Care Home: Cathedral View Residential Home

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What the care home does well The service provides a comfortable homely environment that is very clean and well maintained for people using the service, staff and visitors. There is ample sitting and dining space and suitable washing and toilet facilities. Good measures are in place for the prevention of infection. There are beautiful spacious grounds that are accessible to the people using the service, with seating areas outside. There is a very friendly welcoming atmosphere and the people using the service say they are happy living in the home. They say the staff are very kind and caring and work well together. Visiting Health Professionals say it is a real pleasure visiting the home and that people using the service are treated with the utmost respect. Information about the service is available in the home and provided to people who enquire about the home. People are only admitted following an assessment to ensure the home can meet their needs. Prospective resident`s and their family are invited to visit the home prior to any decisions being made to live there. On admission each person has a written care plan detailing their individual requirements; this directs staff on how best to meet their needs. The plans are compiled with the resident, reviewed regularly and signed. Several risk assessments are undertaken to enhance peoples care. People using the service said their healthcare needs are met and specialist healthcare professionals visit the home when required. Appropriate equipment is provided for pressure relief and moving and handling purposes. There is a suitable system for medications and staff receive training in this area. Everyone spoken with said the care is very good and they are happy living in the home. They said they are treated with respect and dignity and their privacy is upheld at all times. They also said their individual preferences are respected and they can choose what they do each day. People using the service are able to maintain contact with their family and friends as they wish. Visitors are welcome in the home and some residents go out with their families. A range of activities are on offer in the home and people can join in as they wish, some said they stay in their rooms and this is accepted. Staff said they do try to spend time on a one-to-one basis with residents. Life histories are on file to help staff improve their interaction with people using the service. The food served is to a good standard with homemade cooking, fresh fruit and vegetables. Special diets and individual needs are catered for. Comments about the food were very good. There have been no complaints but there is a system in place that ensures complaints are dealt with promptly and records are kept. There is a suitable policy for the prevention of abuse and staff receive appropriate training. There is a robust recruitment policy and procedure. Residents said that staff are kind and caring and there are enough of them to meet their needs. 61% of care staff havean NVQ qualification in care. The training records show that staff receive regular training relevant to the job. The Registered Manager is a qualified mental nurse and a competent manager. Staff and residents spoke very highly of her and her management skills. They said she is approachable and works as part of the team. The management endeavour to ensure that working practices are safe and relevant service checks take place when required. CSCI survey comments include "I feel very fortunate to work at this home and I only hope that if any of my family need to be placed in a care setting it is to the standard of Cathedral View" and "The staff are welcoming, friendly and above all very caring and I would have no doubts about placing a parent here". What has improved since the last inspection? Carpets and furnishings have been replaced as required and the home is kept in good decorative order. An administrator has been employed to assist with the paperwork and maintain the records. The care planning system has greatly improved and the plans give more direction to staff on how care is to be provided. For those who lack capacity, individual assessments have been undertaken and people`s best interests considered in respect of any deprivation of liberties. A specific care plan format has been developed in consultation with the department of adult social care. Recruitment processes have been improved including the application forms, interviewing and the organisation of staff files. Staff training has also improved with more opportunities available to staff. What the care home could do better: Feedback was given to the registered manager throughout this inspection and she agreed to address any issues raised. Where risk assessments have a scoring system the details should be included in the care plans with appropriate instruction for staff to follow. A controlled drugs cupboard that complies with current legislation must be provided for safe storage. People on as required medicines, self-medicating and so on need to have a medicines care plan to fully instruct staff on the actions they must take. Any hand written instructions on the medicine administration record charts must be witnessed and signed by two members of staff. Individual activity sheets for each person detailing their involvement and emotional reactions would provide evidence that activities are appropriate and fulfil people`s preferences.There should be evidence that new employees are supervised, and by whom, between receipt of a POVA check and the full CRB disclosure. