Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: Whitebriars Care Home 20 Bedford Avenue Bexhill on Sea East Sussex TN40 1NG 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: June Davies
Date: 1 8 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 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: Whitebriars Care Home 20 Bedford Avenue Bexhill on Sea East Sussex TN40 1NG 01424215335 01424215335 info@whitebriars.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Whitebriars Ltd Name of registered manager (if applicable) Sally Ann Devlin Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category (OP) Dementia (DE) 2. The maximum number of service users to be accommodated is: 26 Date of last inspection Brief description of the care home Whitebriars is a care home providing personal care and accommodation for up to 19 older people. The home is located a short walk from Bexhill sea front and town centre with its shops, churches and other community services. There is good access to bus and rail routes. The house is a detached property set in its own grounds. Accommodation is provided on three floors, stair lifts are fitted to assist residents to access first and second floor accommodation, however those with bedrooms on these Care Homes for Older People
Page 4 of 30 care home 26 Over 65 0 26 26 0 Brief description of the care home floors are still required to manage some stairs that are not covered by the stair lifts. The home has a large lounge and dining room area, whilst the outside of the building has a pleasant paved garden and fishpond. Fees are £361.00 to £450.00 per week. Residents will be expected to pay for their Hairdressing, Chiropody services, Newspapers and Magazines, Private Telephone and toiletries. 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: This key unannounced inspection took place on Thursday 19th February 2009 over a period of seven hours. The inspector spoke with the Registered Provider, Registered Manager, six residents and two members of staff. The inspector joined residents in the dining room for lunch, carried out a tour of the home, and observed a medication round. An audit of medication was also carried out. Documents relating to the key standards inspected were looked at. Some information gained from the Annual Quality Assurance Assessment was also used in formulating this report. Care Homes for Older People Page 6 of 30 What the care home does well: Pre-admission assessments for prospective residents are carried out by the registered manager and from this assessment it is decided if the home and staff knowledge can meet the needs of the resident. Further assessment is carried out in the first four weeks of the resident coming to stay in the home. Care plans are informative with detailed daily records being kept. Care plans and risk assessments are reviewed monthly and any changes in the resident their needs and wishes are recorded. Evidence is available to show that residents have access to a variety of health care specialists as and when required. Staff were observed treating the residents in a respectful manner, and ensuring the residents rights to privacy and dignity. There are a variety of activities on offer in the home, and most residents said how much they enjoyed the activities, and that they are able to choose which activities they wish to be involved in. One resident said that they were not satisfied with the activities on offer. Residents said how much they enjoyed having the registered providers dogs on the premises, and the inspector observed residents talking to the dogs, and petting them. Mealtimes are taken in a relaxed in pleasant dining room. Residents spoke highly of the food they received in the home, and said that they are offered choice, and that their dietary requirements are well met. The inspector joined residents for a lunch time meal and found the meal to be well presented and nutritious. Residents said they would know how to complain should the need arise, and the complaints file showed one complaint made since the last inspection had been recorded and investigated in an apropriate way, with feed back being given to the complainant. The home offers residents a warm and comfortable environment that is kept clean, tidy, odour free and well maintained. There has recently been an extension added to the home which will provide a further four bedrooms with en-suite facilities and a new first floor communal lounge. There is a passenger lift, and stair lift available for residents. The back garden is laid mostly to patio with built up flower beds, and provides residents with a safe area in which to sit when the weather permits. Staffing levels were seen to be good, and residents said that there are always staff available to sit and talk with, and that call bells are answered promptly. At least three quarters of the care staff have obtained their NVQ level 2 and above. The registered manager is pro-active in encouraging staff to gain their qualifications. Many of the staff have been trained in Health and Safety mandatory training, and further training has been booked to take place in the next three months, to ensure that all staff have achieved this training and that other staff are able to update their skills. The Registered Manager has worked hard in ensuring that all documentation is up to date, and that residents assessed needs are being met. Health and safety in the home is treated with high importance, and there are regular checks taking place of