Inspection on 20/02/09 for Westfield Lodge Nursing Home

This inspection was carried out on 20th February 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Westfield Lodge Nursing Home 29/02/08

Westfield Lodge Nursing Home 08/08/06

Westfield Lodge Nursing Home 28/12/05

Westfield Lodge Nursing Home 01/09/05

Westfield Lodge Nursing Home 26/01/05

Westfield Lodge Nursing Home 04/08/04

Westfield Lodge Nursing Home 17/03/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Westfield Lodge Nursing Home Weston Coyney Road Weston Coyney Stoke-on-Trent Staffordshire ST3 6ES     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: Yvonne Allen     Date: 2 0 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 32 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 32 Information about the care home Name of care home: Address: Westfield Lodge Nursing Home Weston Coyney Road Weston Coyney Stoke-on-Trent Staffordshire ST3 6ES 01782336777 01782598368 westfield.lodge@ashbourne.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Exceler Healthcare Services Limited Name of registered manager (if applicable) Mrs Christine Carol Meakin Ms Joanne Eardley Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users to be accommodated is 54 The registered person may provide personal care (with nursing) and accommodation for service users of both sexes whose primary care needs on admission to the home are within the following categories: Older People (OP) 54 Physical Disability (PD) 54 Physical Disability over 65 (PD)(E) 54 Date of last inspection Brief description of the care home Westfield Lodge is a purpose built nursing home admitting people over 65 of age who require personal and nursing care. The home was built about 17 years ago. Accommodation is to two floors, bedrooms are single occupancy and some have an enCare Homes for Older People Page 4 of 32 care home 54 Over 65 54 54 0 54 Brief description of the care home suite facility consisting of toilet and wash hand basin. There are three lounges, one to the first floor and two on the ground floor. There is a separate dining room. The two floors are accessed via a passenger lift. There is a central kitchen and laundry. There are adapted bathrooms and toilets sited on both floors. There is limited garden area but a conservatory opens out on to a patio area which is accessible to people who use wheelchairs. There is parking space for several cars. The home is situated two miles from Longton town centre and a short walk allows access to bus routes. The fees charged by this home range from 363.00 to 561.00 pounds per week. This includes the range for people whose care is funded and people who fund themselves. Additional charges are made for hairdressing, activities and private chiropody. Care Homes for Older People Page 5 of 32 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 quality rating for this service is 2 STARS. This means that the people who use this service experience GOOD quality outcomes. Prior to the inspection visit the Provider had completed a self-assessment tool, which is known as the Annual Quality Assurance Assessment (AQAA). Completion of the AQAA is a legal requirement and it enables the service to undertake a self-assessment, which focuses on how well outcomes are met for people using the service. This was completed to a good standard and gave detailed information about the services offered. All of the Key minimum standards were assessed and for each outcome we have made a judgment based on the evidence we have found. These judgments tell us what life is like in this home for the people who live there. Care Homes for Older People Page 6 of 32 The ways in which we collected our evidence are as follows, We sent out twenty surveys prior to the inspection visit for people who live in the home to complete. We also sent the same number of surveys out to relatives and some to staff members. Most of these were returned to us with some surveys containing comments. We have included these comments in this report. During the inspection visit we spoke to people who live in the home about what life is like here. We also spoke to some visitors who were present during the inspection visit. We spoke to some of the staff members who work in the home. We held discussions with the Registered Manager and the Deputy Manager of the home. We spoke with a visiting health care professional. We walked around the home and looked in some of the bedrooms and all of the communal areas. We looked at records and documentation relating to personal and nursing care. We looked at records relating to management of the home and health and safety. What the care home does well: What has improved since the last inspection? The presentation of the environment has changed somewhat since the last inspection. There has been on going redecoration which has helped improve the appearance of the home but also the manager has changed the way in which communal areas are used. The conservatory is now available to be used by all and there is a separate smoking room for people to use. People who are accommodated on the second floor are now using their own dining room and lounge area. The front entrance area has been made more welcoming and the nurses office, administrators office and managers office have all changed around. This makes for a more effective operation of the home. The Care Homes for Older People Page 8 of 32 manager has plans for ongoing improvement of the home both internally and externally. The moral of the staff team has improved since the last inspection. Staff appear more settled and are well managed. People who live in the home are complimentary about the staff, I am very pleased with all the staff. I find everybody alright. We spoke to the Community Matron who visits the home regularly giving advice and support to the staff. She confirmed that the staff listen and act on her advice. 