Care Home: Cleveland View Care Home

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What the care home does well The manager was not present for the inspection, however the deputy manager and area manager of the home should be complimented on the smooth running of the inspection process. Cleveland View is well managed and provides people that use the service with a good standard of care. Staff working at the home are well trained and know the people that they are caring for very well. Care plans are detailed, include evidence of personal choice and are updated on a regular basis. Activities and outings are plentiful and visits from family and friends are encouraged. The home is welcoming and staff are friendly. Comments made from people who use the service and surveys received included, "This is a happy and comfortable place to be" and "I feel safe and protected here the staff are marvellous" and "It took me a little while to settle but I like staying here". The home`s recruitment process is robust. What has improved since the last inspection? Numerous improvements have been made since the last inspection. A new manager has been appointed and a senior care staff member promoted to deputy manager. The home is well managed and a clear sense of leadership is demonstrated. Record keeping is good and files are well organised. Staff now receive the required standard of induction training when they start working at the home and the amount of training provided to staff has increased. All but one of the requirements identified at the last inspection of the service has been addressed. What the care home could do better: The registered person must ensure that all medicines are stored securely at the temperature recommended by the manufacturer so that they are safe to use. This requirement is outstanding from the last pharmacist inspection of the service in August 2007. The complaints procedure needs to be updated to include stages and timescales for action, who to contact including contact details of Social services to help to ensure that complaints are dealt with promptly and appropriately.Thought should be given to the environment on the dementia unit. Improvements could be made to assist people that use the service with identifying their bedrooms. CARE HOMES FOR OLDER PEOPLE Cleveland View Care Home Cleveland View Cargo Fleet Lane Middlesbrough TS3 8NN Lead Inspector Katherine Acheson Key Unannounced Inspection 5th June 2008 10:00 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 Cleveland View Care Home DS0000059270.V365910.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. Cleveland View Care Home DS0000059270.V365910.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cleveland View Care Home Address Cleveland View Cargo Fleet Lane Middlesbrough TS3 8NN 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) 01642 244977 01642 242077 clevelandview@bondcare.co.uk www.Bondcare.co.uk Bondcare Homes Limited Julie Peyton Care Home 60 Category(ies) of Dementia - over 65 years of age (60), Old age, registration, with number not falling within any other category (60) of places Cleveland View Care Home DS0000059270.V365910.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places: 60 2. Dementia - Code DE, maximum number of places: 60 The maximum number of service users who can be accommodated is: 60 7th June 2007 Date of last inspection Brief Description of the Service: Cleveland View is a purpose built care home that is registered to provide personal care to sixty older people. The home is split into two units. The ground floor of the home accommodates thirty older people and the first floor of the home accommodates thirty older people with dementia. On the ground floor of the home there is a large communal lounge area and a smaller lounge that is used by people from both units who wish to smoke. On the first floor of the home there is a large communal lounge and an adjoining quiet lounge area. All bedrooms are for single occupancy and have en-suite facilities, with washbasin and toilet. All rooms are comfortably furnished and residents may personalise their rooms by bringing possessions and small items of furniture. All bedrooms meet the minimum amount of space required. Cleveland View Care Home is located close to a social club, churches and shops. Nearby there is a bus route into Middlesbrough town centre. On the date of this inspection the cost of care at Cleveland View ranged from £385 to £388.50 per week. Cleveland View Care Home DS0000059270.V365910.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 two stars. This means that people who use this service experience good quality outcomes. This announced key inspection was carried out on the 5th June 2008 and lasted for seven hours in total. Following the last key inspection of the service in June 2007 there was a themed pharmacist inspection to look at how the home supported the safe handling of medicines. This was carried out on 7th August 2007. The manager was not present at the time of the inspection, however the homes deputy manager and area manager were present. The reason for the inspection was to see how good a job the home does in meeting the National Minimum Standards set by the government for care homes. Numerous records including care plans, complaints and staff recruitment and training records were examined. The Inspector spoke at length to five people that use the