Inspection on 30/09/08 for Windward Court Residential Home

This inspection was carried out on 30th September 2008.

CSCI found this care home to be providing an Excellent 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

Windward Court Residential Home 05/10/06

Windward Court Residential Home 27/02/06

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Fairfields Country Rest Home

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Poldhu

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Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Windward Court Residential Home Totnes Road South Brent Devon TQ10 9JN     The quality rating for this care home is:   three star excellent 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: Wendy Baines     Date: 0 1 1 0 2 0 0 8 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. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 32 Information about the care home Name of care home: Address: Windward Court Residential Home Totnes Road South Brent Devon TQ10 9JN 0136472386 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Geraldine Maria Swift Type of registration: Number of places registered: Thurlestone Court Limited care home 42 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is 42. The registered person may provide the following category of service only: Care home providing personal care - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE Physical disability aged 50 years and over on admission - Code PD Date of last inspection Brief description of the care home Thurlestone Court Ltd. took ownership of the home on 1st November 2005 and registered as Providers. Ms. Brigitte Harvey is the Responsible Individual. The home is now part of a group of loosely affiliated companies and partnerships collectively known as The Court Group. This group has a number of homes in the Torbay and South Care Homes for Older People Page 4 of 32 Over 65 0 42 0 42 0 42 Brief description of the care home Hams areas of Devon and promotes a corporate identity and ethos. Windward House is a detached property set in its own grounds in the village of South Brent. The home provides care for up to 42 older people some of whom may have a physical disability and mobility problems. There is also a separate purpose built unit to support people with Dementia. Accommodation in the main building is on two floors in mainly single rooms with en-suite facilities. A stair lift operates between the two floors. At the time of this inspection, a substantial extension to the home had been completed. Care Homes for Older People Page 5 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The Quality rating for this service is 3 Star. This means the people who use this service experience excellent quality outcomes. The inspection was unannounced and undertaken on the 30th September and 1st October 2008. The Registered Manager was present throughout the visit. Prior to the inspection the Commission had sent surveys to people living in the home to ascertain their views regarding the quality of the service provided: All of the surveys returned contained positive feedback about the services people recieve. The Inspector completed a tour of the premises and was able to meet with residents on Care Homes for Older People Page 6 of 32 an individual basis and in group settings. All of the staff on duty were spoken to and the Inspector was able to spend time with and ask the views of people visiting the home. These included family, friends and other professionals. A sample of records were examined, and the care notes of six people were looked at in detail. Other documentation such as the staff files, residents meeting minutes, quality assurance questionnaires, medication records and those relating to health and safety were also examined. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 8 of 32 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 32 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 32 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People considering moving to Windward Court are provided with sufficient information to help them make an informed choice about where they live and the services they recieve. The homes admission process ensures that people are assessed prior to moving in to ensure that their needs can be sufficiently met. Evidence: The files of three people most recently admitted to the home were examined in detail. All contained comprehensive assessments. The pre-admission assessment for one person was examined and found to provide a clear description of her needs and how these were to be met at Windward Court. The assessment included information about the persons personal and health care needs, Care Homes for Older People Page 11 of 32 Evidence: their social and religious interests as well as their preferred routines. A service user guide detailing the services provided at the home and an example of the contract was provided for people considering moving in. This information also included a copy of the last inspection report and comments from people who currently live in the home. One room is provided as a respite care facility. Several of the residents spoken to had stayed at the home for respite before moving in on a more permenant basis. One resident said that she was familiar with the residents and staff before moving in as she had stayed for respite and had been invited to visit with her family. A family spoken to said that they were happy with how well their mother had settled. They said they were kept fully informed of any important issues and had confidence in the manager and staff. At the end of the admission process the home send a letter to the prospective resident informing them whether or not Windward Court can meet their needs. Care Homes for Older People Page 12 of 32 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Windward Court can be assured that they will recieve good personal and heath care support. Their health care needs will be regularly monitored and any changes dealt with promptly. Evidence: The inspector had access to all records during