Care Home: Blackwell Care Centre

What the care home does well People benefit from an environment, which is maintained to a high standard, is safe and clean and which overall suits people`s needs and choices. People`s needs are suitably assessed and they are generally well informed about the services the home provides. People`s health, personal and social care needs are well accounted for and met from staff that treat them with respect and promote their dignity and rights independence and choice. People told us, `Staff is kind and patient and help me as I wish.` `The care is always very good.` People`s preferred daily living routines and their known lifestuyle choices and expectations are usually well promoted and upheld and they are provided with nutritious, wholesome food, which they usually enjoy. One person told us, `The activities co-ordinator is wonderful, nothing is too much trouble.` `We really enjoyed the recent pub theme night.` People are well supported from staff that is usually effectively, recruited and trained and the home is overall well managed and run in people`s best interests and their health, safety and welfare promoted and protected. What has improved since the last inspection? The service strives to continuously develop and improve and most of the requirements/recommendations made at our last key inspection are achieved. The home has developed individual`s care planning and associated documentation by way of staff training. Additional staff assistance has been provided to suppor the activities co-ordinator and fund raising has resulted in the provision of additional materials and equipment for people`s occupation and leisure. More staff have undertaken safeguarding vulnerable adults training and associated procedures have been reviewed and updated. Administration and record keeping systems have been reviewed and re-organised What the care home could do better: Ensure that the range of fees and what they cover includes details as to the arrangements for the payment of any free nursing care contribution to the fees within the home`s service guide for people. Make key service information available for people in alternative formats as may be necessary to assist people, who are or who may be accommodated at the home, suchas large print, audio, braille etc. Ensure the home`s complaints procedure has named contact persons who will deal with any complaint at various stages and provide up to date contact details for the Commission for people. Review practises in respect of the storage and recording of people`s prescribed creams and lotions where these are kept in people`s own rooms, so as to ensure safe storage and accurate record keeping in respect of their administration. Promote confidentiality by ensuring that people`s individual personal care information is not openly displayed around the home. Consider the implications of the Mental Capacity Act 2005 and develop staffs` awareness and (record) keeping for this in respect of people`s needs assessment and care planing information. Provide a loop system in communal lounge areas to assist people with hearing difficulties, who may benefit and an additional stand aid to promote more availability of access for people who may benefit. Develop the staff induction and training programme to ensure that it fully accords with nationally recognised standard specification, such as Skills for Care. Review the method used to determine planning for staff training so as to avoid any areas of omission/oversight in respect of individual staff training needs. Clearly determine the ongoing arrangements for the management of the home and take the necessary action to ensure that where the home continues to be managed by a named person that they submit an application for registration to the Commission. Formally share the results of any satisfaction survey with people, including any action that may be determined by the home, which occurs directly as a result of the feedback gained from those surveys. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Blackwell Care Centre Gloves Lane Blackwell Alfreton Derbyshire DE55 5JJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Susan Richards     Date: 1 0 0 9 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 30 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 30 Information about the care home Name of care home: Address: Blackwell Care Centre Gloves Lane Blackwell Alfreton Derbyshire DE55 5JJ 01773863388 Telephone number: Fax number: Email address: Provider web address: paulshipstone@onetel.com Name of registered provider(s): Name of registered manager (if applicable) Ambiance Care (Blackwell) Limited Type of registration: Number of places registered: care home 43 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Blackwell Care Home is registered to provide nursing and personal care for up to 43 older persons. It is located in the village of Blackwell, approximately 3 miles from Junction 28 of the Ml motorway. Accommodation is over two floors and has a range of aids and adaptations to assist those with mobility problems, including a shaft lift and emergency call system throughout. The home provides single room accommodation with forty of these having en suite facility. There is a choice of lounge and dining space and a large activities room. People are supported from a team of nursing, care and hotel services staff who are currently led by the provider, who is a registered nurse. A copy of the homes most recent inspection report is openly displayed in the reception area of the home. Care Homes for Older People Page 4 of 30 Over 65 43 0 Brief description of the care home The care home provides a pleasant environment for the residents and accommodation is provided on two floors. There is passenger lift and staircase access to the first floor facilities. There are spacious communal areas, many with views of the grounds of the Home, which are accessible to the residents. Care Homes for Older People Page 5 of 30 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: The quality rating for this service is two stars. This means the people who use this service experience overall good quality outcomes. For the purposes of this inspection we have taken account of all the information we hold about this service. This includes our annual quality assurance assessment questionnaire (AQAA), which we ask the home to complete on an annual basis in order to provide us with key information about the service. We also received a number of comments from people who use/visit the service. Some of