Care Home: Breton Court

Similar services:

• The Shelley
• Springfield House
• Sutton Lodge Nursing Home
• St Helier`s Residential Hotel
• St Joseph`s
• Ridgemount
• Wingham Court
• Old Hastings House

What the care home does well The home has a detailed statement of purpose and service user guide which people feel is very informative. The home has a thorough assessment and admissions process and only admits people where they know they will be able to meet their needs. People have a variety of organised activities to participate in. The home employs dedicated staff to provide and encourage activities. In addition outside entertainers and outings are organised. Relatives and visitors are very positive in their comments about the home, the manager and staff. One said, "They care about the people they are helping, we consider the care excellent, high standards of everything". Another said, "From what I see they do much more than many other homes classified as a care home".People enjoy a wide choice menu with a real emphasis on home cooking and fresh quality food resulting in appetising and nutritious meals. One person said "The food is also exceptionally good and plentiful with well thought out nutritious menu ". People feel the home provides a welcoming, friendly, warm and pleasant atmosphere, and environment, which is always clean and well maintained. It is located in a quiet country setting with attractive grounds surrounding the building. People feel their care needs are met. Staff are attentive, caring and kind and do as people ask. One person said "Breton Court treats people with the utmost kindness and consideration". Another said, "Their kindness and caring nature is very apparent which is so decent to see". People say the manager is approachable and enthusiastic. One letter said "X has been there 3.5 years and seen many changes in the standard of care and attitude of staff. Kathleen Jenkins has had a positive effect on the whole feel of the home. She is always immaculate in her dress, patient and professional with residents and does her level best to see that all needs are catered for. She has a genuine interest in making BC a happy home from home and is always patient and understanding with residents and visitors". What has improved since the last inspection? A permanent manager is in post after several changes. The manager is registered with the Commission. The home has improved the format of the preadmission assessment of needs so now it is clear who undertook the assessment and when. The agreements between those living at Breton Court and management have been updated in line with good practice guidance from the Office of Fair Trading. Medication systems and management has been made safer. Staff files have been audited and any shortfalls in required documentation has been supplied. Training records have also been audited and the staff team have benefited from further training. Induction training to Skills for Care specification has been introduced and staff is receiving supervision. The recruitment process better protects people. All staff has either a Criminal records Bureau (CRB) check or Protection of Vulnerable Adults (POVA) check in place prior to start work at Breton Court. Further work is required to fully protect people living at Breton Court. An audit of all accidents and in particular falls is now undertaken monthly to try and reduce risks and accidents to people. What the care home could do better: Where a local authority fund peoples care the agreement with that person should contain details of the fee payable and by whom. People should have a regular formal opportunity to voice their views and feedback on the home. The continued shortfalls in recruitment processes must be addressed to protect people. Staff should receive further training to enhance their knowledge and care practice. CARE HOMES FOR OLDER PEOPLE Breton Court Grange Road St Michaels Tenterden Kent TN30 6EE Lead Inspector Mrs Sally Gill Key Unannounced Inspection 09:45 28 & 29th January 2008 th 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 Breton Court DS0000023324.V357905.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. Breton Court DS0000023324.V357905.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Breton Court Address Grange Road St Michaels Tenterden Kent TN30 6EE 01580 762797 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) Tenterden Care Homes Ltd Kathleen Jenkins Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (0) of places Breton Court DS0000023324.V357905.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories 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 category: Old age, not falling within any other category: number of service users 28. The maximum number of service users to be accommodated is 28. 