service and in general to others. The Inspector also spoke to three relatives; two care staff, the deputy manager of the home, the administrator and the area manager. The Inspector walked around the home with the deputy manager. Before the inspection fifteen surveys for people who use the service and fifteen surveys for relatives, carers and advocates were sent to the home for the manager to distribute accordingly. Surveys requested feedback on the service and staff provided. Also sent to the home were ten surveys for staff. Surveys requested feedback on care given and the way the home is run. We received fourteen surveys from people who use the service, four from relatives, carers and advocates and six surveys from staff. Comments received can be read within the report. The manager completed and returned an Annual Quality Assurance Assessment, (AQAA). The AQAA is the services self-assessment of how they think they are meeting national minimum standards. This information was received before the inspection and was used as part of the inspection process. The details of any issues identified at this inspection requiring action are to be found at the back of this report. Cleveland View Care Home DS0000059270.V365910.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: The registered person must ensure that all medicines are stored securely at the temperature recommended by the manufacturer so that they are safe to use. This requirement is outstanding from the last pharmacist inspection of the service in August 2007. The complaints procedure needs to be updated to include stages and timescales for action, who to contact including contact details of Social services to help to ensure that complaints are dealt with promptly and appropriately. Cleveland View Care Home DS0000059270.V365910.R01.S.doc Version 5.2 Page 7 Thought should be given to the environment on the dementia unit. Improvements could be made to assist people that use the service with identifying their bedrooms. 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. Cleveland View Care Home DS0000059270.V365910.R01.S.doc Version 5.2 Page 8 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 Cleveland View Care Home DS0000059270.V365910.R01.S.doc Version 5.2 Page 9 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): Standards assessed 3 and 6 People who use 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. Assessments of people who are to use the service are carried out to ensure that the home can meet their needs. EVIDENCE: The deputy manager said that before going into the home people who are to use the service are assessed by a social worker. Staff at the home then carry out their own pre-admission assessment either visiting the person in their own home or at hospital to ensure that the needs can be met at Cleveland View. If people are self-funding then an assessment is usually only carried out by experienced staff working at the home. Three files of people that use the service were looked at during the visit all of which had appropriate assessments in place. Cleveland View Care Home DS0000059270.V365910.R01.S.doc Version 5.2 Page 10 The Annual Quality Assurance Assessment, stated that people who might want to use the service and their families are encouraged to visit the home, spend some time and stay for a meal before coming in. Surveys received from people that use the service and relatives in general felt that they received enough information about the home to decide if it was the right place to come into. The home does not provide intermediate care and as such standard 6 does not apply. Cleveland View Care Home DS0000059270.V365910.R01.S.doc Version 5.2 Page 11 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): Standards assessed 7, 8, 9 and 10 People who use 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 provides a good standard of care, people using the service are happy and care received is based on their individual needs. Procedures are in place to ensure good management of medication to ensure safety of people using the service. The home must ensure that all medicines are stored securely at the temperature recommended by the manufacturer so that they are safe to use. EVIDENCE: Three plans of care were looked at during this visit all of which contained detailed information about the person using the service and the help they needed. Care plans were individual to the person and contained evidence of personal choice. One plan of care detailed how a person preferred a bath to a shower, use bubble bath and wash and condition their hair. Assessments on mobility Cleveland View Care Home DS0000059270.V365910.R01.S.doc Version 5.2 Page 12 contained information on what the person was able to do for themselves, or how much help they needed and if any specialist equipment was needed to help move the person. A discussion took place in respect of one care plan/risk assessment looked at during the visit. One person highlighted as having problems with aggression had a plan of care on file, however this was insufficiently detailed. The plan of care did not highlight what triggered the aggression, how to manage the situation or how successful the plan of care was in de-escalating the aggression. The deputy manager said that she would review/update the plan of care. Care plans were updated on a monthly basis or more often if required. Files of people who use the