Inspection on 30/10/08 for WCC - The Lawns

This inspection was carried out on 30th October 2008.

CSCI found this care home to be providing an Good 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

WCC - The Lawns 18/07/07

WCC - The Lawns 19/09/06

WCC - The Lawns 06/02/06

WCC - The Lawns 15/08/05

WCC - The Lawns 10/03/05

WCC - The Lawns 08/12/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 27/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: WCC - The Lawns 1 Gleave Road Whitnash Leamington Spa Warwickshire CV31 2JS     The quality rating for this care home is:   two star good 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: Lesley Beadsworth     Date: 3 0 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. 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: WCC - The Lawns 1 Gleave Road Whitnash Leamington Spa Warwickshire CV31 2JS 01926425072 01926831577 jillturley@warwickshire.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Warwickshire County Council, Social Services Department care home 35 Number of places (if applicable): Under 65 Over 65 35 old age, not falling within any other category Additional conditions: 0 The maximum number of service users to be accommodated is 35. The registered person may provide personal care (PC) and accommodation for service users of both sexes whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - code OP. Date of last inspection Brief description of the care home The Lawns is a purpose built care home providing personal care and accommodation for 35 older people. This includes a 5 bedded respite / short stay unit which is situated on the ground floor. Warwickshire County Council Social Service Department owns and manages the home. The home is in Whitnash on a housing estate, near to Leamington Spa. A local bus service, which circulates between Whitnash and Leamington Spa, stops nearby. All bedrooms are single, 26 of which have en-suite facilities. A passenger lift enables access to all levels. At the time of the inspection the fees charged were Social Services weekly rates and depended on the type of stay and the persons Care Homes for Older People Page 4 of 30 Brief description of the care home financial situation. The fees did not include newspapers, toiletries, chiropody or hairdressing. 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: two star good 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 inspection included a visit to the Lawns. As part of the inspection process the registered manager completed and returned an Annual Quality Assurance Assessment (AQAA) which is a self assessment and dataset that is filled in once a year by all providers. It informs us about how providers are meeting outcomes for people using their service. We sent ten surveys to the people living at the home in order to acquire their opinions of the home. Six of these were completed and returned to us. Some of the information contained within these and the AQAA has been used in assessing actions taken by the home to meet care standards and are included in this report. Three residents were case tracked. This involves establishing an individuals experience of living in the care home by meeting or observing them, talking to their families Care Homes for Older People Page 6 of 30 (where possible) about their experiences, looking at residents care files and focusing on outcomes. Additional care records were viewed where issues relating to a residents care needed to be confirmed. Other records examined during this inspection included, care files, staff recruitment, training, social activities, staff duty rotas, health and safety and medication records. The inspection process also consisted of a review of policies and procedures, discussion with the manager, staff, a visitor and with residents. The visit took place between 11.20am and 9pm. Following the receipt of the draft report the responsible individual for the service told us that they were disappointed that we had not had access to an improvement plan during our visit. This had been devised by senior staff of Warwickshire Social Services with the manager and the lack of access was being addressed by them. What the care home does well: What has improved since the last inspection? A letter is now sent to all people with short stays planned at the home to welcome them to the home. A document known as the Support Plan had been implemented that told staff of how residents wished to spend their time and how they wished their care to be provided. This briefer document was kept in the residents rooms. Care Homes for Older People Page 8 of 30 Effort had been put into the care plans in order to meet the individual needs of each resident in a person centred way. Risk assessments to identify the people at risk of developing pressure sores A break in the skin due to pressure, which reduces the blood supply to the area had been put in place in order to reduce the risk of their occurrence. An activity organiser had been appointed since the last inspection visit and a programme was in place that offered residents suitable and sufficient activity and occupation. Several improvements had been made to add to the comfort of the environment since the last inspection including, the decorating of the reception and the corridors, the replacement of floor covering in corridors, some bedrooms, the ground floor dining room, and some toilets. A seating area had been made in the large reception area by providing new and comfortable furniture. A storage space had been made under the main staircase in order to safely store wheelchairs and other equipment. Menus had been revised with input from residents. Safeguarding training had been undertaken by, or planned for, all staff to ensure that they knew how to identify abuse and how to protect residents from abuse. Training related to specialist needs, including Parkinsons Disease, strokes, mental health, death, dying and bereavement and loss had been undertaken by staff at the home to assist them in meeting these needs. