Care Home: Birch Lawn Resource Centre

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What the care home does well The home has a good assessment process which enables potential new service users and their representatives to have the information they need to make an informed decision about whether to move into the home. There is a flexible staff team who support residents in their day-to-day lives and they are treated as individuals and with dignity and respect and residents are given choice in their day-to-day lives with appropriate support provided by staff at the home. We observed staff supporting residents and they were pleasant and respectful. Residents told us !the staff are lovely! !I am very happy here! !I am well cared for! and another told us that !the staff are always cheerful.! One resident told us staff always find time to sit and have a chat. Residents are provided with a balanced diet in pleasant surroundings at a time convenient to them and the home offers a choice at meal times and there is a varied diet. Residents told us that the food was good. Comments from residents included !the meals here are good! and another told us !I always have enough to eat! The home has a dedicated and stable staff team and they receive appropriate training to enable them to provide effective support to residents and there is a robust recruitment procedure, which helps protect residents. From talking with residents and from the comments received back from our surveys it was clear that residents were happy living at the home and we observed that staff and residents got on well together. We asked in our surveys - !What does the home do well! and comments received back included; From heath care professionals - !this is a very caring environment! !There is always a happy atmosphere whenever I have visited and I have witnessed residents always being offered respect, dignity and choice! !the home really cares for its residents! and !it is an excellent home much respected by district nurses! From Staff - !we have a great staff team who work well together! !we have excellent training and support! and !there is a very homely feeling and residents and staff get on well together! From users of the service - !they take good care of me! !everything! !staff are always cheerful and spend time with me! !everyone is very friendly and the home is always clean! and !for me this is a perfect place to live! What has improved since the last inspection? Since the last key inspection of the service all staff have received Mental Capacity Act training and all of the management team have received training regarding the Deprivation of Liberty. Care plans have been adapted to more clearly show an individuals capacity to make informed decisions. The extractor fans in the kitchen have been upgraded. What the care home could do better: There were no requirements or recommendations made as a result of this visit. Key inspection report Care homes for older people Name: Address: Birch Lawn Resource Centre Sullivan Road Sholing Southampton Hampshire SO19 0HS     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Mick Gough     Date: 2 2 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Birch Lawn Resource Centre Sullivan Road Sholing Southampton Hampshire SO19 0HS 02380445906 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Southampton City Council Name of registered manager (if applicable) Type of registration: Number of places registered: care home 33 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: 33 The registered person may provide the following category/ies of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) Dementia (DE) Physical disability (PD) Date of last inspection Brief description of the care home Birch Lawn is a purpose-built property providing accommodation, care and support to up to thirty-three people of either sex over the age of 65 years and who are frail or have a physical disability. Care Homes for Older People Page 4 of 29 33 0 33 Over 65 0 33 0 Brief description of the care home The home is situated in Sholing, a residential suburb in the South East of Southampton. All bedrooms are single with some offering en-suite facilities. Appropriate bathing, WC and communal facilities are provided. Birch Lawn stands on a three-acre site of well laid-out lawns, with shrubs and trees. There is a raised garden, greenhouse and vegetable plot providing opportunities for people to maintain an interest in gardening. Garden furniture on the patio area enables people to enjoy the garden, particularly in the warmer months. The building has two floors with a passenger lift to the first floor. The home has its own shop, hairdressing room, library and bar. The home is owned by Southampton City Council. Care Homes for Older People Page 5 of 29 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: This report details the evaluation of the quality of the service provided at Birch Lawn Resource Centre and takes into account the accumulated evidence of the activity at the home since the last key inspection, which was carried out in September 2007. It also takes into account the evidence gathered at The Annual Service Review of the service, which was conducted in September 2008. The inspection took into account the homes Annual Quality Assurance Assesment. The AQAA is a self assessment tool that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. Prior to the site visit we sent out surveys to interested parties to get their views on the home and we received back responses from 12 service users, 7 members of staff who work at the home and from 7 health care professionals. Care Homes for Older People Page 6 of 29 Included in the inspection was an unannounced site visit to the home, which took place on the 22 September 2009. For this visit the inspector was assisted for part of the inspection by an !Expert by Experience! (this is a person who, because of their shared experience of