the fire alarm system, hot water outlets and emergency lighting. All rooms in the home have a health and safety check and risk assessment. Up to date Care Homes for Older People Page 7 of 30 maintenance certificates are available for all appliances used in the home. All radiators are covered and windows are fitted with opening restrictors. The premises is secure to ensure residents safety. What has improved since the last inspection? What they could do better: Medication is generally well managed in the home with good records being kept but at the present time medication is taken round on an open trolley, which could lead to residents being placed at risk. Discussion took place in relation to this trolley with the Registered Provider and Registered Manager, they understand that the present system is not suitable and the registered provider will ensure that a lockable medicine trolley is purchased. The medication policy and procedure is clear and contains directions for staff in regard to Controlled Drugs and homely remedies, but it was noted that there is no such directions for PRN - as required - medication. In discussion with the registered manager it was agreed that she will down load The Commissions guidance for as required medications from the professional web site and up date the medication policy and procedure accordingly. While infection control is generally well managed in the home, the registered manager must ensure that all communal toilets, bathrooms and the laundry rooms are supplied with paper hand towels in a suitable dispenser, and that she should ensure bar soap is not available within these facilities, so there is no risk of infection to the residents. Most staff have undertaken mandatory training, but there are in the main still two staff who need to complete this training, and while further training sessions have been booked to take place within the next three months, the registered manager must ensure that all staff received this training. While the Registered Manager has completed her NVQ level 4 and has several years experience at management level she does need to complete the Registered Managers Award or equivalent. As far as the quality assurance system has been well developed, there are still further improvements that need to be made. The registered manager should consider ensuring that stakeholder questionnaires include all professionals that visit the home, this could include, care managers, district nurses, chiropodists, dentists, opticians, community Care Homes for Older People Page 8 of 30 psychiatric nurses, counsellors, hairdresser and external entertainers. When the registered manager carries out monitoring of the systems used in the home these should be recorded, and any improvements noted. This together with other quality assurance checks will then formulate the annual quality assurance report. 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. The homes statement of purpose and service user guide are reviewed on a regular basis. Residents move into the home knowing that their needs can be met and that their independence will be maximised and promoted. Evidence: Statement of Purpose and Service User Guide have been updated to reflect that the home now provides accommodation for 26 residents. Prospective residents are visited by the registered manager prior to coming to live in Whitebriars Care Home. At this visit the registered manager carries out a preadmission assessment. Prospective residents are then informed in writing that the home can meet their needs, and are invited to come and stay at the home for four
Care Homes for Older People Page 11 of 30 Evidence: weeks, to ensure that they are happy, and ensure that all their needs can be met. It is after the four week assessment period if agreeable to both parties the residents stay at the home becomes permanent. Whitebriars does not offer 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care planning system used in the home is clear and consistent and provides staff with the information they need to meet residents needs. There was evidence that the health care needs of the residents are met. The medication in the home is generally well managed, but a medication trolley must be obtained to ensure that residents are not placed at risk. Personal care is offered in a way to protect residents privacy and dignity and promote independence. Evidence: Three care plans were viewed and it was found that they contained sufficient information, and risk assessments to enable staff to treat residents as individuals. All the care plans were based on the initial pre-admission assessment, and the four week assessment period where the resident first comes to stay in the home. There was