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information required to make a decision about choice of home is available when needed. Pre-admission assessments are carried out to assess if the needs of prospective residents can be met. Effort is made to meet the equality and diversity needs of people living at the home. Evidence: The home had a Statement of Purpose and a Service User Guide that contained sufficient information for a person to make a decision about whether they wanted to live at the home or not. All residents were given a copy of these documents and a copy was available in the reception area. A copy of the inspection report and residents views were included in the Service User Guide. Of the six surveys returned to us five residents said that they had been given enough information about the home before moving in. Comments were added by some of Care Homes for Older People Page 11 of 30 Evidence: them that showed that they had spent short stays and/or day care at the home before moving in. All residents had been referred to the home by Social Services. A visit to their current location then took place by senior staff from the home before a decision was made for admission and a letter confirming the outcome of the assessment was sent to the person afterwards. The AQAA informed us that letters are now also sent to short stay service users prior to each stay to confirm their bookings and welcome them to their visit. Three sets of care files were looked at as part of the case tracking process. Each contained a pre-admission assessment that had taken place at the visit made by senior staff. These had been carried out using a format that had included all the necessary headings and sufficient detail to decide if the home could meet the persons needs or not. Care plans were devised from the assessments and generally reflected the information in the assessments. There were two conflicting pieces of information where a social workers assessment said that a person required assistance to get undressed for bed but the care plan said that the person was independent in this. The previous inspection report and the homes training records showed that staff had undertaken training related to equality and diversity in order to give staff knowledge to assist in meeting the race, gender, disability sexual orientation, religion and age needs of the people living at the home. The AQAA advised us that the pre admission assessment takes into account religious and cultural needs and preferences of individuals. A volunteer from the Association for the Blind visits residents with visual impairment and provides listening tapes when wanted by them. The manager also takes into account gender needs when recruiting staff. The staff at the home and the AQAA informed us that the local church hold a service once a month and other local ministers visit other individiuals as their needs determine. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans are available to instruct staff of the care required. Residents have access to health care professionals and are cared for in a respectful manner. Medication systems safeguard the residents well being. Evidence: Three care files were looked at as part of the case tracking process. The care plans had been reorganised and divided in a way that made it easier to find the information being looked for. Each set of the care plans looked at set out the care required in sufficient up to date detail to ensure that all aspects of the health and personal health needs of residents are met. However there were two conflicting pieces of information where a social workers assessment said that a person admitted for short stay required assistance to get undressed for bed and that they had not been eating and drinking properly but the care plan said that the person was independent in getting ready for bed and that they ate and drank everything. It was not clear if this conflict was due to improved health since entering the home or not. Care Homes for Older People Page 13 of 30 Evidence: A document known as the Support Plan had been implemented that told staff of how residents wished to spend their time and how they wished their care to be provided. This briefer document was kept in the residents rooms, with their permission and were available for all staff to refer to, including agency staff. In a mental health care plan there were clear instructions to staff to enable them to know what to look for in the persons behaviour and how to manage this, thereby safeguarding the mental health of those residents. Care plans were written in the first person in order to make the plans person centred, for instance I have a hearing aid but rarely wear it, but this can be misleading in cases when it is apparent that the person does not have the mental capacity and, or communication skills to have said this. Training records and the AQAA told us that staff had been assisted by a trainer in looking at person centred care and that this was having a positive impact on the way care was being provided. Care plans had been reviewed monthly and formal reviews had taken place at six monthly intervals with the resident, the relative or their representative and the staff at the home. Annual reviews took place initiated by allocated social worker. There was evidence in the care files of residents having chosen to keep their own GP. Residents on going health care needs were being met with evidence of visits to or visits by the GP, District Nurse, optician, chiropodist and Community Psychiatric Nurse being identified in the care files looked at. Residents spoken with confirmed that they could see the doctor if they wished and that they had visits from the chiropodist, optician, district nurses or other health professionals when necessary. All surveys answered always to the question, Do you receive the medical support you need? and one resident said in a survey, I always receive first class medical support and have the doctor when I need him. When asked in the surveys if they received the care and