these are referred to below. Care Homes for Older People Page 6 of 30 At this inspection there were forty-two people accommodated. We used case tracking as part of our methodology, where we looked more closely at the care and services that three of those people receive. We did this by talking with them, observation of staff interactions with them, looking at their written care plans and associated health and personal care records and by looking at their private and communal accommodation. We spoke with staff about the arrangements for their recruitment, induction, training, deployment and supervision and we examined related records. We also spoke with the manager, who has managed the home for a number of years, about the arrangements for the management and administration of the home and we examined associated records. All of the above was undertaken with consideration to any diversity in need for people who live at the home. At the time of our visit all people accommodated are of British white backgrounds and of Christian religion. As at the date of this inspection, the range of fees charged per week is: 345.52510.87. Fees are determined in accordance with individuals assessed needs and may include for those deemed eligible, contributions as determined via local authority (for personal care and accommodation) and/or local primary care trust arrangements (for free nursing care). What the care home does well: What has improved since the last inspection? What they could do better: Ensure that the range of fees and what they cover includes details as to the arrangements for the payment of any free nursing care contribution to the fees within the homes service guide for people. Make key service information available for people in alternative formats as may be necessary to assist people, who are or who may be accommodated at the home, such Care Homes for Older People Page 8 of 30 as large print, audio, braille etc. Ensure the homes complaints procedure has named contact persons who will deal with any complaint at various stages and provide up to date contact details for the Commission for people. Review practises in respect of the storage and recording of peoples prescribed creams and lotions where these are kept in peoples own rooms, so as to ensure safe storage and accurate record keeping in respect of their administration. Promote confidentiality by ensuring that peoples individual personal care information is not openly displayed around the home. Consider the implications of the Mental Capacity Act 2005 and develop staffs awareness and (record) keeping for this in respect of peoples needs assessment and care planing information. Provide a loop system in communal lounge areas to assist people with hearing difficulties, who may benefit and an additional stand aid to promote more availability of access for people who may benefit. Develop the staff induction and training programme to ensure that it fully accords with nationally recognised standard specification, such as Skills for Care. Review the method used to determine planning for staff training so as to avoid any areas of omission/oversight in respect of individual staff training needs. Clearly determine the ongoing arrangements for the management of the home and take the necessary action to ensure that where the home continues to be managed by a named person that they submit an application for registration to the Commission. Formally share the results of any satisfaction survey with people, including any action that may be determined by the home, which occurs directly as a result of the feedback gained from those surveys. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 30 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 30 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 need are suitably assessed and they are generally well informed about the services the home provides. Although lack of availability of the service guide in alternatives formats does not best promote equality of access to information for all people who may use the service. Evidence: At our last key inspection we judged that peoples needs were suitably assessed. In our annual quality assurance questionnaire completed by the home, they say that people are providced with the information they need about the home before they choose to live there. They also say that peoples needs are fully assessed before their admission to the home to ensure they can be met. They tell us they have developed their approach in formulating peoples care planning documentation by way of staff training and do not feel they could improve further in this area. Care Homes for Older People Page 11 of 30 Evidence: At this inspection most people told us they receive a contract and mostly enough information about the home. People also told us that their needs are usually met. However, one person case tracked and with significant sight impairment was not able to access the homes service information as it is in written format only. Welcome pack had recently been introduced placed in each persons own room, include service guide and key service information including complaints procedure. details as to the range of fees charged and what they cover. However, this does not include the arrangements for the free nursing care element of the fee, for those who may be eligible. Peoples individual needs assessment records were comprehensive and in accordance with a recognised nursing assessment tool and are person centred. Care Homes for Older People Page 12 of 30 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. Peoples health, personal and social care needs are well accounted for and met from staff that treat them with respect and promote independence and choice and usually their dignity. Evidence: At our last key inspection we judged that peoples health, personal and social care need were well accounted for. That they were treated with respect and protected by the homes medicines procedures. We made three quality recommendations at that inspection relating to care plans, records kept regading the use of bed rails and an area of medicines protocol. These are all met at this inspection. In our annual quality assurance questionnaire completed by the home they say that peoples health, social and personal care needs continue to be well accounted for within their care planning records. That they encourage peoples independence in Care Homes for Older People Page 13 of 30 Evidence: accordance with their capabilities and that people are treated with respect and their rights to privacy upheld. They