Care Home: Brookdale House Residential Home

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What the care home does well Assessment processes that include the provision of information mean people move into the home confident their needs can be met and with an understanding about the running of the home. Care planning processes mean that people living at the home receive the care and support in the way they like and need. People living at the home have their health care needs met by a work force that has a good understanding about their health needs and prompt referral to health care professionals when needed. People living at the home have the opportunity to take part in meaningful activities and maintain contact with family and friends. People living at the home benefit from a varied and nutritious diet. Systems are in place to enable people living at the home and their representatives to express complaints about the service. People living at the home are protected from the effects of abuse by a staff team that has a good understanding of safeguarding procedures. People living at the home benefit from living in a safe and comfortable environment which is suitably furnished and maintained. Staff development and training provision ensure that people living at the home are cared and supported by a skilled and knowledgeable work force in suitable numbers. Recruitment procedures mean that people living at Brookdale House are supported and cared for by staff suitable to work in the caring profession. People live in a home that is effectively managed and seeks the views of those using the service to influence the development of the home. Management of the home believes in the continued improvement of the service. This includes continued improvements to activity calender including the regular visits of Southampton University Music students and the use of using the home`s quality auditing process to produce an on-going development and maintenance plan that includes the carpeting of the dining room and improvements in the garden area and the continued implementation of computerised care planning. Medication practices support people to manage their own medications if they are able to and wish to. What has improved since the last inspection? Improvements have been made the environment including the provision of a walk in shower which now gives people living at the home a choice between showering or bathing. A small quiet lounge has been provided to allow people living at the home a quiet area to socialise. The home has invested in a long distance dementia course for staff members to enhance the training already provided. What the care home could do better: No requirements have been made as a result of this inspection. Discussions with the providers during the inspection process have resulted in them planning to develop a system that will enable staff training to be monitored in an easier and clearer manner. The controlled drug cupboard was not secured to the wall in a manner meeting the Misuse of Drugs (Safe Custody) ( Amendment) Regulations 2007. The provider contacted us on 22nd January 2009 confirming that the controlled drug cupboard is now secured in the correct manner. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Brookdale House Residential Home 31 Hursley Road Chandlers Ford Eastleigh Hampshire SO53 2FS     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Gina Pickering     Date: 2 1 0 1 2 0 0 9 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. 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. 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 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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 29 Information about the care home Name of care home: Address: Brookdale House Residential Home 31 Hursley Road Chandlers Ford Eastleigh Hampshire SO53 2FS 02380261987 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): info@brookdalehouse.co.uk Mr Ronald Cairnduff,Mrs Lesley Anne Cairnduff Name of registered manager (if applicable) Mrs Lesley Anne Cairnduff Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 22 The registered person may provide the following category 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: Dementia (DE) Mental disorder, excluding learning disability or dementia (MD) Old age, not falling within any other category (OP) Date of last inspection 22 22 0 Over 65 0 0 22 care home 22 Care Homes for Older People Page 4 of 29 Brief description of the care home Brookdale House is registered with the Commission for Social Care Inspection to provide a service for a maximum of 22 older people over the age of sixty-five and is also able to support people who have a mental disorder or dementia. The home is located in a residential area close to local amenities. Accommodation is provided over two floors and has a stair lift to assist access between floors, there is and L shaped lounge/dining area together with a separate lounge area with comfortable seating. There is a large secure garden and the front of the property provides parking for visitors to the home. The home is owned by Mr Ronald Cairnduff and Mrs Lesley Cairnduff who are both registered with us as the providers of the care home. Mrs Cairnduff is also registered as the manager of the home. Current weekly fees range from 447 british pounds to 825 british pounds per week with additional costs being made for hairdressing, and chiropody. 