2. Date of last inspection 31st October 2006 Brief Description of the Service: Breton Court is registered to provide accommodation for up to 28 older people although due to changing all rooms to singles only accommodates 26 and admits low to medium dependencies. The company, Tenterden Care Homes Ltd owns the home. Mrs Kathleen Jenkins is the Registered Manager and is in day-to-day control of the home. The premise is a purpose built detached property with all accommodation for people on the ground floor suitable for wheelchair access. There are 26 single rooms, eleven of which have ensuites. People have the use of four bathrooms. There is a dining room and lounge over looking a large well-maintained garden to the rear with mature shrubs and a secure duck pond. Each room has a call bell for people to call for assistance should it be needed. All rooms have a television point. A telephone can be installed in rooms by arrangement. There is car parking space to the front of the Home. The Home is set in a quiet residential area in the village of St. Michaels. Within a short distance there is a church, public house, shops including a post office and the bus stop. Tenterden town centre is approximately one mile away. The staff compliment consists of a registered manager, deputy manager and care assistants. In support is an administrator, cook and kitchen assistant, domestic and laundry assistant and maintenance person. Staff work a rota that includes a minimum of four care staff on duty in the morning, three in the afternoon and two at night. The current fees range from £309.04 to £626.99 per week. There are Breton Court DS0000023324.V357905.R01.S.doc Version 5.2 Page 5 additional charges for hairdressing, magazines and newspapers, chiropody, telephone, personal toiletries and holidays. A copy of the latest inspection report can be viewed at the home or down loaded from www.csci.org.uk. Breton Court DS0000023324.V357905.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was carried out over a period of time and concluded with an unannounced visit to the home on 28th January between 09.40am and 5.40pm and an announced visit on 29th January between 9.25am and 11.05am. The registered manager assisted throughout day one and the administrator assisted on the return visit. People that live at Breton Court, relatives and staff were spoken to. Observations included interactions between those that live at Breton Court and staff. Twenty-six people were living at the home including one person on a respite stay. Surveys were sent to the manager to distribute to those living at the home and relatives. Feedback received was very positive. The care of three people was tracked to help gain evidence as to what its like to live at Breton Court. Various records were viewed during the inspection and parts of the home were viewed. The home returned the annual quality assurance assessment (AQAA) when we asked. This was clear and contained all the information asked for and has been used to inform this report. The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. What the service does well: The home has a detailed statement of purpose and service user guide which people feel is very informative. The home has a thorough assessment and admissions process and only admits people where they know they will be able to meet their needs. People have a variety of organised activities to participate in. The home employs dedicated staff to provide and encourage activities. In addition outside entertainers and outings are organised. Relatives and visitors are very positive in their comments about the home, the manager and staff. One said, “They care about the people they are helping, we consider the care excellent, high standards of everything”. Another said, “From what I see they do much more than many other homes classified as a care home”. Breton Court DS0000023324.V357905.R01.S.doc Version 5.2 Page 7 People enjoy a wide choice menu with a real emphasis on home cooking and fresh quality food resulting in appetising and nutritious meals. One person said “The food is also exceptionally good and plentiful with well thought out nutritious menu “. People feel the home provides a welcoming, friendly, warm and pleasant atmosphere, and environment, which is always clean and well maintained. It is located in a quiet country setting with attractive grounds surrounding the building. People feel their care needs are met. Staff are attentive, caring and kind and do as people ask. One person said “Breton Court treats people with the utmost kindness and consideration”. Another said, “Their kindness and caring nature is very apparent which is so decent to see”. People say the manager is approachable and enthusiastic. One letter said “X has been there 3.5 years and seen many changes in the standard of care and attitude of staff. Kathleen Jenkins has had a positive effect on the whole feel of the home. She is always immaculate in her dress, patient and professional with residents and does her level best to see that all needs are catered for. She has a genuine interest in making BC a happy home from home and is always patient and understanding with residents and visitors”. What has improved since the last inspection? What they could do better: Breton Court DS0000023324.V357905.R01.S.doc Version 5.2 Page 8 Where a local authority fund peoples care the agreement with that person should contain details of the fee payable and by whom. People should have a regular formal opportunity to voice their views and feedback on the home. The continued shortfalls in recruitment processes must be addressed to protect people. Staff should receive further training to enhance their knowledge and care practice. 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. The summary of this inspection report can be made available in other formats on request. Breton Court DS0000023324.V357905.R01.S.doc Version 5.2 Page 9 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 Breton Court DS0000023324.V357905.