Care Home: Cambron House Care Home

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What the care home does well People living in the home said that the care they were receiving was good. They made comments such as, "Everyone is very kind". "The staff will do anything I ask". "I have a nice room which I enjoy being in". "I can`t grumble". Comments received from questionnaires and from talking to relatives were positive and included, "This is the best care for someone who has sadly lost their memory and changed beyond all expectations". "The staff are very helpful and supportive". "Very homely and friendly". "Having visited many homes around South Yorkshire before moving here, it was the best and remains an excellent choice". "The home is well run, although I feel more staff could be on duty". "All staff are excellent and take pride in their jobs. I have found that they can`t do enough for the people they care for". "The care and support given to people and their relatives by both the management and staff is second to none". "I wish to state in writing my thanks to all the staff, from the manager to the domestic staff for the wonderful work they do". A health professional said, "The staff are kind and cheerful towards people and they know each resident very well". We observed that people were well dressed in clean clothes and had received a good standard of personal care. People`s health care was monitored and access to health specialists was available. People and relatives said that staff were always respectful towards them. People said that they had a choice of food and that the quality of food served was `good` and `plentiful`. There was a complaints procedure and adult protection procedure in place, to promote peoples safety. People said they had confidence in the homes manager and staff, who would listen to any concerns and take them seriously. People said that they felt safe living at the home. What has improved since the last inspection? The manager had been in post for one month. During this time she had worked extremely hard to make improvements. It was very evident that the staff team had responded positively to her style of management. Staff had completed training in report writing and care planning. This meant that the information recorded in peoples care plans and daily notes was much better. Individual risk assessments were completed. These were seen on peoples files when a risk to a persons moving and handling or health and safety had been identified. Medicine Administration Records (MAR) sheets were completed with staffs signatures. Substances that could be hazardous to health were safely stored and locked away. We saw certificates that confirmed the gas and electrical installations had beenserviced as required by health and safety. What the care home could do better: The service provided at Cambron House had improved and everyone involved with this improvement should be proud of this. We acknowledge that the provider and manager continue to evaluate and monitor the service and make any changes necessary to ensure that the home continues to improve. So that people`s health and welfare are protected, staff that have made errors during medication administration should receive further training. At no time should medication be left unattended. All medications should be kept safely locked away. Any complaints received at the home should be recorded in the complaints log. So that people are kept safe the fire risk assessment should highlight any particular precautions that need to be in place for people that have dementia. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Cambron House Care Home 3 Flanderwell Lane Bramley Rotherham South Yorkshire S66 3QL     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: Sue Turner     Date: 2 4 1 1 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 28 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 28 Information about the care home Name of care home: Address: Cambron House Care Home 3 Flanderwell Lane Bramley Rotherham South Yorkshire S66 3QL 01709543197 01709702992 cambronhse@tiscali.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Kirsten Properties Limited Type of registration: Number of places registered: care home 38 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 38 The registered person may provide the following category of service only - Care home with nursing - Code N, to service users of the following gender: Either, whose primary care needs are within the following categories: Mental Disorder - Code MD, and Dementia - Code DE Date of last inspection Brief description of the care home The home is situated in Bramley, which is approximately 4 miles from Rotherham. Cambron House is a registered care home that provides both residential and nursingcare for people in the categories of elderly with dementia and mental disorder. The home provides both long and short-term care for its client group. Cambron House is a converted and extended building, which provides accommodation for up to 38 people Care Homes for Older People Page 4 of 28 Over 65 0 0 38 38 Brief description of the care home in 32 single and 3 double bedrooms. The accommodation is provided over 2 floors and there is a passenger lift to the first floor. The communal space, located on the ground floor, consists of a dining room and a large lounge. The kitchen and the laundry room are also situated on the ground floor. There are garden areas at the back and in the front of the building. Car parking spaces are provided to the front and side of the home. The home is well served by regular public transport services, a range of shops, post office and a number of public houses and fast food outlets. Copies of the last