Inspection on 04/01/07 for Wren House

This inspection was carried out on 4th 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

Wren House 07/02/06

Wren House 01/09/05

Wren House 09/03/05

Wren House 09/08/04

Wren House 30/01/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Wren House 32 Vicarage Street Warminster Wiltshire BA12 8JF Lead Inspector Thomas Webber Key Unannounced Inspection 4th January 2007 09:00 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 DS0000056886.V303700.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. DS0000056886.V303700.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wren House Address 32 Vicarage Street Warminster Wiltshire BA12 8JF 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) 01985 212578 Wren House Ltd Mrs Anne Elizabeth Anderson Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places DS0000056886.V303700.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th February 2006 Brief Description of the Service: Wren House is a private residential home offering accommodation and personal care to a total of 13 residents over the age of 65 who require care primarily through old age. Short-term care places can also be offered. In addition, there are two sheltered flats in an adjacent building with a further number of sheltered flats having been built to the rear of the home. However, the sheltered flats do not form part of the registered accommodation although the people here may have the opportunity to move into the care home at a later date, should their needs change. The home is situated close to the centre of Warminster, which offers a full range of amenities. The service is privately owned and registered as Wren House Limited. Mr Twinn and Mrs Anderson, the registered persons, who have constant involvement with all aspects of the home, run the home and they divide their responsibilities according to their own particular areas of expertise. Residents are provided with their own bedrooms and twelve of them have ensuite facilities, providing either a bath or a shower. The remaining bedroom has a private bathroom directly adjacent to it. Residents bedrooms are located on the ground and first floor levels and stair lifts have been installed on two flights of stairs, which enable easier access to the first floor for people with reduced mobility. A call bell system with an added speech facility is installed in each room, which is used by residents to call for staff assistance. The home’s fees charged to residents for the care and accommodation range from £687 to £743 per week. Information about the care and services provided can be accessed either by way of the home’s service users’ guide or through the home’s website. CSCI inspection reports can also be seen in the home and interested people can also download these directly from the CSCI website. DS0000056886.V303700.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection conducted over a period of one day on 4th January 2007 from 09:00 to 17:30. The judgements contained in this report have been made from evidence gathered during the inspection, which included a tour of the premises and takes into account the views and experiences of six of the ten residents accommodated. Residents’ views were sought on an individual basis. The comments of two members of staff, the deputy manager and manager were also sought. The records of the most recent resident admitted to the home since the last inspection was also checked in greater detail to ensure that the records were being appropriately maintained and that the person’s care needs are being suitably met. Twenty nine of the thirty eight Standards were also assessed on this occasion which included the examination of records, staffing, care practices, systems and policies and procedures. Feedback was provided throughout the inspection. What the service does well: Prospective residents are provided with information to make an informed choice about whether to live at the home. Each resident is provided with either a copy of the home’s agreement or placing authority’s terms and conditions so that they are aware of the services being provided to them. Residents are assessed by the home, prior to admission, to ensure that their needs can be met. Likewise prospective residents and their families are also provided with the opportunity to visit the home prior to admission to assess the quality, facilities and its suitability. The home is run and managed by persons who are appropriately qualified and who have sufficient experience within the relevant care setting. Residents continue to live in a home which provides good leadership within a relaxed atmosphere. The home is run in the best interests of the residents and their views regarding the care and services provided are sought on a regular basis. The health, safety and welfare of the residents and staff are promoted and protected. The home continues to provide sufficient numbers of staff on duty at all times to meet the needs of the residents. The staff team collectively have a range of experience and training to meet the needs of the residents and residents are supported and protected by the home’s recruitment practices. Residents who were spoken with commented very favourably about the standard of care and services provided by the staff. They stated that the staff who are excellent, very good, kind and caring treat them very well. Residents DS0000056886.V303700.R01.S.doc Version 5.2 Page 6 also confirmed that they felt very lucky and fortunate to be living at the home. Some residents described the home as