Inspection on 09/02/09 for Windsor Court

This inspection was carried out on 9th February 2009.

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

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

Other inspections for this house

Windsor Court 23/02/10

Windsor Court 19/02/08

Windsor Court 19/02/07

Windsor Court 24/05/06

Windsor Court 07/12/05

Windsor Court 06/06/05

Windsor Court 02/11/04

Windsor Court 10/05/04

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

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Windsor Court The Avenue Wallsend Tyne & Wear NE28 6SD     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: Jim Lamb     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: Windsor Court The Avenue Wallsend Tyne & Wear NE28 6SD 01912635060 01912633472 windsor@ladhar.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Baldev Singh Ladhar care home 45 Number of places (if applicable): Under 65 Over 65 0 0 0 dementia learning disability mental disorder, excluding learning disability or dementia Additional conditions: 45 3 5 The maximum number of service users who can be accommodated is: 45 The registered person may provide the following category 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: Dementia Code DE, maximum number of places: 45 Mental disorder, excluding learning disability or dementia - Code MD, maximum number of places: 5 Learning disability - Code LD, maximum number of places: 3 Date of last inspection Brief description of the care home Windsor Court is a purpose built three storey Care Home providing both Nursing and Residential care for up to 45 service users. Categories of care are Dementia, Learning Disabilities and Mental Disorder. The home provides care for service users above and below 65 years of age. The home is situated in The Avenue, Wallsend, close to the High Street, giving ease of access to shops, stores, restaurants and other public amenities. The fees range from 396.39. per week to 412.10. A service user guide and Care Homes for Older People Page 4 of 31 Brief description of the care home Statement of purpose for the home are available which provide information for potential residents and their families. A copy of the most recent inspection report is also available. 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: We have reviewed our practice when making requirements,to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The quality rating for this service is 2 stars. This means that the people who use the service experience good quality outcomes. How the inspection was carried out. Care Homes for Older People Page 6 of 31 Before the visit we looked at information we have received since the last visit, how the service dealt with any complaints and concerns since the last visit, any changes to how the home is run, the providers view of how well they care for people, and the views of people who use the service and their relatives, staff and other professionals. During the visit we talked with people who use the service, relatives, staff, the manager and visitors,looked at information about the people who use the service and how well their needs are met,looked at other records which must be kept, checked that staff had the knowledge, skills and training to meet the needs of the people they care for, looked around the building/parts of the building to make sure it was clean, safe and comfortable,and checked what improvements had been made since the last visit. We told the manager/provider what we found. What the care home does well: What has improved since the last inspection? What they could do better: The lounge space available on each unit is limited. Thought should be given to creating Care Homes for Older People Page 8 of 31 additional lounge/communal space for service users. To meet the service users holistic needs, the development of emotional, psychological and social care plans will help to achieve this. To safeguard and protect individuals,when service users display challenging behaviours that cause distress to themselves and others, appropriate professional advice should be sought as soon as possible, and treatment/therapeutic plans should be implemented and adhered to. Improved signage and orientation boards throughout the home will help service users to recognise their own rooms, bathrooms, toilets and aid their awareness of time and place etc. One service user has been prescribed rectal diazepam, to promote the heath and wellbeing of this person, it is important that the staff are appropriately trained to administer this medication. To ensure that all service users receive the support that they require during mealtimes, the mealtime routines should be reviewed. To keep people safe from harm, the aroma therapy oils and burners must be kept in a safe secure place. 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 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 10 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. Prospective service users are provided with enough information about the service to enable them to make a choice about whether this is where they want to live. Evidence: The care records for three service users were examined. These showed that the manager makes sure that a full assessment of a new service users needs is carried out by the persons social worker before they come into the home. This information is then used to implement initial care plans for each individual. The manager also carries out her own pre admission assessment, which ensures that the home can meet all of the new persons needs. More detailed assessments are carried out once the new service user has come into the home. These include assessments of risk, of nutritional needs, social needs, Care Homes for Older People Page 11 of 31 Evidence: moving and handling needs and of behavioural needs. A dependency rating scale is also completed. Skin care assessments are also carried out for those