Inspection on 09/02/09 for Whitelow House

This inspection was carried out on 9th 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Whitelow House 27/02/07

Whitelow House 28/07/06

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Whitelow House 429 Marine Road East Morecambe Lancashire LA4 6AA     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: Susan Dale     Date: 0 9 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 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 31 Information about the care home Name of care home: Address: Whitelow House 429 Marine Road East Morecambe Lancashire LA4 6AA 01524411167 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Qualitas Care Limited Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 32 Number of places (if applicable): Under 65 Over 65 32 old age, not falling within any other category Additional conditions: 0 The registered person may provide the following category/ies of service only: Care home with nursing - Code N 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 - Code OP The maximum number of service users who can be accommodated is: 32 Date of last inspection Brief description of the care home Whitelow House is a care home providing Nursing care. The building is a detached property with front, side and rear garden areas. The home is situated on Marine Road East facing the promenade with extensive views of Morecambe Bay. Nursing and residential care is provided for 32 people on three levels of the building. Many of the bedrooms have sea views. There is a passenger lift in place and ramp facilities for access to areas of the home and garden. The home has two lounges and two dining rooms. A large proportion of the home has been refurbished and six double Care Homes for Older People Page 4 of 31 Brief description of the care home rooms have been turned into single rooms with en-suite facilities and new built in wardrobes. The lower ground floor has been completely redecorated and has a conservatory. A smoking room is available on the top floor. Current weekly fees are between 390 pounds and 581 pounds according to need and for a sea view; there are additional extras for example, hairdressing and newspapers. Care Homes for Older People Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 site visit was unannounced and took place over six hours; a second inspector was also present to assist in the process. Various records belonging to the people being cared for were examined as well as policies and procedures. Prior to the inspection, the owner/manager of the home completed an Annual Quality Assurance Statement (AQAA) that is a self assessment provides information about how well outcomes are being met for people using the service as well as some numerical information. Surveys were provided to both the people who use the service and staff who can respond anonymously if they wish. Five surveys were returned from people using the service and one from staff; the findings were positive and there were no negative comments. Various people were spoken with including the people who use the service, the Care Homes for Older People Page 6 of 31 owner/manager, staff and a domestic member of staff. The last key inspection was on the 27th February 2007 and an Annual Service Review was undertaken on the 1st February 2008. What the care home does well: What has improved since the last inspection? The service users guide has been improved and become more user friendly and is called the Welcome Pack; a copy is within each bedroom. Care plans have a great more detail about individuals who are at increased risk of weight loss. A record had been kept of weight once a month and a food diary had been kept for those at risk of losing weight. The food diary detailed the amount eaten and fluid intake. It was evident that peoples health was being monitored with in-put and liaison with other health professionals such as their GP or a dietician. A full English breakfast is now available. Five double rooms have now been turned into top quality single rooms with an ensuite. The 2nd dining room has been turned into a single bedroom and a smaller second dining room. The lower ground floor has been vastly improved and refurbished. The bedrooms now have fitted wardrobes with ample storage space and a spacious en- Care Homes for Older People Page 8 of 31 suite with sliding doors for easy access by a wheelchair. Seven out of twenty six bedrooms have been refurbished including new paint, wallpaper and carpet. Five additional profile beds have been purchased; all but one of the thirty two beds are now profile beds. One of the older hoists has been replaced. A sensory garden has been established and raised flower beds to promote an interest in gardening. New laundry trolleys with lids have been provided to create more space. Additional staff have been provided at lunchtimes three times a week and there are plans to recruit additional staff to cover the other four days. Staff rotas have been changed to ensure that staff have a lunch break. The owner/manager has devised and reviewed surveys to be provided to the people being cared for and their relatives to ensure that quality is maintained and improved; a newsletter has also been devised. What they could do better: The current owner is keen to improve the home in all areas and has followed advice previously in areas that needed to be improved. The food diaries did not always include enough information about whether a good amount of food had been eaten. There was no evidence that one person having a nutritional drink had been prescribed this by her GP. There were a few gaps in some of the care plans according to whoever had completed the details; attention needs to be paid to completing all areas and ensuring dates and signatures of the person recording. The care plans require additional detail in certain areas, for example, how regularly a person should be weighed although this had been done once a month. There is unclear information recorded on