being a home from home, which is exceptionally well run and residents appreciate the warm and caring atmosphere provided by the home. Residents also enjoy the noninstitutionalised environment created by the management. Residents live in a warm, welcoming, safe and comfortable environment, which is maintained to a very high standard and meets the residents’ individual and collective needs. Residents are provided with their own individual bedroom which they have personalised to their individual wishes. Residents have access to safe, comfortable and suitably furnished and decorated communal facilities together with sufficient toilet, shower and bathroom facilities. The home is maintained to a good standard being clean and tidy and provides suitable laundry facilities. Residents’ clothing is labelled to ensure that garments are appropriately returned. Residents commented very favourably about the laundry arrangements in place, stating that their clothing is returned the following day in very good condition. Residents also commented that they were extremely happy with the size of accommodation and the facilities available to them as well as the standard of cleanliness maintained. Residents’ bedrooms are normally redecorated and re-carpeted when there is a change of resident and this was evident during the inspection. Residents have been provided with an appropriate complaints procedure and they were confident that any complaints or concerns would be listened to, taken seriously and acted upon. Appropriate procedures are in place to protect residents from abuse. The health care needs of the residents are being suitably met and their medication is managed carefully and individual needs are taken into account. Residents’ privacy and dignity are respected at all times. Residents find the lifestyle experienced in the home matches their expectations and preferences, which satisfy their social, religious and recreational interests and needs. As stated previously they enjoy the non-institutionalised environment. Residents maintain contact with their families and friends in accordance with their preferences and visitors are welcome at the home at anytime. Residents exercise choice and control over their lives and they receive a varied, appealing and balanced diet, which caters for their needs and preferences. Residents who were spoken with were extremely complimentary about the quality and quantity of food provided. They confirmed that the food is excellent, they receive plenty and alternatives are provided to meet their individual preferences. What has improved since the last inspection? The home continues to provide a good standard of care to the residents, which is very much appreciated by them and meets their lifestyle. There have been no significant areas of improvement since the last inspection, as none were identified. DS0000056886.V303700.R01.S.doc Version 5.2 Page 7 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. DS0000056886.V303700.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 DS0000056886.V303700.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 5 and 6 This judgement has been made using available evidence including a visit to this service. Prospective residents are provided with information to make an informed choice about where to live. Each resident is provided with either a copy of the home’s agreement or placing authority’s terms and conditions so that they are aware of the services being provided to them. Residents are assessed by the home, prior to admission, to ensure that it can meet their needs. Prospective residents and their families are provided with the opportunity to visit and assess the quality, facilities and suitability of the home. Quality in this outcome area is excellent. EVIDENCE: Residents who are privately funded are provided with a copy of the home’s agreement that is dated and signed by the home, resident and witnessed by a family member or person who deals with the resident’s finances. However, where residents are funded by social services, they would be provided with a copy of the relevant local authority’s statement of terms and conditions. All residents have been issued with written contracts and evidence was available to confirm that a signed contract had been established for the most recent resident who has been admitted to the home. The home’s agreement is DS0000056886.V303700.R01.S.doc Version 5.2 Page 10 reviewed yearly and residents are informed in writing and in advance of any changes to the fees. The agreement clearly sets out the care and services covered by the fees. The home’s pre-admission assessment form is completed both at the enquiries stage and added to once the resident is admitted. Evidence was available to confirm that this assessment tool had been completed in respect to the recent admission to the home. Prospective residents and/or their families are provided with a copy of the home’s brochure and agreement at the enquiry stage. Alternatively, they can access copies through the home’s web site. Admissions to the home tend to be by recommendation. Prospective residents and their families can make as many introductory visits to the home, as they wish, to assess its quality, facilities and suitability. The resident most recently admitted to the home confirmed that pre-visits had been made to the home and this was supported by comments made by the provider. The home is not registered to provide intermediate care therefore this Standard is not applicable. DS0000056886.V303700.