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 5 & 6 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People feel they have sufficient information needed in order to make a decision as to whether this home was right for them. People agreements are not clear about fees payable when a local authority is funding or part funding their care. EVIDENCE: People felt they had sufficient information about the home prior to moving in. A detailed statement of purpose and service user guide is in place. Details of the range of fees have not been included which was previously a recommendation. They have been included in the homes small brochure leaflet. A copy of the service user guide is given to each service user and one is also located with the signing in book in the front hall. Prospective service users receive a copy of the brochure leaflet. One person who had recently moved in said the service user guide “has been interesting reading” they found it “very informative”. Breton Court DS0000023324.V357905.R01.S.doc Version 5.2 Page 11 People have agreed terms and conditions with the home. The home has obtained a copy of the Office of Fair Trading guidance for fair contracts in care homes. As a result agreements have been improved/updated. One person did not have terms and conditions agreed but the administrator agreed to put these in place. The administrator also agreed to add the amount of the fees agreed with the local authority and the break down of that fee where it is known to all appropriate agreements. Details of fees were clearly recorded in all privately funded peoples agreements. People confirmed that staff undertook an assessment of their needs prior to admission in their environment. These are used to develop the care plan. The format for the assessments has been updated to include the name and signature of the person completing it and the date. Assessments generally contain sufficiently detailed information and cover all areas of care needs. Some contained much better detail than others. In discussions it was apparent that more information was gained than was actually recorded. Assessments would benefit if all information were recorded. Where a local authority funds people a copy of their needs assessment has been obtained. People said that they had the opportunity to visit the home prior to admission, to walk round and meet people. Intermediate care is not provided although respite care can be vacancies allowing. Breton Court DS0000023324.V357905.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: People’s health, personal and social care needs are set out in individual care plans. Each person has a care plan in place. All people spoken to were very happy with the care provided. They were either unaware of their care plan or said they did not want to be involved in a review. They feel they are able to say if something is wrong. Involving people in their care plans was discussed with the manager. This is an area where the home could develop and should consider using innovative ways to achieve the more person centred planning approach. Four care plans were examined. Care plans show the needs of people and how staff are to help them achieve these. Staff advised that since the manager has been in post work has gone into improving the detail in care Breton Court DS0000023324.V357905.R01.S.doc Version 5.2 Page 13 plans. Of those examined the detail of information varied. At times they were very informative to staff and in others they were adequate. In one instance where detail was not so good it was also not possible to track through daily records whether a care need was being met. Examples were discussed with the manager such as who managed medications, intervention guidance for changing catheter bags and monitoring blood sugar levels. Care plans contain risk assessments including mobility, falls and tissue viability. Risk assessments were not evidenced as reviewed specifically. The deputy advised these are reviewed each month along with the care plan. It is suggested that risk assessments evidence reviews. People’s health care needs are met. People confirmed that they have access to doctors, district nurses and other health professionals, as they require. Peoples health is monitored closely and referrals made when necessary. A dentist, optician and chiropodist visit the home or people can arrange their appointments in the community. The manager has implemented a system to audit and monitor all accidents and falls. As a result of this routines at one time of day routines have been changed and the manager advised this has resulted in a reduction of falls. People are supported to manage their own medication. Medication administration undertaken by the home is managed safely. Some people are managing their own medication. Risk assessments are in place but would benefit from the actual safe storage being recorded. Information indicated that regular audits of the medication system are undertaken. Internal and external medicine should be stored separately. Information indicated that staff that administer medication are trained. People said that staff treat them with respect, are sensitive when helping with personal care and always knock before entering their room. When asked whether staff respected their privacy and dignity one person said “yes their wonderful”. Several people have telephones in their own rooms which relative’s feel helps them to keep in regular contact. There are no shared rooms. Breton Court DS0000023324.V357905.