Inspection on 19/01/07 for Wildashs

This inspection was carried out on 19th January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Wildashs 10/11/05

Wildashs 07/07/05

Wildashs 06/01/05

Wildashs 10/09/04

Wildashs 14/01/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Wildashs 68/70 Greentrees Avenue Tonbridge Kent TN10 4NE Lead Inspector Mrs Ann Block Unannounced Inspection 19th January 2007 09:30 X10015.doc Version 1.40 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Wildashs DS0000024047.V325883.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Wildashs DS0000024047.V325883.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wildashs Address 68/70 Greentrees Avenue Tonbridge Kent TN10 4NE Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01732 356815 Miss Corina Mary Wildash Miss Corina Mary Wildash Care Home 8 Category(ies) of Old age, not falling within any other category registration, with number (8) of places Wildashs DS0000024047.V325883.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One place is restricted for care of one person whose date of birth is 13/05/1905. 10th November 2005 Date of last inspection Brief Description of the Service: Wildash’s is a residential home for up to seven older people. The owner and four senior members of staff are qualified nurses. The stated intention of the owner is to provide a high standard of care for older people and where possible, to provide a home for life. All service users have single bedrooms. They have easy access to the rear conservatory and to the garden. Prospective service users and their supporters are able to obtain information from the owner about the homes services and facilities. Each prospective service user receives a full assessment to ensure the correct level of care can be provided. Care services are provided by both registered general nurses and care assistants. There is a range of specialist equipment available to enable care to be provided for very frail older people. The home is in a residential area close to Tonbridge and a bus-route is nearby Car parking is readily available. At the time this report was written fees ranged from £309.00 to £700.00 per week. Visits from the hairdresser cost from £7 to £30. Newspapers can be delivered to the home and charged at cost. Phone calls on residents’ private phone lines are billed direct. Long distance phone calls made on the homes phone line are charged at cost, there is no charge for local calls. Escort to hospital appointments are provided at cost of petrol and token £10 to staff cost. Physiotherapy will be charged at cost to the resident unless judged necessary to assist staff handling. Wildashs DS0000024047.V325883.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the report of a key inspection carried out by Ann Block which included an unannounced visit to the home. A day was spent at Wildash’s talking to residents, visitors, staff and the owner and observing day to day activities, care and support. A sample of records was seen. All corroborated the owner and staff’s excellent knowledge of each resident and good practice seen. Feedback was given to the owner during the inspection. Information from a pre inspection questionnaire completed by the owner was also used to inform judgments of service provision. The lead inspector has known the service for some time. Where judgments made at previous inspections remain the same, these have been included in the assessment of standards in this report. Residents, visitors and staff gave their full cooperation to the process of gathering evidence for service provision. To further obtain views of the service comment cards and survey forms were sent to residents and a sample of families, care staff and professionals. Verbal and written comments were consistently favourable and included: I am so lucky to be here it’s been the best year of my life. (Resident) All the staff are lovely, I was so worried about having to come into care but as soon as the front door was opened, I knew here was the right place. (Resident) My husband has been in this home for three years. He seems contents and eats well. He is treated with great care & kindness & I’m very lucky to have him there. (Relative) Wildash’s is a very friendly, caring home & was just the right place for my late mother. They looked after her splendidly. (Relative) I am very satisfied with the care and attention my mother receives from all the staff. (Relative) My husband has been in this home for almost three years and I am more than satisfied with the care and kindness he has received. (Relative) An excellent home. The standard of care and support given is superb. I really could not wish for a better environment for my mother to be cared in. It’s like a ‘home from home’ for her. (Relative) Wildashs DS0000024047.V325883.R01.S.doc Version 5.2 Page 6 My family and I are very pleased with the home. The nursing care is careful and effective, and the staff are caring and cheerful. The unconventional adaptation of two large bungalows works well. (Relative) Miss Wildash runs the best home in Tonbridge. The care is first class. I would recommend the home to my patients without reservation. (Health professional) What the service does well: Wildash’s is an unusual home both in its size and the complete dedication of the owner, Miss Wildash, to provide the ‘right’ care for older people. She ensures that each resident is treated as an individual and given respect at all times. Her principles are to offer a very high standard of care, including health care. She ensures that only staff who follow her principles are employed and uses in depth recruitment practices to make sure the right staff are employed. Miss Wildash is always ready to ‘roll her sleeves up’ and is ready for a chat and offer a listening ear for residents, relatives and staff. Residents said they feel fortunate to live in such a friendly and welcoming