Care Homes for Older People Page 13 of 30 Evidence: evidence in daily reports of external health care visits, but because there is so much good information written into daily reports it would be a good idea to highlight where such a visit has occurred. The inspector noted from daily reports that there was good follow through in reporting when a resident has been ill. The inspector was concerned in regard to one resident who is now in hospital, that when the registered manager requested a specialised mattress to prevent bed sores occurring, that this request was turned down. The inspector discussed this issue with the registered manager and advised that turning charts are immplemented should an incident like this occur again. The resident in question was given a pressure relieving cushion to use when she was sitting in her arm chair. There was evidence both from daily records and from residents themselves that they have access to chiropody, dental, optician and other external health care services. Residents said that if they are not feeling well staff do not hesitate to call their Doctor. Medication in the home is generally well administered, but a proper lockable medication trolley should be purchased, to ensure that medications do not leave residents at risk. The registered provider was pro-active in this when this was discussed with him, and assured the inspector that a trolley will be purchased forthwith. Conversation also took place with the registered manager in regard to drawing up a PRN (as required) policy and procedure, and the registered manager stated that she would look up the guidance on this on the The Commissions professional website. Controlled drugs are kept in a double locked cupboard and from an audit it was established that these a managed appropriately in the home, with two staff signatures being gained each time a controlled drug is administered. There is very little stock medication in the home, and any medication left at the end of the medication cycle is returned to the pharmacy. Policies and procedures are up to date and give the staff clear guidelines for the receipt, recording, administration, storage and return of medication. All staff who administer medication have received the appropriate training, and there is an up to date list of trained staff, together with their signatures and initials. During the course of the inspection the inspector observed that staff respect the dignity and privacy of the residents. Staff were observed talking to residents in a kindly, friendly but professional manner. All doors are kept shut while personal hygiene tasks are carried out. Staff knock on doors before entering residents bedrooms. Both the registered provider and the manager were observed talking to residents in a kindly manner. Residents stated that everybody in the home is very kind to them. Staff always have time to stop and listen. The proprietor is pro-active in informing residents of what is happening in the home. Care Homes for Older People Page 14 of 30 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. A variety of activities are offered in the home, and residents have access to the local community either on their own, with visitors, the manager or staff. Residents are helped to maintain and exercies choice and control over their lives. The meals in this home are good offering both choice and variety and catering for specials diets. Evidence: An activities co-ordinator is employed in the home for six hours a week, and the registered manager will revise these hours as more residents move into the home. There is a new activities sheet for each resident, prior to this sheet residents activities were recorded collectively, which contradicted the Date Protection Act 1998. A variety of activities are offered in the home on a daily basis. The majority of residents spoken to on the day of the inspection said they were safisfied with the activities on offer. One resident was not satisfied with activities on offer. The registered manager promotes one to one sessions with residents. One resident said that she would like to make some pastry as she had always enjoyed doing this. Residents also enjoy having the
Care Homes for Older People Page 16 of 30 Evidence: registered providers dogs in the home when he visits. The inspector observed that the dogs are well behaved and that residents were enjoying making a fuss of them and talking to them. Many of the residents are able to go out into the community on their own and frequently visit the local shops. The manager confirmed that when she goes shopping for the home she often takes a resident or residents who would like to go especially those reisdents who do not feel confident or are not safe going into the community on their own. A different resident is offered to participate in this on each occassion. None of the residents are particularly religious. There are two nonpracticing Roman Catholics in the home. One lady who is about to come into the home has expressed that she would still like to attend church and the registered manager will arrrange for this to happen. The local church visits the home three times a year and the church choir sing to the residents, and residents are able to join in with hymns that they know. There are no restrictions on visiting in the home, and residents are able to have visitors as and when they want to. Residents have their own private telephones in the bedrooms if they wish to, some have their own mobile phone and there is a call box in the front hallway. Some residents in the home choose to manage their own financial affairs, others have advocates who do this for them. Neither the registered provider or the registered manager have dealings with residents finances. There has been one issue recently where the registered provider while acting in a concerned manner on a residents behalf, should have found the services of an advocate to save implicating himself. This issue is now being resolved and an advocate sought, to act on the residents behalf. During a tour of the home the inspected noted that residents are able to bring small personal possession into the home with them. The inspector observed and joined in with a lunch time meal. The lunch was presented in an appetising manner, and residents had been given choices. The cook confirmed that she often cooks several different meals to cater for residents preferences. The home at present caters for two vegetarian diets. The menus show that residents are offered a choice of meals throughout the day, and that the meals offered are wholesome and nutritious. All cakes are cooked on the premises. Fresh fruit, vegetables and meat are used in the home on a daily basis. The cook frequently asks residents their advice when replanning menus for the home. Meals are served in a relaxed an unhurried manner by the staff. Some residents choose to eat their meals in their bedrooms. All residents spoke highly of the food in the home. 