support they needed all residents said that they always or usually did and comments included, Help is available whenever I need it, if not I will ask for assistance. I am quite independent but get assistance when needed. Sometimes have to wait but that is understandable. Care Homes for Older People Page 14 of 30 Evidence: Records for falls, pressure areas, weight, bathing and nail checks were in place within the files looked at. Completed risk assessments for nutritional risk screening, pressure sores (a break in the skin due to pressure, which reduces the blood supply to the area) and a manual handling risk assessment were also in place. These would help to minimise any risk. Preventative measures such as pressure relieving mattresses and cushions were in use for residents who had been identified to be at risk of developing pressure sores. The medication system was assessed. A medication policy and procedure were in place although the Local Authority was in the process of revising this. A multi dose system (bubble packs containing pre-dispensed tablets) was provided by the pharmacist and observations and discussion with the manager showed that there was a safe administration system in practice, which safeguarded the health and well being of the people living at the home. Storage of general medication and controlled drugs was satisfactory and storage temperatures were in line with the manufacturers recommendations. All ointments, creams and drops seen had been dated on opening to ensure that they were discarded at the appropriate time. This would prevent the use of unstable substances. Only senior staff who had undertaken accredited training were responsible for medication in order to further safeguard residents. Medication Administration Sheets (MARS) were examined. These were auditedtwice a day by the staff responsible for medication for inappropriate gaps and against tablets remaining. No gaps were seen at the time of the inspection. A random audit was carried out of tablets supplied in original packets. The majority of these were correct but antibiotics prescribed for one person were checked and found to have one more tablet remaining than was calculated with the MARS. This indicated that one had been signed for but had not been given. The audits carried out by the home did not include those that monitored staff competence and therefore errors found could not easily be attributed to the person who had made the error. Records showed that the staff were recording the receipt and disposal of medication. A system was in place for the recording and checking the accuracy of medication brought in by people staying at the home on a short term basis for either respite, assessment or phased care. Terms of preferred address are on the residents care plan and heard to be used by staff. Residents were cared for in a respectful manner and this ensures that their Care Homes for Older People Page 15 of 30 Evidence: dignity and self esteem are maintained. Discussion with residents confirmed this with a resident commenting that they were always happy with the response of the staff. Further to this the AQAA informed us that Induction training emphasises the principles of dignity, choice,respect and privacy. Care Homes for Older People Page 16 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. Residents were occupied and stimulated. Visitors were made welcome and their needs considered. Residents had choices and control over their daily lives. Residents enjoyed the nutritious and varied meals provided. Evidence: Since the previous inspection a designated activity organiser had been appointed to work 14 hours a week. A programme was in place that was facilitated by the staff on the respite and day care units along with the activity organiser. The activities were organised to take place for two hours in the morning and one and a half hours in the afternoon in various areas of the home. A small, bright room off the reception was used for storing a large and varied selection of activity equipment, and which was also furnished with tables and chairs to use for such things as board games, crafts and jigsaws. Residents and staff confirmed that all people living and staying at the home were invited to join in and that one to one occupation took place on a regular basis. Short holidays are also organised twice a year for a few residents who wish to go and who are able to do so. All responses to the survey asking if there were activities arranged by the home that they could take part in were always or usually. Care Homes for Older People Page 17 of 30 Evidence: Comments in the surveys included, But I only choose ones that I want to take part in. I like the flower arranging. I am going with the home on holiday to Prestatyn, Wales. People spoken with said that they were sufficiently occupied during the day. Visiting is between 8am and 10pm and a visitor spoken with said that they were always made welcome. They said that they were more than happy their relatives first respite care stay at the home. Observations made and discussion with staff and residents showed that people living and staying at the home have the opportunity to make choices in their daily lives, such as when to get up and go to bed, what to eat, whether to join in activities or not and where to spend their time. It was also noted that the bedrooms viewed had been personalised by possessions belonging to the occupants, such as pictures, photos and ornaments. A dining room was situated on each of the three floors. the large dining room on the ground floor catered for day care and short stay residents and a small dining room on the first and second floors catered for the people living on those units. Residents spoken with said that they enjoyed all the meals at The Lawns. All those who completed the surveys also said that they always or usually liked the meals at the home and some additional comments included, Variety of meals supplied Considering my diet is different from most of the residents. Preferences and dislikes respected and