home and consistently spoke highly of the owner and staff. Staff also enjoy working at the home and spoke highly of the owner’s commitment and care for residents and their relatives. Relatives become part of the home. Visitors spoken with said they were pleased that the home was there for their relative and wholeheartedly complimented the care and attention given. Visitors are welcomed with the immediate offer of a drink and biscuits and can stay for a meal. With the residents’ permission they can be as involved as they choose in their relatives care. Health care is particularly good. Whilst the home isn’t registered to provide nursing care, elements of health care which qualified staff can carry out are done by these staff. Residents and relatives appreciate that in many cases this reduces anxiety for the resident and improves general wellbeing, including pain relief. Miss Wildash ensures that rights to external and domiciliary health care are met and will push for suitable appointments and in patient treatment to be provided for the resident’s benefit. The house itself has a truly homely atmosphere and as far from an ‘institution as it is possible to be. It is kept clean and refurbishment takes place as necessary and when budgets allow. Practices make sure that the risks of cross infection are minimised whilst allowing for a relaxed comfortable atmosphere. Wildashs DS0000024047.V325883.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Wildashs DS0000024047.V325883.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Wildashs DS0000024047.V325883.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have all the information they need to choose whether to move into Wildash’s and that it will be the right place for them. EVIDENCE: Miss Wildash has owned the home for some years and through that time has built up a reputation for a particular style of service being a small, welcoming and homely environment with conscientious care and support for older people often to those who are frail. Many residents come to her through recommendation and already know what the home can provide, two current residents are family members. Staff employed have the skills and experience to work with older people and include trained nurses as senior staff so that Wildashs DS0000024047.V325883.R01.S.doc Version 5.2 Page 10 agreed health care can be provided. As the home is on one level, people with mobility difficulties can be accommodated. At the last inspection a requirement was made that a service users guide be provided. Miss Wildash has produced a very comprehensive service users guide, in addition to a summary trifold leaflet, which would meet regulation. She felt that prospective residents would be unlikely to use them but that they were ready if necessary. She has also written a revised contract which she will use for any new residents admitted. Residents spoken with were fully aware of the nature of the service and what the terms and conditions were, which they felt were more then adequately met. A copy of the latest CSCI inspection report is available in the entrance hall. The usual way for residents to decide to live at Wildash’s is, as already mentioned, by recommendation but also by visiting the home and meeting staff and other residents. Many come for a trial stay for both parties to judge whether Wildash’s is right for them. Some long term stays have resulted from a positive experience of respite care. When the person needed long term care, their experience of respite care made Wildash’s the obvious choice for them. Miss Wildash ensures that she obtains as much information as possible before any resident is admitted. She makes sure she has opportunities to meet with the resident and assess what are their hopes for their care and any special needs they might have. Any information given in this way will be recorded and later used in providing care. Each residents needs are continually evaluated and recorded. If it is found that needs really cannot continue to be met at Wildash’s, help will be given to find another home. This situation is rare as Miss Wildash considers that the home should be a home for life and will care for people until the last stage of life. Wildashs DS0000024047.V325883.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 & 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents know their care and health needs will be well met in a safe and caring manner. EVIDENCE: Residents’ files hold a wealth of information covering physical, emotional, social and spiritual records and copies of relevant documentation. Staff have access to information in a need to know basis. Given that the home is so small, sharing of information is not a problem. All staff have a superb understanding of each person, they know their likes and dislikes but even then will ensure they are offered choices and can make their own decisions. Staff record daily events after each shift and do so in an illustrative and useful way. Any concerns will immediately be reported to Miss Wildash or a senior. Wildashs DS0000024047.V325883.R01.S.doc Version 5.2 Page 12 Residents are only too happy that the standard of care is so good and have no interest in reading documentation although aware that it is held. Health care and medication practices are unusual in a home for older people which is not registered to provide nursing. This has been discussed at many inspections and has now been formalised with local health care providers. Each health task which would normally be deemed the remit of a general practitioner or district nurse, but which qualified staff at the home are competent to do, has been signed off by the general practitioner or district nurse. This means that not only is someone on hand to do such tasks, thus releasing district nurse to care for more vulnerable people, but that residents have a better quality of life. In a particular case this included care for