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. Residents know their complaints will be listended to and acted on. Staff have good knowledge and understanding of Safeguarding Vulnerable Adults and this helps to protect residents from abuse. Evidence: The complaints policy and procedure is up to date and gives clear guidance on how to make a complaint and what actions will be taken in the event of a complaint being made. This complaints procedure is displayed in the home. There has been one complaint made to the home since the last inspection, and this was recorded and dealt with appropriately. Residents told the inspector that they would know how to complain should they need to do so. The home has up to date policies and procedures in regard to Safeguarding Vulnerable Adults, and Whistle blowing. Out of the twelve care staff employed in the home 10 staff have undertaken Safeguarding Vulnerable Adults training and another training day has been organised for 23rd April 2009 for those staff who have not received this training, and for other staff to update their knowledge. There has recently been one Safeguarding Vulnerable Adults referral, which is in the process of being resolved. From viewing staff personnel files the inspector found that the both the registered provider and registered manager carry out stringent checks on new staff prior to be
Care Homes for Older People Page 18 of 30 Evidence: employed in the home. 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. The appearance of the home creates a warm and comfortable environemnt for those living there and visiting. The home is clean and hygienic and free from offensive odours, but further attention to infection control procedures should ensure that residents are not placed at risk. Evidence: Whitebriars is a comfortable and well maintained home, which as been recently extended to provide a further four bedrooms and another first floor communal lounge. Six of the residents spoken to during a tour of the building said that they were very happy at the home. On the day of this key inspection the home was warm, clean and hygienic. The furniture, soft furnishings and decoration throughout the home is of good quality and condition. The building has recently been inspected by the local fire officer and there are no outstanding issues. The back garden of the home is safe and accessible to the residents. It is laid mainly to a patio area with built up flower beds. The residents said that they enjoy using the garden when the weather is nice. The home is clean and tidy throughout and there are no offensive odours. The laundry room is situated away from the kitchen area, and is supplied with an industrial washing machine with sluicing facility, another smaller washing machine for more
Care Homes for Older People Page 20 of 30 Evidence: delicate articles and an industrial tumble drier. There is hand washing facilities at the sink in the laundry room, and while there is liquid soap provided, there is no holder for paper hand towels. This was pointed out to the registered provider and registered manager, who stated they would rectify this. There are some other communal hand washing facilites in the home that did not have a supply of paper hand towels. It was also noted that in the staff toilet while there was liquid soap supplied there was a bar of soap on the hand basin. It is not good practice to use bar soap in communal hand washing areas as this can spread infection. Staff are provided with disposable gloves and aprons, to use when carrying out personal hygiene and for cleaning up spillages. The registered provider said that he is planning to re-site the laundry area as the present area is very small. 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. Staff morale is high resulting in an enthusiastic workforce that works positively with residents to improve their quality of life. The standard of vetting and recruitment practice is good ensuring that residents are not placed at risk. Most staff are multi skilled ensuring good quality of care and support. Evidence: At the present time sufficient staff are employed to ensure residents assessed needs are met. The registered manager said that in view of the new extension with a further four bedrooms being added to the home, she will be keeping the care staff hours under review to ensure sufficient staff are employed to meet the residents needs. At the present time sufficient ancillary staff are employed to cover cooking, cleaning and maintenance. Seventy five per cent of care staff have achieved their NVQ level 2 or above and a further member of staff is in the process of doing this qualification. The registered manager is pro-active in ensuring staff are encouraged to gain qualifications, to assist them in giving residents a good quality of care.