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: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The inspection considered information received by the Commission about the service since the last key inspection in March 2007. This includes information provided to us in the form of the homes Annual Quality Assurance Assessment (AQAA) in which the registered providers told us how the service has developed over the past twelve months and how they propose to continue to develop the service. We surveyed people who use the service, staff and health care professionals who have input into the service. We received nine surveys from people using the service, eight from staff members and three from health care professionals. Information from these surveys has been used to inform the inspection process. Care Homes for Older People Page 6 of 29 A visit was made to the home on 21st January 2009. We looked at documentation relating to four people using the service. We had conversations with the registered providers, four staff members, six people who live at the home, a health care professional visiting the home and three visitors as well as looking at various documentation as part of the inspection process. What the care home does well: What has improved since the last inspection? What they could do better: No requirements have been made as a result of this inspection. Discussions with the providers during the inspection process have resulted in them planning to develop a system that will enable staff training to be monitored in an easier and clearer manner. The controlled drug cupboard was not secured to the wall in a manner meeting the Misuse of Drugs (Safe Custody) ( Amendment) Regulations 2007. The provider contacted us on 22nd January 2009 confirming that the controlled drug cupboard is now secured in the correct manner. Care Homes for Older People Page 8 of 29 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 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. Assessment processes that include the provision of information mean people move into the home confident their needs can be met and with an understanding about the running of the home. Evidence: The AQAA told us that information is provided to people interested in living at the home in the form of an easy to read brochure that includes details about the annual fee structure. We looked at the information that is supplied to people interested about living at Brookdale House. The brochure provides information about about the environment of the home including the communal and private areas, details about the home owners and staff training, activities, philosophy of care and contact details for the home. Also included in the brochure is a sample of the fee structure for living at the home. More detailed information is available in the homes statement of purpose and service users guide that is available to all people at the home. We looked at these Care Homes for Older People Page 11 of 29 Evidence: documents. It was discussed with the home owners that the statement of purpose requires revising to ensure it includes all the details as listed in the Care Home Regulations 2001. They told us that this will be done. Copies of recent inspection reports are available in the service users guide. The AQAA told us that if possible someone interested in living at the home visits Brookdale House for a day during which time an assessment is made of their needs and the decision made as to whether the home is suitable for them. If someone is unable to visit the home the manager visits them to asses their needs. We looked at documents for four people living at the home. All contained completed assessments of their needs prior to moving into the home. People living at the home confirmed in surveys and conversations they had visited the home prior to moving in. Comments received included I had an excellent day visit before I went to Brookdale. I quickly felt at home and felt that I would be happy to spend the rest of my days there. Another person living at the home told us he had visited the home several times as well as looking at other homes before making the decision that this was the home he wanted to move into. Visitors told us their relative had visited the home for a day during which time the assessment had been completed as to whether the home would be able to meet their relatives needs. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care planning processes mean that people living at the home receive the care and support in the way they like and need. People living at the home have their health care needs met by a work force that has a good understanding about their health needs and prompt referral to health care professionals when needed. Medication practices, that support people to manage their own medications if able, protect the wellbeing of people using the service. People living the home have their privacy and dignity protected by care practices and the provision of equipment. Evidence: The AQAA told us that care plans detailing the actions to be taken to meet peoples needs are in place. We looked at care plans belonging to four people living in the home. Three of the people had a detailed plan of care and evidence the plans are being reviewed on a monthly basis. The other person had only moved into the home earlier in the week and the care plan was in the process of being developed. But details about how to meet that persons needs are included in the assessment of needs completed prior to moving into the home. Care Homes for Older People Page 13 of 29 Evidence: Each person has a plan of care detailing their abilities, assessed needs, goals and what action care staff need to take to meet the goals. This includes details about mobility, dressing, personal and health care, eating and drinking, recreation, and mental health and wellbeing. Risk assessments are completed for other identified activities and needs for example moving and handling and falls risk assessment; a plan of care to minimise hazards is in place for identified risks. Care plans include details about the involvement of a persons family. For example the family of one person living at the home are involved in supporting and encouraging that person to maintain a good nutritional intake. This is detailed in the persons care plan. Staff members demonstrated in conversation a good understanding about the care and support they need to provide to people living at the home to meet their needs. They spoke about the importance of enabling people to have choices about the care and support they want. The AQAA told us that care plans are going to be transfered to a computerised system. The registered provider told us the plan is that care plans will be accessible to people living at the home and their next of kin by a password protected login system. He hopes this will encourage family members to be more active in the care and support of their relative living at the home. Care plan documentation contained information about contacts that people living at the home have with health care professionals, including G.P.s, community nurses, and dental services. In surveys people living at the home told us they receive the medical care they need. Comments from a care