the visit. Five of the care plans were examined in greater detail. Each plan had been signed by the resident and/or their representative, and contained details of particular individual needs. Some of the care plans had no or limited information about peoples social/ leisure needs. This was discussed with the manager who said that where necessary this information would be added during the next care plan review. The plans had been reviewed regularly and residents had signed their reviewed plans. Staff spoken to said that they were able to access the information they needed to meet the needs of the people they care for. Care Homes for Older People Page 13 of 32 Evidence: Examples of recording included details of oral care, a falls register, nutritional screening and weight monitoring. Individual care plans stated when particular monitoring processes were in place such as fluid intake, and monitoring charts were found to be well maintained and up to date. Continence care is promoted and advice and assessment sought from the Continence advisor when required. Risk assessments were found in each care plan for different areas of care including; Prevention of falls, Moving and handling and Pressure care. All residents are registered with the local GP and are able to see visiting health workers in the privacy of their own room. The inspector was able to meet with a GP and District Nurse who were both visiting residents during the inspection. The feedback from both professionals was positive regarding the care of residents living at Windward Court. Comments included, When residents are particularly unwell the care provided by staff is excellent, the home makes prompt and appropriate referrals, and have been particularly skilled at following a skin care plan for one resident. Feedback from the GP was also positive. She said that the families she had spoken to had always been very positive about the care provided to their relative during their time at Windward Court. The GP also said the home is always clean and I feel residents recieve good care, particularly when they become unwell. The new system of nutritional screening and monitoring was of particular note. The homes new kitchen had been fitted with sophisticated equipment, which enabled food to be prepared in a way that maximises the nutritional value. Discussions with the homes cook and other staff demonstrated an awareness of the high nutritional standards which the home is implementing. Fresh ingredients were used in the preparation of meals, one of which was sampled. Levels of hydration are monitored and residents were being encouraged to take plenty of fluid. The homes systems for the administration of medications were examined. A monitored dosage system was in use. Since the last inspection two medication trolleys had been purchased to ensure that medication is appropriatly and safely stored. Records of the administration of medication was sampled. These were found to be in good order and up to date. The use of Homely remedies was supported by a professionally approved list. The manager said that they would be purchasing a small fridge for medication that requires cold storage. Care Homes for Older People Page 14 of 32 Evidence: Throughout the inspection staff were observed knocking on residents bedrooms before entering and speaking to residents in a respecful manner at all times. All intimate care took place in the privacy of residents own rooms. Care plans included information about the individuals and familys wishes at the time of death. The Registered Manager works very hard to ensure that the privacy and dignity of a resident who is dying is maintained at all times. A visiting priest said that he was always very impressed by the homes end of life care. He said that the manager and staff ensure that a separate room is available for the family to spend time together and following a residents death the bedroom is beautifully prepared in a way that is appropraite and respectful for the resident and family members. Care Homes for Older People Page 15 of 32 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Windward are able to enjoy a relaxed, homely atmosphere where they can make choices about their lifestyle. Dietary needs are very well catered for with a balanced and varied selection of food avilable that meets peoples tastes, choices and specific dietary needs. Evidence: The inspector was able to discuss daily life and social activities with staff, residents and visitors. As the Inspector was also in the home over two days it was also possible to observe how people were spending their time and the interaction between staff and the people they were supporting. Information about local events and in-house activities were advertised on the homes notice boards. Some of the individual care plans had limited information about peoples specific social and leisure interests although the manager said that this information is gathered at the time of admission. Throughout the visit the atmosphere in the home was warm and welcoming. The layout and size of the home allows for people to spend time sitting quietly on their own Care Homes for Older People Page 16 of 32 Evidence: or with others if they so choose. Residents were observed reading the daily papers in the large communal sitting room, one lady was knitting, others were sat in small communal areas enjoying visits from family or just having some quiet time on their own. During the afternoon of the second day a group of residents joined in an organised music group led by a local music therapist, this was clearly a very popular activity. As the inspector toured the home it was possible to observe residents relaxing in their bedrooms, whilst watching television or listening to music. Residents were being offered the opportunity to enjoy a hand and nail massage and several residents had an appointment with the homes visiting hairdresser. Staff spoken to said that not all residents choose to join in the planned activities and this choice is respected. The home had recently purchased some reminiscence games for staff working with residents