Care Home: Cobgates

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What the care home does well Comments received by the commission from residents and visitors to the home included ` I`m very satisfied with the home` ` If this was a hotel I would give it five stars, its like home` `Every week I have my hair done` ` Its excellently clean and the staff are good, kind and thoughtful` `The care home provides a first class service and it would be difficult to find an area where major improvements could be made`. `Cobgates staff work hard to ensure the home provides care and comfort for everyone`. `They provide a good homely environment for the residents`. The home ensures that pre- admission assessments are carried out on all new and potential residents with only those whose needs can be met, being admitted to the home. The location and layout of the home remains suitable for its stated purpose and all areas of the home are accessible to residents. The health needs of residents are well met with evidence of good working relations with other health care professionals to ensure the safety and well being of residents. Meaningful occupations are arranged according to each resident`s choice. Mealtimes are unhurried and all meals are home cooked with an alternative option being available for each mealtime. The management and administration of the home is good, with evidence of consideration being given to residents and their representative`s opinion with an efficient complaints procedure in place. What has improved since the last inspection? The home have complied the requirements made at the last inspection in July 2006 in accordance with the Care Homes Regulations 2001 (as amended 2006). The home have talked to residents about where they prefer to have their tea and resident now have tea on their units. Residents had asked for more fruit and bowls of fruit have been provided througout the home. Notice boards have been put in each of the units offering a variety of general and loacl information. The home have revised the care plans and introduced extra pages which have assisted in record keeping and continuity of care and include medical profiles which record visits from health professionals and a falls monitoring sheet which is a prompt to refer the residents to the falls clinic when required. A specific room has been assigned as a medical room to provide a facility for the district nurses to complete their paperwork and keep their dressings. The home have also changed the provider of the medication system which has resulted in an improved service. The home have purchased a large number of books, games, activities, posters and reminiscence material which is used regularly to promote meaningful occupation. An aromatherapist visits the home every month and has been a great asset for the residents as they look forward to their individual sessions. What the care home could do better: The residents are not fully protected by the homes recruitment policies and procedures and staffing records need to be better managed to evidence staff have received appropriate training. CARE HOMES FOR OLDER PEOPLE Cobgates Falkner Road Farnham Surrey GU9 7UG Lead Inspector Suzanne Magnier Unannounced Inspection 3rd March 2008 08:15 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 Cobgates DS0000033558.V359245.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. Cobgates DS0000033558.V359245.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cobgates Address Falkner Road Farnham Surrey GU9 7UG 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) 01252 714834 01252 734256 South West Surrey Adults & Community Care Services Mrs Gaye Munton Care Home 50 Category(ies) of Dementia - over 65 years of age (8), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (1), Old age, not falling within any other category (50), Physical disability over 65 years of age (50), Sensory Impairment over 65 years of age (50) Cobgates DS0000033558.V359245.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Accommodation and Services may be provided to named persons aged 60 - 65 years with the prior written agreement of the CSCI. Respite Care may be provided to a maximum of 5 persons at any one time. Accommodation and services may be provided for a named service user with mental disorder with the prior written agreement of the CSCI. That the residents with dementia are all accommodated on the new unit. The activities organizer should receive specialist training in the provision of activities for clients with dementia. 31st July 2006 Date of last inspection Brief Description of the Service: Cobgates is a two-storey residential care home owned by Surrey County Council. The home is registered to provide care and accommodation for up to 50 residents over the age of 65. Two of the units are currently closed and the home is providing care and accommodation to 37 residents. The home is very near Farnham town centre and has easy access to all facilities. The home is in its own grounds with garden areas and ample parking. The home is very well presented and offers a good standard of accommodation. All bedrooms are single occupancy. The home has seven separate units, each with its own sitting/dining area and kitchenette. All parts of the home are accessible to residents. Currently the fee is £540 per week. Cobgates DS0000033558.V359245.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. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the care home was an unannounced ‘Key Inspection’. Some additional standards were assessed and have been included within the report. Ms S Magnier Regulation Inspector carried out the inspection and the registered manager represented the service. For the purpose of the report the individuals using the service prefer to be addressed as residents. The inspector arrived at the service at 08.15 and was in the home for seven hours. It was a thorough look at how well the home is doing. It took into account detailed information provided by the home and any information that CSCI has received about the service since the last inspection. The Commission sent questionaires to people associated with the service. The use of an ‘expert by experience’ (who is a person who visits the service with the inspector to help the get a picture of what it is like to use the service) was not used as part of this inspection. Comments received by the commission have been included within the report. The home had supplied the commission with a documented Annual Quality Assurance Assessement (AQAA) some detail of which has been included within the report. During the course of the day the inspector met with the majority of residents some newly admitted to the home and some who had lived at Cobgates for many years. A number of residents living at the home have communication difficulties, so their responses were assessed by observing their facial expressions, using sign and body language, listening and requesting staff to interpret the individuals own way of communicating and observing the residents and staff interactions. Additional information was also sought from talking with visitors to the home during the inspection. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. Documents sampled during the inspection included the homes Statement of Purpose and Service User Guide, care plans, daily records and risk Cobgates DS0000033558.V359245.R01.S.doc Version 5.2 Page 6 assessments, medication procedures, staff files, a variety of training records, health and safety records, and several of the homes policies and procedures. The commission noted that requirements made during the previous inspection in December 2006 had been complied with. From the evidence seen by the inspector it is considered that the home would be able to provide a service to meet the needs of clients who have diverse religious, racial or cultural needs. What the service does well: What has improved since the last inspection? The home have complied the requirements made at the last inspection in July 2006 in accordance with the Care Homes Regulations 2001 (as amended 2006). The home have talked to residents about where they prefer to have their tea and resident now have tea on their units. Residents had asked for more fruit Cobgates DS0000033558.V359245.R01.S.doc Version 5.2 Page 7 and bowls of fruit have been provided througout the home. Notice boards have been put in each of the units offering a variety of general and loacl information. The home have revised the care plans and introduced extra pages which have assisted in record keeping and continuity of care and include medical profiles which record visits from health professionals and a falls monitoring sheet which is a prompt to refer the residents to the falls clinic when required. A specific room has been assigned as a medical room to provide a facility for the district nurses to complete their paperwork and keep their dressings. The home have also changed the provider of the medication system which has resulted in an improved service. The home have purchased a large number of books, games, activities, posters and reminiscence material which is used regularly to promote meaningful occupation. An aromatherapist visits the home every month and has been a great asset for the residents as they look forward to their individual sessions. What they could do better: 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. Cobgates DS0000033558.V359245.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 Cobgates DS0000033558.V359245.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): 1, 3, 5, 6. People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. The home provides well-written information regarding the services provided by the home and offers the opportunity of visits to the home for prospective residents / clients in order that they can make an informed choice about moving to the home. The homes admission and assessment procedures ensure that client’s needs are appropriately identified and met. EVIDENCE: The homes Statement of Purpose, Service User Guide and the welcome to Cobgates information pack were well documented to inform prospective residents and their representatives about what the home offers, the management and staffing structures of the home, the accommodation and services available, the staff members level of training and how people could complain if they were unhappy with the service provided. Cobgates DS0000033558.V359245.R01.S.doc Version 5.2 Page 10 A person being admitted to the home and their family explained to the inspector that they had visited the home a few days previously in order that they could bring personal items and put up pictures and photos in their relatives bedroom. They spoke highly of the staff and how friendly and welcoming the home was. The staff confirmed that prospective residents are offered the opportunity and choice if they would like to have a trial period at Cobgates prior to their stay in order to ensure that people felt included in their admission to the home. A pre admission assessment, which had been completed by one of the homes deputy managers, was sampled and evidenced that robust arrangements are in place to ensure that the home would meet the needs of prospective residents. No intermediate care is offered by the home. Cobgates DS0000033558.V359245.