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 This judgement has been made using available evidence including a visit to this service. Residents’ care plans do not set out their health, personal and social care needs. The health care needs of the residents are being suitably met. Medication is managed carefully and individual needs are taken into account. Residents’ privacy and dignity are respected at all times. Quality in this outcome area is good. EVIDENCE: All residents have been provided with a care plan. However, these tend to refer purely to residents’ personal care, mobility and dietary requirements with a small section to record any other requirements. The level of content of the care plan seen in relation to the most recent admission was limited. The manager was advised of the need to review and re-design the format for residents’ care plans. This should provide more detailed information that reflects residents’ total needs, which include their health, personal and social care needs and how these are to be met. They should also contain the information reflected within Standard 3.3 of the National Minimum Standards of the Care Standards Act 2000. The format used for residents’ care plans should also contain the date and signatures of the resident and member of staff completing the form. Regular comments are recorded in residents’ daily DS0000056886.V303700.R01.S.doc Version 5.2 Page 12 case notes which refer to family visits, health care appointments and their general well-being. Although issues concerning the new resident’s personal safety were identified and recorded on her pre-admission assessment form, the resident’s personal safety and risk assessment form had not been completed. This deficiency was brought to the attention of the manager. Residents are currently registered with one of two different surgeries and the manager reported that the quality of service provided by them varies significantly. Some doctors provide residents with home visits if they need to see a GP whilst others require residents to attend the surgery for any appointments, unless their condition determines otherwise. Some residents are largely self-caring and staff support them where necessary. District nurses visit to treat certain conditions, take blood tests and offer advice. Various services including dental, chiropody and ophthalmology are provided by professionals visiting the home. The home has established a medication policy and care staff read and sign the update sheet at the beginning of their shift which details any changes in care or medication. Residents are supported to retain some responsibility for their medicines if desired, following a risk assessment. On the day of the inspection, one resident was self-medicating. Medication kept by the home is stored in locked cupboards. Appropriate systems have been established for the receipt, administration and return of unwanted medicines. A spot check of residents’ medication sheets showed that that they are being properly recorded for medication administered. More experienced staff, who have received internal training and have been deemed competent, only administer medication. The manager was advised of the need to explore external medication training for staff. Since the inspection and prior to the production of this report, the manager has reported that a DVD has been purchased for this purpose. A new lock has also been fitted to the medication cupboard and a double locking controlled drug safe is now in place for the storage of controlled drugs. Observations and discussions with residents confirmed that they are provided with their own bedrooms where they can conduct all their personal affairs in complete privacy. Residents can also choose whom and where to see any visitors either in the privacy of their bedrooms or in the communal areas provided. Residents’ mail is given directly to them unopened. Residents’ bedrooms are treated as their private space and staff knock before entering. Residents are provided with a telephone line in their bedrooms and each has their own telephone, which enables them to make and receive any calls in total privacy. DS0000056886.V303700.R01.S.doc Version 5.2 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 This judgement has been made using available evidence including a visit to this service. Residents find the lifestyle experienced in the home matches their expectations and preferences, which satisfy their social, religious and recreational interests and needs. Residents maintain contact with their families and friends in accordance with their preferences. Residents exercise choice and control over their lives and they receive a varied, appealing and balanced diet, which caters for their needs and preferences. Quality in this outcome area is excellent. EVIDENCE: Organised activities are not arranged by the home, as such, although drink parties are held yearly. However, opportunities exist for residents to pursue their own hobbies and interests and games of bridge and scrabble are organised by some of the residents, which also involves inviting people from within the community. Other residents within the home can also join in these activities. Residents, within their physical capabilities, come and go as they wish and some go into town on their own whilst staff or their families would assist those who are less able. Monthly Church of England services are held within the home, although the frequency of these can be increased at the request of the residents. Other religious denomination services could also be arranged. A hairdressing service is provided within the home or alternatively