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Social, cultural and recreational activities meet people expectations. People receive a healthy, varied and wholesome diet with special diets catered for. EVIDENCE: People feel they have the opportunity to participate in a variety of activities. Dedicated activity staff work Monday to Friday afternoons. The manager hopes to increase these hours to include mornings and weekends. The manager advised it is hoped in the mornings these could be used to spend time with people who choose to stay in their own room. This was something raised in a survey. People surveyed were all aware activities take place although some said they choose not to participate which is respected. There are a wide variety of activities including dominos, painting, exercises, card making, reminiscence and crosswords, bonus ball, hoy and bingo. Outside entertainers also visit the home usually people playing a musical instrument and or singing. Representatives from two different religions visit the home and are able to Breton Court DS0000023324.V357905.R01.S.doc Version 5.2 Page 15 give communion to those who want to participate. A hairdresser visits weekly. A quiet library area has a selection of books and can be used to sit and read. Several people spend time in the lounge watching the ducks on the pond and the birds feeding at the bird table. Additional garden furniture was purchased last summer to encourage people out into the garden. Although one relative surveyed felt that people should be encouraged to use the garden more often and that the garden furniture is not always kept clean. People are able to get out into the community. Recent outings have included tea at a garden centre, lunch at London Beach Hotel, a carol service and a pantomime. The home organised a garden party in the summer, which was open to all families, friends and the local community. Relatives all gave positive feedback stating they were very happy with the care provided. Visitors said they are always made to feel very welcome usually with a cup of something. One talking to the inspector was enjoying a cup of coffee with a slice of homemade cake. Visitors said staff are always kind and approachable. People said they were able to exercise choices in their day-to-day lives. People felt they had choices about where they eat their meals, getting up and going to bed, how they spend their day, what they eat, and when they have a bath. People confirmed that they enjoy the food and their special diets are catered for. Menus include a wide choice including a vegetarian menu and special diets. People are asked about choices the day before. Breakfast is mainly served on trays in rooms although some choose to go the dining room. Lunch and tea is encouraged in the dining room to make it a social occasion. Lunch is the main meal and can be up to three choices always with a vegetarian option. A lunch seen on the day of the visit was shepherds pie with carrots, swede and gravy. This look hot, home made and appetising. Supper can be up to four choices of a light meal or sandwiches plus two sweet options, which can include homemade cakes. Meat is bought from a local butcher to ensure good quality. Fruit and vegetables are delivered two to three times per week to ensure freshness. The Environmental Health Office visited the home in December 2007 and awarded the home three stars. The dining area is pleasant overlooking the garden and duck pond. Tables are laid with linen table clothes. Staff are on hand to assist if required. Breton Court DS0000023324.V357905.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People have access to a robust, effective complaints procedure and are protected from abuse although this could be further enhanced. EVIDENCE: People feel that if they had any complaints the manager would deal them with. People were keen to say they didn’t have any complaints. People confirmed that the manager is available and approachable if anyone should have any concerns. One said, “I would speak to Kath and know she would sort it out”. The complaints procedure is displayed around the home and is in the service user guide. Three complaints have been received by the home in the last twelve months from relatives and a member of staff. Two were substantiated and one was partly substantiated. All were investigated fully and complainants responded to with outcomes. Not all investigations could be tracked through the records although a verbal account could be given. The manager was advised to improve records of the investigations. It was also suggested to have a complaints log. A daily issues or minor ‘niggles’ book is not in place, which was a recommendation at the last visit. People are protected from abuse but further training could enhance this. A safe guarding adults and prevention of abuse and whistle blowing policy are in place. Staff are asked to read and sign these as part of their induction. Breton Court DS0000023324.V357905.R01.S.doc Version 5.2 Page 17 Safeguarding adults is covered within the Skills for Care induction training. Some staff has attended Protection Of Vulnerable Adults (POVA) training but it is recommended that all staff attend this training. The home does not hold any monies for people or deal with their finances. Information on advocates is displayed. Breton Court DS0000023324.V357905.