service included healthcare visits and appointments. The records showed the regularity of visits for treatment from: doctors and district nurses, opticians, dentists and other healthcare specialists. One survey received stated, “When and if I need a GP or nurse, staff always see that I get a visit, but I am pretty healthy at the moment”. It was evident following discussion with the deputy manager, staff and looking at surveys received that staff working at the home know the people that they are caring for very well. People who use the service, relatives spoken to during the inspection by the Inspector, and surveys received said, “I am well cared for and happy, within reason I can do what I want” “The staff are very good and they try their best to help you” “ They give good care and attention to my mothers needs. Everything in the care home is up to a very good standard” “Staff are available when you need them. If you are worried about anything they are there to listen and help you if they can” “It’s a happy atmosphere everyone gets on so well” People who use the service confirmed that their dignity and privacy was respected. Each unit has a room in which to store medication. During the inspection arrangements for receiving, storing, administering, recording and disposing of medication on the older persons unit were observed and examined. Cleveland View Care Home DS0000059270.V365910.R01.S.doc Version 5.2 Page 13 The ordering and returning of unused medication was good and records were well written. The deputy manager said that it is the responsibility of senior care staff to give out medication to people that use the service. The deputy said that before senior care staff give out medication they do medication training and have their competency checked to make sure that they are following safe practice. Competency checks are carried out on a regular basis thereafter. Records were available to confirm that staff who administer medication have their competency checked. On the day of the inspection the deputy manager contacted the pharmacy that they used to arrange some refresher medication training for staff. During the visit a medication audit of a person that uses the service was carried out. Medication administration charts had been completed correctly and the stock balance of medication belonging to the residents was correct, matching up with medication ordered, received, administered and remaining in the home. Appropriate codes were being used when medication was not being given for a particular reason. A pharmacist inspection of the service to look at how the home support the safe handling of medicines was carried out in August 2007. It was identified at this inspection that the temperature of the medication storage rooms were too warm and that action must be taken to ensure that medication is stored at correct temperatures according to the manufacturers instructions. It was noted during this visit that on occasions the medication storage rooms were still too warm. The area manager said that the temperature of the medication rooms has been monitored and that action is to be taken to address the problem immediately. At this inspection it was identified that the temperature of the fridge in which medication requiring cool storage is kept was not always within normal limits. This was pointed out to the deputy and area manager at the time of the visit who said that they would take immediate action to address the situation. Cleveland View Care Home DS0000059270.V365910.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards assessed 12, 13, 14 and 15 People who use 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 and enjoyable activities do take place at the home and people are able to exercise choice and control. Visitors are encouraged and made to feel welcome at anytime. Food provided is enjoyed by people who use the service and provides them with a wholesome balanced diet. EVIDENCE: The home employs a diversional therapist to plan, arrange and take part in activities for people who use the service. The diversional therapist works Monday to Friday either 8am until 2:30pm or 8:30am until 3pm (Monday to Friday). At other times care staff working in the home are involved in activities. Activities taking place include, baking, listening to music, reminiscing, manicures and day trips. The area manager said that the home hosts weekly party nights on a Saturday. The area manager said that the party night usually has a theme, examples given were cheese and wine, themed events Cleveland View Care Home DS0000059270.V365910.R01.S.doc Version 5.2 Page 15 according to the time and year and most recently watching X Factor and Britain’s got Talent. Files of people who use the service sampled during the visit all contained a plan of activities that had taken place over previous months. The plan detailed what people had taken part in and enjoyed. Files examined showed that people had participated in baking, watching films, celebrating the Grand National with a variety of drinks, and following their religious beliefs. One file informed that a person using the service had received communion. Records were available to show a good and varied plan of activities and what individuals had taken part in. It was pointed out to the deputy that it would be a good idea to date the entry of when someone had taken part rather than just listing all that they had