manager include health care needs are always monitored and attended to and a G.P. told us that the home usually seeks advice and acts upon it. A community nurse visiting the home at the time of our visit spoke highly about the health care provision at the home telling us the home seeks advice from the community nurses appropriately, and the home provides excellent care for people who are dying. She told us she has been so impressed with the provision of care at the home that she nominated the home for the Hampshire carers of the year award. Visitors we had conversations with confirmed their relative has their health care needs met and that the home involves them in promoting the health care of their relative. Policies and procedures about the safe management of medications are in place. These include procedures for people to manage their own medications. We spoke with one person living at the home who is managing his own medications who told us assessments are completed to ensure he can safely manage his own medications. Documentation in his care plan evidence this assessment is completed. Staff told us they complete training provided by the the pharmacy supplying medications to the home and this is regularly updated. Discussion with staff evidenced they have a good understanding about the management of medications and they will refer any concerns Care Homes for Older People Page 14 of 29 Evidence: about medications to the relevant health care professional promptly. We looked at the medication administration records (MAR) sheets for four people living at the home. These detailed the name of the medication , the amount of medications and the time medication is administered. Records are kept of all medications ordered, received and returned to the pharmacy and have access to the prescriptions of people living at the home. This means the home can ensure people are receiving medications as prescribed by their medical practitioner and the home is able to track all medications in the home, thus ensuring none go missing. It was noted that although the storage of medications is in an orderly manner the controlled drug cupboard in use to store controlled medications at the time of our visit to the home did not comply with the Misuse of Drugs (Safe Custody) (Amendment) Regulations 2007. Mr Cairnduff, the registered provider, told us the cupboard would be secured in the correct manner and he contacted us the following day to confirm he had completed this work. During our visit to the home we did not observe any breaches in the dignity of people whilst receiving personal care. People living at the home confirmed that staff knock on their bedroom doors before entering their bedroom and we observed staff doing this. Shared rooms have screening to promote the dignity and privacy of people whilst receiving personal care in their own bedroom. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home have the opportunity to take part in meaningful activities and maintain contact with family and friends. People living at the home are supported to exercise choice and control over their daily life. People living at the home benefit from a varied and nutritious diet. Evidence: The AQAA informed us the home employs a dedicated activity coordinator who plans structured activities at the home three days a week. The assessment process includes details about a persons interests, hobbies and past life experiences which help to inform the activity coordinator of what activities people living in the home will be interested in. We looked at the annual report the activity coordinator completed in December 2008. This detailed activities that people have been supported to enjoy in the past year including games and quizzes, themed sessions including growing sunflowers and astronomy, reminiscence sessions, regular outside entertainers including the local infant school, flower arranging, interactive poetry, and musicians including students from the music department at Southampton University. Individual records are kept detailing the activity that a person has joined in with and their response to the activity. With these details, conversations with people living at the Care Homes for Older People Page 16 of 29 Evidence: home and quality assurance processes the home is able to ensure activities are available that people living at the home are interested in. People living at the home told us so much is going on that I am never bored, we have music activities each week plus bingo and other things. During our visit to the home a group of people living at the home were partaking of a sing a long followed by a quiz. One of the visitors to the home told us that her relative takes the opportunity to go on theatre trips the home organises as well as being supported to continue with interests she had prior to moving into the home such as going out ot a day centre once a week. Some people living at the home told us they do not often join in with the activities but they are supported to enjoy their hobbies in their own rooms, such as reading, listening to music, watching television and for one person a sewing machine had been purchased at her request so she take up her hobby of sewing again. People living at the home confirmed they see the activity coordinator regularly whether it is during activities or on a one ot one basis in their bedrooms, enjoying social contact. The statement of purpose and service users guide details there are no restrictions on the time people living at the home can receive their visitors. We spoke to three visitors during our visit, all of whom confirmed they can visit at any time of the day. Details in the visitors book detailed that people living at the home receive visitors at varying times of the day. Assessments include details about a persons religious and spiritual needs. The statement of purpose details religious needs are catered for by the provision of religious services by the local Church of England minister and Roman Catholic priest. One visitor spoke about how the home supports her relative to meet her religious needs by making her aware of days of religious significance, providing relevant spiritual CDs and supporting her to dress according to her religious beliefs. Throughout the inspection process evidence was gathered confirming people living in the home are able to make choices about