who have Dementia. The games had just arrived and the manager said that staff would require some training to ensure that they were used appropriatly. Visiting clergy enable residents of different denominations to practice their chosen religion. Those who are able are supported to visit local places of worship. Throughout the two day visit the Inspector observed a number of friends and relatives visting the home. All said that they are able to visit at any time and are made to feel very welcome. One family member was spending time enjoying lunch with their relative. Family and friends were able to spend time with their relative in their own room but due to the size of the home could also have privacy whilst sitting in one of the many communal areas. The manager was offering support and reassurance to the family of one resident. Staff and visitors said that the manager is always available and allows time to offer support to residents and their families. The Inspector was able to see the daily menu, speak with kitchen staff and join residents for a midday meal. Staff and the cook were very aware of the likes and dislikes of individual residents and this information as well as special dietary requirements were also recorded in care plans. Due to the size of the home and differing needs of residents the dining areas have been organised to allow for people to eat their meals in smaller groups. On the first day the Inspector joined residents in the main dining room, which had recently been extended. The dining area was very attractive and the food served was of a very high standard. The mealtime was relaxed and unrushed and staff responded promptly and respectively to any specific requests made by residents. Care Homes for Older People Page 17 of 32 Evidence: On the second day the Inspector observed staff supporting residents at mealtime within the part of the home specifically providing care for people with Dementia. One staff member supported six residents all of whom required some 1:1 support during the meal. Although the staff member provided excellent and sensitive care and support it was observed that more staff were needed during this busy time. Care Homes for Older People Page 18 of 32 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Windward Court can feel confident that their concerns will be listened to and taken seriously. The Registered Manager and staff are effective in protecting people from abuse. Evidence: Thurlestone Court Ltd. has a complaints policy and procedure. A copy of this information is provided to residents at the time of the admission and is also available on the homes noticeboard. Residents and relatives spoken to said that the manager is always available and that there is a very open atmosphere in the home. During the inspection the manager was approached numerous times by residents to answer questions about their care and daily arrangements or just to have a chat, and at all times she responded in a sensitive and respectful manner. The manager also met with the family of one resident to offer support and reassurance during a difficult time. Some of the people who use the service and their family and representatives said that they felt confident that their concerns would be taken seriously by the staff and Registered Manager. Awareness training is provided for staff concerning the protection and safeguarding of Care Homes for Older People Page 19 of 32 Evidence: vulnerable adults. New staff recieve this training as part of their induction programme. The manager said that by the end of September 2007 all staff would have attended this training. The staff notice board included information about arrangements to discuss safeguarding within a team meeting as part of a policy of the month discussion. In discussion staff were clear about the action they would take in the event of a disclosure. The Registered Manager has a well-developed understanding of abuse issues. She has previously acted in a commendably robust and determined way to protect the interests of people who use the service. The manager was also able to give recent examples of when she has sought advice regarding the protection of peoples personal finances. Residents financial affairs are handled by relatives or professional advocates. Small amounts of money are securely stored for residents in the home. Receipts are kept and any transactions recorded. These records were sampled and found to be in good order. Policy statements preclude staff from gaining financial benefit from residents. Care Homes for Older People Page 20 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Windward Court benefit from a clean, comfortable and wellmaintained environment. Residents are now benefiting from new accommodation and facilities that have been appointed to a high standard. Evidence: Since the last key inspection Windward has completed a major programme to extend and upgrade the premises. The home now provides accommodation for 42 people and has a separate purpose built unit to support people with Dementia. Several residents, family and visitors spoke about the changes to the building during the last year and all said that they were impressed with the improvements and did not feel that residents had been particularly effected during this time. The Registered Provider, Registered manager and staff at Windward are commended for minimising the potential disruption to residents during this development. The new accommodation has been fitted and furnished to a very high standard. There are now 42 bedrooms, 36 of which have en-suite facilities. The first part of the programme was completed at the time of the last inspection and Care Homes for Older People Page 21 of 32 Evidence: included a new kitchen, laundry facilities, large lounge, and specially equipped toilet and bathroom facilities. Further work has now been completed to include a further extention to the rear of the original building, which has provided 24 bedrooms with en-suite facilities a separate shower room, bathroom with assisted bath, two communal lounges and a hairdressing facility. A new