Commission For Social Care Inspection (CSCI) reports were kept in the entrance for people and their families to read. The weekly fees range from 397.00 to 556.00 pounds. This information was provided on the day of the site visit. The home charges extra for chiropody, toiletries, clothing, holidays and hairdressing. Care Homes for Older People Page 5 of 28 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: We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. This was an unannounced key inspection carried out by Sue Turner regulation inspector. This inspection took place over one day, between the hours of 8.00 am and 2.30 pm. The manager is Julie Fletcher, who was present during the inspection and was given feedback during and at the end of the inspection. Care Homes for Older People Page 6 of 28 Prior to the visit the manager had submitted an Annual Quality Assurance Assessment (AQAA) which detailed what the home was doing well, what had improved since the last inspection and any plans for improving the service in the next twelve months. Information from the AQAA is included in the main body of the report. Questionnaires, regarding the quality of the care and support provided, were sent to people living in the home, their relatives and any professionals involved in peoples care. We received eight from people living in the home, some had been completed by their relatives for them. We also received three from professionals and three from members of staff. Comments and feedback from these have been included in this report. On the day of the site visit opportunity was taken to make a partial tour of the premises, inspect a sample of care records, check records relating to the running of the home and check the homes policies and procedures. Time was spent observing and interacting with staff and people. Six staff, one relative and seven people living in the home were spoken to. We checked all key standards and the standards relating to the requirements outstanding from the homes last key inspection in December 2007. The progress made has been reported on under the relevant standard in this report. We wish to thank the people living in the home, staff, and relatives for their time, friendliness and co-operation throughout the inspection process. What the care home does well: What has improved since the last inspection? The manager had been in post for one month. During this time she had worked extremely hard to make improvements. It was very evident that the staff team had responded positively to her style of management. Staff had completed training in report writing and care planning. This meant that the information recorded in peoples care plans and daily notes was much better. Individual risk assessments were completed. These were seen on peoples files when a risk to a persons moving and handling or health and safety had been identified. Medicine Administration Records (MAR) sheets were completed with staffs signatures. Substances that could be hazardous to health were safely stored and locked away. We saw certificates that confirmed the gas and electrical installations had been Care Homes for Older People Page 8 of 28 serviced as required by health and safety. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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 28 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 28 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. The home provided sufficient information to inform people about their rights and choices. People were encouraged to visit the home, look around and meet other people staying there. Evidence: The home had an incorporated Statement of Purpose (SOP) and Service User Guide (SUG). This was available for people living in the home and anyone who may be considering living in the home. It had been recently reviewed and updated. The SOP and SUG although informative was not set out in a way that people could easily read or refer to. Considering that the home accommodates people with dementia some pictures and colour would assist people with dementia to understand the information more easily. Before people stayed in the home they were assessed by a social worker. The manager also carried out a pre assessment by visiting people in their own home or hospital. This Care Homes for Older People Page 11 of 28 Evidence: meant that everyone could be assured that the home could meet the persons needs. People were invited to visit the home, try out the meals and spend time meeting the staff and seeing the services available. Any information collated from the needs assessment would then form the basis for the care plan. When staff were asked, are you given enough information about people to enable you to care for their individual needs. Two staff said always and one said usually. People were asked Did you receive enough information about the service so you could decide if it was the right place for you. Eight people said Yes. Relatives said We came and discussed care with them and other homes, we thought this was the most homely. We called in unannounced to look around. We were very impressed by the staff, cleanliness and surroundings. I met with the manager, had a tour of the home and all my questions were answered fully. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care needs of people were met. A range of health care professionals visited the home. Medication procedures did not fully protect peoples health and welfare. Staff should give more consideration to peoples privacy and dignity. Evidence: Three care plans were checked. The standard of the care plans had improved significantly since the last inspection and the staff had clearly made an effort to meet the requirements made at the last inspection. Staff said they had received training in care planning and report writing, this had been of great benefit. Staff completed daily records at the end of each shift. These had also improved and related well to peoples care plans. They detailed how people had spent their day, what diet they had, if they had joined any activity or had visitors and how they were generally feeling. Care plans identified that a range of health professionals visited the home to assist in maintaining peoples health care needs. People said that dentists, GPs, opticians and chiropodists visited as requested. Individual risk assessments were completed. These were seen on Care Homes for Older People Page 13 of 28 Evidence: peoples files when a risk to a persons moving and handling or health and safety had been identified. Risk assessments were reviewed and updated by senior staff. The manager said she was in the process of inviting relatives to be involved in care planning if they wished. Two relatives said they had been involved in reviewing their loved ones care plan. Three professional surveys returned said that peoples individual health care needs were usually met by the service. They also said that the service usually promoted peoples privacy and dignity. Eight people returned surveys. When asked Do you receive the care and support you need. Five people said always and three said usually. When asked Do you receive the medical support you need. All eight people said always. Relatives said, My sisters care is very good. Retaining staff means we get to know each other and therefore care is first class. Sometimes I feel a little prompting is required to follow through certain issues. The homes medication system had been changed. Staff said this was a much safer system. The pharmacist, who supplied the medication carried out checks to ensure that medications were being administered, stored and disposed of correctly. There was evidence that qualified staff were auditing medication administration procedures. Trained staff administered medications in the home. Medicines were securely stored around the home in locked trolleys within treatment rooms. Medicine Administration Records (MAR) checked were completed with staffs signatures. At breakfast we observed a staff member leaving a persons tablets on the dining room table whilst they attended to someone at another table. We talked to the staff member and manager about this. The staff said that this was not usual practice and only happened because they believed the other person needed immediate attention. The risks associated with this practice were reiterated to the staff and manager. The manager said she would carry out close monitoring of medication procedures. During the site visit we observed that people were cared for in a friendly way. Some staff were very skillful in ensuring that people maintained their privacy and dignity, others were not as mindful. We talked to the manager about staff being trained in privacy and dignity issues and she agreed that this was necessary. Care Homes for Older People Page 14 of 28 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. People had a choice of lifestyle within the home and were able to maintain contact with family and friends ensuring that they continued to be involved in community life. A range of activities was on offer, which promoted choice and maintained interests. Meals served at the home were of a good quality. Evidence: People said they were able to get up and go to bed when they chose, and were seen to walk freely around the home, if able. Relatives spoken to said they were able to visit at any time and were made to feel very welcome. Staff took time to make sure friends and family were made to feel comfortable whilst visiting their loved one. Some people said they preferred to stay in their room at certain times of the day and that the staff respected their decision. The home employed an activities worker who worked 20 hours per week. We saw notices advertising church services, film shows, crafts and music and movement. Special events were planned for over the Christmas period. People said that they enjoyed taking part in social activities within the home. The activities worker said she also took people out of the home on a one to one basis. People were asked are there activities arranged at the home that you can take part Care Homes for Older People Page 15 of 28 Evidence: in. Six people said always and two said sometimes. Two people said there were always activities arranged but they were unable to take part in them because they were blind. One person said, Because I am nearly blind I do feel alittle isolated. I am fed but a little more contact with someone would help. We suggested that the activities worker considered these peoples disabilities and looked at ways in which they could be involved in activity sessions. We observed breakfast and lunch being served in the dining room. It was very evident that the cook was aware of peoples likes and dislikes and people were offered a number of choices to suit their preferences. Dining room tables were set nicely with tablecloths, cutlery and matching crockery. The dining room was quite small and at times seemed busy and noisy. Staff had made every effort to enhance peoples mealtimes by introducing two sittings. This greatly improved the ambiance in the dining room. Staff were also able to give one to one assistance to people were necessary. When people were asked do you like the meals. Four people said always, three people said usually and one said sometimes. Relatives said, People are very well fed. My mother is very difficult to please with food and staff are very good at trying her with different options. My father enjoys