done during the month. Singers come into the home to entertain people that use the service and there is a visiting sweet shop that comes in once a month that sells humbugs, toffees, jellies and many others from the jar. People that use the service go on regular shopping trips and outings. On arrival at the home three people that use the service were going out with staff to the local supermarket for a look round and to have coffee in the café. Recent trips out have included Redcar and Strikes Garden Centre. A person that uses the service said that they are going out on a river cruise in the next couple of weeks. Comments made in respect of activities and outings from speaking to people and on surveys included, “I enjoy going on the days out and also when a singer comes in to sing for us. I love to listen and join in the songs. I like going over to the club for a little drink” “We have been shopping to Redcar and to the garden centre. I have always been a gardener so I really enjoyed that”. One person spoken to during the inspection said that “I enjoy going out into the garden, I have planted plenty of plants to keep the garden bright and cheery”. On the day of the inspection some people that use the service were out in the garden enjoying the afternoon sun. The home is visited by the Library bus, which provides a large selection of books for those people that use the service. Large print books and audiotapes are also available for the visually impaired. One person that uses the service said, “I like to read we have a mobile library that visits the home. They came Cleveland View Care Home DS0000059270.V365910.R01.S.doc Version 5.2 Page 16 when I was out today, but they left me some books because they know what I like”. Visits from relatives and friends are welcome at any time. Relatives are able to spend time and enjoy a meal at the home. People who use the service are encouraged and supported to practice their religion. Ministers from the local Church of England and Methodist church visit regularly as does a representative from the local Roman Catholic Church. The lunchtime of people who reside on the dementia that use was observed. The lunchtime menu of the day was lamb casserole or cheese and leek hotpot with creamed potatoes cauliflower and sweet corn and for dessert there was fruit and ice cream. Tables were appropriately set, one person that uses the service was singing as they came into the dining area and told staff how they had enjoyed tea and a teacake at the café that morning. Lunchtime was relaxed with staff supporting and encouraging those people that needed help at mealtime. Staff were observed to interact well with the people that use the service telling them what they were going to do before they did it an example being, one staff member was heard to say, “I am just going to push your chair in”. Staff were observed and heard to be encouraging independence reminding people that their lunch was in front of then and to pick up their cutlery. For those people that needed feeding staff sat down and made conversation with the person whilst they were helping to feed. People who use the service and surveys received in general spoke positively about the food provided. Comments made included, “The meals are lovely, I enjoy them all but I do not like the soup” “The home deserves credit for the way the food is served” “I do not like most of the food, but I will let the cook know and she always accommodates me by suggesting other meals. I do not like lamb so she will give me corned beef. I do not like fish so she will cook me an omelette” “The food is excellent. For breakfast I like a cup of tea and toast with marmalade. I could have a cooked breakfast” “The food it does for me” “The food is good and there is always choice” “I would like more fresh fruit” Cleveland View Care Home DS0000059270.V365910.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): Standards assessed 16 and 18 People who use 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 who use the service are confident that their complaints would be listened to, taken seriously and acted upon, however there needs to be a complaint procedure updated to include all of the required information to help to ensure that complaints are dealt with promptly and appropriately. Adult protection procedures are in place, which helps to protect people that use the service from abuse. EVIDENCE: A number of different versions of the complaint procedure were available in the home. The complaint procedure displayed on the wall in the entrance to the home was different to that in the policy manual. This was pointed out to the deputy and area manager at the time of the visit. There must be one complaints procedure that is updated to include stages and timescales for action, who to contact including contact details of Social services. The home keeps a record of complaints. There has been one complaint made in the last twelve months. Cleveland View Care Home DS0000059270.V365910.R01.S.doc Version 5.2 Page 18 Surveys received from people that use the service and people spoken to during the visit said that they know how to make a complaint and who to complain to. The home has an adult protection policy that details action that staff should take if abuse is suspected. The deputy manager said that staff receive adult protection training on a regular basis, staff spoken to during the visit confirmed that this was the case. The deputy manager and staff spoken to during the visit were aware of action to take if abuse is suspected. There have been no adult protection referrals made in the last twelve months. Cleveland View Care Home DS0000059270.V365910.