using services, and or ways of communicating, visits a service with an inspector to help them get a picture of what it is like to live in or use the service). Evidence for this report was obtained from reading and inspecting records including pre admission assessments, plans of care, training records and records of complaints and adult protection issues. We also looked at some of the homes policies and procedures. We were also able to observe the interaction between staff and users of the service. The expert by experience spent time talking to residents to obtain their views on how the service was meeting their needs and expectations. We were also able to speak with 4 members of staff, 2 care co-ordinators and the homes manager who assisted us throughout the visit. The home is registered to provide support for 33 residents, however Southampton City Council is undertaking a review of all its care services and the future of the home is uncertain. At the time of the inspection there were only 17 people living at the home. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? Since the last key inspection of the service all staff have received Mental Capacity Act training and all of the management team have received training regarding the Deprivation of Liberty. Care plans have been adapted to more clearly show an individuals capacity to make Care Homes for Older People Page 8 of 29 informed decisions. The extractor fans in the kitchen have been upgraded. 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 29 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 29 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. Potential new residents have a needs assessment undertaken prior to moving into the home and this allows the home, the resident and their relatives to see if the home can meet the residents needs. The home does not provide intermediate care. Evidence: The home carries out an individual needs assessment prior to residents moving into the home and there is a clear admission process and assessments were on file at the home and were looked at for the 3 residents. Needs assessments seen had information on a wide range of needs including; mobility, communication issues, physical care needs, medication, dietary requirements, history of falls, financial arrangements, activities of daily living, leisure and interests, day routine, night routine, skin hygiene, pain, mobility, medication, dressing, undressing, personal care and any other specific needs. Assessments were made using a needs assessment form and therefore covered the same issues for everyone. The AQAA told us that the home works closely with Service Users and their family to ensure that their needs will be Care Homes for Older People Page 11 of 29 Evidence: appropriately met when they move into the home and this was confirmed by some of the residents spoken with on the day of the visit. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health, personal and social care needs of residents are set out in an individual plan of care and residents and have access to all relevant health care professionals and their health care needs are met. The administration of medication is satisfactory and residents at the home are treated with dignity and respect and their personal care is given in private. Evidence: Care plans for 3 residents were looked at and these had good information on care needs and contained information about how the resident would like their care to be given. Their was information of the persons personal history such as where they were born, their childhood, adolescence and adult life, there was also information on the persons health and abilities. There was information about what the person was able to do for themselves and also detailed when support was required. For example one plan stated !can sit by the sink and wash upper body but needs prompting and Patience! Another entry told staff that the person !needs assistance when pulling clothes over their head and needs help with zips and buttons! The home does use some agency staff so there is good information on how each resident would like to be supported. Care Homes for Older People Page 13 of 29 Evidence: Service users spoken to were positive about the care they receive, comments included; !they look after me very well! !the staff are so kind and caring! !they cant do enough for you! and !I am well looked after! Staff members spoken with said that they know all the residents well but still used the care plans to provide them with information to enable them to give the right type of support at the right time. Thencompleted AQAA told us that all service users have a care plan which reflects their individual abilities, needs and support requirements. Daily recording takes place at the end of each shift and this provided good information on what support has been given during each shift. Recording, showed that residents who needed continence aids had these checked and changed regularly. Each care plan was reviewed monthly. There is a GP surgery adjacent to the care home and a number of residents are registered with this surgery and have a number of different GPs, however they may keep their own GP if they wish. Community nurses visit regularly when required and we were able to speak with one visiting community nurse who told us that the staff are always cheerful and that on arrival at the home there is always a member of staff who will take them to the service users who needs support, she told us that the home will always make contact if they have any concerns and that the staff are very caring. The home uses a continence nurse who advises on all residents at the home who need support. Some residents keep their own dentist and optician. and the home has a visiting dentist and optician service and the local hospital provides a visiting audiology service. A chiropodist calls every 6 weeks and any other relevant health care professionals are arranged