diabetes and associated conditions, which was making life more comfortable for the person concerned. Staff are active in ensuring residents remain as pain free as possible. Support, both practical and emotional, will be given to residents where health needs increase such as post operatively. A physiotherapist, optician and chiropodist visits the home as needed. Pressure will be put on external and domiciliary health care providers to make sure residents get their entitlement in time. Pressure was put to reinstate a domiciliary audiology service which Miss Wildash said she had just been told has happened. Miss Wildash will make a formal complaint on a person’s behalf if she thinks something is unjust, such as the return of a resident from hospital at 11pm without any notice being given to staff at the home and by taxi which was not a suitable means of transport for the person concerned. Medication is stored securely and well managed although is not in the conventional manner of a monitored dosage system. The prescribers are aware of the system used and confident that medication is given as directed and properly recorded. Medication is reviewed both in house and by the general practitioner. Only qualified nurses are allowed to prepare medication for an individual and ensure that medication is given correctly. Staff have access to pharmaceutical reference books and update their own knowledge as nurses. Residents felt that medication was given correctly and at the right time and had confidence in staff. They felt part of the process of maintaining good health and that any decision regarding health practices would not be made until fully discussed with them or an advocate, such as next of kin, and general practitioner. General practitioners are fully supportive of the home which they consider gives an excellent standard of care. Residents rights to dignity and privacy are well maintained both in the manner of approach by staff and by the facilities. There are no shared rooms. Where there is a view into the room by others from using a passageway or the conservatory, staff make sure that such views are screened when personal care is being given. The attitude of staff seen during the site visit at all times showed they have respect for each person, even when the actions of a resident made it quite difficult at times. Miss Wildash not only ensures that residents are treated with respect but that staff aren’t discomfited by Wildashs DS0000024047.V325883.R01.S.doc Version 5.2 Page 13 inappropriate behaviours and will make sure that no one member of staff continually has to care for more ‘difficult’ residents. Miss Wildash aims to provide a home for life. As she and senior staff are qualified nurses, the home can care for people in the later stages of life and provide a high standard of care at that time. Over the years the home has cared for a number of people who have lived a comfortable and pain free life for much longer than was expected when they were admitted. Wildashs DS0000024047.V325883.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a home where they are occupied and where they have as much control over their lives as possible. EVIDENCE: Residents can be involved in the day to day life of the home if they choose. One resident for example likes to assist by peeling potatoes and cleaning the silver, others like to assist in the garden in better weather. There are many opportunities during the day to chat with other residents and staff plus activities such as the music group two evenings a week, music for health, individual and group exercise, listening to the guest organist, playing games, reading or watching TV. Care is taken to work on a one to one basis especially with the more frail residents. Key events such as Easter and Christmas are celebrated with parties and making decorations including Easter bonnets. Wildashs DS0000024047.V325883.R01.S.doc Version 5.2 Page 15 There are regular and frequent visitors to the home as confirmed in the visitors book. Visitors say they feel welcomed and are always offered a drink and biscuit when they arrive. Family and friends are included in the social life of the home. Staff appreciate that residents like to have visitors and give them the opportunity to meet in private or join in with the group if they choose. Many relatives like to take the resident out for a drive or for a meal out. Miss Wildash understands how important it is for residents to continue to make decisions about their lives and not to have things done to them just because they are elderly or frail. Staff ensure that each resident is treated as an individual. Whilst choices are recorded in the care plan it was noted throughout the visit that staff always asked the resident what they wanted and, where possible, the preferred timing. Where tasks were carried out for residents who had greater difficulty in communicating, the resident was involved as far as possible in the process with staff gently advising the resident what was going on. Residents are able to bring in personal possessions, a resident showed the furniture and effects she brought with her and was pleased to have been able to do so. Rooms are very well personalised. All meals are home cooked, varied and use fresh seasonal ingredients as far as practical with the aid of a friendly helpful local greengrocer. Designated cooks prepare meals. Meals can be taken in the dining area or in residents rooms, wherever they prefer. Those meals taken on trays are covered and served attractively. Residents said the meals were good and commented on the quality of home made cake that was offered for afternoon tea. A resident said she appreciated the china in use and how pretty it was. Special diets are catered for. Wildashs DS0000024047.V325883.