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): Standards assessed 19, 24 and 26 People who use 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 standard of the environment within this home is good providing the people who live there with and attractive, homely and comfortable place to live. Small changes to the environment on the dementia unit would further enhance this. EVIDENCE: Cleveland View is a modern, purpose built care home that is registered to provide personal care to sixty older people. The home is located close to a social club, churches and shops. Nearby there is a bus route into Middlesbrough town centre. Cleveland View Care Home DS0000059270.V365910.R01.S.doc Version 5.2 Page 20 The home is split into two units. The ground floor of the home accommodates thirty older people and the first floor of the home accommodates thirty older people with dementia. Externally there is a garden/patio area that looks onto Cargo Fleet Lane. People that use the service said that they like to watch people walking past, the cars and buses. Each unit has a large communal lounge area and separate dining room. The Inspector walked around the home with the deputy manager. The home in general is well maintained. Lounge areas are pleasant and homely and furniture provided is of a good standard. Since last inspection all communal areas including corridors with the exception of the lounge designated for those people that wish to smoke have benefited from new carpets. At the last inspection the smoking area for those people that use the service was open plan and smoke was able to filter through into other communal areas. Since last inspection the smoking area has been sectioned off. The administrator of the home said that a plain carpet had been fitted to the dementia unit as research had shown that people with dementia were more likely to fall on patterned carpet. Patterns were often thought to be objects and people with dementia would try to pick them up or step over, which could result in more falls. A number of bedrooms were visited, these were observed to be very personal, with residents having their own furniture such as tables and chairs as well as more personal items. The deputy manager said that there is a rolling programme in place for re-decoration of bedrooms. All bedroom doors on the dementia unit were locked. The deputy manager said that doors were locked at family request, however people who use the service could go to their room at ant point. It was acknowledged that many people residing on the unit would not ask or are unable to ask to go to their rooms. A discussion also took place around making bedroom doors individual to the person, which might just help the person who uses the service to find their own bedroom. The area manager said that the home has a policy in respect of control of infection. Staff spoken to during the inspection said that there was always a plentiful supply of protective clothing. Appropriate laundry facilities are in place. On the day of the inspection the home was observed to be clean and odour free. Cleveland View Care Home DS0000059270.V365910.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): Standards assessed 27, 28, 29 and 30 People who use 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’s recruitment procedure is robust which helps to ensure that people are protected. Staff are trained, skilled and in sufficient numbers to meet the needs of people living at the home EVIDENCE: At the time of the inspection there were thirty-eight people living at the home, nineteen on the older persons unit and nineteen on the dementia unit. The home’s duty rota showed that on each unit there is four care staff on duty between the hours of 8am and 8pm one of which is a senior care assistant. On night duty there are two care staff on duty one of who is a senior care assistant and shares their time between both units. In addition the manager of the home is supernumerary and works full time. People who use the service who were spoken to during the visit and surveys received felt that there was sufficient staff on duty. The AQAA detailed that 62 of care staff working at the home have achieved a minimum qualification of NVQ level 2 in care. Cleveland View Care Home DS0000059270.V365910.R01.S.doc Version 5.2 Page 22 The home’s recruitment procedure is robust. The files of two newly appointed staff were looked at during the visit. Evidence was available to confirm that appropriate Criminal Record Bureau checks are carried out before staff start working at the home. Both files examined contained all of the required information including, proof of identity, photograph and two references. Records were available to confirm that new staff receive induction training that meets with the required standard. The manager keeps a training matrix that lists all staff, training they have completed and when they’re next training is due. Records were available to confirm that staff receive mandatory training on a regular basis and other training specific to the job that they do. Staff spoken to during the inspection said, “I think that this is a positive place to work. The Manager is excellent and we receive lots of training”, and, “We do regular fire safety drills, we have pretend fires and we all take part”. Cleveland View Care Home DS0000059270.V365910.