at risk of developing pressure sores. As a result of all these levels of assessment, the manager can clearly demonstrate that all the service users are in a home that can give them the care that they need. The homes service users guide is available, and information is available in a range of formats. All service users, or their representatives are provided with a contract explaining the homes terms and conditions, and fees. Care Homes for Older People Page 12 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 promotion of health care is taken seriously, and service users have their personal needs fully met. Evidence: People using the service are given sensitive personal support by the staff, who promote each individuals independence, dignity, privacy and choice. Three service users confirmed that staff treat them with respect at all times. Each person has an individual assessment of his or her personal needs, and has a care plan in place to meet those needs. Plans are person-centred, sensitive and thoughtful. They stress the strengths of the individual, and are positive in terms of seeking to develop the skills and abilities of the person. The care plans are working documents which are reviewed and updated with the individual, their representatives and other professionals involved in their care. Care Homes for Older People Page 13 of 31 Evidence: Although the plans are person centred, they follow the Roper Logan and Tierney model of activities for daily living. Those looked at lack enough detail about each persons emotional and psychological care needs. The manager agreed with this, and intends to address these areas, and arrange some additional care plan training that will focus on these aspects. Care plans are in place covering such issues as personal care, mobility, daily living and communication. For example staff have taken time to find out about previous life histories including family, friends, interests and religious preferences. The manager agreed that this information should be used to implement specific social care plans for each individual. Care plans are also detailed about peoples preferences. For example one person doesnt like to mix, and another person prefers not to eat or drink with other service users. People living in the home have full access to all health services including, GPs dental, ophthalmic and chiropody services. The home has good contact with district nursing services and asks the advice of specialist health care professional such CPNs and dietitians when required. Currently there are two service users with challenging behaviours, and at times their behaviour can cause distress not only to themselves but also to other service users. For these service users care plans are not sufficiently detailed and specific, which means that the staff may not be consistant in the way these behavoiurs are managed, and suitable diversional therapies may not be followed. To support staff, and to keep the service users safe, it would be helpful to seek advice from external experts, such as the Challenging Behaviour Team. There are dietetry care plans in place and these have been up-dated to include what action staff should take. Nutritional assessments are routinely completed, and this ensures that there is clear information now available about peoples dietary needs. All service users weights are monitored closely. Medicines are ordered monthly, and these are delivered in blister packs for two of the units. The other unit is in the process of having the same system introduced. This is said to be working well, and will minimise any risk of a medication error. No controlled drugs are currently prescribed, but should this change, appropriate procedures are in place. The Medication Administration Records were checked. These were found to be Care Homes for Older People Page 14 of 31 Evidence: completed to a good standard, with no gaps, and the codes used properly. One person has recently been prescribed rectal diazepam. This is administered by one of the qualified nursing staff, however it is still important that staff are appropriately trained to administer this medication. The manager confirmed that she will arrange appropriate training. Medicines are safely stored. All staff have had training on how to use the medication system. Not all staff have had external Safe Handling of Medicines training. This was discussed with the manager, who then immediately arranged training to take place with an accredited training company. Care Homes for Older People Page 15 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 service users are offered a good quality lifestyle, which includes social contact, and activities. Evidence: Each service user has a social skills life story completed. All service users and their representatives participate in this process. The completion of the life story assessment should be used to assist staff to implement more detailed social care plans for each service user. There are daily activities available, and entertainers frequently visit the home, and outings are arranged. Some service users regularly visit the local shops and other local amenities. The home employs an activities co-ordinator, and she maintains records of the activities that take place, and keeps a record of all those who have participated in the various activities. The activities programme is based on service users interests and choice. Care Homes for Older People Page 16 of 31 Evidence: All service users are supported to maintain very close links with their families. They can choose who they want to see and when. One relative spoken to said,I visit most days, and the care here is good, they take good care of my relative. The home is in the process of creating memory boxes, and these are fixed to the wall outside of each individuals bedroom. This is good practice. The homes menus are based on the known likes and dislikes of the service users. At least three hot meals