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have processes to make a complaint and be protected from the risks of harm or abuse. EVIDENCE: A complaint procedure is available which says how to complain and gives contact details. Information provided by relatives and professionals record that there has been no need to make a complaint. Miss Wildash said that any minor niggles would be talked about at the time and action taken. Staff are ready to listen to anything residents might wish to talk about and this may include something which needed attention. Any recording of these would be made in care files. Residents and a visitor spoken with said they were very happy with the service and couldn’t imagine why anyone would need to complain. Miss Wildash is passionate that older people receive a good safe service and will either act herself on a resident’s behalf to make a complaint or use an advocate if necessary. Staff have training in adult protection processes and know what could constitute abuse. They have access to the Kent & Medway adult protection joint working protocol. The staff team support protection of Wildashs DS0000024047.V325883.R01.S.doc Version 5.2 Page 17 older people and wouldn’t hesitate to raise an adult protection alert if necessary, none have needed to be raised. Residents say they feel safe, secure and well cared for in the home. Wildashs DS0000024047.V325883.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a homely, safe and well maintained home. EVIDENCE: Wildash’s is formed from two semi-detached bungalows in a residential area which have been converted to provide a single unit suitable for caring for older people. There are 8 bedrooms for single occupancy. Being a bungalow it has level access with ramps to the front door and rear garden. The bungalow has a very homely feel which residents like. Some residents have brought in their own possessions and have them displayed around the house or use them as part of daily living. A large conservatory built across the back of the house is used as a communal area and there is a separate room which can be used for Wildashs DS0000024047.V325883.R01.S.doc Version 5.2 Page 19 chats and has been used as the dining room. There is a separate office, laundry and kitchen. A small area of the house is for private use including a cabin in the rear garden. Other areas of the house and garden are accessible to residents. A visiting handyman gardener carries out essential maintenance. Necessary repairs are carried out and the handyperson or contractors are asked to do refurbishment work when the budget allows. Recent work has included new carpeting and redecoration of three bedrooms. Miss Wildash is always planning how best to present the bungalow to meet the needs of the residents living there. Lavatories and bathing facilities are provided. One bath isn’t used, the bathroom remains in use as a toilet. Miss Wildash is considering whether a hoist might be needed when a resident comes out of hospital. Until now, residents needing a bath are able to use the standard baths. Doors have been widened as necessary when the occupant is a wheelchair user. Grab rails have been fitted and adaptations necessary for individuals provided, including adjustable height beds. Rooms are well personalised and reflect the character of the occupant. Notices which can be hung outside the door maintain respect to privacy. The home is warm and well lit. The conservatory offer a high degree of natural light which provides some natural light to the two bedrooms leading off it. Radiator covers have been fitted to prevent the risks of burns and hot water safety valves prevent the risks of scalding. Supplementary heating can be provided if a resident feels particularly cold. Systems are in place to reduce the risks of cross infection. Staff have a good understanding of how cross contamination can occur and deal properly with laundry and dressings. Gloves and protective clothing are provided. Due to revised working systems and the size of the home, the Environmental Health Officer and Fire Safety Officer have delegated responsibility to Miss Wildash for monitoring and maintaining health and safety and prevention of fire Wildashs DS0000024047.V325883.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Residents are cared for by staff who they like and are properly recruited. Obtaining criminal records bureau certificates for all staff will enhance this process. EVIDENCE: There is a strong staff team consisting of senior staff who are qualified nurses, care staff, cooks and domestics. Residents unanimously said they like the staff, comments such as ‘they’re are lovely bunch of girls’, ‘couldn’t be nicer’, ‘they know what I want and do it’ were made. Residents and family said there are always staff available to attend to them and call bells were answered promptly during the site visit. Miss Wildash will find ways of ensuring that all residents have systems which they can use to request help. Those that are unable to use a call system will be regularly checked on. There are always at least two staff on duty, one of whom will be a senior. Waking night staff are employed. Miss Wildash works in a hands on capacity Wildashs DS0000024047.V325883.R01.S.doc Version 5.2 Page 21 on a regular basis and is readily available. Where necessary the staff team will be supplemented by agency staff with one agency used who send staff already known to the home. Residents and family like the reassurance that the staff team consists of qualified staff as well as carers. Staff files contain details of their various training with both in house and day training course accessed. Staff are encouraged to undertake training including core training such as manual handling and fire safety. Flyers offering training courses are displayed in the office area. Study hours are separately arranged pertinent to care delivered. Staff are expected to update their training files when training has been undertaken. Miss Wildash makes sure that updated recommendations from appropriate agencies are