Care Home: Cherry Hinton Nursing Home

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What the care home does well What has improved since the last inspection? Both of the requirements made at the last inspection have been met. We found no medication in people`s rooms and staff members are receiving regular supervision sessions. We looked at the records that show medication receipt, administration and return and these are completed accurately. There are some issues with recording what happens when medication is either not given or given out of sequence and staff members should be able to improve this easily. Records are kept when staff members have supervision and these show that staff members are receiving supervision at least every 2 months, if not more often. What the care home could do better: There are a few things the home could do better, although these are not serious enough to be made requirements and in one case action has already been taken to improve the issue. Staff members should record when they ask a health care professional to see someone at the home, even if the professional person isn`t able to visit. Everyone at the home should be able to participate in some activities and these should be to individual tastes and take into consideration previous pursuits and interests. When staff members help people at meal times their attention should be on helping that person. This was not an issue for most staff members, who were very good at giving their undivided attention to people. But, for one or two staff members they were easily diverted from helping one person and the outcome for that person was a slow, cold meal. There is a strong smell of urine in the corridors of the ground floor unit. The manager has told us a new odour control system has been purchased to help resolve this problem. Although staff members are adequately trained, not all staff have up to date training in safe moving and handling techniques, and fire safety. Refresher training must be given to make sure all staff have received this and are up to date with new ways of working. CARE HOMES FOR OLDER PEOPLE Cherry Hinton Nursing Home 369 Cherry Hinton Road Cambridge Cambridgeshire CB1 8DB Lead Inspector Lesley Richardson Unannounced Inspection 16th April 2008 10:35 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Cherry Hinton Nursing Home DS0000024283.V362534.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Cherry Hinton Nursing Home DS0000024283.V362534.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cherry Hinton Nursing Home Address 369 Cherry Hinton Road Cambridge Cambridgeshire CB1 8DB Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01223 210071 01223 413572 Rockley Dene Homes Limited Mrs Doris Bater Care Home 40 Category(ies) of Dementia - over 65 years of age (20), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (20), Old age, not falling within any other category (20) Cherry Hinton Nursing Home DS0000024283.V362534.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th May 2007 Brief Description of the Service: Situated in a residential area on the south-eastern outskirts of the city of Cambridge, Cherry Hinton Nursing home was purpose-built to accommodate forty service users. The home has three floors, connected by a lift and stairs. The kitchen, store rooms and staff facilities are on the top floor. Nursing care is offered on the middle floor, and the ground floor accommodates older people with dementia. Most of the bedrooms are single rooms and all have ensuite facilities. There are lounge and dining areas on both floors, as well as bathrooms and offices. There is a good size parking area to one side of the building, and attractive, enclosed gardens to the other side and at the back. Cherry Hinton Road is one of the main roads into the city centre, which is about a ten minute drive away. Cambridge offers a range of facilities and leisure activities such as shops, restaurants, cinemas, theatres, swimming pools and a bowling alley. There is a regular bus service passing the home and taxis are available at all times. The railway station, with a good train service to London and the Midlands, is within a five minute drive and major roads such as the M11 and A14 are easily accessible. In a questionnaire completed before the inspection the manager said the fees ranged from £353 to £875 per week. Copies of CSCI inspection reports are on display in the entrance hall and in the upstairs corridor, and a copy is given to anyone who asks for one. Cherry Hinton Nursing Home DS0000024283.V362534.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was a key inspection of this service and it took place over 6 hours and 50 minutes as an unannounced visit to the premises. It was spent talking to the manager and staff working in the home, talking to people who live there and observing the interaction between them and the staff, and examining records and documents. Both requirements from the last inspection have been met. There have been no requirements and one recommendation made as a result of this inspection. Information obtained from the Annual Quality Assurance Assessment and from returned surveys were also used in this report. Two surveys each were returned from people who live at the home and staff members, and seven were returned from relatives and visitors to the home. What the service does well: An assessment is obtained before people go to live at the home to make sure staff there are able to care for them. People are able to visit the home and the manager keeps in touch so that everyone knows what is happening. One person said, “the care home manager, spent time with us on the telephone and we were shown round the home when all our questions were answered regarding the needs of my mother-in-law. We were very well informed and supported during our decision making”. Staff are polite and respectful to people living at the home. They take their time and don’t hurry people. Comments we received about the home and staff who work there include, “What I have seen to date has been very impressive. The staff are always very friendly and obliging”, “staff are lovely, so patient and kind”, and “Care for my mother-in-law in a homely environment, providing all her nursing needs. We were very touched by the welcome she got when she moved into the home and she was given some flowers. My husband and