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23, 24, 25 & 26 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People benefit from comfortable and pleasant environment, which is clean and well maintained. EVIDENCE: People live in a safe, well-maintained environment. Since the last inspection work has continued to improve the environment. All radiators are now guarded with low temperature surfaces, further bedrooms and bathrooms have been decorated, a new assisted bath has been install and shower facility. New flooring has been laid in a bathroom and shower room. The freezer and storage area has been renovated. Further door guards for protection against fire have been fitted. The home remains well maintained. The Environmental Health Office has visited the home in December 2007. A requirement was made relating to replacing the kitchen floor and a recommendation that this is Breton Court DS0000023324.V357905.R01.S.doc Version 5.2 Page 19 non-slip. The owner has already had people in to look and quote for the flooring. The dining area and lounge areas have changed around to provide a more cosy area in which to sit. The home is non-smoking. The home was warm on the day of the visit even though cold outside. The garden is accessible to people and people can sit and view the garden and duck pond from the lounge and dining areas. One survey said that some areas of the garden are not so well maintained. The manager agreed an area round the side is not as pleasant as other areas. People confirmed they are happy with their own rooms, which they have personalised. One said it very nice I’ve got my own bits and pieces. Another said I like my room I like the two windows and I have my own possessions. People said the home is always spotless clean and there are never any odours. One said, “cleanliness is quite something and we looked at a lot of homes prior to moving in”. The laundry is efficient with industrial type machines. An area of the floor in the laundry is not impermeable and areas of the walls are not readily cleanable. Breton Court DS0000023324.V357905.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People benefit from a very caring staff team some of which are qualified and trained but further mandatory training could benefit people and would enhance the team. Recruitment processes continue not to fully protect people. EVIDENCE: People benefit from a more stable staff team. A survey commented on the use of agency. However staff, and the manager advised that the home has not used agency staff for some considerable time. Staff numbers have increased, and shortages can be covered using the team, which aids consistency of care to people. Everyone spoken to was very complementary about staff. People said they were kind, caring and did what people wanted. Comments included “can’t fault what the staff do for us” and “got some brilliant staff here especially night staff”. In addition to care and dedicated activity staff there is also a cook, kitchen assistant, domestics, laundry assistant, administrator and a company handyman. Recruitment practices are improved but continue not to fully protect people. The recruitment files of three staff were examined. The application form continued to only ask for five years work history. To obtain a full work history was a requirement at the last inspection. The administrator changed the Breton Court DS0000023324.V357905.R01.S.doc Version 5.2 Page 21 wording of the form on the second day of the visit to the home. Other wording was also made clearer on the form. The completion of application forms was in some instances poor, and management had not addressed this during the recruitment. One had gaps in employment history, which had not been checked out, and an explanation recorded. One start date of employment on the application form and references differed. This had not been picked up but could relate to how information was asked for. One application form was not completed fully (blank work history and reference details), although it was clear that information should have been recorded in these sections. All staff has a POVA check in place prior to working with people. Although the home was unable, at the time of the visit to evidence any POVA 1st checks were in place. The home only receives a telephone call to advise a POVA is through. The information had to be obtained from the umbrella organisation. The home must have effective systems in place, where they can evidence the dates POVA 1st checks are in place. One member of staff had started on a POVA 1st but only has one written reference in place. Another two staff is working and only have one reference in place. The administrator advised that these have been requested. It is management’s responsibility, to ensure these are in place prior to staff working with people. Two references from one person had been addressed to whom it may concern. The administrator advised that she had telephoned and checked these but had not made a record. Recruitment areas discussed above were included as requirements made at the previous inspection and it is disappointing they have not been addressed. The previous requirements have not been carried forward as the wording for requirements has been changed to be more specific. People benefit from a staff team who have improved training opportunities. The manager advised that new improved training arrangements are in place. Staff agreed this has improved, and has resulted in more opportunities and not having to wait so long for training and up dates. The induction programme has been updated and is now to Skills for Care specification. Training relevant to peoples needs has taken place and includes courses on catheter care, diabetes, continence and pressure area care. Some staff is about to undertake a 12week course at a local college on dementia. Further mandatory training is needed see standard 38. Nine staff has obtained a National Vocational Qualification (NVQ) in care level 2 and another three are currently undertaking this. After completion the 50 target will be more than met. Breton Court DS0000023324.V357905.