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Cathedral View Residential Home Kenwyn Church Road Truro Cornwall TR1 3DR     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: Diana Penrose     Date: 0 2 0 4 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 03000 616161 (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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Cathedral View Residential Home Kenwyn Church Road Truro Cornwall TR1 3DR 01872240974 01872240974 cathedralview.res@btintenet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Cathedral View Limited care home 34 Number of places (if applicable): Under 65 Over 65 15 15 34 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: 0 0 0 Service users to include up to 15 adults aged over 65 with a mental illness (MD) Service users to include up to 15 adults aged over 65 with dementia (DE) Service users to include up to 19 adults of old age (OP) Total number of service users not to exceed a maximum of 34 Date of last inspection Brief description of the care home Cathedral View Limited owns two registered care homes, Cathedral View Residential Home and Cathedral View Nursing Home. Both homes are located on the same site, close to the centre of Truro with good transport links into the town and surrounding areas. Cathedral View Residential Home is registered to accommodate 34 elderly residents Care Homes for Older People Page 4 of 29 Brief description of the care home requiring personal care; some may be suffering with a degree of mental disorder or dementia. All facilities are accessible to residents including those who have limited mobility or need specialist equipment such as wheelchairs. There are extensive accessible gardens and there is sufficient parking outside the home for staff and visitors. The home provides single bedrooms for the majority of residents although two rooms are registered for shared accommodation. Bedrooms are situated on three floors and there is a shaft lift to all floors. There are stair lifts but these are not to all floors. There are two lounges, a large dining room and a conservatory for residents use. Meals are prepared and cooked in the nursing home and transported to the Residential Home. Suitably qualified and experienced staff provide care in a relaxed and friendly atmosphere. Suitable activities take place two or three afternoons a week organised by an activities co-ordinator. Information about the home is available in the form of a statement of purpose, residents guide, and colour brochure, which can be supplied to enquirers on request. A copy of the most recent inspection report is available in the home. Fees range from 450 to 850 pounds per week; this information was supplied to the Commission on the day of inspection. Additional charges are made in respect of private healthcare provision, hairdressing and personal items such as newspapers, confectionary and toiletries. 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: An inspector visited Cathedral View residential Home on the 02 April 2009 and spent eight hours at the home. This was a key inspection and an unannounced visit. The purpose of the inspection was to ensure that peoples needs are properly met, in accordance with good care practices and the laws regulating care homes. The focus was on ensuring that residents placements in the home result in good outcomes for them. On the day of inspection 32 residents were living in the home, one of these was receiving respite care. The methods used to undertake the inspection were to meet with residents, relatives, staff and the registered manager to gain their views on the services offered by the home. Records, policies and procedures were examined and the Care Homes for Older People Page 6 of 29 inspector toured the building. This report summarises the findings of this inspection. People using the service expressed satisfaction with the care and services provided at the home and the atmosphere in the home is very relaxed, friendly and welcoming. What the care home does well: The service provides a comfortable homely environment that is very clean and well maintained for people using the service, staff and visitors. There is ample sitting and dining space and suitable washing and toilet facilities. Good measures are in place for the prevention of infection. There are beautiful spacious grounds that are accessible to the people using the service, with seating areas outside. There is a very friendly welcoming atmosphere and the people using the service say they are happy living in the home. They say the staff are very kind and caring and work well together. Visiting Health Professionals say it is a real pleasure visiting the home and that people using the service are treated with the utmost respect. Information about the service is available in the home and provided to people who enquire about the home. People are only admitted following an assessment to ensure the home can meet their needs. Prospective residents and their family are invited to visit the home prior to any decisions being made to live there. On admission each person has a written care plan detailing their individual requirements; this directs staff on how best to meet their needs. The plans are compiled with the resident, reviewed regularly and signed. Several risk assessments are undertaken to enhance peoples care. People using the service said their healthcare needs are met and specialist healthcare professionals visit the home when required. Appropriate equipment is provided for pressure relief and moving and handling purposes. There is a suitable system for medications and staff receive training in this area. Everyone spoken with said the care is very good and they are happy living in the home. They said they are treated with respect and dignity and their privacy is upheld at all times. They also said their individual preferences are respected and they can choose what they do each day. People using the service are able to maintain contact with their family and friends as they wish. Visitors are welcome in the home and some residents go out with their families. A range of activities are on offer in the home and people can join in as they wish, some said they stay in their rooms and this is accepted. Staff said they do try to spend time on a one-to-one basis with residents. Life histories are on file to help staff improve their interaction with people using the service. The food served is to a good standard with homemade cooking, fresh fruit and vegetables. Special diets and individual needs are catered for. Comments about the food were very good. There have been no complaints but there is a system in place that ensures complaints are dealt with promptly and records are kept. There is a suitable policy for the prevention of abuse and staff receive appropriate training. There is a robust recruitment policy and procedure. Residents said that staff are kind and caring and there are enough of them to meet their needs. 