through GP referral. The home keeps a record of any appointments or visits by any health care professionals. In the homes AQAA we were told that service users can continue to be seen by a G.P. of their choice (unless G.P. is out of area) and that health care needs are met by appropriate health care professionals. The home has a policy for the receipt; storage, return and administration of medication and all staff at the home who are authorised to administer medication have undertaken training with regard to medication. The home uses a monitored dose system from a local pharmacy and the medication administration records sheets (MARS) were inspected and found to be up to date. Some residents had been prescribed paracetamol 1 or 2 to be given !when required! (PRN) however it was not clear on the recording sheet what dose had actually been given and the home must ensure that the actual dose given is recorded to provide a clear audit trail. When this was pointed out to the manager and care co-ordinators we were informed that this would be actioned immediately. We also found that staff were recording !refused! when PRN medication was not given and this was confusing, it was pointed out that when required medication only needs a signature when it has been administered. Care Homes for Older People Page 14 of 29 Evidence: The homes medication storage was looked at and this was suitable for its purpose and medication was kept in locked trolleys that were stored securely when not in use. Currently the home does not hold any controlled drugs, however appropriate storage facilities are available should there be a need for any controlled drugs to be held at the home. During the visit staff were seen to behave appropriately with residents and we and the expert by experience observed staff interacting well with residents and using their preferred form of address. All members of staff who the expert by experience met were gentle, caring and seemed to enjoy their job. They had good rapport with the residents as well as with other members of staff. There was good teamwork; they helped each other when necessary, and no residents had to wait long before their needs were attended to. In the hall lounge one resident was promptly helped by a district nurse and a carer, when the resident needed a cushion put underneath her. There was always a member of staff at hand to deal with the needs of the residents. Staff were seen to knock on residents doors before entering and residents spoken to confirmed that staff treat them with dignity and respect. The expert by experience also observed a good friendly rapport between the staff and residents. Care Homes for Older People Page 15 of 29 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 home provides a range of activities for residents, which meet their expectations and the religious and recreational interests of residents are provided for. Residents are able to maintain contact with family and friends and visitors are welcome at any time. Residents are supported to exercise choice and control over their lives as much as possible and are provided with a wholesome and balanced diet in pleasant surroundings at a time convenient to them. Evidence: The home provides a range of activities for residents and there are afternoon activities each day, residents are asked what they prefer to do each day and this is then organised. Activities are directed by a member of staff and they include bingo, board games like ludo, craft work, musical movement and quizzes. Several residents remarked that they enjoyed the bingo. One resident, who is disabled and has to use a wheelchair, loves gardening and was pruning roses in the patio garden. He had built up the garden from nothing with the help of a community worker over 4 years. Last year the home won 2 city awards for the garden. One resident said, We have lovely trips out and told us about several recent outings including a boat trip on 7th Sep (involving 7 residents) and a visit to a pub (about 9 of us went) another resident told us we also go to the Nuffield theatre. The Council loan a mini bus for these occasions. Care Homes for Older People Page 16 of 29 Evidence: Other activities include visiting entertainers, and seasonal parties like Halloween and Shrove Tuesday. There were happy photos of residents on a notice board at the home following a residents recent 101st birthday party. One resident told us he went to a local church and another resident was being taken out by her son for the afternoon to her local social club. Another resident had taken a taxi in the morning to do her shopping. This same resident enjoyed reading in her room. We observed staff supporting residents and they were consulted about life in the home through the residents meetings held every month. Copies of these meetings are written up by staff. The manager and staff told us that they listen to what the residents want. One resident said, If theres something we like, we say, and if not, we are not afraid to mention it. Care plans had good information on residents choices, there was information on what time residents liked to get up and go to be, what type of drink they would like when they wake up, preferences on how they like to spend their time, some wish to remain in their rooms, while others like to sit in the lounge. There was an attractive display of raffle prizes in the main open lounge area, raising money for amenities on the occasion of the Homes impending 40th birthday. Residents spoken to confirmed that they are able to make informed choices and are able to control their own lives as much as possible, they said that they were consulted regularly and that staff at the home respected their views and that if they wanted anything all they had to do was ask. Residents can smoke in a smoking room as well as in the garden. A number of residents had bought some of their own possessions into the home and rooms had been personalised. The