shaft lift has also been installed providing access for all residents occupying first floor rooms. The home now provides ample communal space. There is a beautiful large conservatory, where residents were sat reading, listening to music and enjoying the company of staff and visitors. There are three other communal lounges around the home and residents are able to choose whether they wish to spend time sat quietly on their own or in the company of others. There is also sufficient communal space for residents who may need more space and assistance of staff due to their greater care needs. A sample of the new and original bedrooms were seen and all were furnished to a high standard. Residents were able to bring their own furniture to the home and bedrooms contained many personal belongings. All the new bedrooms were comfortably furnished and attractively decorated. Rooms were fitted with locks and each room contained lockable storage. A new cordless call system was in operation. This consisted of a staff pager system, which would minimise call bell disturbance to residence. There were three separate dining areas and residents are able to choose where they eat their meals. There is also a separate dining area for residents who may require more support and space during meal times. The original dining room has been extended to provide a large, airy attractive room for residents to enjoy their meals. All areas had access to good natural and artificial light and all parts of the home were sufficiently heated. Much consideration had been given to making the outside of the property as attractive as the inside and many of the original features had been kept or improved. The bedrooms within the new part of the building looked out at an enclosed court yard with water feature, seating and raised flower beds. The Inspector was impressed by the attention to detail as even the area for bins had been disguised by attractive lattice fencing. Radiators and hot pipes were all covered, and water temperature regulated. Care Homes for Older People Page 22 of 32 Evidence: Around the home various aids and adaptations were seen. These included such items as toilet frames, booster seats and hoists. A new sit on scales had also been purchased to enable staff to weigh residents safely. The new laundry was equipped with state of the art machinery for washing and drying.The washing machine had a sluicing facility and was capable of hot wash cycles. Floors and walls in the laundry were cleanable. Hand washing facilities were available for staff using the laundry. Cleaning equipment was colour coded for different uses and cleaning staff were clear about the system in operation. Separate disposal arrangements were seen to be in place for infected waste. A very high standard of cleanliness was evident around the premises. The staff and Registered Manager are commended for their diligence in controlling offensive odours. Care Homes for Older People Page 23 of 32 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Windward will recieve care from a skilled group of staff who will be sufficient in number to meet their current and changing needs. Evidence: Staff were descibed by people living in the home and those visiting as very kind and caring with nothing being too much trouble. People said they were supported promptly indicating that staff were employed in sufficient numbers to meet the needs of those currently living in the home. On the day of the inspection there were four care staff plus one new staff member completing part of an induction programme, a chef, the Registered manager and Deputy manager. The rota and Registered manager confirmed that this would be a normal shift in the home with the addition of three night staff, one sleeping and two waking. The asssistent manager was working on the day of the inspection with the specific task of reviewing residents care plans. She said that it was important to have time to fulfill this task without any other duties or distractions. Throughout the inspection staff were attending to chores, assisting residents and spending time with residents in the communal parts of the home. One staff member was offering residents the opportunity to have their hands massaged and nails Care Homes for Older People Page 24 of 32 Evidence: manicured. All the staff on duty were spoken with and all said they felt well supported to undertake their work and found the owners and Registered Manager approachable. Throughout the inspection staff were observed responding promptly and sensitively to the requests of residents and demonstrated particular skill and compassion when supporting people with Dementia. It was noted that one member of staff was available to support six residents in the Dementia unit during the midday lunch. Although the staff member was patient and skilled when providing care, residents had to wait for help with their meal as they all required some 1:1 support during this time. The Inspector spoke with the Registered Manager about this issue and the need to review staffing levels in this part of the home. The personal files for six members of staff employed at the home were examined, some of these were files of staff recently appointed. All these files contained the necessary pre-employment checks including two written references and a Criminal Record Disclosure (CRB). New staff were provided with in-house induction training to ensure they are given information about the care home and the people living there: this was evidenced in a number of staff files. One new member of staff was spoken to during the inspection and said that she had been given lots of support and is always told to ask if she had any concerns. Staff files confirmed that staff complete and update training in health and safety, fire safety, moving and handling and first aid. The manager confirmed that all staff either had or were in training for a National Vocational Qualification, a nationally recognised qualification for which staff must demonstrate their knowledge and skills in supporting older people. All staff have access to the Registered Providers