I also feel very welcome when we visit – we are always offered tea or coffee, and the day room where most of the residents sit during the day has a lovely homely atmosphere”. Every person living at the home has a care plan to show staff what they need to do to help that person. The plans are written to show what people can still do for themselves and tell staff members exactly what they need to do for that Cherry Hinton Nursing Home DS0000024283.V362534.R01.S.doc Version 5.2 Page 6 person to continue being able to do these things. People have access to health care professionals, such as opticians, chiropodists, GPs and community nurses. An activities co-ordinator arranges a programme of things for people to do nearly everyday. Most people said there are a lot of things to do, but there were some people who said they don’t have anything to do and the days can be quite long. This is talked about more in the section, ‘what they could do better’. There are things in the home, like flower arranging, and people coming in to provide entertainment. Comments from visitors also show there are church services in the home and these are enjoyed by many people who live there. Visitors are welcome at any time and staff at the home help people who are able to keep in touch with their relatives and friends. People are able to choose how they spend their days and they are able to continue making decisions. Staff at the home have started to record what decisions people are still able to make for themselves. This means that these rights and abilities are not taken away and people who have declining abilities are helped to keep them. Meals are appetising and people we spoke to said they like them. Staff members help people to eat, if this is needed, and they mostly do this with respect and consideration for the person they are helping. There have been no complaints made to the home or referrals to the local safeguarding team. We spoke with people at the home and received comments in surveys, and everyone said they know how to make a complaint and who to speak to if they have any concerns. Staff have training in safeguarding people and managing challenging behaviour. We saw staff members deal very well with an aggressive incident during the inspection. There are usually enough staff members at the home to care for the people who live there. New staff are recruited properly and the manager makes sure all the required checks are carried out before new staff start working at the home. They are given induction training, which gives them a basic knowledge of how to care for people, National Vocational Qualifications and further training is also given to make sure all staff continue good standards. This means that the staff working at the home have enough skills and knowledge and are safe to work with vulnerable people. The manager is very experienced and has worked at the home for many years. She makes sure the running of the home is carried out and attends training in management areas to keep up to date with current practice. Maintenance checks and servicing of equipment is completed when required to make sure that people using hoists, lifts and simply living in the home are safe. There is an annual quality assurance survey where people living at the home and their relatives are asked what they think. A report is published and a copy is kept in the manager’s office. People living at the home are also able to attend meetings every month to talk about how the home is run. Cherry Hinton Nursing Home DS0000024283.V362534.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: There are a few things the home could do better, although these are not serious enough to be made requirements and in one case action has already been taken to improve the issue. Staff members should record when they ask a health care professional to see someone at the home, even if the professional person isn’t able to visit. Everyone at the home should be able to participate in some activities and these should be to individual tastes and take into consideration previous pursuits and interests. When staff members help people at meal times their attention should be on helping that person. This was not an issue for most staff members, who were very good at giving their undivided attention to people. But, for one or two staff members they were easily diverted from helping one person and the outcome for that person was a slow, cold meal. There is a strong smell of urine in the corridors of the ground floor unit. The manager has told us a new odour control system has been purchased to help resolve this problem. Although staff members are adequately trained, not all staff have up to date training in safe moving and handling techniques, and fire safety. Refresher training must be given to make sure all staff have received this and are up to date with new ways of working. Cherry Hinton Nursing Home DS0000024283.V362534.R01.S.doc Version 5.2 Page 8 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Cherry Hinton Nursing Home DS0000024283.V362534.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cherry Hinton Nursing Home DS0000024283.V362534.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. The home and people think about moving in have enough information before people live there, which means the home knows whether the person can be cared for and the person knows if they would like living there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Assessments are completed before people move into the home and assessments by health and social care teams are also obtained to provide more information. We looked at the care records of one person who had moved into the home in the last 6 months. Although the homes own assessment had been completed there was some information that should have been looked at in more detail. For example, how aggressive or challenging behaviour is shown and what helps stop it. Most people who returned surveys said they had enough information about the home before moving in. Comments from one person show there is support from the manager for people making this decision, “the care home manager, spent time with us on the telephone and we were shown round the home when all our questions were Cherry Hinton Nursing Home DS0000024283.V362534.R01.S.doc Version 5.2 Page 11 answered regarding the needs of my mother-in-law. We were very well informed and supported during our decision making” and “we were kept up to date with everything – when the moving date was going to be, what time, etc, etc. The care home manager also informed is when she was going to visit my mother-in-law in her residential home to meet her and assess her needs”. This means the home is able to say whether it has the staff with the skills and experience to care for someone before they move in, but may not know everything about that person. The home does not provide accommodation specifically for intermediate care or for rehabilitation purposes. Cherry Hinton Nursing Home DS0000024283.V362534.