residents can attend salons within the community. DS0000056886.V303700.R01.S.doc Version 5.2 Page 14 The home is situated only a short distance from Warminster town centre where residents can access the amenities, should they wish to do so. Most residents have contact with family and friends who are welcome at the home at anytime. Residents can choose whom and where to see any visitors, either in their bedrooms or in the various communal areas. Observations and discussions with the residents confirmed that they exercise their personal autonomy and choice within their capabilities. Residents have brought items of furniture and personal possessions to make their bedrooms more homely, they choose how and where to spend their time, where to eat their meals and what time to get up and go to bed. Residents handle their own financial affairs in the privacy and comfort of their own bedrooms. The home is keen to offer a ‘hotel’ service and meet all reasonable requests and wishes of the residents. A satisfactory and varied menu is in operation, which provides a choice at breakfast, including the option of a cooked meal. All residents eat their breakfast in their bedrooms. Residents are provided with a range of choices for their evening meal, although a set main meal tends to be provided at lunchtime. However, alternatives are provided for this meal, if required, to meet residents’ preferences. Management reaffirmed that residents, to a large extent, determine what they have to eat. Residents’ special dietary needs are well catered for and there is also flexibility with regard to mealtimes so that residents can choose where and when to eat their meals. A range of drinks and snacks are available on request at any time: day and night. Residents who were spoken with were extremely complimentary about the quality and quantity of food provided. They confirmed that the food is excellent, they receive plenty and alternatives are provided to meet their individual preferences. DS0000056886.V303700.R01.S.doc Version 5.2 Page 15 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 This judgement has been made using available evidence including a visit to this service. Residents are confident that any complaints or concerns would be listened to, taken seriously and acted upon. Appropriate procedures are in place to protect residents from abuse. Quality in this outcome area is good. EVIDENCE: The home’s complaints procedure is written into the agreements drawn up with residents. The procedure provides the contact details of the Commission for Social Care Inspection. To date, there has not been an occasion to use this procedure. Residents who were spoken with stated that they had no complaints but felt confident that if they did have any concerns these could be discussed with the proprietors and staff who would listen and deal appropriately with them. Currently any concerns would be recorded on the home’s update form. However, for easier monitoring purposes, the manager agreed to develop a form which would record any concerns expressed as part of its open and transparent approach to dealing with concerns. The home has developed internal procedures relating to abuse and protection, which refers to the requirement to involve other parties. Guidelines on whistle blowing for staff have also been developed. Management reaffirmed that all members of staff have been provided with their individual copy of the Swindon and Wiltshire Vulnerable Adults procedures, which are in line with the Department of Health Guidance “No Secrets” document. Refresher training has also been provided to staff which was confirmed in their training records. DS0000056886.V303700.R01.S.doc Version 5.2 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23, 24 and 26 This judgement has been made using available evidence including a visit to this service. Residents live in a warm, welcoming, safe and comfortable environment, which is maintained to a very high standard and meets the residents’ individual and collective needs. Residents are provided with their own individual bedrooms which they have personalised to their individual wishes. Residents have access to safe, comfortable and suitably furnished and decorated communal facilities together with sufficient toilet, shower and bathroom facilities. The home is maintained to a high standard being clean and tidy and provides suitable laundry facilities. Quality in this outcome area is excellent. EVIDENCE: The home is situated only a short distance from Warminster town centre where residents can access the variety of amenities, should they wish to do so. The home offers high quality accommodation and continues to be kept clean, tidy and well maintained. The premises provide sufficient heating, lighting and ventilation and the standard of furnishings, fittings and decoration is maintained to a high standard. There is an ongoing maintenance programme DS0000056886.V303700.R01.S.doc Version 5.2 Page 17 within the home and maintenance staff are employed to undertake minor jobs with contractors being engaged, when necessary, for larger projects. The home provides a dining room, a main drawing room and a couple of smaller sitting areas off the ground floor corridor. These are attractively furnished and decorated to a high standard. Residents enjoy spending time in the garden, weather permitting and a number of residents’ ground floor bedrooms have French windows, which offer them direct access to this. Twelve of the home’s thirteen bedrooms have en-suite facilities, providing either a bath or a shower. The remaining bedroom has