are provided each day. The menus are varied and well balanced. The cook had good knowledge of the service users dietary needs. Special diets are provided when necessary. The food stock levels were good, and there was plenty of fresh fruit available for service users. All those spoken to said that the meals were good and that they were always offered a choice. The menus are displayed on the dining room tables. Consideration should be given to implementing pictorial menus, particularly for those service users with communication and memory impairment. A religious service which is open to all denominations, is held in the home every two weeks. An Expert by Experience who attended the inspection said: I arrived at the care home mid afternoon. Upon arrival I was greeted by one of the RMNs who led me into the main office where I introduced myself to the inspector and he in turn introduced me to the Manager. I was shown around the home with a very accommodating lady called Denise, who was the Administrator but also held an NVQ III award in Health and Social Care. Denise had worked at the home for approximately four years and stated that she enjoyed her role. She displayed a lovely manner with the residents whilst we walked round. She advised me that the ground floor was predominantly for those residents who were frail, the middle floor for challenging behaviour and the second floor for residential. Denise showed me to the Sensory room. The room is well equipped with different lights and lava lamps. There is also a music system and a selection of relaxing music. The room includes electrical oil burners/humidifiers which give off pleasing scents. I observed however, that the oils were stored in a plastic bag on a shelf near the music system with the burners directly on top of the system. I felt that this could present a potential safety hazard firstly due to the potency some aromatherapy oils may have Care Homes for Older People Page 17 of 31 Evidence: and thus being perhaps a danger to residents and also the location of the burners was concerning. Denise advised that the home employed an Activities Co-ordinator who was employed for 25 hours per week. Previously there had been a daily rota of activities but this had not worked well so it was then changed to a weekly rota. The rota was on display on the group floor. It was very small - A4 size, with no date and not really situated in a prominent place. I would suggest that the activities rota be made much larger and placed in a prominent place , on each floor for all residents to see. Denise advised that there was a good range of activities provided. The co-ordinator would often have a film afternoon, where popcorn would be provided to give a more cinema feel. A hairdresser also frequently visited. Residents were often taken out to the bank or to the shops. The activities co-ordinator would also carry out one-to-one activities and interaction for residents, structured and tailored to their individuals needs. The residents were often taken off-site for a ballroom evening. Some residents also accessed an enabler service. This is provided by an outside agency Care Watch. One of the dining rooms had a small non-functional bar-setting in the corner of the room with bar stools, settee and large TV. This had a nice feel and Denise advised that the male residents would often sit and watch the sport on TV. The room also had an organ. Some residents had previously been able to play this but due to progression of their illness this was not always possible. There were patio doors which led into the back garden. Local school children had been involved in creating a mural on the walls. There were raised flower beds for ease of access for the residents and also several seating areas. Some of the paving slabs were slightly uneven. I was asked to have a meal with the residents. I was seated in the ground floor dining room. The residents sat for some time before their meal or indeed a drink was given. The tables were not particularly laid well, had no condiments, serviettes or cutlery. The dining room was small and several residents had their walking frames positioned very near to them. This was a little cluttered with not much room to walk around or serve the meal. The residents were served with a cup of tea first. A lady on the opposite table had been served her tea in a feeder cup. The male assistant stated that it was far too hot. Care Homes for Older People Page 18 of 31 Evidence: However, he put it down in front of the lady, who would need assistance, tried to reach for it. He then moved it back and said it was far too hot for her to drink. I feel perhaps that it may have been more appropriate to make the tea more temperate or to leave the cup out of reach and sight rather than to have it right in front of her where due to mobility she was unable to take a drink. During the meal one of the residents was quite agitated and repeatedly banged her trolley into the patio doors in the dining room wanting to get out. The staffed tried relentlessly to pacify her. This was much to the detriment of the other diners as the staff got up to tend to the lady but in doing so left the resident whom they were assisting with their diet. Another lady required to use the toilet and the male assistant left the person he was attending to deal with the lady, she did however say she did not want a male assistant to help and she was asked to go to her room and someone would come to her. She came back to the dining room and announced that it was too late. Another member of staff assisted her to her room. Generally the meal time was very disjointed and at one point, the lady with the feeder cup had three different people assisting her but at long intervals which meant her meal got cold. One member of staff suggested that the meal could easily be warmed up this I feel is against food safety standards and could result in food poisoning or the like. This lady also did not appear to be positioned well in her wheel chair being a little slouched. The lady did have a long coughing episode which may have been a result of eating in this position. Another lady was left sitting on the settee whilst the staff dealt with the agitated lady and again had two different people assisting her. Several clients needed assistance with diet however the staff were very dispersed. The meal consisted of two choices. Liver with mash and vegetables and pasty with chips and peas. I chose the latter. The food was satisfactory but not of a great standard with the pastry a little hard and possibly difficult for an older person to manage. The food choices were given verbally and there was no other format for the residents to choose from. For example a visual pictorial menu, for ease for the residents who may have cognitive problems. 