Care Homes for Older People Page 22 of 30 Evidence: The registered provider and registered manager run a stringent recruitment procedure, and ensure that all new staff have the appropriate checks carried out prior to working in the home. From two staff personnel files viewed the inspector found both Protection of Vulnerable Adults and Criminal Records Burea checks had been carried out in a timely manner, and that two written references and two forms of identification have been obtained. There was evidence in one file that new staff are now offered Skills for Care Induction standards. The majority of staff have completed their mandatory training in moving and handling, fire safety, food hygiene, first aid, infection control, safeguarding vulnerable adults and medication. Further mandatory training courses have been booked to take place in the next three months, to ensure that all staff have completed this training, and some other staff have been able to update their training. There was evidence within staff personnel files that other work related training has taken place. The registered manager said that nine staff have received one day dementia care training, but she is now looking into a more extended course for dementia awareness. All new staff are issued with the General Social Care Council code of conduct. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Both the registered provider and registered manager have a good understanding of areas in which the home could be improved, to ensure that residents live in a safe and inviting environment. The quality assurance system is good but further improvements could be made to ensure that throughout the best quality of care is offered to the residents in the home. The registered manager is supported well by the staff in the home, and staff demonstrate an awareness of their roles and responsibilites. Evidence: Sally Devlin, Registered Manager has achieved her NVQ level 4 but has not done the Registered Managers Award. She has four years experience of managing in Whitebriars. The inspector observed during the course of the inspection that the registered manager operated in an open and professional manner both towards the
Care Homes for Older People Page 24 of 30 Evidence: residents and the staff. Residents spoke highly of the manager, stating that she is very kind, and always has time to talk to them. The quality assurance in the home is good but further development is necessary to ensure that all views are sought and that the results of the whole quality assurance is then published on an annual basis. The registered manager has developed questionnaires for residents, relatives and stakeholders, which have been sent out this month. Further discussion took place with the registered manager, to ensure that she seeks the views of all stakeholders visiting the home to include care managers, chiropodists, dentists, opticians, hairdresser and other professionals who visit the home. While the registered manager monitors systems used in the home this monitoring needs to be recorded. A fire risk assessment of each room in the home has been carried out, and there is evidence in residents files that each room in the home has been health and safety checked. Regulation 26 inspections are carried out monthly by a consultant employed by the registered provider. A report is produced of the consultants findings. Some the residents and their relatives request that the registered manager keeps personal allowance safely in the home. Where this occurs each resident has their own personal accounts book, which records monies brought into the home and monies being given to residents or spent on their behalf. Where money is spent on the residents behalf a receipt is obtained and kept. Each resident has their own seperate money bag. All accounts and monies are kept safely and securely in the home under lock and key. All staff received five supervisions per year and one annual appraisal. From these supervision the registered manager is able to ensure that staff carry out their job descriptions in accordance with the philosophy of the home, and any training needs are identified and acted upon. All appliances used in the home have an up to date maintenance certificate, this was evidenced via information given to us in the Annual Quality Assurance Assessment and by certificates supplied by the registered manager on the day of the inspection. Further regular checks are carried out and recorded for the emergency lighting, hot water outlets and fire point checks. A fire drill is carried out monthly and recorded in the fire register, and fire point check book. The building and grounds are safe and secure for the residents and all windows have been fitted with opening restrictors. The accident book viewed showed that staff record accidents in an appropriate manner, giving the date, time and nature of the accident. There have been three accidents recorded for this year, two for the same resident. Care Homes for Older People Page 25 of 30 Care Homes for Older People Page 26 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 27 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 1 26 13 The registered person shall 30/03/2009 make suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home. All communal areas must have a supply of liquid soap and paper hand towels. Bar soap should not be used, and paper hand towels should be available from a fixed container. This is to prevent the spread of infection and keep resident free from risk of infection. 2 31 9 A person is not fit to manage a care home unless having regard to the size of the care home, the statement of purpose and the number and needs of the service users has the qualifications, skills and experience necessary for managing the care home. 30/04/2009 Care Homes for Older People Page 28 of 30 The registered manager must obtain her registered managers award or Leadership and Management for Care Service Award. 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 9 The registered manager to download, the PRN (as required) medication guidance from CSCI website and update Medication Policy and Procedure to include PRN (as required) medication. A medication trolley needs to be purchased because at the present time, the trolley used for medication is open and cannot be locked and can place residents at risk. 2 30 The registered manager must ensure that all staff including night staff have completed their mandatory training in moving and handling, fire safety, food hygiene, first aid, infection control, safeguarding vulnerable adults and medication. The manager to continue to develop the quality assurance system, by seeking the views of all professionals visiting the home, and ensuring that she records all monitoring of systems used in the home. 3 33 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!