choices given. Menus were made available and showed that the meals were nourishing, varied and that choices were provided. these had been recently revised with input from residents. A meal time was observed and staff were seen to interact with residents and to offer assistance as necessary in a sensitive and discreet manner. The kitchen was visited and was clean, well organised and well managed. A record of fridge, freezer and high risk cooked food temperatures were held and had been regularly maintained. Care Homes for Older People Page 18 of 30 Care Homes for Older People Page 19 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. The home has appropriate policies and procedures to safeguard residents. Evidence: The home used the Social Services Complaints and Representations Policy which included specific timescales and included several stages of complaint from those with on the spot solutions to those requiring investigation by Social Services Customer Relations Team. The leaflets relating to this policy and the complaints procedure were available in the reception area of the home in order that residents and visitors knew how to complain. A complaints log was kept by the home in which complaints, concerns and compliments were recorded. The investigation of any complaint and the outcome was also recorded. Records showed that complaints were investigated and addressed satisfactorily, giving people the confidence that their concerns would be listened to and acted upon. A suggestion box was available in the reception area where any resident or visitor could add any suggestions or make known any concerns in an anonymous way if they wished. These practices gives residents and visitors the confidence that they will be listened to and that appropriate action will be taken. In the surveys all those who responded said that they always knew who to speak to if they were not happy and this was confirmed Care Homes for Older People Page 20 of 30 Evidence: with residents who were spoken with. The following comments were made in the surveys, Any problem is readily dealt with and resolved. I would always ask a member of staff who would forward it on to a care officer or the manager. I would speak to staff. The majority also said that they who know how to make a complaint. Some staff were undertaking safeguarding training at the time of the inspection and three further sessions were planned during that week, giving staff the knowledge and skills they require to be able to identify adult abuse and to know what action to take if they suspect or witness abuse. The home has the Local Authority Safeguarding policy and procedure. There had been one safeguarding referral since the last inspection which was investigated and found to be unfounded. All recruitment practices safeguard residents from the employment of unsuitable people. All financial practices safeguard residents financial interests. Care Homes for Older People Page 21 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. The home offers the people living there comfortable surroundings, which are clean, free of offensive odour and safe and well maintained. Evidence: The accommodation is provided over three floors, with the ground floor being used for people staying at the home on a short term basis and for day care and the other floors for permanent residents. The day care is not required to be registered with us and was therefore not a part of this inspection. There is a large dining room adjacent to the kitchen for the short stay and day care service users with a small sitting area and a small lounge on this floor for the short stay service users. These have had new floor covering with the lounge having been redecorated and offer improved comfort for the people using these communal spaces. There is also a new seating area in the reception area and an activity room adjacent to this. The other two floors have a small dining room and a lounge for the people living on those units. The home therefore offers a variety of communal space for the people living at the home. There had been several further improvements in the physical environment since the last inspection, which included, new carpet on the corridors, redecorating of the hall, stairs and three bedrooms and new non slip floor covering in one of the lounges and in the toilets. All areas viewed were clean, free of any offensive odour and were furnished Care Homes for Older People Page 22 of 30 Evidence: and decorated to a good standard. A storage space had been made under the main staircase in order to safely store wheelchairs and other equipment. Three bedrooms were viewed and were personalised with the personal possessions of the occupants, including small pieces of furniture, photos, pictures and ornaments. Shelving had been added to some of the en suite facilities to store toiletries. All the rooms viewed were clean, free of offensive odour and offered comfortable living space. The passenger lift had been out of action for two days. As residents private accommodation was on the same floor as the one they spent the day the impact on them was less than it might have been. However people on the upper floors who were unable to use the stairs could not move about the building or to go out during that time. The lift was satisfactorily repaired during the visit. The home had sent us the appropriate required notification about the incident. All residents replied in the survey that the home was always fresh and clean and made positive comments to this effect. Observations made at the time of the visit confirmed this. Laundry facilities were inspected and found to be well organised, clean and hygienic. All communal hand washing areas were provided with disposable towels and soap dispensers in order to maintain infection control. Protective clothing, that is disposable gloves and aprons, were available for use by staff. Care Homes for Older People Page 23 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. There are sufficient staff available to meet the needs of the