their daily lives. Examples of these include being able to make choices about involvement in activities and their wishes regarding care support being included in the care planning process. People were observed being able to move freely or with assistance, choosing whether to use the communal areas or sit in their bedrooms. A health professional commented the home does their best to help people to chose the lifestyle they want. The statement of purpose and service users guide detail the times meals are provided and gives a sample of the menu. Conversations we had with the cook at the home confirmed that although the menu for the day does not include a choice, she is fully aware of the likes and dislikes of people living at the home and plans the menu according to their wishes. She told us an alternative meal is always offered if the Care Homes for Older People Page 17 of 29 Evidence: person does not like or does not want the meal planned for that day. Visitors confirmed their relatives can have alternative meals and these are provided. The menu for the day we visited included for lunch sweet and sour pork, vegetables and black cherry crumble with custard, for tea salmon vol u vants, soup and sandwiches and for supper in the evening tea and cake or fruit. The manager and the cook told us about their involvement with research into malnutrition that is being run by the University of Southampton medical school. This has given them greater access and understanding about nutritional supplements and their use in the provision of food. People we had conversations and surveys returned to us indicate a high level of satisfaction with the provision of food at the home. Comments include the meals are delicious - as good as a hotel and meals are always excellent, always of good quality and food plentiful. Menus vary daily. A health care professional told us the home provides excellent 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. Systems are in place to enable people living at the home and their representatives to express complaints about the service. People living at the home are protected from the effects of abuse by a staff team that has a good understanding of safeguarding procedures. Evidence: The AQAA told us a complaints procedure is in place. The statement of purpose and service users guide both contain information about raising complaints. Both people living at the home and visitors to the home told us they would speak with the manager or staff members if they had a complaint about the service. They told us the home owners respond promptly to any concerns or queries and believe they would act quickly and appropriately if a formal complaint was made. The AQAA told us no formal complaints have been received, but there is a log book to detail complaints received, the action taken to investigate complaints and the response made to the complainant. Discussion with staff members evidence they understand the importance of responding to complaints in a timely manner and they would refer any complaints to the home owners or if they were not available ot the team leader on duty at the time of the complaint. Policies and procedures are in place about the safeguarding people, including the local authorities procedures. Discussion with staff members evidenced they have a good Care Homes for Older People Page 19 of 29 Evidence: understanding about the procedures for safeguarding people and they would take the appropriate action if they suspected an act of abuse had occurred. 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. People living at the home benefit from living in a safe and comfortable environment which is suitably furnished and maintained. Evidence: As part of the inspection tour was made of the environment looking at a sample of bedrooms, bathing facilities, communal areas, the kitchen and the laundry. The AQAA told us about improvements made to the environment over the past twelve months. These include the provision of a walk in wet room giving people living at the home the choice of bath or shower, the addition a a small quiet day room for people to meet relatives in they wish to and work to meet the new fire regulations. Communal areas consist of three lounge areas down stairs and the small quiet lounge as detailed in the AQAA as well as a dining room. These areas are decorated in a homely manner and offer a variety of seating for people to use. We observed people moving freely between the communal areas and their bedrooms making the choice about where to sit and how to occupy themselves. A pleasant garden is available for people to use in the warmer months that is accessible for people with mobility difficulties with level pathways around the garden. At one end of the garden a wooden gazebo known as the folly provides sheltered seating areas and is decorated with items of memorabilia including old cooking and household implements to encourage Care Homes for Older People Page 21 of 29 Evidence: reminiscence. Bedrooms were to varying degrees personalised depending on the wishes of the individual living at the home. Screening is available in shared rooms to promote privacy for the people sharing a room. There are sufficient bathing and toileting facilities for people who live at the home that include the provision of choice of bath or shower. The home owner showed us the development plan for the next year. This includes work to the floor and new carpets in the dining room and improvements to the garden area. Policies and procedures are in place about hygiene practices and the control of infection. A team of housekeepers are responsible for cleaning the home. During our visit the home was clean and tidy with no offensive odours. People who live in the home told us the home is always clean and fresh. The homes laundry facilities are on the ground floor. The home only launders personal items of clothing, the home uses a commercial laundry to launder bed linen and other large items. The position of the laundry and good laundry practices reduce the risks of cross infections from dirty laundry. The laundry floors and wall are easily cleanable and were clean and tidy on the day of our visit. 