a private bathroom directly adjacent to it. Residents are very appreciative of these facilities. Residents’ bedrooms are suitably furnished and equipped to ensure comfort, privacy and meet their assessed needs. Residents would be provided with a lockable storage space if they wish this facility to store their personal effects. Residents have brought items of furniture and personal possessions to personalise their bedrooms to their individual wishes and to make them more homely. Most residents choose to spend much of their time in their bedrooms, which are large enough to entertain visitors in comfort. Residents who were spoken with commented that they were extremely happy with the size of accommodation, the facilities available to them as well as the standard of cleanliness maintained. Residents’ bedrooms are redecorated and re-carpeted when there is a change of resident. Since the last inspection, the home has redecorated and refurbished one bedroom, including its en-suite. The home continues to be maintained to a high standard being clean, tidy and comfortable and free from offensive odours. The laundry room provides suitable facilities to meet the needs of the home with staff undertaking the washing and ironing duties. Residents’ clothing is labelled to ensure that garments are appropriately returned. Residents commented very favourably about the laundry arrangements in place, stating that their clothing is returned the following day in very good condition. DS0000056886.V303700.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 This judgement has been made using available evidence including a visit to this service. The home continues to provide sufficient numbers of staff on duty at all times to meet the needs of the residents. The staff team collectively have a range of experience and training to meet the needs of the residents. Residents are supported and protected by the home’s recruitment practices. Quality in this outcome area is good. EVIDENCE: The deployment of staff continues to ensure that during the week there are three carers on duty in the mornings with two in the afternoons and evenings. These staffing levels exclude those hours worked by a supervisor, normally undertaken by the manager or deputy manager. At weekends a helper substitutes a morning carer. There is one waking night member of staff on duty with one member of care staff sleeping in each night. The manager or deputy manager also provides an on call service. The home also employs two domestics who work during the week and a cook who covers the lunch and suppertime meals. Discussion was held with management about the need to improve the recording of the staff rota to make it easier to understand the role of staff on duty. In addition, the hours worked by management needs to be recorded on the rota where they are providing cover to the basic numbers of staff on duty. Residents who were spoken with commented very favourably about the standard of care and services provided by the staff. They stated that the staff who are excellent, very good, kind and caring treat them very well. Residents DS0000056886.V303700.R01.S.doc Version 5.2 Page 19 also confirmed that they felt very lucky and fortunate to be living at the home. Some residents described the home as being a home from home, which is exceptionally well run and residents appreciate the warm and caring atmosphere provided by the home. Residents also enjoy the noninstitutionalised environment created by management. The files for two newly appointed staff were checked and these confirmed that, in the main, appropriate recruitment practices are being followed for the protection of the residents. These included obtaining medical clearances, two satisfactory written references and satisfactory Criminal Record Bureau enhanced checks. However, it was noted that a full employment history had not been obtained for one member of staff and the deputy manager agreed to ensure that the person’s employment history record is updated. Signed contracts have also been established. The majority of staff have a number of years experience in the care profession. The deputy manager reported that eight of the eighteen staff have achieved the National Vocational Qualification in level 2, one of which has also completed the NVQ 3. These together with the deputy manager’s qualifications ensures that the home have achieved the 50 of staff being trained in at least NVQ 2 in Care. The home has established a formal induction programme for new staff and since the last inspection the home has purchased the “Training Record of Induction in Care” booklets, which are being used for this purpose. The booklets reflect the common induction standards that meet the General Social Care Council’s “Code of Practice”. Evidence was available to confirm that the two most recent members of staff employed are using these. All new staff are considered as being additional for their initial shifts. Management are aware of the need for staff to complete the various mandatory training courses, some of which have already been undertaken by staff with further training being provided. Since the inspection some DVDs relating to training in medication administration, infection control, food hygiene and death, dying and bereavement have been purchased to assist with this process. Staff who were spoken with commented very positively with the training opportunities available. DS0000056886.V303700.R01.S.doc Version 5.2 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38 This judgement has been made using available evidence including a