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 32 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 32 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 undergo an assessment of their needs prior to being offered a place at this home. People moving into the home can be assured that their needs will be met. Evidence: In their AQAA the Providers tell us that plenty of information is given to people prior to admission. They have an open doorpolicy where people can visit at any time. The home is made inviting and people are encouraged to visit prior to admission. Key staff are introduced to the people at an early stage. The manager will visit the person prior to admission and carry out a full assessment of their needs. People are admitted on a four week trial basis and written contracts are in place. Prior to the inspection visit we received four surveys back from relatives, carers and Care Homes for Older People Page 11 of 32 Evidence: advocates. Out of these all four indicated that they had received enough information about the home to help them make a decision. All four also put that the home meets the needs of their relatives. One person said The home meets all of my mums needs and she is well cared for. We received surveys back from people who use the service and they indicated that they had received a contract and enough information about the home prior to moving in. We spoke with the Registered Manager and Deputy Manager about the assessment process. They explained that people undergo an assessment of their needs prior to being offered a place at the home. They said that they go out to visit people in hospital or in their home in order to carry out this assessment of needs. The manager told us, I only accept people into this home when I am confident we can meet their needs. We looked at records of pre-admission assessments which had been carried out by the manager and found these to be comprehensive and informative. We also saw that some care plans contained pre admission assessments which had been carried out by Social Services and other funders of care. Care Homes for Older People Page 12 of 32 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 is planned, person centered, and delivered with dignity and respect. Peoples health care needs are monitored and met with the involvement of other health care professionals where required. Evidence: In their AQAA the Providers tell us that a comprehensive care plan is drawn up and that this is reviewed regularly with the person and their representative. Privacy and dignity is respected at all times. GP visits are actively sought when required. The manager is a nurse and available for on call. Medication is stored and administered as required. We received surveys back from people who live at the home and from relatives, carers and advocates. All of these surveys indicated that people are happy with the care and services provided to them at the home. The following comments were received, Care Homes for Older People Page 13 of 32 Evidence: They look after my mother very well and see to all her needs. I am very pleased with the care provided to me. I see the doctor whenever I need to. We looked at a number of individual care plans including that of a person who had been resident in the home. This person had developed a pressure sore which had gone undetected by the staff, until it had developed into an advanced ulcer. This had then been referred under the Protection Of Vulnerable Adults (POVA) procedure, where a strategy meeting had been held following which the manager had taken action to ensure that this could not happen again. We looked at the action taken by the manager and are satisfied that appropriate care and precautions are in place to help keep people safe from developing pressure ulcers. There is a recommendation to improve the personal care sheet which is contained in care plans and which the care staff complete daily. This did not direct staff to check between skin folds, and as such, could not guarantee that staff would automatically do this. Following discussions with the manager and deputy manager they told us that these sheets will be amended to ensure that staff carry out the relevant checks on a daily basis. Also the deputy manager told us that she carries out weekly checks on all of the people accommodated in the home to ensure that any developing pressure damage is detected early and the relevant care plan put into place. We also identified, by looking at care plans and tracking the care of people in the home, that the risk of developing pressure damage is assessed and regularly reviewed. Where the risk is increased, then precautions are taken to minimize this risk. We saw the use of special airflow mattresses and cushions and we noted on care records that people who are unable to change their position in bed are turned by staff and this is monitored regularly throughout each 24 hour period. We noted that there is good medical and nursing support for this home. There are records of visits by doctors, chiropodists, opticians, community psychiatric nurses (CPN). The home has access to specialist clinics such as the Speech And Language Therapist (SALT) to assess people who have difficulty swallowing. We saw the monitoring of nutrition and involvement of the dietitian. We also saw the involvement of the tissue viability nurse specialist in the assessment, reviews and treatment of pressure ulcers. We noted that people are assisted to attend clinic appointments as necessary. The home also benefits from the on going support of the Community Nursing and Health Support Team. We met with one of these nurses during the inspection visit. She told us that she and her colleagues visit the home regularly to offer advice and train staff. This helps to ensure that care practice is current and up to date. Care Homes for Older People Page 14 of 32 Evidence: We noted that one person had had a positive infection result contained in a nasal swab a few weeks ago on admission but that this had not be followed up with a re swab. Neither had the necessary precautions been taken in respect of infection control in this case. The home does have a policy and guidelines for staff in place for this infection but this was not being