his meals. He is given things he used to have at home like porridge. We know that if we wanted to share a meal with him that would be possible. Care Homes for Older People Page 16 of 28 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. Complaints procedures were in place to enable people and relatives to feel confident that any concerns they voice would be listened to. Staff had an understanding of the procedures to be followed should they suspect any abuse at the home, so helping to ensure people were protected from abuse. Evidence: People and their families had been provided with a copy of the homes complaints procedure, which was also on display in the entrance hall. This detailed who to speak to at the home or, if preferred, external to the home to make a complaint, should they wish to do so. Eight people were asked Do you know how to make a complaint. Seven people said yes and one said no. Relatives said, I have never had any reason whatsoever to complain. If I needed to speak to someone I would see the manager. I havent used the complaints procedure but I am aware of it. We had been informed of two complaints since the last inspection. The home was also made aware of these. Both were investigated and unsubstantiated. The homes complaints log was not up to date. It did not contain any details of the two complaints made since the last inspection. The manager said she was aware of this and would ensure that any further complaints were recorded in the log. Staff spoken to were aware of their role and responsibilities in dealing with any alleged safeguarding incidents. In conversation with staff, we noted that they had a good Care Homes for Older People Page 17 of 28 Evidence: understanding of safeguarding adults and whistle blowing policies, procedures and practices. The manager said that updated and refresher training in adult safeguarding had been arranged and was due to take place over the next few months. There has been two safe guarding referrals since the last inspection. Following social workers investigating, the home were given recommendations for improvement to practices in relation to peoples pressure care. The AQAA stated this has been actioned. The other was an allegation about a staff member. The staff member was suspended from duty pending an investigation. The safeguarding board found that no abuse had occured and the staff member was reinstated. The home had fully co operated with the safeguarding investigations. People said they felt safe living at the home. Care Homes for Older People Page 18 of 28 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. The home was maintained to a good standard, was very clean and fresh smelling. Procedures for the control of infection were in place which promoted peoples health and welfare. Evidence: The home had outdoor space, which was accessible to all people including those with mobility problems. People could walk outside into an enclosed patio area. Tables, chairs and shrubs made the area look pleasing. The home was clean and tidy. Lounge and dining areas were domestically furnished. Bedrooms were personalised. Since the last inspection refurbishment of the home had continued. Some carpets and furniture had been replaced and some bedrooms had been redecorated. However there still remained areas of the home in need of refurbishment and modernisation. The tiolets and bathrooms were very basic and did not provide a homely environment Some attempts had been made at making the communal areas look more homely. A new conservatory had added more space and people were enjoying sitting in there. The home smelt fresh and clean throughout the day. Controls of infection procedures were in place. Staff were observed using protective aprons and gloves. The homes laundry was sited away from food preparation areas. Staff had undertaken training in infection control. Relatives said, Care Homes for Older People Page 19 of 28 Evidence: Only odd times when accidents happen is there a problem. It is soon dealt with. There are excellent standards of hygiene throughout the home. Bedrooms and communal areas always appear to be well kept. Care Homes for Older People Page 20 of 28 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. Sufficient staff were provided to meet the needs of people. The recruitment information obtained for staff was sufficient to adequately protect the welfare of people. Staff had completed training that ensured they had the competences to meet peoples individual needs. Evidence: Staff interviewed said that they enjoyed working at the home and got a lot of job satisfaction. On the day of the site visit staffing numbers were at an acceptable level. Staff said that the new manager had ensured that staffing levels were kept at an acceptable level. They said that when people were sick or on holiday, other staff were called in. They also said that rotas were arranged so that the needs of people living in the home could be met. Relatives said that they had noticed that more staff were around and where necessary people were being more closely observed. The manager had undertaken a review of staff training and had identified the shortfalls. Mandatory training had been booked and further training in specialized topics for example dementia was being delivered. Staff interviewed said that when they started work they received induction training in the first three months of their employment. Three staff files checked identified that the member of staff had received or were undertaking induction training. Staff were able to talk about the various training courses that they had attended, Care Homes for Older People Page 21 of 28 Evidence: which included, Moving and Handling, Food Hygiene, First Aid and