are serviced and tested regularly. Records showed that maintenance of equipment and systems, such as gas and electrical systems, and equipment such as the passenger lift, and hoists were up-todate. Care Homes for Older People Page 25 of 30 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 27 18(1a) The nursing staff must receive training to allow them to give appropriate care to the people in the home. This includes continence care, pressure area care and safe feeding and swallowing and an induction for new staff. 31/03/2008 Care Homes for Older People Page 26 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 1 26 13 Suitable arrangements must be put into place to prevent infection and the spread of infection at the care home, (This relates to sluicing procedures). This will ensure that people living at the home are kept free from harm. 30/04/2009 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 7 12 You must ensure that service users receive treatment that makes proper provision for their health and welfare needs. You must ensure service users health and welfare needs are reviewed, monitored and followed up. You must ensure staff are provided with clear instructions on how to meet service users health and welfare needs. This relates to clear instruction of the care needs of someone with diabetes and for someone who is nursed in bed. 24/03/2009 Care Homes for Older People Page 27 of 30 This is so that people living at the home can be sure that all their care needs will be met safely at all times. 2 7 15 The care plan must be up to date and reviewed when required. This will enable staff to be clear about any new care needs and how to meet them 3 9 13 You must ensure people are 27/02/2009 given their medication within the correct timescale. Medication no longer used must be returned and recorded appropriately ( this relates to creams and controlled drugs) This will ensure that people are given their medication safely. 4 12 12 Each person living here must 31/03/2009 have their social needs and interests identified and you must make arrangements to enable these needs to be met. This is particularly important for those people with dementia. This will enable everyone living at the home to have a fulfilling life. 5 27 18 Staff must receive training 30/05/2009 appropriate to the work they are top perform. (This related to updating on Moving & Handling, First Aid and POVA. 24/03/2009 Care Homes for Older People Page 28 of 30 This will ensure people living at the home are looked after by staff trained to do so properly. 6 38 13 In order that the needs of 24/03/2009 the people who live here can be met, staff must be suitably trained and be competent. Carers must receive training that is appropriate to the work they do, (Moving & handling training. This will ensure that people are moved and handled in a safe and appropriate way. 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 18 In order to ensure that people living at the home are protected from abuse or harm, it is recommended that all staff are provided with up to date training in adult Protection. An alternative bath arrangements should be considered for the use of people needing a hoist. All staff should receive formal supervision at least six times a year. 2 3 21 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!