followed at the time of the visit. Also there is currently no provision for staff to wash their hands in peoples bedrooms. This was discussed with the manager and deputy manager and action was taken by them to ensure that the infection control guidelines were put into practice. Staff hand wash facilities must be provided discreetly in bedrooms. We looked at the process of receipt, storage, administration and disposal of medication at the home. We observed the nurse administering the lunchtime medication as part of the tracking of care. We also looked at the safe storage and handling of controlled drugs at the home. People are able to administer their own medication if they wish to and are able to do so following a suitable risk assessment. This process was found to be safe and in keeping with the requirements of the medications act and the Nursing and Midwifery Council. We observed a good atmosphere at the home with staff and people who live there chatting to each other and interacting well. Staff were seen to be polite and respectful to wards people who they were caring for and respect for individual privacy and dignity are promoted at this home. Care Homes for Older People Page 15 of 32 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. The lifestyle in the home is made flexible and varied. Social and therapeutic needs are assessed and met. There is a friendly atmosphere where people are encouraged to socialize but can choose to enjoy their personal space if they wish to. Evidence: In their AQAA the Providers tell us that they have a full range of activities programme. They employ an activities coordinator who works 30 hours per week. The coordinator also sources outside entertainers and a full programme is displayed in the home. There are good links with the community. They try to ensure that daily routines are made flexible and varied. They have an extensive menu which has been nutritionally analyzed. Personal choices and preferences are upheld wherever possible. We were told by staff and people who live in the home that recent trips out have included going out for meals at Taybarns and Buffet Island. There was a trip to Blackpool, one person told us We had a great trip to Blackpool on 10/11/08. Some people also went to an old time music hall performance. Afternoon tea was enjoyed at one of the other homes. The home is able to have access to use of the minibus from one of the other homes within the group. Valentiness day was celebrated by a special Care Homes for Older People Page 16 of 32 Evidence: breakfast of bucks fizz and croissants, with afternoon tea of cream scones and crumpets then chocolates in the evening. Peoples birthdays are celebrated with a party and cake and family members are welcome to come and join in. Since the last Key Inspection the Providers have employed another activities coordinator who works five and half hours per day then sometimes at weekends. Outside entertainers are booked to come into the home on average once a month. There is a programme of activities in place and activities are regularly recorded for each person. The manager is keen to develop activities and entertainment at the home. The hairdresser visits weekly. This is a social event where people can talk to each other. Monthly Church services are held in the home. Also members of the clergy visit people. Spiritual needs are documented in care plans. A new smoking room has been provided. This means that the Conservatory can be used by everyone. This has been thoroughly cleaned and is now enjoyed by all. One person told us that this is how they thought the home could improve to have the conservatory. This has now been addressed. Another person told us that the this is what the home does well, tries to help all the people feel at home as well as looking after their welfare. The environment has been changed around to encourage people to socialize and make use of all the communal areas on both floors. Surveys told us, I can always phone my family. I have never been stopped doing anything. They make you want to eat if you are not happy with the menu. E is settled in Westfield Lodge because she is now allowed to stay in her own room where she is familiar with her surroundings as she cannot hear and see much. We observed visitors coming in and out of the home throughout the visit. There is an open visiting policy. Families are encouraged to participate in trips out and entertainment. We observed the lunchtime meal beings served. This looked appetizing and offered a Care Homes for Older People Page 17 of 32 Evidence: choice to the main menu. Some people were observed having the alternative. Menus are four weekly rotational and offer variety and choice. They are regularly reviewed and changed. Some people were eating in their chairs in the lounge area outside the dining room as this is their preference. People were also dining in the dining room on the second floor. This has helped to improve the overall dining experience in the home. We spoke with a set of visitors during the inspection visit. They told us that the home is generally ok here but its the little things like they dont always leave the call bell within reach of my mum and she cant reach it for herself. Care Homes for Older People Page 18 of 32 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 who live in this home can be assured that any concerns they might have will be dealt with effectively. The systems in place at the home help to ensure that people are kept safe from harm or abuse. Evidence: In their AQAA the Providers tell us that the home has a clear and detailed complaints procedure and that people are given a copy of this. All complaints are investigated and recorded by the home. All staff are required to attend POVA training and are made aware of the Whistleblowing policy. There are safeguarding procedures in place to help protect people who live at the home. We have not received any complaints about this home since the last Key Inspection. We noted the complaints procedure prominently displayed in the entrance to the home. People we spoke