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. Staff development and training provision ensure that people living at the home are cared and supported by a skilled and knowledgeable work force in suitable numbers. Recruitment procedures mean that people living at Brookdale House are supported and cared for by staff suitable to work in the caring profession. Evidence: A staff rota details who is on duty and what capacity. Staff working at the home told us they all have input into developing the rota which means they are allocated the shifts they are able to work resulting in no staff absences and little turnover over of staff members. The staff rota details that on a morning shift there are three care staff on duty, a cleaner, a cook, a maintenance man, the registered manager and the second registered provider available if needed. In the afternoon the rota details that until 5pm there are two care staff plus the registered manager and from 5pm till 9pm there are three care staff and a member of the kitchen staff on duty. Two members of staff are on duty at night time, with the registered providers being available if needed. Members of staff told us there is also a system of on call duties in which a member of the senior care team can be contacted by then homes staff for advice and support if needed. Information we received from people living at the home in the form of surveys and discussions indicated there are sufficient staff to support them and meet their needs. Observation during our visit to the home showed that staff members have time Care Homes for Older People Page 23 of 29 Evidence: to sit and talk with people living at the home and call bells were answered promptly indicating there were sufficient numbers of staff on duty at that time. We looked at a sample of staff records. These evidenced that good recruitment practices are followed ensuring that no one commences employment at the home prior to two written references being received and checks against the Criminal Records Bureau(CRB) and Protection of Vulnerable Adults(POVA) list being received. These processes protect the welfare of those living at the home. Staff surveys confirmed that checks such as references and CRB were obtained prior to them commencing employment at the home. Staff records also contained copies of certificates for courses attended and qualifications obtained by staff members. These indicated staff have received training that provides them with the knowledge and skills to care and support people living at the home. This was confirmed in conversations we had with staff working at the home. Examples of courses undertaken in the past year included induction training that complies with Skills for Care common induction guidelines, a dementia course provided by a specialised professional body,and NVQ training. We were told that over 50 of care staff have NVQ level 2 in care or above. Of the three staff we had conversations one had NVQ level 3, One had NVQ level 2 and the third was commencing her NVQ level 2 that week. They all told us that the home provides them with any training they feel necessary to do their job. However there was no easy manner in which to quickly see what training people had completed, the only record was by the course certificates in their personal files. The manager told us she will develop a matrix for documenting training received, so it can be clearer and simpler to asses when people require further training. Positive comments about the provision of training at the home were made by health care professionals. These include there is a high managerial emphasis on education and the home encourages staff to seek furthur knowledge about professional care issues. 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. People live in a home that is effectively managed and seeks the views of those using the service to influence the development of the home. Procedures ensure that the finances of people using the service are protected. Good health and safety practices protect all people at the home. Evidence: The manager has is registered with us and has the relevant qualifications to manage a care home. People living at the home, visitors, staff and visiting professionals speak highly about the manager and the registered provider of the home. Staff members told us the registered manager and provider are always approachable and will support them with professional and personal issues, this is a good place to work, I get lots of support both personally and work orientated from the home owners and the home owners are always happy to be contacted if we have any concerns about the running of the home. Care Homes for Older People Page 25 of 29 Evidence: The AQAA told us an annual quality audit assessment is carried out that seeks the views of people living at the home and their relatives. We saw details of the audit carried out in October 2008. Aspects covered by the survey included personal care, catering, laundry service, activities and the environment. The home owners spoke about how they have responded to comments received in the audit which include new security lighting on the exterior of the building, planned improvements to the garden and more attention being paid by staff to the tidiness of peoples drawers and wardrobes in their bedrooms. Procedures are in place about the safe handling of money for people who live at the home. People can make use of a safekeeping facility if they wish. Records are kept of monies held for people including details of income and expenditure. The AQAA tells us the home had polcies and procedures about health and safety. Records detail staff have received training about health and safety issues including moving and handling, fire safety, first aid and food hygiene. A risk assessment is completed for the environment and for fire risks. The fire logbook indicates that fire safety checks are carried out in accordance with the Fire and Rescue Services guidelines. The AQAA detailed that service and equipment are serviced at the required intervals as stipulated by the relevant legislation or manufacturers. We viewed a sample of service certificates to confirm this statement. A food hygiene inspection was carried out by the local authorities environmental services in July 2008 following which the home had no requirements. 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: 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 © (2009) 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. 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