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): Standards assessed 31, 33, 35 and 38 People who use 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 in is well run, health and safety is promoted. Quality assurance systems are in place to ensure that the home is run in the best interest of people who use the service. EVIDENCE: Since last inspection a new manager has been appointed and a senior care staff member promoted to deputy manager. The Manager is a Registered Nurse who has worked in the nursing and social care environment for a number of years. The area manager said that the manager is well on her way to achieving her management qualification. Staff Cleveland View Care Home DS0000059270.V365910.R01.S.doc Version 5.2 Page 24 spoken to during the visit and staff surveys received spoke of good leadership. One survey received stated, “The manager and all staff are excellent. There is always lots of support within the home to deal with the different needs of people that use the service”. The area manager said that the home have quality assurance systems in place. Surveys are sent out to people that use the service and relatives on a yearly basis to see if they are happy with the home and care received. She said that the provider last sent out surveys in May 2007, however the manager has sent some more surveys out in February 2008. Results of the quality assurance survey sent out in February were available, however in a statistical form and not easily understandable to people that use the service. This was pointed out to the area manager who said that she will ask the manager to publish the results of the survey to people that use the service and their relatives in a user friendly way. The home operates an open door policy in which people that use the service, relatives and their representatives can speak to the management team of the home at any time. The home holds three monthly meetings for people that use the service, relatives and their representatives. The home looks after small amounts of money belonging to some people who use the service. Appropriate records of transactions are kept. A sample of health and safety records were examined and were found to be in order. Records were examined to confirm that the fire alarms, emergency lighting and fire extinguishers had been serviced within the last year. On average there are weekly tests of the fire alarm system some of which involve staff to help to ensure that they would know what to do if there was a fire at the home. Records were available to confirm that water temperatures are taken on average weekly to ensure that they are within safe limits. It was highlighted that at the last inspection that the fixed electrical installation (hard wiring) servicing was out of date. The area manager said that this had been carried out about two weeks ago and that the home was awaiting a certificate to confirm this. Cleveland View Care Home DS0000059270.V365910.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 3 9 2 10 3 11 N/A DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 X X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Cleveland View Care Home DS0000059270.V365910.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13(2) Requirement The registered person must ensure that all medicines are stored securely at the temperature recommended by the manufacturer so that they are safe to use. Previous timescale for action of 31/08/07 not achieved 2. OP7 15 Care plans for people that use the service and can be aggressive must include what triggers the aggression, intervention required and how successful the plan of care is at de-escalating or managing the problem to ensure that care needs are met and safety maintained The Registered Person must ensure that the temperature of the fridge in which medication requiring cool storage is kept is between 2 and 8 degrees Celsius. This will help to ensure that medication is safe to use 31/07/08 Timescale for action 30/06/08 3 OP9 13 05/06/08 Cleveland View Care Home DS0000059270.V365910.R01.S.doc Version 5.2 Page 27 4. OP16 22 The Registered Person must ensure that the complaints procedure is updated to include stages and timescales for action, who to contact including contact details of Social services to help to ensure that complaints are dealt with promptly and appropriately The Manager must continue working towards achieving an NVQ level 4 in management or equivalent. A copy of the certificate of achievement must be forwarded to the Commission for Social Care Inspection once received 31/07/08 5. OP31 9 30/11/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP24 Good Practice Recommendations The Registered Person should give thought to the environment on the dementia unit. Individualising bedroom doors might just help the person who uses the service to find their own bedroom. The results of the surveys of people that use the service and relatives should be published in a user friendly way so that they can be easily understood. 2 OP33 Cleveland View Care Home DS0000059270.V365910.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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. 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