Fire. Staff said they were encouraged to attend training on various care topics and the frequency of training had increased in recent months. A number of care staff had completed the NVQ Level 2 in care and others had commenced the training. However the number of staff trained did not meet the required minimum of 50 per cent of the staff team trained to NVQ Level 2 in Care. When asked did your induction cover what you needed to know when you started the job, all three staff said very well. All three staff also said they were receiving training which was relevant to their role. When three professionals were asked do the care staff have the right skills and experience, two said usually and one said sometimes. Three records of employment were checked. These included all of the required information including interview assessment, verification of identity, references, certificates of training, health checks and evidence of Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) check. Application forms did not fully record peoples previous employment. We discussed the importance of gaining previous employment histories with the manager. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The managers approach benefited people and staff. The quality assurance systems ensured that the home was run in the best interests of everyone. Peoples monies were safely handled, which ensured that finances were accurate and safeguarded. Peoples health and safety had been promoted and protected. Evidence: The manager had been in post for one month. She had previously been the deputy manager at the home. She was in the process of registering with us. She was a registered nurse and was undertaking an NVQ Level 4 in Management qualification. Since the last inspection the manager, with the support of the provider and staff, had worked hard to action the requirements made and this was evidenced by the many developments made within the service. The manager was hard working, competent and carried out her role to a high standard. She was clearly committed to ensuring that people living in the home were consistently well cared for, safe and happy. Care Homes for Older People Page 23 of 28 Evidence: The manager said that the home was visited each month by the person nominated to carry out Regulation 26 visits. Each month he spent time speaking to people, staff and relatives. A report about the quality of the service provided was completed. Staff said that regular staff meetings took place. The manager said that relative meetings had not taken place as the response to these were very poor. Everyone spoken to and information from questionnaires confirmed that people, staff and relatives were all happy to approach the manager at any time for advice, guidance or to look at any issues. They all said that they were confident that she would respond to them appropriately and swiftly. There was a well organised system in place to ensure that people, relatives and professionals were given the opportunity to give their views of the home and make suggestions for improvements. Questionaires were sent out on a rotating basis. The manager said she was collating the information provided and would then write a report informing people of any actions that had been taken following comments made. We saw a selection of questionaires returned and they were very positive. The home handles money on behalf of some people. This was checked for three people. Account sheets were kept, receipts were seen for all transactions and monies kept balanced with what was recorded on the account sheet. Formal staff supervision, to develop, inform and support staff took place at regular intervals and staff said that they found this useful and beneficial. Fire records evidenced that fire alarm checks took place each week. Staff said that they had received fire training and fire drills. A fire risk assessment had been completed. As the home cares for people with dementia the risk assessment should have highlighted what particular precautions were in place to keep people with dementia safe. Care Homes for Older People Page 24 of 28 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 25 of 28 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 9 13 Medications must be kept safe. Medications must not be left unattended and out of sight of staff. So that peoples health and welfare are protected. 28/11/2008 2 16 22 A record must be kept of all complaints made. The record must include details of the investigation and any action taken. So that peoples health, safety and welfare is protected. 28/11/2008 3 38 13 The fire risk assessment 28/11/2008 must highlight any particular precautions that need to be in place for people that have dementia. So that people are kept safe. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards Care Homes for Older People Page 26 of 28 and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 3 4 5 6 7 1 10 12 19 19 28 29 The design of the SOP and SUG guide should be revised to make it easier for people to read and more appealing. Staff should undertake training in maintaining peoples privacy and dignity. Activities should be provided, that are suitable for people who are blind or have other disabilities. The rolling programme of refurbishment and redecoration should continue. Bathrooms and toilets should be made more homely and appealing. 50 of the staff team should be qualified to NVQ Level 2 or equivalent in care. During the recruitment process peoples full employment histories should be provided. Care Homes for Older People Page 27 of 28 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). 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. 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