61 of care staff have Care Homes for Older People Page 8 of 29 an NVQ qualification in care. The training records show that staff receive regular training relevant to the job. The Registered Manager is a qualified mental nurse and a competent manager. Staff and residents spoke very highly of her and her management skills. They said she is approachable and works as part of the team. The management endeavour to ensure that working practices are safe and relevant service checks take place when required. CSCI survey comments include I feel very fortunate to work at this home and I only hope that if any of my family need to be placed in a care setting it is to the standard of Cathedral View and The staff are welcoming, friendly and above all very caring and I would have no doubts about placing a parent here. What has improved since the last inspection? What they could do better: Feedback was given to the registered manager throughout this inspection and she agreed to address any issues raised. Where risk assessments have a scoring system the details should be included in the care plans with appropriate instruction for staff to follow. A controlled drugs cupboard that complies with current legislation must be provided for safe storage. People on as required medicines, self-medicating and so on need to have a medicines care plan to fully instruct staff on the actions they must take. Any hand written instructions on the medicine administration record charts must be witnessed and signed by two members of staff. Individual activity sheets for each person detailing their involvement and emotional reactions would provide evidence that activities are appropriate and fulfil peoples preferences. Care Homes for Older People Page 9 of 29 There should be evidence that new employees are supervised, and by whom, between receipt of a POVA check and the full CRB disclosure. 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –03000 616161. Care Homes for Older People Page 10 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 11 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. Appropriate information is given to prospective residents enabling them to make an informed choice as to where to live. Residents are only admitted to the home following an assessment of their needs to ensure the home can provide suitable care. Evidence: The home has a suitable statement of purpose and residents guide. There is also a colour brochure with photographs of the home and grounds. The documents require some updating and this was discussed with the manager and one of the officers who said they would address this. The AQAA states that the home could offer a statement of purpose in Braille or a different language if the need arose. It also states that a web site is being looked into to give people more accessible information about the home. The registered manager said that prospective residents and their relatives are encouraged to visit the home before deciding it is the right one. The registered Care Homes for Older People Page 12 of 29 Evidence: manager or the matron from the nursing home visit prospective residents to undertake an assessment of needs. This is recorded on specific forms, which were seen and completed appropriately. Information from social workers or hospital nurses is included where appropriate. Care Homes for Older People Page 13 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. Each person using the service has a written care plan that directs staff to ensure that healthcare needs are met. There is an appropriate system for the use of medicines that safeguards the people using the service. Evidence: Each person using the service has an individual written care plan and four were inspected. For those who lack capacity, individual assessments have been undertaken and peoples best interests considered in respect of any deprivation of liberties. A specific care plan format has been developed in consultation with the department of adult social care. The care plans inspected were very detailed and include health, personal care, social needs, religious needs and end of life wishes. They inform and direct staff on the individual care to be provided. They have been compiled with the resident and signed by them or their representative where possible. Regular reviews take place and are documented. Life histories are included for each person with information provided by Care Homes for Older People Page 14 of 29 Evidence: the resident and their family. Where risk assessments have a scoring system the details need to be included in the care plan with appropriate instruction for staff to follow. This was discussed with the manager and one of the officers. Daily event records are maintained and those seen were informative. Residents spoken with said their health needs are met very well and they have access to their GP and other health professionals when required. The manager said that links with specialist healthcare professionals is very good. Several doctors and a community nurse visited during this inspection. The doctors spoken with said they visit regularly and are contacted appropriately by staff when required. There is appropriate moving and handling and pressure relieving equipment provided. Care practice was observed to be appropriate during the inspection and carried out in a calm, efficient manner. Residents said their personal care is carried out as they wish it to be. There is a policy and system in place for the use of medicines in the home that has been reviewed since the last inspection. There is also a homely remedies policy and a list approved and signed by a doctor. A copy of the handling of medicines in social care document and other reference books are available to staff to refer to. A monitored dose system is used and staff have received appropriate certificated training to enable them to administer medicines. Records are kept of all medicines entering and leaving the home and there were no gaps observed in the administration records. Any hand written instructions on the medicine administration record charts must be witnessed and signed by two members of staff, this was discussed with the manager. We found there is safe storage for medicines including those requiring refrigeration. Controlled drugs are stored in a double locked facility, which does not comply with current legislation. This was discussed with the manager who agreed to address it. For people prescribed to have medicines administered when required we found that no record is maintained of any assessment made before the administration of the medicine. We also found that there is no reference made in the care plan about the use of this medicine, nor are there any directions on how to make an assessment if this medicine is required. The manager and one of the officers agreed to address this promptly. Staff were observed to uphold peoples privacy during this inspection and knocked on doors before entering. Residents said they receive their post unopened and the telephone arrangements are suitable. Peoples preferences in respect of the gender of care staff providing personal care is recorded in the care files and staff were aware of peoples wishes. People spoken with