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 & 38 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The management of the home is based on openness and respect. Formal quality assurance systems need to be developed to ensure people’s views underpin the development of the home. The health, safety and welfare of people are protected but further training could enhance this. EVIDENCE: People live in a home, which is managed by a person who is experienced and committed to improving services for them. Since the last visit a permanent manager was appointed and registered with the Commission. Kath has 29 years experience of the care sector five of which have been in a senior or management role. It is evident that she is very keen to improve care provided Breton Court DS0000023324.V357905.R01.S.doc Version 5.2 Page 23 to people. All feedback from people was very positive and reflected her enthusiasm and caring nature. One said “she’s first class, has a genuine desire to make it home from home, a good sense of humour and its obvious staff like her”. Another said, “Kath is one step ahead thinking what she can do”. Kath will enrol on the Registered Managers Award (RMA) at NVQ level 4 in care in February 2008. People benefit from the ethos, leadership and management of the home. The management of the home ensure an atmosphere of openness and inclusion on a day-to-day informal basis. People that generally spend most of their time in their rooms confirmed that ‘Kath pops in most days’. She also works as part of the team and people appreciate that she is available and approachable. The home is generally run in the best interests of people that live there. Development of the formal side of quality assurance could enhance this. Management must adopt a robust recruitment to protect people. People feel the manager is visible and approachable but formal systems for feedback should be improved. The last resident meeting was seven months ago. Minutes show these meetings have always been an opportunity taken by people to voice their views. These should be held more frequently. A suggestions box was discussed with the manager. As previously mentioned a daily niggles book should be implemented. People completed quality assurance questionnaires in March 2007 but these appear not to have been analysed and people have not received feedback on the findings. The home does not have any involvement in people’s finances. Staff spoken to confirm they feel well supported and receive supervision. They said the manager is approachable and will resolve any issues. The manager and the administrator undertake supervision. A start has been made on introducing regular supervision sessions. A staff meeting was held recently. The health, safety and welfare of all is promoted and protected. Some staff has received training in manual handling, food hygiene and infection control. Most staff has received fire training and all have received first aid training. Further numbers of staff should be trained in mandatory subjects. Accidents and incidents were recorded appropriately and are reported appropriately. Information received stated that all necessary tests and servicing are carried out. See previous comments regarding EHO. Breton Court DS0000023324.V357905.R01.S.doc Version 5.2 Page 24 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 3 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 2 X N/A 3 X 3 Breton Court DS0000023324.V357905.R01.S.doc Version 5.2 Page 25 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 OP29 Regulation 19 Requirement The home must operate a robust recruitment procedure. In particular The employee must submit a fully completed application form with full work history and any gaps checked and a record made Two written references to be in place prior to the employee starting work Evidence that POVA checks are in place prior to the employee starting work Timescale for action 01/02/08 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 Breton Court DS0000023324.V357905.R01.S.doc Version 5.2 Page 26 1 2 3 4 OP2 OP18 OP33 OP38 All agreements with people funded by local authority to detail fees payable and by whom All staff to receive training in safe guarding adults The home to hold a regular forum for people to give their views and feedback on the home Further staff to receive mandatory training Breton Court DS0000023324.V357905.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 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 © 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 Breton Court DS0000023324.V357905.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!