pressure sores or the type of pads or pressure mattress in use. The care plan does not always indicate the frequency of positional turns despite a high pressure risk; it is unclear on the records seen whether positional turns are given. Bed rails and reclining chairs were in use without consent or a risk assessment. Clear directions must be recorded on the MAR sheets about how the medication is to be administered. According to the records, one person was resistant to staff at times although this was not mentioned on the care plan and there were no instructions for staff on how to handle any challenging situations that arose. There is a need to ensure that action is taken to review care plans following any issues arising from complaints. Care Homes for Older People Page 9 of 31 A check should be undertaken on all staff to ensure that they are familiar with Adult Protection/Safeguarding measures and the reporting procedures. The procedure for recording any personal belongings or valuables belonging to new persons entering the home should be strengthened and a receipt provided to ensure safekeeping of any valuables in the safe. The application form should allow enough space for a complete employment history to be recorded and any gaps explained. Written references should not be accepted that are To whom it may concern and two appropriate written references should be received, one from the last employer. 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 10 of 31 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 11 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is sufficient information available about the services provided by the home to make an informed choice about living at the home. The pre-admission procedures ensure that individual requirements are met and ensure that the services provided by the home are suitable. The home does not provide intermediate care. Evidence: Information is available about the services provided by the home including the Statement of Purpose and the Service User Guide which, has been updated and now called the Welcome Pack. The Welcome Pack is user friendly and contains detailed information about the home and the services provided including how to raise any concerns. A copy is provided within each bedroom. Care Homes for Older People Page 12 of 31 Evidence: Any new person wishing to take up residence is able to have a trial visit to sample the services provided. A number of persons in the home are receiving respite care. The pre-admission information is recorded and contained within a Standex System. As`well as key details about the individual concerned and their physical requirements, information is also gathered where possible about their background and social history. Six care records were examined and the initial assessment recognised and recorded individual wishes and choices over daily living, choice of dress, food and beverages. The initial weight of a person entering the home had been recorded and any particular issues over nutrition such as the need for a special diet or poor appetite. A nutritional risk assessment had been completed as well as any potential additional risks over personal care, mobility and risk of falls. Some recent admissions to the home did not have as much detail as others who had resided longer in the home. Staff need to pay attention to complete all areas of the pre-admission forms as there were a few gaps and ensure that the forms are signed and dated by the person recording the information. Comments were received via a relative for a person residing at the home: My niece checked the home. She was shown around and given all details and a Welcome Pack which she brought to me which had all the information in and photos and names of owners etc. The standard of care is excellent. Care Homes for Older People Page 13 of 31 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care needs of the people living at the home are met by the care provided by the staff. Some improvements should be made to the recording of information on the care plan including any potential risks to ensure all aspects of their care needs are met. Evidence: Six care plans were examined. Four of the care plans belonged to people assessed as requiring nursing care and two assessed as requiring residential care although one of the residential persons is being re-assessed for nursing care. Relatives had been involved with the compilation of four out of the six care plans seen. The care plans included risk assessments for nutrition, moving and handling and risk of falls. Individual choices were recognised with regard to daily living, getting up, going to bed and whether they preferred bed rails or not. Care Homes for Older People Page 14 of 31 Evidence: It was evident that peoples health was being monitored with in-put and liaison with other health professionals such as their GP or a dietician. A record had been kept of weight once a month and a food diary had been kept for those at risk of losing weight. The food diary detailed the amount eaten and fluid intake; the food diaries did not always include enough information about whether a good amount of food had been eaten. One person was having Fortsip which is a nutritional drink although there were no records to support that this had been prescribed by her GP. The care plans require more detail in certain areas, for example, the care plans state how food is to be cut up or thickened but dont indicate how regularly their weight should be recorded although this had been done once a month and advice had been sought. Care plans do not indicate the type of pads or pressure mattress in use. Skin care plans do not always indicate the frequency of positional turns despite a high pressure risk. There is unclear information recorded on pressure sores, for example one person had a red area of skin but no up to date information only comments such as: apply a dressing if broken and pressure sore is healing. Staff say that there is no pressure sore but there is a