said they are treated with respect and their privacy is always respected. Care Homes for Older People Page 15 of 29 Care Homes for Older People Page 16 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff encourage residents to socialise and join in activities, visitors are welcome and efforts are made to ensure that residents choices and preferences are respected so they can live a life that suits them. Evidence: Activities are organised by an activities co-ordinator, but these are not every day. A list of forthcoming events was seen on a notice board. Activities include Holy Communion, quizzes, chair exercises, skittles and reminiscence. The activities coordinator said that some residents are in the process of making Easter cards. Trips out are arranged and people said they walk around the lovely grounds when the weather is good. The AQAA states that there has been an increase in staffing levels to give more individual time to service users, for example for manicures and nail painting. They acknowledge they could still improve on the one to one activities provided. The manager said that a recent survey has shown that people using the service would like more singing and piano playing and this will be addressed. One CSCI survey comment was I do not wish to take part in activities but I am aware there is a varied amount to be enjoyed if desired. Records of attendance are kept and there are some details regarding activities in the daily event records. Individual sheets for each person that Care Homes for Older People Page 17 of 29 Evidence: detail their involvement and emotional reactions would provide evidence that activities are appropriate and fulfil peoples preferences. There is a record of visitors to the home and there were visitors in the home during this inspection. People using the service said they could receive visitors in private and at any time. Visitors spoken with said they are always made welcome in the home and can call in when they like. One visitor was offered a meal during this inspection and she said meals are always offered. She said she is part of a relatives support group and finds it helpful to chat with other residents families. Residents said they choose when they get up and go to bed within reason. They said they choose what clothes to wear and how they spend their day. They said they choose whether to stay in their room or go to the lounge. All residents were suitably dressed in clean clothes. Peoples rooms were personalised with their own belongings and furniture. Some people control their own money. Staff said residents choose what they do each day. The lift continues to break down and is sometimes out of use for several days, which restricts people moving from upstairs. The registered provider said that the plans for a new lift have been with the council planning department for some time. He said he couldnt move on with this project until he has received planning permission. The meals are cooked in the kitchen in the nursing home (not inspected on this occasion) and transported to the residential home. There is a kitchen facility in the home for the provision of drinks and snacks. Meals are served in the dining room but residents can eat in a lounge or their bedroom if they prefer. The manager said that the menu has been discussed during residents meetings and a survey was undertaken to incorporate as many peoples preferences as possible. It is a six week set menu but everyone spoken with said there are alternatives for those who do not wish to have the set meal. This was also evidenced in the record keeping. The menu is displayed on the dining room tables. Nutritional needs are assessed and the registered manager said that special diets are catered for. Fresh fruit and vegetables are included on the menu and there were homemade cakes at teatime. Beverages were seen available for residents throughout the day and wine is offered at lunchtime. Likes and dislikes are recorded in the care files. Everyone spoken with said the food is very good. The registered manager said the cook has undertaken Intermediate Food Hygiene training and other kitchen staff basic Food Hygiene training. Care Homes for Older People Page 18 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are suitable policies and processes in place for complaints and adult protection to ensure that people using the service are safeguarded. Evidence: The home has a suitable complaints policy and a method for recording complaints. The inclusion of reporting complaints to department of adult social care, in the policy, was discussed with the manager. There have been no complaints to the home or the Commission since the last inspection. People using the service said there are no barriers to raising concerns with the staff or the management. CSCI surveys show that people know the complaints procedure and feel confident they will be listened to. Thank you letters and cards are kept and there are many. The abuse policy is appropriate and includes local authority procedures. Staff said they have received training regarding abuse and the records confirmed this, a majority have attended the local No Secrets courses provided by the department for adult social care. The home has been involved in the production of an abuse training DVD. There have been three appropriate safeguarding referrals to the department of adult social care to safeguard peoples interests. There has been one sexual abuse allegation that was reported appropriately, investigated and unfounded. Care Homes for Older People Page 19 of 29 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. The home is comfortable, very clean and well maintained making it a safe homely place for people to live and work in. Evidence: The home is well maintained and appears to be safe. It is comfortable, warm, homely and very clean with no offensive odours. There are several communal lounges and a conservatory attached to the dining room where several people like to sit. Furnishings and decoration are to a good standard and refurbishment is ongoing. More furniture and carpets have been purchased since the last inspection along with new chairs for the lounge and other communal areas. As previously mentioned the registered provider hopes to replace the lift and is awaiting planning permission from the County Council. There are stair lifts but not to every level. The property is situated in beautiful grounds, which residents can utilise, and there are several seating areas outside. The laundry facilities are suitable with two washers and one large drier. Protective clothing is supplied for staff and they