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. Care is provided in a person centred way that makes sure people are able to receive the care they need to continue doing things for themselves. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each person in the home has their own set of care plans that guide staff members in how to care for them. Care plans for four people were looked at as part of this inspection. They show that each person has a plan that gives staff members’ information about what they need to do to meet most of the identified needs. Risk assessments, for things like falls and moving and handling, are completed and reviewed regularly. The care plans are written in a style that asks staff members to look at what people are able to do for themselves and what staff need to help with to make sure this can carry on. For example, one person’s plan for dressing gives staff clear guidance about laying out the person’s choice of clothes in the order that she needs to put them on. There are some issues that should be looked at to Cherry Hinton Nursing Home DS0000024283.V362534.R01.S.doc Version 5.2 Page 13 make the plans easier to use and give staff members more personal information and advice about each person. We found it difficult to easily see what some plans were giving advice about, so we talked to the manager about this and suggested simple things like underlining key words at the beginning of the plan. One person’s plan shows how they need to be distracted from challenging behaviour, but doesn’t say where the item for distraction is kept. Care plans are reviewed every month, although some of these are only a statement of no change, rather than a review of the care given and whether it has been effective. One person has a plan telling staff about falls, and although he had fallen 9 times since the beginning of this year, all of the reviews of this plan since then said “no change”. Another person who is physically aggressive has a plan for that, but only one of the monthly reviews says this is still happening. Other plans that we saw had more information in their reviews and show that staff are looking at whether the person is more or less able to do something and what needs to change. Risk assessments are completed for moving and handling, falls and continence, and there is a general risk assessment that looks at other issues like aggressive behaviour. Some of these records give a great deal of information about the risk and how staff are able to reduce to risk. For example an assessment for one person shows the exact behaviour that indicates when she is not happy with something. This means that staff are able to take steps to stop a situation becoming worse or have the knowledge about when the person may not be happy with something and be prepared for it. There is information in care records to show health care professionals, such as specialist nurses, opticians and chiropodists, are contacted for advice and treatment. The manager said a specialist nurse had been contacted for the person who had fallen 9 times this year, and although the nurse could not visit, this was not recorded in the person’s care records. A falls co-ordinator or other health care professional that may have been able to give advice in this instance had not been contacted. We talked to the manager about the importance of writing down this information and contacting other people who may be able to give advice, even if this is to let staff know they are doing as much as they can. Medication administration records are completed correctly, with no entries not signed or given a key code to indicate the reason the medication was not given. One of the keys requires staff to write a definition, rather than the others that have common definitions already assigned. This had not been done for two people’s MAR sheets that we looked at. Medication was also missing from another person’s blister pack, but there was no explanation on the MAR sheet about this. It became apparent the medication had been started before the MAR sheet had started and the nurse on duty confirmed this, but it was not clearly explained and took some time to find the reason. Medication is stored in locked trolleys, which are kept in a locked room and Cherry Hinton Nursing Home DS0000024283.V362534.R01.S.doc Version 5.2 Page 14 storage for controlled drug medication is also stored in a locked cupboard. We looked to see if any prescribed creams had been left in people’s room but didn’t find any. In view of this and because MAR sheets on the whole are properly completed, the previous requirement has been met and another requirement has not been made. Staff members are polite, and they speak to people with respect. People said staff are nice, they usually do everything they need to look after them and they do things like knock on doors before going into the room. Relatives and visitors to the home also said the home gives the care that is expected and keeps them up to date with any issues that arise. One person commented that, “What I have seen to date has been very impressive. The staff are always very friendly and obliging”. Another person living at the home said, “staff are lovely, so patient and kind”. During the inspection we saw one staff member whose actions did not put people she was caring for first, but this was very much an isolated incident. We saw staff working on the ground floor care with people who can be very demanding. During the inspection they were polite, calm and respectful, despite some quite aggressive behaviour. Cherry Hinton Nursing Home DS0000024283.V362534.