risk. Pressure relief charts do not indicate two hourly turns and just say lounge it is unclear whether positional turns are given. Bed rails were in use without consent or a risk assessment, only one had consent without explanation of the risks. A recliner was used to stop someone falling this also needs to be risk assessed as it is a form of restraint. One persons record included a consent from from a GP to crush an iron tablet but the detail had not been recorded on the care plan or indicated on the Medication Administration Record (MAR). There were no temporary care plans seen, for example when a person has a chest infection. According to the owner of the home, temporary care plans are completed and kept separately. One person was resistant to staff at times although this was not mentioned on the care plan and there were no instructions for staff on how to handle any situations that arose. The format and recording of the care plans could be improved as the information required was not always recorded or where you would expect to find it in the Care Homes for Older People Page 15 of 31 Evidence: documentation. It would not be easy for any new member of staff to find clear information about the daily needs of each individual. There was evidence that the care plans had been reviewed once a month and a signature had been obtained from the person concerned or their representative. The medication policies and procedures seen were detailed and clear. Records showed that medication was generally managed safely although clear directions were not always recorded on the MAR sheet; this could put a person at risk of of not receiving their treatment as prescribed. One person was receiving dietary supplements without evidence that this had been prescribed by a GP; this meant she was receiving another persons prescribed treatment. The storage of medication was appropriate and secure. Monthly medication audits were in place and were being further developed; this will help to determine whether staff are following safe procedures. Staff are taught the importance of privacy and dignity at their induction training. Staff were observed to be attentive and gentle with the persons being cared for and their privacy and dignity was recognised. It was also observed that a visiting GP examined one person in a lounge and that this could be normal practice to avoid the need for a hoist to move them to a bedroom. Staff need to be aware that people living at the home should be medically examined in the privacy of their room. Care Homes for Older People Page 16 of 31 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The daily routines and services provided by the home are suitable for the various needs, expections and capabilities of the people cared for. Evidence: The majority of people living at the home are dependant on the staff because of their poor mobility and health requirements. On admission to the home a recording is made of any hobbies and interests and staff are aware of Equality and Diversity and the importance of individual needs with regard to culture or religious requirements. There is a variety of activities provided and they are recorded on the noticeboard in the entrance hall. An Activities Co-ordinator is employed and attends the home most days. Individual wishes are taken into account and according to their capabilities. Activities provided include, sing-a longs, board games, hand massage/manicure, one to ones, musical afternoons, scottish party with a highland piper and haggis supper, balloon games and films. There are trips out along the promenade to Happy Mount Park. A mens club has commenced in the summer established by the activities coCare Homes for Older People Page 17 of 31 Evidence: ordinator. There is easy access to the garden where there is a water feature and seating under a gazebo. A sensory garden has been established and there are raised flower beds for any person wishing to do some gardening. The downstairs lounge has sensory lighting to provide a relaxing environment. Ministers attend the home from the United Reformed and Methodist Churches as well as the local Catholic Priest and provide a service. Local schools are to provide a show at the end of March. Relatives are able to visit the home at any reasonable time and are consulted on the care and activities provided by the home. The home provides surveys to both the people cared for in the home and their relatives in order to ascertain their satisfaction with the care provided and how they could improve. There have been issues raised about food and nutrition previously and measure have been put in place to address any concerns. Meals are provided in a very attractive dining room as well as in the lower ground floor lounge. Several of the persons cared for, require assistance with feeding and the staff were observed to provide assistance in a sensitive manner. Additional staff are available at mealtimes and assistance is also provided by the activities co-ordinator. Staff spoken with stated that they had sufficient time to provide assistance at mealtimes and were also able to record the amount of food and beverages taken by the persons at risk of losing weight. The people living at the home are provided with the menu the day before and are able to choose what they eat. The people spoken with expressed their satisfaction over the food provided. Both hot and cold food is available at both lunch and tea time. A full English breakfast of bacon and eggs is now available. There have been issues raised about two dogs that belong to the owner of the home, sniffing around the food trolleys and specially made barriers have been devised to enclose the food trolleys and entrance to the kitchen. The following comments were received from persons living at the home: I dont like to go out of my room or take part in activities, but the activities person comes to see me in my room. I am very pleased with the care and attention I receive. There are activities and the music events are