home has a clear visitors policy and there are no set times, visitors sign in at the home and the visitors book is kept in the hallway. Residents spoken to said that their visitors were always made welcome and we had the opportunity to speak with 2 visitor to the home who confirmed that visiting times were flexible and they had never experienced any restrictions. A visitor said, !The staff are all very nice and friendly. You wouldnt get the same anywhere else! On entering the home we saw a large bowl of bananas and apples for the residents to help themselves. We observed that residents had either a hot or cold drink at hand for most of the time we were at the home. The home operates a four week rolling menu and staff go round to inform residents what the menu is and offer them a choice if they prefer. Breakfast is fruit juice, choice of cereals and toast. A cooked breakfast is provided 3 times per week but any resident who wishes can have a cooked breakfast whenever they want it. There is a mid morning snack and the main meal of the day is at lunchtime, a snack is served mid afternoon, a light tea is served at 1730 and this is sandwiches, soups (some home made) or a snack meals such as egg on toast. A milky drink and cheese and biscuits are served for supper. One resident had their sherry at Care Homes for Older People Page 17 of 29 Evidence: lunch and another had a small fridge in their room with some bottles of drink on the side table. Lunch on the day was either sausages or bacon and onion suet pudding and gravy with butter beans, cabbage and mashed potato. Jelly or rhubarb crumble followed. A member of staff said that jelly was another way to help hydrate the residents. The food looked well cooked and well presented. Residents also have another choice such as omelets, cold meats, baked potato or salad if they dont like the main courses. There are no vegetarians at present, although one resident chooses to be from time to time and has the vegetables only. We observed lunch at the home and this was a friendly sociable occasion and support was provided for residents as required. One resident who needed assistance with feeding was helped by a carer throughout lunch. The carer was patient, spoke reassuringly and demonstratively. One resident chooses to have all her meals in her room, and that need is met, we observed that her food was delivered promptly and there was no waiting time before receiving her pudding. Tables were nicely laid up with cloth table napkins changed at every meal. Birthday cakes are provided for residents birthdays. Residents comments included; !The food is all good & very fresh! !I enjoy the food! Another said !when we ask for things like boiled eggs, we get them! After lunch the expert by experience spoke with residents who told her; !I enjoyed it! !it was very good.! !I always like the lunch! and !you cant grumble about the food! Care Homes for Older People Page 18 of 29 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. There is a simple, clear and accessible complaints procedure, which includes timescales for the process and any complaints are logged and responded to appropriately. The homes policies and procedures help protect users of the service from any form of abuse. Evidence: The home has a clear complaints procedure, which contains all of the required information and a copy is issued to all residents and relatives when they move into the home. The expert by experience spoke to the majority of residents and all those spoken with were happy and siad that they had no cause to complain, they told her, if they did, they would go to a member of staff if they had a problem. Staff members spoken to were aware of the complaints procedure and said that they would support any service user to make a complaint if they wished to do so. The homes AQAA told us that there had been four complaints received in the home in the past 12 months and the home keeps a record of all complaints and records seen confirmed that complaints had been recorded and responded to appropriately. All staff have received training on adult protection and the home has a whistle blowing policy and also a copy of the Hampshire Adult Protection procedure. Staff spoken to were aware of their responsibilities in this area and knew what to do should they Care Homes for Older People Page 19 of 29 Evidence: suspect any form of abuse had taken place. Care Homes for Older People Page 20 of 29 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. Residents live in a safe and well-maintained environment and have access to comfortable indoor and outdoor facilities. Residents have the specialist equipment they require to maximise their independence and the home was generally clean, pleasant and hygienic and free from offensive odours, however re-decoration of the home would benefit service users. Evidence: It was observed that all areas of the home were clean and tidy and furniture was in a good state of repair. There is a large enclosed garden at the rear of the property and this was very well maintained with trees and shrubs and a display of flowers in tubs and baskets. One of the residents helps to maintain the gardens and last year the home won two awards for its garden. There was a patio area with tables and chairs and was shaded from the sun and access was via steps with handrails and also a wheelchair ramp. The home is run by Southampton City Council(SCC) and SCC has a maintenance department who carries out routine maintenance. The home has a call system for service users to summon assistance and these were available in all rooms and were easily accessible. Some areas of the home were in need of decoration and the manager was aware of this but with the future of the home uncertain she was not able to confirm if any redecoration would take place. Care Homes for Older People Page 21 of 29 Evidence: The home has a laundry, which is equipped with 2 industrial washing machines