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 complaints management is effective, and this results in service users being protected from harm and abuse. Evidence: There is a complaints procedure. It contains details of how to contact the CSCI to make a complaint, if complainants are not happy with the homes investigation and response. The procedure is not written in a way that ensures service users fully understand its contents. Large print and pictorial formats could be considered, which would help some service users to fully understand its contents. Three service users said that they had been given copies of the procedure and that staff listened to their concerns and always dealt with them fairly. The home keeps a record of complaints. During the last twelve months there have been several complaints received. All were appropriately investigated and resolved, for example, the organisation responded by letter to each complainant, if a complaint was found to be upheld, they apologise, and outline the action they have taken to prevent a reoccurrence. Concerns raised by local authority contracts teams and reviewing officers have been addressed. The home has a Whistle Blowing policy, a copy of the Local Authorities Vulnerable Adults procedures, and a copy of the Department of Healths document, NO SECRETS. Staff are aware of these procedures and have easy Care Homes for Older People Page 20 of 31 Evidence: access to them. Safeguarding adults training is ongoing for all staff. Service users can deposit cash for safe keeping in the homes safe and records are kept of accounts. A sample of personal finances records was examined. Transactions were appropriately recorded and had two signatures for each entry. There was plenty of evidence of personal spending. Receipts are obtained for purchases and numbered and cross-referenced to the transaction. Weekly checks of balances and cash are carried out. 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 provides a comfortable and safe environment for those living there. Evidence: The home was clean, well decorated and well maintained. The grounds were tidy, attractive and accessible. There is a sensory garden to the rear, with an attractive raised deck area. The home does not have an appropriate amount of lounge space. There is not enough room in the lounge areas on each unit to allow service users to socialise and relax with each other all at the same time. This results in some service users remaining in their rooms, adding to the risk of becoming socially isolated. To increase the lounge space in the home, consideration should be given to adding a conservatory, perhaps one leading off from the light sensory room, overlooking the rear gardens. During the last year, there has been some improvements made to the environment. Several bedrooms have been refurbished and decorated, and communal areas and corridors have all been decorated to a high standard. There was a distinct lack of appropriate signage and orientation boards displayed throughout the home. Picture signs should be introduced, to give information about Care Homes for Older People Page 22 of 31 Evidence: the day, month, season and include pictures and names of the staff on duty. These will help to orientate service users. To help to avoid some service users wandering into other peoples bedrooms, resulting in distress and sometimes conflict, recognised research reveals a number of ways to minimise this happening, for example: bedroom doors should not be painted in the same uniform colour, large door numbers, and large photographs of the person displayed on, or next to the door will help to avoid this happening. (Permission must be sought for the latter) Pictorial signs should also be considered for bathroon and toilet doors. Service users can see visitors in private in their own rooms. Furnishings and fittings were domestic in design and in good condition. Lighting was bright and domestic in design. All doors have privacy locks and room sizes meet the minimum required. There is space on either side of beds when necessary, to enable access for carers and specialist equipment. Service users bedrooms have opening windows and restrictors are in place where needed. The rooms have underfloor heating. There was emergency lighting throughout the home. Water is stored at over 60 C. Valves at water outlets ensure water is provided close to 43 C to prevent scalding. The home was clean and free from offensive odours. An Expert by Experience who attended the inspection said: I was taken into a room on the middle floor of an elderly gentleman who advised me that he had a PHD. I chatted a while with him, although pleasantly confused he stated that he felt comfortable staying there and that the folkwere satisfactory. The room was bright and airy with very tasteful furnishings. As I looked around the home, I observed that there was no orientation board i.e. displaying what day, date, month, year, season, what the weather was like etc. I had a brief discussion with a lady who was visiting her mother. She advised me that she was very pleased with the