circulated to staff. Planned training includes ‘end of life and absence of life signs’ delivered by the local hospice, health and safety and NVQ2. Two staff already have NVQ2, three have qualified nurse status and two hold first aid certificates. Because Miss Wildash is passionate about good care and ensures the right staff are employed to provide that care, recruitment is thorough. Written references are required and will be substantiated through the interview process and by telephone enquiries to the referee. Prospective staff are expected to demonstrate the qualities they possess through written information such as an application form but also by observing practice in the home and shadowing staff. In this manner, Miss Wildash is able to assess whether the staff are suitable and for the staff to decide whether they would like to take on permanent work at Wildash’s. With the retirement of the former deputy, recruitment is taking place for a replacement. Staff who work directly with residents have all had criminal records bureau certificates and POVA checks. Miss Wildash hadn’t realised that two of the cooks hadn’t had a criminal records bureau check done. Both have worked at the home for some time and have proved reliable and honest. Miss Wildash agreed to apply for a check immediately. Wildashs DS0000024047.V325883.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,37 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well managed, personal service where they feel safe and secure. EVIDENCE: Miss Wildash originally set up Wildashs as a home for older people where she could provide the type of service which she felt older people were due. Throughout that time she has stuck to her principles of care and has been central to the running of the home. She provides leadership to the staff team who respect her and recognise the high standards of care she insists on. Wildashs DS0000024047.V325883.R01.S.doc Version 5.2 Page 23 Residents and visitors expressed and recorded a high regard for Miss Wildash recognising that without her the home wouldn’t function at the level it does. Not only does Miss Wildash live in the premises but she is available day and night to give assistance, have a chat and support residents or staff who need her. Her belief in treating each person as an individual with rights extends to families and staff. Professionals also hold her in esteem, being aware that she and her team maintain quality of life for older people in a way that few other services are able to. Miss Wildash herself is a qualified nurse and keeps up to date with training and knowledge. She is considering undertaking the registered managers award, but time constraints make this difficult when her focus is on quality of life for residents, including caring for her mother. Families said they can chat to Miss Wildash whenever they need, they will be listened to and can make comment about the service. They are able to work in partnership with staff at the home. Residents’ views are always taken into account when decisions are made. Miss Wildash has a good understanding of each person and anticipates whether they are receiving the right service. Feedback is also sought on an informal basis from visitors to the home including relatives and professionals. There is little need for formal meetings, being such a small unit. There are frequent opportunities for staff, residents and relatives to get together. Staff handover to each other between shifts and have a communication book. Supervision also takes place in an informal manner. Staff say they feel supported and know the expectations of their role and whether they are meeting them. Miss Wildash ensures that the service is viable. Insurance cover is maintained with current insurance certificates on display. Miss Wildash says she doesn’t have control of any residents’ monies. She assists one person in dealing with small financial matters and makes sure everything is properly accounted for. The others have families or friends who deal with their finances. Policies are drawn up which are relevant to the service and are shared and accessible to staff. Policies are reviewed as necessary, including when professional guidance is issued. Records are held securely and accessible only on a need to know basis. Staff are expected to maintain good records and aware that documentation is evidence of the work they carry out. Throughout the site visit staff were observed to follow good working practices. They are trained to carry out correct moving and handling techniques to ensure residents are safe. Use of protective clothing and systems to reduce the risks of cross infection are maintained. Staff are aware of the action to take in the event of fire and fire safety systems are recorded as being regularly tested and serviced. Information given by Miss Wildash records that servicing of equipment is carried out within correct timescales. Accidents are properly recorded in line with Data Protection guidelines. Wildashs DS0000024047.V325883.R01.S.doc Version 5.2 Page 24 Wildashs DS0000024047.V325883.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 3 3 3 3 3 3 Wildashs DS0000024047.V325883.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP29 Regulation 19 (1) (b) Requirement The registered person shall not employ a person to work at the care home unless a satisfactory criminal records bureau certificate has been received. The two staff who currently have no criminal records bureau certificate must have one carried out if they are to continue to work at the home. Timescale for action 28/02/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations None from this inspection Wildashs DS0000024047.V325883.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Wildashs DS0000024047.V325883.R01.S.doc Version 5.2 Page 28 - 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. 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