and tumble driers. The laundry had suitable hand washing facilities and all surfaces were easily cleanable. The home employs a dedicated staff member to carry out laundry duties and she told us that she is well supported by the staff team and that she has all the necessary protective clothing she requires. All bathrooms and WCs had hand washing facilities and had paper towels. All staff have received training with regard to infection control and the home was clean and tidy and there were no offensive odours. Care Homes for Older People Page 22 of 29 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. The home has sufficient staff on duty to ensure residents receive the support they require. Staff were found to be well motivated and competent to do their jobs and residents are protected by the homes recruitment procedures. The home provides training for staff to enable them to carry out their roles effectively Evidence: The homes staff rota showed that there is a senior care co ordinator plus 4 care staff members on duty between 0730 to 2200 and 1 senior care co ordinator and 2 care staff members awake between 2200 and 0800. In addition the homes manager is available Monday to Friday between 0900 to 1700 and she is also available outside these hours if required. The home also employs a cook, kitchen assistant, 2 house keepers and an administrative assistant who work flexibly throughout the week. Those residents spoken with said that they felt that staffing levels were adequate. Staffing numbers were discussed with the manager and she stated that she felt that staffing levels were sufficient, however staffing numbers would be kept under review. The home employs a total of 11 care staff and the manager stated that all of the care staff hold a minimum of NVQ level 2. The manager told us that the home would support staff to obtain National Vocational Qualifications. Recruitment records were seen for three members of staff and all of the files seen Care Homes for Older People Page 23 of 29 Evidence: contained all of the required information including application form, 2 references, photo, passport, birth certificate, health declaration, Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks and contract of employment. The manager told us that at present the home is using a number of agency staff and these are regular staff who come to the home. On the first visit agency staff are expected to bring along a relevant Criminal Records Bureau check. SCC has a centralised training organisation and there are a number of training courses which are run throughout the year. Staff can view what training courses are available via a web site and this lists what training courses are being run together with dates and booking details. There is a comprehensive induction system based on !skills for care! and each section is signed of as it is completed. Staff training records were looked at and the manager showed us a training matrix, which showed that training is provided in; first aid, food hygiene, moving and handling, fire, infection control, adult protection, medication, health and safety, pressure areas, palliative care, dementia care, deprivation of liberty, COSHH, risk assessment, disability discrimination, falls awareness and challenging behaviour. Staff spoken to confirmed that they received a thorough induction and that they are provided with appropriate training in order to carry out their care tasks. Care Homes for Older People Page 24 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a manager in place, although she is not yet registered with the Care Quality Commission. The home has a quality assurance system in place to seek the views of residents, relatives and other professionals to measure the effectiveness of the service. Staff are supervised as part of the normal management process and systems are in place for the safekeeping of residents personal spending money. The health, safety and welfare of residents and staff are promoted and protected Evidence: The current manager of the service has worked at the home for over 11 years in a senior position. She is not yet registered with the CQC but has now obtained the necessary documents and told us that she will be submitting her application in the very near future. Staff who spoke with us told us that she was very approachable and provided good guidance and support for the staff team. The home has an effective quality assurance system in place. Regular regulation 26 visits are conducted and the home holds regular staff meetings every month and Care Homes for Older People Page 25 of 29 Evidence: residents meeting are also held every 4 weeks and minutes of these meetings provided evidence that any issues that are raised are taken seriously and are actioned by the home whenever possible. The home does not manage any residents money or hold valuables for people living at the home. SCC provide individual banking account facilities for service users and the home can assist people to open an account should they wish to do so, these accounts provide a clear audit trail. Every room has a lockable facility in which people can keep any valuables. There is an in date fire risk assessment for the building and a recent inspection by Hampshire Fire and rescue service found no areas of concern. Regular health and safety monitoring takes place and on the day of the visit a contractor was visiting to check the water system in the home. The fire logbook was inspected and all appropriate testing and checks have been recorded. Appropriate certificates were in date for gas safety, fire alarms systems and equipment, private electrical equipment, passenger lift and fixed hoists. Care Homes for Older People Page 26 of 29 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 27 of 29 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 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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