residents. Robust recruitment practice protects residents from the employment of unsuitable people. The importance of training is recognised. Evidence: The manager advised that the usual staff on duty were six care staff in the mornings, four in the afternoon, six in the evenings and two during the night. They are supported by adequate catering, laundry and general domestic staff. These numbers were confirmed by rotas that were available for inspection. The AQAA told us that the home had had a large amount of staff absence since the last inspection. However by the time of this visit the situation had greatly improved. The manager and the AQAA told us that agency staff were used when necessary to cover absences that could not be covered by permanent staff but that to maintain continuity of care they tried to use the same agency staff wherever possible. All new staff undertake appropriate induction, which was confirmed by staff records looked at. This gives them the knowledge and skills that they need to do their job. Ten of the care staff had achieved National Vocational Qualification Level 2 in Care, Care Homes for Older People Page 24 of 30 Evidence: which means that these people have been assessed to be competent in their role. The home has not yet achieved the required 50 of care staff with this qualification. Mandatory training undertaken by staff at the home included that related to fire safety, moving and handling, infection control, food hygiene, Control of Substances Hazardous to Health and adult abuse. Other training included that which was relevant to their role, such as Parkinsons Disease, Mental Health Awareness in Older People, Death, Dying and Bereavement, Dementia Care and Stroke Awareness that helped them understand and meet the needs of service users and kept them up to date with new ways of working. Three staff files were looked at and all of them contained the required information including Criminal Record Bureau disclosures, Protection of Vulnerable Adult checks and two written and validated references. Employment histories had also been verified. These robust recruitment practices safeguarded residents from the employment of unsuitable people. The manager said that residents had also been involved in the recruitment of staff and their opinions had been taken into account in the selection process. Care Homes for Older People Page 25 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A person with the appropriate qualification and who has previous management experience manages the home. The monitoring and auditing of the service and practices takes place to ensure that all services operate in the best interests of residents. Health and safety practices provide a safe environment for people living and working at the home. Evidence: The AQAA had been comprehensively completed by the registered manager giving us the information we had asked for in a detailed and informative manner. The manager had been at the home for just over ten months having previously being the manager of a similar home belonging to the authority for eleven years and had worked in Adult Social Care with Warwickshire Social Services for over 20 years. She had achieved the Registered Managers Award, a degree in Social Work and NVQ Level 4. These qualifications and experience made her more than suitably qualified for the Care Homes for Older People Page 26 of 30 Evidence: post of registered manager at the home. The manager is supported by an assistant manager, four care officers and a part time administrative assistant, although there had been a great many absences amongst the senior staff in the past year. The home used the extensive Local Authority Quality Assurance system, which monitored and audited the services provided at the home and from which action for improvement was planned. A representative of the Local Authority carried out monthly unannounced visits to the home and provided a report on the findings. Surveys had last been distributed to residents at the end of 2007 and residents meetings, which included feedback on the service, were held monthly. These systems indicate that the home is monitoring the service in order to enable growth and improvement. Residents financial records were looked at. There were appropriate records of transactions, and cash that balanced against these records, for any money held on behalf of residents. Receipts were available for all transactions made. Balances were reconciled weekly by the administrative assistant and any cash banked as necessary, keeping cash held by the home to the minimum. A bank account held on behalf of residents paid appropriate interest to individuals. These practices indicated that the financial interests of residents were safeguarded. Staff records seen and discussion with the manager showed that staff supervision was carried out at regular intervals and was on target for six sessions a year. Staff supervision is necessary as it enables the management to meet with staff on a one to one basis to discuss practice, personal development and philosophy of the home issues. It is also an opportunity for staff to contribute to the way that the service is delivered. Training records showed that staff had undertaken mandatory training related to health and safety issues. There was also evidence from a random check of records, that equipment was regularly serviced and maintained, health and safety checks were carried out and that in house checks on the fire system were up to date. There were no concerns regarding health and safety noted during the visit. Evidence indicated that the home was a safe place to live and work. Care Homes for Older People Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 28 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 3 9 Assessments should be reviewed and revised as circumstances change. Audits of medication that monitors individual staff competence and efficiency should be undertaken. 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. 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