rolling training programme. Due to the recent changes in the home all staff have attended an intensive six day training course focusing on the needs of people with Dementia. The manager said that this training will continue to be updated as part of the homes ongoing training programme. Information was available on the staff notice board regarding staff meetings to discuss current policies including Safegaurding Adults. Staff spoken to confirmed that they also have opportunities to attend regular staff, handover meetings and 1:1 supervision sessions. Care Homes for Older People Page 25 of 32 Care Homes for Older People Page 26 of 32 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Windward Court benefit from an inclusive and open style of management. Staff are led by a very competent manager who is an excellent role model for her staff and diligent in safegaurding residents health and welfare. Evidence: The Registered Manager has managed Windward Court for a number of years under the present and previous ownership. She holds the Registered Managers Award and NVQ level 4 in Care. This training is supplemented by short courses such as Dementia Care, Health and safety and other training specific to the care of the Elderly. The ethos of the home under the Registered Managers leadership is commendable. The atmosphere is warm and friendly whilst maintaining clear professional bounderies. Staff have a good understanding of the needs of the people they care for and say that they can always speak to senior staff and management if they need support. The Care Homes for Older People Page 27 of 32 Evidence: Registered manager has demonstrated a clear understanding of her role and a committment to meeting the National Minimum Standards. She has also shown an ability to deal effectively with complex issues to protect residents and maintain the standards of care in the home. The Registered Manager should be particularly commended during the recent major refurbishment by ensuring minimal disruption to staff and residents. Visitors said that the Registered Manager has on several occassions shown considerable compassion and sensitivity when planning end of life care for residents and when supporting family during these difficult times. Throughout the inspection the manager demonstrated a very good awareness of the needs of people with Dementia and her calm sensitive approach to situations provided a good role model for staff. Stratagies are in place to promote and improve the quality of the service. For example regular staff and residents meetings enable people to contribute their views about the home. Annual questionnaires are sent to residents, relatives and professionals and the results are published and made available. Results of these questionaires are analysed and discussed in team meetings and an improvement plan to address issues agreed. The home was awarded the Quality Standard Investors in People Award in February 2008. Residents finances are handled by relatives or professional advocate. Small amounts of money were securely stored for residents in the home. Reciepts were kept and transactions recorded.These records were sampled and found to be in good order.Policy Statements precluded staff from gaining financial benefit from residents. Staff spoken to said they felt well supported and records confirmed that all staff have the opportunity to discuss their role, and personal development within 1:1 supervision sessions. A sample of the homes records were inspected including care records, risk assessments, staff files and health and safety information. All the records seen were found to be up to date and safely stored. The assistant manager was reviewing residents care plans during the inspection. It was noted that residents care plans are hand written and as these are completed and reviewed by different members of staff some of the writing was difficult to understand. As these records contain the information about individual care needs it is crucial that they can be understood by those providing support. This area of concern was discussed with the Registered Manager and the owner of the home. Care Homes for Older People Page 28 of 32 Evidence: Health and Safety issues were examined. Records of training reflected staff access to the Registered Providers training programme in health and safety. This included topics such as infection control, moving and handling and first aid. Information provided prior to the visit confirmed that there are up to date maintenance and servicing of systems and equipment. Risk assessments for the building were available for inspection. The manager stated that all radiators were covered and window restrictors in place for all bedrooms above ground level. Records confirmed that a record is kept of any accidents or injuries to residents and the appropraite agencies informed of the event. Care Homes for Older People Page 29 of 32 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 30 of 32 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 12 Care plans should include information about peoples social and leisure needs. This information should be monitored and reviewed as part of the individuals care plan. The home should ensure that sufficient staff are available within the Dementia care unit to sufficiently meet peoples needs during meal times. The manager should ensure that staffing levels are kept under review to ensure that there are a sufficient number of staff available at all times to meet the needs of people living in the home. This is particularly important within the Dementia care unit where peoples needs are more complex. The home should ensure that care plans are completed in a way that can be understood at all times by those providing care. Any changes made to this information should also be clearly and consistently documented to avoid any errors being made when providing care. 2 15 3 27 4 37 Care Homes for Older People Page 31 of 32 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) 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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