were seen wearing aprons and gloves. Hand washing facilities for staff are suitable and alcohol hand cleansing gel is provided. There are relevant policies in place for infection control. Care Homes for Older People Page 21 of 29 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. There are suitable staffing levels for the number of residents and 61 of care staff hold NVQ qualifications. Recruitment procedures are robust and staff receive regular training to update their skills, this helps to safeguard people using the service. Evidence: The registered manager said that staffing levels are adjusted according to the dependency of people using the service. The normal levels are one officer in charge and six carers in the mornings, one officer and three carers in the afternoons, one officer and three carers in the evenings (until 7pm) then one officer and one carer awake overnight. The registered manager is on duty during the week and on call at all times; the matron from the nursing home does some on call duties as well. An administrator has been employed since the last inspection. Staff and residents said they feel there are sufficient staff and the team works very well. People said the staff are very kind and caring and nothing is too much trouble. Comments include Everyone is very good to me and If I am not happy here I cant be happy anywhere. There is a recruitment policy and the home operates an equal opportunities policy. The manager said that all staff are treated equally. The application forms have been improved since the last inspection and staff files have been re-organised for easier Care Homes for Older People Page 23 of 29 Evidence: use. The AQAA states that interview techniques have improved and records were seen. Four staff files were inspected and contained the documents required by legislation. Relevant employment checks were seen and we were told that staff are supervised from receipt of the POVA check until the full CRB disclosure is obtained. This could not be evidenced in the staff files and was discussed with the manager. 61 of care staff are qualified to at least NVQ level 2 in care and others are studying for the qualification. There is an induction programme for new staff that complies with the skills for care standards. The induction pack includes the in-house induction checklist and the GSCC code of practice. Care staff are enrolled onto NVQ training following induction if not sooner. We were told that training needs are identified during the interview process for new staff, at annual appraisals and during supervision or staff meetings. The administrator showed us a training matrix held on her computer. It showed that statutory training for staff is up to date and that a significant amount of other training takes place. Packs supplied by a training company are used for some training. Certificates for training attended were seen in the staff files. Care Homes for Older People Page 24 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered manager is competent in running the home and systems are in place to monitor and improve the service for residents and staff. An appropriate system is in place for managing peoples monies and training and safety checks are undertaken to ensure the health, safety and welfare of residents, staff and visitors. Evidence: The registered manager is a Registered Mental Nurse with 30 years experience and 25 years at Cathedral View; she is very competent in running the home. She said she attends all statutory training updates and reads the nursing press to keep up to date on current issues relevant to the client group. Recent training includes Mental Capacity Act and Deprivation of Liberties. Both staff and residents spoke very highly of her and her ability to manage the home. One resident said She is a lovely person and the home would not be the same without her. A CSCI staff survey stated The home is perfectly run. Visiting Health professionals said It is well organised and run and The home is run efficiently and extremely effectively. Care Homes for Older People Page 25 of 29 Evidence: An annual quality assurance survey takes place with residents, relatives and external stakeholders. The results of the most recent survey were seen and they are very positive in all areas. The manager said that the results are compared year on year with an aim to improving the services provided. Residents, relatives and staff meetings take place regularly and the minutes show that people can air their views and actions are taken. A suggestion box is accessible to everyone in the home. We were told that the owners of the home visit regularly and meet with staff and residents. The manager completed her Annual Quality Assurance Assessment (AQAA) in detail and returned it to the Commission within the allotted timescale. There is a policy for the safekeeping of peoples money in the welcome pack. Some residents deal with their own money and they have a lockable facility in their rooms. A member of staff is appointee for one resident and records are maintained. Money is held for residents for toiletries, chiropody and hairdressing and so on. It is held in a non-interest account and records are kept for all transactions. Receipts are kept for all purchases. No cash is held in the home for residents, there is petty cash for day-today requirements. Power of attorney details are recorded. The registered providers endeavour to ensure that working practices are safe and there is satisfactory evidence that appropriate health and safety and fire precautions are in place. Health and safety and fire risk assessments have been undertaken and relevant service checks take place, certificates show that these are up to date. Staff receive statutory training according to legislation and records are kept. The kitchen staff have all received basic food hygiene training and one at intermediate level. Accident reporting complies with data protection and there are normally very few accidents. The increase during February 2009 was explained. We were shown the report of a recent asbestos test. The environmental health officer visited in March 2009 and the report recommends some deep cleaning and that the floor covering be repaired, this is being addressed. 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 1 9 13 Arrangements must be made to ensure that controlled drugs are stored in accordance with the current regulations To comply with current legislation. 07/09/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) 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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