visit to this service. The home is run and managed by persons who are appropriately qualified and who have sufficient experience within the care setting. Residents continue to live in a home which provides good leadership within a relaxed atmosphere. The home is run in the best interests of the residents where their views are sought periodically regarding the care and services provided. Residents benefit from the knowledge that staff are supervised. The health, safety and welfare of the residents and staff are promoted and protected. Quality in this outcome area is good. EVIDENCE: The manager has considerable management and supervisory experience in the care setting she manages but as yet she has not gained the NVQ 4 Registered Managers’ Award. However, the manager is complemented and supported by her deputy manager who has day to day management of the care provided to the residents. The deputy manager has achieved the NVQ 4 Registered DS0000056886.V303700.R01.S.doc Version 5.2 Page 21 Managers’ and NVQ Assessors’ Awards. Since the last inspection the deputy manager has also completed the Manual Handling Trainer’s Award. Residents are seen daily by management or a supervisor and have the opportunity to comment regarding the care and services provided. The care and services provided by the home is monitored on a day to day basis by the manager and deputy manager with residents being given the opportunity to comment about the standard of care and services provided. Questionnaires had been developed and continue to be given or sent out to residents and their relatives yearly, as part of the home’s quality assurance system. The replies received were extremely positive about the care provided. However, a report of the survey detailing the results needs to be produced and made available to all current and prospective residents and their relatives should they wish to access to it. A copy also needs to be forwarded to the Commission for Social Care Inspection. The manager agreed to ensure that this is achieved for the questionnaires sent out for 2007. Residents handle their own financial affairs with the help of their families or their financial advisors. The proprietor or manager do not act as appointee for any residents and nor do they hold any money on their behalf. Therefore this Standard is not applicable. There are a range of mechanisms in place for the manager to both brief and receive feedback from staff in order to monitor the standard of care and services provided to the residents. Handover meetings are held daily which includes the recording of any specific issues relating to particular residents on the daily update form. Arrangements are in place to ensure that staff receive formal supervision and appraisals which was confirmed by staff who were spoken with and staff files examined. Informal supervision arrangements have also been established. Staff who were spoken with commented that they felt well supported. The home ensures that safe working practices are maintained which comply with the relevant legislation. A tour of the premises did not highlight any areas of concern with regard to health and safety issues. However, restrictors have not been fitted to residents’ bedroom windows that are located on the first floor. The manager re-affirmed that this is because the current group of residents have declined to have these fitted. The home does not cater for mentally ill persons, and the manager therefore feels this is an acceptable risk especially since all of these windows except one, which has bars in place already, are not such that a resident could fall from them. The manager reported that residents’ risk assessments have been updated accordingly and residents’ families have also been consulted. The manager has also reported that should the residents to these rooms change, then this stance will be reviewed. Radiator covers have been fitted to all radiators for the protection of residents. Examination of the fire log book showed that appropriate servicing, DS0000056886.V303700.R01.S.doc Version 5.2 Page 22 tests, checks, drills and instruction to staff are being carried out at the appropriate frequencies. DS0000056886.V303700.R01.S.doc Version 5.2 Page 23 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 X 4 3 X 4 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 4 4 X 4 4 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X N/A 3 X 3 DS0000056886.V303700.R01.S.doc Version 5.2 Page 24 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 OP7 Regulation 15(1) Timescale for action The registered person shall, after 28/02/07 consultation with the service user, prepare a written plan (“the service user plan”) as to how the service user’s needs in respect of their health and welfare are to be met. (Action must be taken to ensure that residents’ care plans are always completed and in sufficient detail and reflect their total needs). The registered person shall 28/02/07 ensure that unnecessary risks to the health and safety of service users are identified and so far as possible eliminated. (Action must be taken to ensure that residents’ personal safety and risk assessment forms are completed for all residents where specific risks have been identified). Requirement 2. OP7 13(4)(c) DS0000056886.V303700.R01.S.doc Version 5.2 Page 25 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 DS0000056886.V303700.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB National Enquiry Line: 0845 015 0120 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. 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