care her mother was given, that the staff were lovely and had no concerns. The conversation was very brief as her mother started to Care Homes for Older People Page 23 of 31 Evidence: become agitated. I also spoke to another lady visiting her mother. Her mother had not been a resident for very long. She felt that her mother was well looked after and although her mother had been there only a short time, she was quite pleased with the care and service. She advised that the carpet in her mothers room was a little dilapidated but she had expressed this to the staff and the issue had now been resolved or near to resolution. She advised that her mother was able to be taken out depending upon the staffing levels and also her mother was able to walk around on other floors - for a change of scenery. She advised that the staff were very good and she felt that there were open channels of communication. She also stated that she felt that she was well looked after as a carer. I asked if she was aware of any complaints procedure - she was not. She did however express that she had no qualms about raising any issues or concerns as she felt the staff were very approachable. The top floor had a small communal room which appeared to be on the small side to cater for the 16 residents on this floor. There was a table in the room with dining chairs which some of the residents preferred to sit at rather than the low sofas/lounge chairs. The carpets on the two sets of stairs between the floors were a little messy and untidy. Care Homes for Older People Page 24 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 enough staff employed to meet the needs of service users and safeguard their welfare. Evidence: Staff levels on the day of the inspection met the agreed level for the number of service users. On the day of the inspection there were 43 service users. In addition to the manager, the required numbers of staff were on duty: on the first and second floor units there are 2 qualified nurses, 1 RMN and 1 RGN, 5 care staff between 8am and 2pm and 4 care staff after 2pm until 10pm. The top floor unit has a senior carer and a support carer at all times during the day. There are 5 carers and a qualified nurse between 10pm and 8am. The home has a full time administrator. There are 143 domestic hours, 30 hours maintenance, and 110 catering hours. All staff were over 18 years of age and those left in charge were at least 21. The training needs of the staff are identified in supervision and appraisal sessions. Care Homes for Older People Page 25 of 31 Evidence: The homes training programme meets the National Training Organisation requirements for the first six months. Staff receive at least three days paid training each year. The home has a good staff training and development programme in place. The following training sessions have been arranged, February- April: Challenging behaviour, equality and diversity, food hygiene, infection control, health and safety, dementia awareness, risk assessment, moving and handling, first aid and medication training. The service has a rigorous staff recruitment and selection process to ensure that all appropriate checks and references are in place prior to employment. All statutory training was up to date and 80 of the staff team has completed NVQ level 2/3. Care Homes for Older People Page 26 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 manager is supported by the organisation in providing good leadership throughout the home, with staff demonstrating a clear awareness of their roles and responsibilities. Evidence: The manager has been in post for five months. She has the appropriate experience and management skills necessary to manage the service. She has commenced the registered managers award. All staff interviewed were clear about their responsibilities, and they had very good knowledge of the service users needs. Service users are told when inspections take place and there are copies of reports available for relatives and others to see. A quality system is in place to monitor the quality of the service provided. This involves gaining feedback from service users and their relatives. Currently other Care Homes for Older People Page 27 of 31 Evidence: professionals are not sent questionnaires, but the manager agreed that this will be done in future, and that outcomes will be published and made available to all prospective service users.The home will also produce an annual development plan. The service has applied for the Investors in Peoples Award. There is a health and safety policy and a range of associated procedures. The staff receive training in health and safety and safe working practices (fire safety, moving and handling, first aid, food hygiene, and infection control). Servicing and maintenance agreements are in place for facilities and equipment. All fire safety checks, tests and instructions to staff are conducted at the required frequency and recorded. Water storage tanks, gas and electrics are checked annually. Care Homes for Older People Page 28 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 29 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 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 Professional advice must be sought to enable staff to manage service users specific challenging behaviours appropriately and safely. Staff must be appropriately trained to administer rectal diazepam. Safe handling of medication training (Accredited) must be in place for all staff who administer medications. To promote the health and safety of the service users, the aroma therapy oils and burners must be stored in a locked cupboard. To ensure that service users are provided with assistance in eating where necessary, discreetly, sensitively, individually and safely, the mealtime routines in the home must be reviewed. 2 3 4 9 9 12 5 15 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. 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