aim to ensure that standards are maintained in this are over the coming twelve months. At this inspection people told us they always received the care and support they need, including medical care. Comments received, include: The care here is always very good. Staff are kind and patent and help me as I wish. Written care plans and associated health care records that we looked at were formulated in accordance with peoples risk assessed needs, were comprehensive, person centred and had regularly recorded reviews. They were also reflective of recognised guidance and practise concerned with the care of older people and peoples choices and decisions concerning their daily living arrangements are also clearly accounted for. Staff spoken with was conversant with peoples needs and required care interventions and were observed overall to be respectful in their approaches with people. Although written instructions as to named peoples bathing routines and nutritional requirements were posted on the dining room wall and bathroom corridor wall, which does not best promote dignity and confidentiality. The arrangements for the ordering, receipt, recording, administration and disposal of peoples medicines were overall to a very high standard and in accordance with recognised practise, with the exception of some arrangements for the storage, recording and adminsration of creams and lotions, where these are kept in peoples own rooms. These are not always consistent with best practise and require review. We discussed these with the nurse responsible for overseeing medicines management in the home, who agreed to action the areas we identified. Quality auditing and monitoring systems are in place in respect of medicines, which are regularly undertaken and recorded. Care Homes for Older People Page 14 of 30 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. Peoples preferred daily living routines and their known lifestyle choices and expectations are usually well promoted and upheld and they are provided with nutritious and wholesome meals, which they enjoy. Evidence: At our last key inspection of this service we judged that people were provided with stimulating lifestyles and were able to maintain contat with relatives and friends and exercise choice in their lives. We also judged that they received a wholesome and balanced diet. In our annual quality assurance questionnaire completed by the home they say that aim to uphold peoples lifstyle prefences and expectations and promote normalisation and individuals choice and control over their lives as far as possible with assistance as required. They also say that people are provided with wholesome and appetizing meals made from fresh produce and that dietary needs are catered for. They tell us they have improved over the last twelve months by providing additional staff assistance to support the activities co-ordinator, more fund raising, which has Care Homes for Older People Page 15 of 30 Evidence: been used to increase the provision of materials and equipment for occupation and leisure. They feel they could further promote their fund raising by engaging assistance from more relatives and supporters and aim to do so over the coming months in order to purchase a minibus to take people on spontaneous and more regular outings/trips out. At this inspection people told us that activities are always organised that they can join in with and that they always enjoy the meals provided. Comments received, inlcude, The meals are very good and enjoyable. The activities co-ordinator is wonderful, nothing is too much trouble. I really enjoyed the pub theme night we had this week. There is a dedicated large activities room, which is suitably furnished and equipped. A group of people were engaged during the morning of our inspection playing a game of bingo, which provided a large electronic number display screen and large wipe clean marker cards. People there told us about some of the activities that are regularly organise, which include quizzes, board games, musical bingo, crafts, singing, in house entertainments, trips out, card games, reading groups, reminiscence, trivial pursuits beetle drives, manicures, puzzles and games adapted from popular TV programme, such as Play Your Cards Right. Photographs of residents engaging in activities in and outside the home are displayed, with recent ones taken at the local carnival and line dancing event. Residents make and sell greetings cards to help with fund raising for the residents fund, which is aimed at purchasing a mini-bus for the home. Individual records are kept in respect of peoples engagement in activities, including their choices, participation and enjoyment. Individual records are also kept within their needs assessment and care planning information as to their preferred daily living and lifestyle choices, including the handling of their financial affairs and medicines arrangments. However, for one person case tracked, their care plan agreements were signed by their family, with no detail as to their individual capacity to consent or their agreement to these. This person had refused some aspects of their care, which staff had recorded within their care notes and a formal care review was to be held. Staff were not familiar with the Mental Capacity Act 2005, which we briefly discussed with the manager. We were advised that relative and resident meetings are held, although there were no records available of recent meetings. Care Homes for Older People Page 16 of 30 Evidence: We observed lunch being served and assistance provided to people, which was undertaken in an organised, calm and unhurried manner. People chose where to eat, with some preferring to stay in their own rooms. Tables were attractively set and people were provided with the assistance they required from staff or their relative as they chose and including eating aids as necessary. Food was presented in accordance with peoples assessed needs. Full and daily menus are displayed, which reflect a varied and nutritious diet and people said they are consulted daily as to their meal choices. They also told us they could have drinks and snacks as they requested and that special diets can be catered for. Care Homes for Older People Page 17 of 30 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. People may be assured that a concerns or complaints they raise will be taken seriously and acted upon and they are protected from abuse. Evidence: t our last key inspection of this service we judged that people were protected by robust complaints