thoroughly enjoyed. Care Homes for Older People Page 18 of 31 Evidence: Because of my eating problems my meals are blended and every attention is given to my needs. The lovely room and friendly staff and atmosphere have brought about a lot of happiness to my life since moving here. As my family agree this is an excellent home. Care Homes for Older People Page 19 of 31 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The policies, procedures and training of staff ensures that the people living at the home and staff are protected from and any concerns are recognised and investigated. Evidence: The home has a suitable complaints policy and procedure that is publicised in the Statement of Purpose and the Welcome Pack. A record of complaints is kept and was examined. The details were up to date and included the action taken. A recommendation was made that care plans should be reviewed and adjusted following any concerns that could effect the way care is delivered, for example, one male person cared for became agitated if personal care was provided by a male carer. A record is kept of any compliments and there was plenty of recent evidence from relatives of thanks for the care provided as well as where the home has raised funds for a charitable organisation. An inventory was seen to be kept of clothing and personal belongings as new persons enter the care home. Any valuables are able to be kept in a safe. Following some recent concerns over a missing item, the owner/manager is to review the current procedure. It is recommended that two staff members are present when the inventory is taken or items placed in the safe with a signature and date and receipt provided. Care Homes for Older People Page 20 of 31 Evidence: There was evidence on the staff files that staff had received Adult Protection/Safeguarding Training. The Protection of Vulnerable Adults (POVA) Register is checked before new staff are employed. a recommendation was made that some of the new staff. particularly from overseas should be provided with some additional training to ensure their familiarity with Adult Protection issues and reporting procedures. The owner/manager intends to become familiar with the new Deprivation of Liberty Safeguards which comes into force in 2009. Care Homes for Older People Page 21 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well maintained and provides a very comfortable safe environment for the people living at the home as well as staff. Evidence: A tour of the home was undertaken and all parts of the home were well maintained clean and comfortable. Five double rooms have now been turned into top quality single rooms with an en-suite. The 2nd dining room has been turned into a single bedroom and a smaller second dining room. The lower ground floor has been vastly improved and refurbished. The bedrooms now have fitted wardrobes with ample storage space and a spacious en-suite with sliding doors for easy access by a wheelchair. There was evidence of personal possessions in the rooms and comfortable reclining chairs; many of the rooms have stunning sea views over Morcambe Bay. A smoke room is available on the top floor of the home. All bathrooms, communal toilets and sluice rooms have wall mounted hand wash dispensers. Staff are instructed in correct hand washing techniques as part of their induction. Care Homes for Older People Page 22 of 31 Evidence: There are two domestic staff as well as a kitchen assistant and one of the domestic staff spoken with had worked at the home for seventeen years. She confirmed that the recent owners of the home had made many improvements particularly to the lower ground floor which had previously been rather neglected compared to the rest of the home. She stated how much pleasure she took in ensuring high standards of cleanliness were maintained and that the owner of the home was very supportive. Seven out of twenty six bedrooms have been refurbished including new paint, wallpaper and carpet. Five additional profile beds have been purchased; all but one of the thirty two beds are now profile beds. One of the older hoists has been replaced. New laundry trolleys with lids have been purchased that would fit into the bathrooms. Previously, large laundry hoppers with no lids sat in the corridor. The lower ground floor corridors were completely re-papered and painted. The top two floors have recently been decorated. There was evidence that all the equipment used by the home is well maintained and staff are provided with training on Fire Safety. A CCTV is in operation at the entrance to the home for an overview of any visitors to the home and for security purposes. Care Homes for Older People Page 23 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient trained staff on duty for the current number and needs of the people being cared for in the home. Evidence: There were adequate staff on duty for the number and needs of the current people residing in the home. Additional staff would be beneficial according to some of the comments received by staff on surveys received before the site visit. During the visit staff spoken with said there was adequate time for them to provide the care required and in the afternoon, staff were observed to be providing hand massage and gently talking to some of the less capable persons and providing reassurance. There has been a lack of permanent nursing staff and two bank nurses have been employed on a regular basis; the owner is currently recruiting a suitably qualified and experienced nurse to be Head of Care. Additional staff have been provided at lunchtimes three times a week and there are plans to recruit additional staff to cover the other four days. Staff rotas have been changed to ensure that staff have a lunch break. The home has a suitable recruitment policy and procedure and the records of staff who Care Homes for Older People Page 24 of 31 Evidence: commenced at the home within the last twelve months were examined. A number of the staff were from overseas and from different