with during the visit told us that they knew how to raised concerns and who to talk to. Some visitors told us Oh yes I know who to speak to. I am very vocal and will raise concerns if I need to. Care Homes for Older People Page 19 of 32 Evidence: We received the following comments from people who completed the surveys we sent out. I would speak to the manager. I would go to Carol. I would tell my family. We looked at the complaints log at the home. Complaints and concerns are dealt with effectively by the manager who has many years experience of handling these. Meetings are held where people who live at the home are encouraged to raise any concerns and talk about them. We saw minutes of these meetings which had been held. There is an open culture in the home and the manager often has one to one meetings with people or family members where concerns can be discussed. We have received one Safeguarding referral since the last inspection and this has been dealt with effectively by the manager. Plans have been put into place following this to help ensure that people are kept safe. The details of this have been discussed previously in this report under the outcome Health and Personal care. Procedures relating to the Protection Of Vulnerable Adults (POVA) are kept in the home. Staff recruitment is robust and staff are very carefully selected to work at the home. Staff receive training in keeping people safe. When we spoke with them they confirmed this and we saw records of this training. The manager is also very experienced in dealing with Vulnerable Adult and Safeguarding issues. Care Homes for Older People Page 20 of 32 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 provides a safe, clean and homely environment which has been adapted to meet the needs of the people who live there. Evidence: In their AQAA the Providers tell us that the home is safe and secure, clean and in accordance with infection control guidelines. The Housekeeper and chef monitor and ensure that environmental health guidelines are adhered to. All Health and Safety requirements are adhered to. They employ a maintenance man to oversee the maintenance of equipment. They have numerous adaptations and adapted bathing facilities. They encourage bedrooms to be personalized with items brought in from home. Redecoration is ongoing at the home. They encourage a positive dining experience plus people can take meals in their own rooms if they wish. All the surveys we received back indicate that people are happy with their environment and consider the home to be clean and well presented. We walked around the home during our inspection visit, and looked at all the communal areas, the laundry, kitchen and a selection of bedrooms. The manager pointed out redecoration which had been carried out since the last inspection. This has Care Homes for Older People Page 21 of 32 Evidence: helped to improve the appearance of the environment which had started to look worn. There is still room for further improvement with redecoration and refurbishment and there are plans in place to address this. It was pleasing to note how the conservatory off the ground floor has been cleaned up and is now available for general use. This was a smoking room but is now free to be enjoyed by all the people who live in the home. A separate room has been provided for people who smoke. The layout of the home is now more user friendly and people who have their bedroom located on the second floor no longer need to come down to the main dining room or lounge if they do not wish to, as they have this provided for them on their own floor. The reception area of the home has been made into a pleasant and welcoming area and the administrator and nurses have moved offices. The managers office is now located off the administrators office. As we walked around the home we noted the various hoists and equipment in use to help with moving and handling of people. We also noted the many aids and adaptations provided to help people maintain as much of their Independence as possible. All the equipment is regularly serviced and maintained. People had adapted their bedrooms to suit themselves and to meet their individual needs. We noted that people had also brought in personal effects and small items of furniture from home to help make their personal space more homely. There are adequate toilets, bathing and showering facilities which have been fitted with aids and adaptations. The kitchen is inspected by Environmental Health and, as such, adheres to their guidelines relating to health and hygiene. At the time of the visit the Cook was busy preparing lunch. The laundry was tidy and maintained in accordance with infection control guidelines. When we looked at staff files and the training matrix we noted that staff had received the required training in infection control and food hygiene. Staff had also received training in Control Of Substances Hazardous to Health (COSHH) and the related guidelines were displayed in each area. When we spoke with staff they confirmed that this training takes place. Care Homes for Older People Page 22 of 32 Care Homes for Older People Page 23 of 32 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live in the home are cared for by a staff team who are safe and competent. Some areas of the staff training programme need to be better delivered in order to ensure that staff are equipped with all the skills necessary to meet peoples needs. Evidence: In their AQAA the Providers say that they have a rigorous recruitment procedure in place and that all staff have an in depth induction training. All staff are given mandatory training updates and there is a high percentage of staff trained to NVQ standards in care. All nurses are checked with the Nursing and Midwifery Council and receive medication update training. All care staff have bi-monthly supervision and all staff receive annual appraisals The manager and deputy meet on a monthly basis to discuss general staffing requirements. There is an on call rota in place and staff meetings take place regularly. During our