procedures, although safeguarding adults procedures were less clear. We made a requirement that the homes safeguarding vulnerable adults procedures must be consistent with social services joint agency safeguarding adults procedures and be available in the home at all times. This is complied with at this inspection. In our annual quality assurance questionnaire completed by the home, they say that people may be confident that they take all complaints seriously, rigorously investigate and act upon them and keep people informed as to progress and outcomes. They also say that peoples legal rights are upheld and that they are protected from abuse. They tell us that over the last twelve months, they have improved by ensuring that more staff undertake safeguarding adults training and that recognised procedures concerned with safeguarding people are in place. And, that they aim to ensure that all staff complete the stated safeguarding adults training over the coming months. Care Homes for Older People Page 18 of 30 Evidence: At this inspection all people told us that they knew who to speak with if unhappy and that they know how to complain. Although the homes written complaints procedure had been revised since our last inspection, with a copy provided in each persons own room, displayed on the noticeboard and within the service guide, this did not provide the name of the manager/named person for dealing with complaints. People said they would go to the nurse in charge or the owner/manager, whose names they knew. The procedure also did not give the correct contact address details of the Commission. Staff spoken with was conversant with their roles and responsibilities in terms of dealing with complaints and recognising, responding to and reporting any suspicion or witnessing of abuse of any service user. A copy of the recently revised safeguarding procedures for staff in the home were provided and are satisfactory. Care Homes for Older People Page 19 of 30 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. People benefit from an environment, which is maintained to a high standard, is safe and clean and which overall, suits peoples needs and choices. Evidence: At our last key inspection of this service we judged that people lived in an attractive, homely and hygienic environment. We made two recommendations about repairs to an identified bathroom and ensuring that key infection control policy and procedures are always available for staff. These are met at this inspection. In our annual quality assurance questionnaire completed by the home, they say that people continue to live in a clean, hygienic, safe and well-maintained environment, which is suitably equipped and meets peoples needs. They tell us that they aim to continue to maintain their environmental standards and by way of their ongoing redecoration and renewal programme. They also tell us that they have received planning approval for a buildings extension, which they intend to progress. Care Homes for Older People Page 20 of 30 Evidence: At this inspection all people told us that the home is always kept fresh and clean and that they were able to personalise their own rooms. All areas that we inspected, including communal, private accommodation and the laundry were clean, safe and free from hazards and well decorated and furnished to a high standard. People we case tracked were provided with suitable equipment in accordance with their individually assessed needs and choices. Although, one person we case tracked had a loop system in their own room, but said there was no loop system in the main lounge, which they felt would benefit. Staff that we spoke with felt that an area of improvement would be to provide an additional stand aid to the one provided in order to better assist people in their mobility needs, promote their independance. People can access a garden area and seating is provided, along with some car parking to the front of the home, although grounds are not extensive. Bathrooms and toilets have vacancy/in use signs to the doors (in addition to locks) to promote peoples privacy. Care Homes for Older People Page 21 of 30 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. Overall people are supported from staff that is suitably recruited, trained and deployed, although further development of staff induction and training methodology may benefit people. Evidence: At our last key inspection of this service we judged that peoples needs were being met from a suitably qualified and competent staff group and that they were protected by the homes recruitment procedures. In our annual quality assurance questionnaire completed by the home, they say that they have an effective recruitment structure and ongoing staff-training plan and that staff morale is good and their training kept up to date, including NVQs. They tell us they have improved their administration and record keeping in respect of staff files and their training, which they say are better organised and are being updated. They also tell us they could improve their staff planning better by way of more effective rota planning and by reducing the number of agency staff and that they currently have a recruitment drive underway, in order to meet this. Care Homes for Older People Page 22 of 30 Evidence: At this inspection people told us that staff is usually available when they need them and that they listen and act on what they say. Overall staff described suitable arrangements for their recruitment, induction, training and deployment, although their induction arrangements do not meet with Skills for Care standards and som staff identified a few areas of key health and safety training, which was overdue for updates. Staff records that we examined also reflected these, together with one person who had commenced their employment before the issue of their CRB, although there was no POVA first record in place to support this, although we were advised by the provider and administrator that this was obtained before their commencement. The arrangements for NVQ training for staff are satisfactory, with well over 50 having achieved at least NVQ 2 with some achieving 3 and a further nine people working towards an NVQ in care. An overall training plan was in place, although there was no training needs analysis showing at a glance who had undertaken what training and when and what was due for who and when. We advised the acting manager to formulate this along with a rolling programme for key training areas, in order to determine individual staff training in a timely manner. Care Homes for