nationalities. Security checks from the Criminal Records Bureau (CRB) and the Protection of Vulnerable Adults (POVA) Register had been undertaken. Staff from overseas were seen to have a Certificate of English. There have been some issues raised previously about the ability of staff from overseas to be understood and the staff currently employed at the home all speak English well. There has been one person previously employed who did not speak English well and they were dismissed. The application form is small and does not allow enough space for a full employment history to be recorded. Some references seen were To whom it may concern and these are not acceptable; one of the records seen did not have any references. There was evidence of good induction training including, Health and Safety, Electrical Safety, Fire Safety, Smoking Hazards, RIDDOR, COSHH, Food Hygiene, Infection Control, Moving and Handling, Safeguarding, First Aid and Dementia Care. All training is registered on the Lancashire Plan which ensures all staff have a level of training considered necessary for their role as carers. As well as professionally qualified nursing staff, there are fourteen residential care staff and seven have a National Vocational Qualification in Care (NVQ) at level 2. Four more care staff are in the process of obtaining an NVQ at level 3 in Care. A comment was received from a staff member: The staff are caring and very pleasant and the owners always encouraging us to take courses and keep up to date on all aspects of the home. Care Homes for Older People Page 25 of 31 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed well for the benefit of the people living at the home and staff. Evidence: The owner of the home is in the process of applying to become the registered manager. The owner is currently managing the home together with his wife and senior staff; there are also two administrators. A Head of Care has been appointed and will be commencing shortly. The Head of Care has considerable experience in Care and will be working closely with the Manager. Both the Manager and Head of Care are working towards an NVQ4 qualification in leadership and Management of a Care Service. Currently Senior Nursing Staff are supporting the Owner/ Manager in the running of the home. The Annual Quality Assurance Assessment (AQAA) provided by the home as part of the inspection, states that importance is placed on continuous improvement. Internal and external quality assurance systems are in operation. Revised surveys are provided to Care Homes for Older People Page 26 of 31 Evidence: both the people being cared for and their relatives. The surveys seen indicate that the home is meeting the needs of the people they care for. The quality systems are audited by an external auditor every six months. Comments suggestions and complaints are also used to improve the service provided. A Newsletter has been devised and provided. It is evident from the work already carried out to the existing policies and procedures particularly around Health and Personal Care that improvements have been made and that there is a willingness to improve further. Staff meetings take place on a regular basis as well as individual one to one supervision with staff. The following comment was received from a staff member: I feel the service do well in all aspects. If there are problems they are sorted out within that day. The home is run well and the service users are looked after to a good standard. If I had to be placed at a care home this one would do me fine. And a comment from a relative: The standard of care is excellent. Care Homes for Older People Page 27 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 28 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 Food Supplements 03/03/2009 prescribed for one person must not be given to another person in the home. In order to protect the health and safety of the people cared for. 2 9 13 Clear directions must be recorded on the MAR sheets about how the medication is to be administered. In order to protect the health and safety of the people cared for. 03/03/2009 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 3 Staff should ensure that there are no gaps in the preadmission recordings and that all the records are signed and dated. The care plan should set out in detail the action to be taken to ensure that all aspects of their care needs are met. Page 29 of 31 2 7 Care Homes for Older People 3 7 The use of restraint (bed rails and recliner chairs) should be risk assessed and discussed with the person concerned and their relatives to determine whether this action is appropriate. The procedure for self medication should include that the people provided with care can take reponsibility for their own medicines within a risk management framework. A procedure should be developed to support staff with the covert administration of medicine to ensure that the correct procedures are followed. There is a need to ensure that action is taken to review care plans following any issues arising from complaints. A check should be undertaken on all staff to ensure that they are familiar with Adult Protection/Safeguarding measures and the reporting procedures. The procedure for recording any personal belongings or valuables belonging to new persons entering the home should be strengthened and a receipt provided to ensure safekeeping of any valuables in the safe. The application form should allow enough space for a complete employment history to be recorded and any gaps explained in order to protect vulnerable people being cared for in the home. Written references should not be accepted that are To whom it may concern and two appropriate written references should be received, one from the last employer in order to protect vulnerable people being cared for in the home. 4 9 5 9 6 7 16 18 8 18 9 29 10 29 Care Homes for Older People Page 30 of 31 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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