visit to the home we met with staff members, the manager and the deputy manager. It was identified that staff moral has improved and there is a more dedicated staff team at the home with less staff turnaround. Care Homes for Older People Page 24 of 32 Evidence: It was also identified that the numbers and skill mix of the staff on duty appear to be satisfactory to meet the needs of the people who live in the home. We spoke to some of the people who live in the home and they told us, I am very pleased with all the staff. I find everybody alright. We spoke to the Community Matron who visits the home regularly giving advice and support to the staff. She confirmed that the staff listen and act on her advice. Some visitors told us that the staff are good but that some are more attentive than others. We looked at staff recruitment in the home and found this to be robust. Staff are carefully selected to work at this home and undergo stringent checks prior to being offered employment. We spoke to the nurses on duty and they told us that they both feel well supported by the manager and by the company. The company are good with supporting training needs. They also confirmed that regular staff meetings are held at the home. We were given a copy of the training statistics for the home. This identified that there are areas which are strong and some which are weak. Obvious areas needing improvement are infection control , pressure care, nutrition, medication updates and care planning. The areas of infection control and pressure care have already been identified in this report as requiring improvement. Therefore it is recommended that the Providers concentrate on improvements in these areas. The areas where staff training has been good are POVA training and Safer use of bed rails. National Vocational Qualification (NVQ) training is ongoing at the home with more than fifty per cent of care staff trained to NVQ level 2 and above in care. We observed staff being polite and respectful to people who live in the home and working well together as a staff team. Care Homes for Older People Page 25 of 32 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and is run in the best interests of the people who live there. Evidence: In their AQAA the Providers say that, Health and safety and well being of people are the main priority of the manager. The manager has a vast amount of experience in this area and updates her knowledge wherever possible. The home has a clear and accountable management structure. The Quality Assurance system ensures that the home continually appraises the care service offered and the service is monitored monthly. The systems in place ensure the safeguarding of peoples monies and valuables. We spoke with manager and her deputy. The manager is a very competent individual and has a lot of experience in management and nursing. Care Homes for Older People Page 26 of 32 Evidence: She told me that she has completed NVQ level 4 in management and has finished the Registered Managers Award last year. She also keeps herself updated with training. People we spoke with told us that they like the manager and find her approachable and friendly. The manager has made some definite improvements to the home since she took up this position last year. She has started to improve the layout and environment of the home. She is a good leader of staff and as a consequence to this staff moral has improved. This has a knock on effect making people who live in the home feel more comfortable and happy. The manager is responsible for monitoring Quality Assurance (QA) in the home and the Company run a monthly QA system where all areas are audited. We saw examples of where these had been completed and action plans to make improvements where indicated. The nurses we spoke with told us that regular staff meetings are held and that the views and opinions of staff are listened to. We saw minutes of these meetings. Regular residents and relatives meetings are held and we saw the minutes for these also. People who live in the home told us oh yes I know the manager, she is very nice and I would go to the mangers if I had any concerns. People views are are listened to and surveys are sent out. We looked at the maintenance of personal allowances and how peoples money is kept safe. This is maintained in accordance with care homes regulations and can be clearly audited. The manager is responsible for the Health and Safety of all the people who live and work in the home. There is a Health and Safety Policy statement in place and records are kept by the maintenance person relating to the maintenance and servicing of equipment. Risk assessments have been developed for all areas and are regularly reviewed. Staff receive regular updates in mandatory training thus ensuring the ongoing safety of the people who live at the home and the staff themselves. Care Homes for Older People Page 27 of 32 Evidence: Care Homes for Older People Page 28 of 32 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 32 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 8 13 13 (3) The registered person 21/04/2009 shall make suitable arrangements for people who live at the home to prevent infection and the spread of infection at the care home. The infection control policy must be adhered to in order to help contain the spread of infections at the home. This must include the provision of staff hand washing facilities within bedrooms. 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 7 That the personal care sheet contained in care plans be amended to include a daily check between skin folds to help prevent undetected pressure ulcers from developing. It is recommended that the delivery of the staff training programme is improved in the areas identified above. This is to help ensure that staff are equipped with the skills Page 30 of 32 2 30 Care Homes for Older People required to meet the needs of people living in the home. Care Homes for Older People Page 31 of 32 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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