Older People Page 23 of 30 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. Overall the home is managed and run in peoples best interests and their health, safety and welfare promoted and protected. Evidence: At our last key inspection of this service we judged that - people were benefitting from the management approach of the home, although a lack of registered manger could, potentially, compromise their welfare, although the home was being run in peoples best interests and their health and safety promoted. In our annual quality assurance questionnaire completed by the home, they say that they have a keen and effective management appraoch, which ensures the home is run in peoples best interests in regularly consultation with them and that they have an annual development plan. They also say they have made considerable improvements to their administration Care Homes for Older People Page 24 of 30 Evidence: systems, but feel they could improve by recruiting a suitable manager. They also say they intend to pursue this at the earliest opportunity. At this inspection staff described reasonable management arrangements, although their access to one to one supervision was variable, with some staff not having receive this since January 2008. Records we examined reflected this, although a recent review of management systems has triggered the commencement of individual staff appraisals, which are well underway. The acting manager, who also owns the home has continued to manage the home in the absence of a registered manager since July 2006. There had been no active recruitment drive she was unsure as to whether to continue to manage the home herself, or to actively recruit. We discussed the need to ensure she submit an application for registration to the Commission should she continue to manage the home. There are effective quality assurance and monitoring systems in place, with records kept as to all auditing of services and systems in the home, along with up to date action plans and an annual development plan. These include regular consultation with people who use the service and with staff, via satisfaction surveys, staff, resident and relative meetings and an open door policy. People said that the manager and staff are always approachable and confirmed that regular meetings are held. However, the results of surveys are not shared with people or published. We recommended to the manager that this be developed. There are also no monthly reports in place as to the conduct of the home. Staff described overall satisfactory arrangements for ensuring safe practises in the home, although felt that the purchase of an additional stand aid would benefit people. We observed the home to be clean, safe and hazard free in the areas we inspected. Care Homes for Older People Page 25 of 30 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 31 8 An application must be made 01/10/2006 to the Commission to register a manager for the Home. Care Homes for Older People Page 26 of 30 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 1 1 5A Information within the service guide as to the range of fees charged, what they cover and arrangements for their payment, must include the free nursing care element of the fee. So as to ensure that people are clearly and equally informed to assist them in choosing a home. 22/10/2008 2 29 17 When any staff member commences employment at the home before their criminal record check result is issued, a record of their POVA first check must be retained. So as evidence that correct procedures are followed in respect of staff employed at the home and that the home can evidence this. 31/10/2008 3 30 18 The staff induction and 31/12/2008 training programme must be Care Homes for Older People Page 27 of 30 developed to ensure that it fully accords with nationally recognised standard specification, such as Skills for Care. To ensure that staff are trained and kept up to date and competent. 4 31 8 If the acting manager (provider) continues to manager the home, she must submit a registered manager application to the Commission with immediate effect. As to continue to mmanage the home without registration is an offence under Section 11 of the Care Standards Act 2000. 30/11/2008 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 1 Key service information should be available in alternative formats as may be necessary for people accommodated at the home, In this instance consideration to large print and audio facility for those people with sight impairments. A review of practise should be undertaken in respect of the storage and recording of peoples creams and lotions, where these are kept in peoples own rooms. So as to ensure they are safely stored there and that records of their administration (or self administration) are always clear and maintained made in accordance with recognised pratise. Written details as to peoples individual bathing and nutritional needs should not be openly displayed in communal areas in the home. Such records/information should be stored as to ensure that confidentiality and individual dignity is maintained. 2 9 3 10 Care Homes for Older People Page 28 of 30 4 14 Staff should be conversant with the key principles of the Mental Capacity Act 2005 and consider its implications for practise. including individual record keeping in respect of maximising peoples capacity to exercise personal autonomy and choice. for any person who is blind or vision impaired they should be provided with information about how to complain in a format which is suitable for that person. The complaints procedure should tell people who will deal with their complaint, (a named person) and also provide the correct contact/address details of the Commission (detailing peoples right to contact us at any time). Consideration should be given to the provision of a loop system in communal lounge areas to assist people with hearing impairments. Consideration should be given to providing an additional stand-aid to assist people who would benefit from this. A training needs analysis should be undertaken in respect of each staff member, which infoms the homes training plan by clearly identifying individuals traning needs and due dates so as to avoid omissions. Satisfaction surveys results should be shared with people/published. Consideration should be given to the provision of an additional stand-aid. 5 16 6 16 7 22 8 9 22 30 10 11 33 38 Care Homes for Older People Page 29 of 30 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). 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