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. The available activities and access to visitors and the local community provide positive experiences for most people. People living at the home are able to exercise choice and continue to make decisions for themselves. This judgement has been made using available evidence including a visit to this service. EVIDENCE: An activities co-ordinator is employed for 30 hours a week. There is a programme of activities that shows a planned activity nearly every day of the week. We also saw people flower arranging and cake decorating when we first started the inspection, although these activities were not listed in the programme. Comments from visitors to the home include, “We joined in a church service in the nursing home on Palm Sunday, taken by a group of people from a local Baptist Church. It was a lovely service and my mother-inlaw enjoyed it, as did the other people who were there”. One of the two people who live at the home and who returned a survey said there are always enough activities for them to take part in. However, the second person said there are never any activities and two other people who we spoke to said there could be more to do. One of these people also said that Cherry Hinton Nursing Home DS0000024283.V362534.R01.S.doc Version 5.2 Page 16 she doesn’t like watching television although her care plan says she does. This means that although there are a good number of activities available, there is not something for everyone to do and some people have little to do. The home has an open visiting policy and people visiting the home during the inspection said they are able to visit when they want. Half of the visitors who returned surveys said the home helps their relative keep in touch with them and everyone said they are kept informed of any issues that arise. The home has started looking at what decisions people with dementia are able to make for themselves. A decision is made about different areas, like what and when to eat or if someone can look after their own finances. Whether the person is able to make a decision or not is recorded and available in the care records. More work is needed to show why a person cannot make their own decisions, but the home has taken a valuable first step in enabling people to continue making decisions and choices about how they live their lives. People we spoke to said they are given absolute privacy and can choose when to go to bed and get up. Most visitors said people are able to live life in the home as they choose and one person commented that, “Dad has been, and still is very active. The support that the staff have given to him to allow him to roam freely under their watchful eye has been superb”. We saw a meal being served during the inspection. This looked appetising, and everyone we spoke to said it was a nice meal and that there is usually a choice. We saw that staff members generally are polite and courteous to people at mealtimes and when they need to help people eat, this is done properly and with consideration to that person. There was one staff member in particular who may need further training in this area, although her actions did not appear to be a deliberate act. For example, she did not give her whole attention to the person she was helping and helped two other people at the same time, she didn’t listen when the person said she didn’t want the food and for one person being helped there was a gap of 15 minutes between being given something to eat from the same plate of food. There is some information in care records about what people do and don’t like to eat, although there could be more detail written for staff. Of the two people who returned surveys one said they always liked the meals provided, the other person did not answer this question. One person we spoke to during the inspection said, “food is excellent, I just love the food”. Cherry Hinton Nursing Home DS0000024283.V362534.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. People have enough information for them to be able to raise concerns and have them dealt with in the correct way. This judgement has been made using available evidence including a visit to this service. EVIDENCE: CSCI has received no complaints directly about the home since the last key inspection, and information we received before this inspection shows there have been no complaints to the home in the last 12 months. Both of the people who live at the home and all of the visitors who returned surveys said they know how to make a complaint. They also said staff members listen to what is said to them and act on what they are told and of those people who had made a complaint; all of them said they had received an appropriate response. Over half of the staff members received training in safeguarding adults from abuse in 2007. We spoke to staff members to find out if they knew what to do if they thought abuse had happened. All of the responses we heard were appropriate, although some staff seemed less sure about incidents between people who live at the home. We saw an incident during the lunch meal when one person grabbed a piece of cutlery (knife) and threatened staff members. Staff members that were helping with the meal dealt with the situation extremely well, they remained calm and did not pressure the person into returning the knife, but observed the situation and cleared the knife away after the person had put it down and left the table. Their actions were entirely Cherry Hinton Nursing Home DS0000024283.V362534.R01.S.doc Version 5.2 Page 18 appropriate as no-one else living at the home was at risk, and it did not appear that many other people eating their meals were aware of the situation. In the last year there has been no referrals the local adult protection team. Cherry Hinton Nursing Home DS0000024283.V362534.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. Overall the standard of the environment provides a safe and pleasant place for people to live, and the home puts measures in place to reduce unpleasant areas. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Accommodation in the home is on two floors, which are divided into two units; the ground floor and the first floor, with the ground floor accommodating people with dementia. Nearly all of the bedrooms are single rooms, with the exception of two rooms on each floor. Every room has en suite facilities, and people are able to bring furniture and other items in to make their rooms more personal. There is a lounge and dining room on the first floor and a lounge and a lounge/diner on the ground floor. There is also a large conservatory for people to sit in or go out to the garden from. Cherry Hinton Nursing Home DS0000024283.V362534.R01.S.doc Version 5.2 Page 20 The home is well maintained and decorated and there are attractive, secure gardens for people to use. One person said she likes to spend time out in the garden. Both people living at the home who returned a survey said the home is always clean and fresh. However, there was a smell of urine in some people’s rooms and in the corridors on the ground floor. This was echoed by a relative who returned a survey and said about how fresh and clean the home is, “Upstairs yes, downstairs – definitely not”. The manager said a new odour control system is being purchased, which should help resolve this problem. Because action has been taken a requirement will not be made on this occasion. Cherry Hinton Nursing Home DS0000024283.V362534.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. Staffing levels ensure people are not kept waiting for help when they need it. Good recruitment checks and training mean that care is given safely and people are not put at risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We looked at staffing levels, training and the recruitment checks that are carried out before new staff members start work. This is to make sure that the home employs people who have enough skills and knowledge, and are safe to work with vulnerable people. On the day we visited the home there were four staff members, including nurses, on both floors. There was an atmosphere of calm and staff were not rushed or unable to attend to people. All of the people, including staff members, we spoke to during the inspection and most of the responses we got from surveys said there are enough staff on duty most of the time. One person said, “What I have seen to date has been very impressive. The staff are always very friendly and obliging”. One of two people who live at the home and returned a survey said staff members were only available when they were needed sometimes, but they didn’t make any other comment about this. Staff members are given induction training when they start working at the home. This includes mandatory health and safety training, and updates to this Cherry Hinton Nursing Home DS0000024283.V362534.R01.S.doc Version 5.2 Page 22 training are also given, although not all staff have received refresher training in fire safety and safe moving and handling in the last year. Training records show nearly all staff have completed food hygiene training, safeguarding (protection from abuse) training and just over half of the care staff members have completed courses in dementia care and challenging behaviour. About two thirds of staff have a national vocational qualification at level 2 or 3 in care. Staff must have training at required intervals to make sure they are up to date with changes and new ways of working. Because we did not find the outcomes (safety) for people at the home were reduced a requirement has not been made on this occasion. We looked at the files for three staff members who have started working at the home since that inspection. All of the required checks and information had been obtained before these staff members starting working at the home. Cherry Hinton Nursing Home DS0000024283.V362534.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. The home has enough support to make sure people living there are safe and they are able to have a say in how it is run. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has worked at the home for a number of years and has been in the position of registered manager a number of years. She is a nurse, and is registered with the Nursing and Midwifery Council. She keeps up with current practice and has completed training in the Mental Capacity Act and in employment issues. A quality assurance survey was carried out in 2007, a report has been written to show what actions the home has taken following the survey and this is kept Cherry Hinton Nursing Home DS0000024283.V362534.R01.S.doc Version 5.2 Page 24 in the manager’s office. Meetings for people living at the home and their relatives are every month and minutes are kept of these. The manager said she goes round the home to talk with people who live there every day. Managers from other homes in the same group of homes to look at standards from the National Minimum Standards and see how well the home is meeting them. The home does not look after money on behalf of people who live there. Relatives or others acting on behalf of people are invoiced directly for fees for hairdressing, chiropody and other services. People who do wish to keep their own money have lockable facilities in their rooms. We looked at staff records to see if they are being given supervision at regular intervals. The records show that this is happening at least every 2 months, with some people receiving supervision more often. Records are kept of the supervision sessions, although at this stage many of the items for discussion are similar for all staff members. Both staff members who returned surveys said they receive supervision. Information provided before the inspection shows that health and safety maintenance and servicing is carried out at the required intervals. Fire equipment was looked at when we walked round the building and this has been checked within the last year. We also looked at fire alarm and emergency lighting records, which show they are checked every week. Cherry Hinton Nursing Home DS0000024283.V362534.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Cherry Hinton Nursing Home DS0000024283.V362534.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP8 Good Practice Recommendations Requests for health care professionals to see someone should be recorded, even if the professional is not able to visit. This is so that an audit trail is available to show all attempts have been made to obtain further advice. Cherry Hinton Nursing Home DS0000024283.V362534.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Eastern Region Eastern Regional Contact Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Cherry Hinton Nursing Home DS0000024283.V362534.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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