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): 7, 8, 9,10. People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. Residents are offered a good provision of health care and personal support by the home. Care is generally administered in way that protects the individual’s privacy and dignity. Medication procedures ensure that all necessary precautions are taken to ensure errors do not occur and that medications are stored and administered safely. EVIDENCE: The care plans had been developed from the pre assessment documentation and included the resident’s care and support needs. The care plans were well written to allow the reader to gain a good overview of the residents medical, social and personal care needs including complexities in communication and behaviours. Due to some residents complex needs the staff informed the inspector that care plans are devised with the resident and their families involvement where possible and reviewed regularly to reflect any changes in the residents needs. Cobgates DS0000033558.V359245.R01.S.doc Version 5.2 Page 12 The care plans evidenced that regular and appropriate health care appointments are attended and the General Practitioner (GP) visits the home regularly. During the inspection the inspector met the district nurse who was visiting residents. She spoke highly of the staff and stated that they provide good care and support for residents. Through sampling care plans it was evident that the home has maintained good working partnerships with health care professionals which include visits from the opticians, dentists and chiropodists to ensure that residents health care needs continue to be met. Comments received by the commission from health care professionals regarding the care provided by the home included ‘ The carers all demonstrate genuine caring attitudes to the residents. Residents appear valued by their carers who build up good relationships with them’. ‘They contact me the GP when they have a cause for concern. They are very kind and caring towards clients’. ‘Each time we visit carers often want advice on clients, which is usually documented and acted upon by care staff’. ‘Any health care needs that the care staff are inexperienced with they ask advise from the district nursing team’. Records sampled indicated that the home were monitoring residents well being by ensuring that people had sufficient nutrition and fortified drinks and that their body weights are monitored regularly to indicate weight loss or gain. Daily care records were professionally written and maintained to reflect the individuals needs and care provided. One care plan sampled did not include that the resident had had a fall the night before and it was noted that the residents risk assessment indicated that they had a high risk of falling yet the risk assessment had not been updated for several months. This was brought to the managers attention and discussed with the deputy manager who updated the records promptly and included within the risk assessment the actions the home had recently taken which included a referral to the residents GP and falls clinic to ensure the safety and well being of the resident. Other risk assessments were seen and considered to be appropriate in order to promote independence whilst ensuring the person’s safety and wellbeing. The home has a monitored dosage system in place and the deputy manager showed the inspector that the home has good, clear procedures in place for the monitoring and recording of all medicines administered and those entering and leaving the home. Records of controlled medication were sampled and checks made were accurate. Some medication administration charts were seen which were well documented, contained the resident’s photograph and were clear to ensure that residents received their prescribed medicines. Some staff certificates were seen to ensure staff that administers medicines had been certificated as safe to do so. One comment card from a visiting health care professional stated ‘Most clients do not self medicate however inhalers are given to clients who can demonstrate their technique and use correctly’. Cobgates DS0000033558.V359245.R01.S.doc Version 5.2 Page 13 Visitors to the home stated that ‘the staff are excellent and are kind and friendly to residents and visitors’. ‘Staff always friendly and caring’. It was observed that residents responded favourably to staff and the staff demonstrated a knowledge and understanding of the residents welfare and support needs. Throughout the day the inspector observed that residents were generally addressed in a polite and courteous way by staff however it was raised with the manager that staff from a different culture should be aware of the culture and age of residents and avoid over familiarity. A comment card received by the commission stated ‘When carrying out activities of daily living the carers respect client’s privacy and dignity. Doors are closed, curtains pulled etc’. Cobgates DS0000033558.V359245.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): 12, 13, 14, 15. People who use the service experience excellent quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. People are able to enjoy a full and stimulating lifestyle with a variety of options to choose from. The home provides a wide range of social, cultural and recreational facilities, including specialist diets to residents, with resident’s choice and wishes being respected. Visitors are welcomed to the home to maintain contact with their family members. EVIDENCE: The home has promoted a meaningful occupation programme which includes a range of activities and entertainment for residents. The home are in the process of starting reminiscence sessions and supporting staff to promote a culture where occupation is seen as essential and integral to the residents care and involves the resident and their families with the residents key workers in developing a life history and scrapbook for residents if they choose. The manager explained that the activities organiser had recently left yet the staff have been able to continue the day time activities which were observed Cobgates DS0000033558.V359245.R01.S.doc Version 5.2 Page 15 by the inspector in the afternoon and involved watching and participating in a gentle exercise video which a small group of residents appeared to enjoy. Residents and visitors to the home confirmed that there are a variety of activities available and that staff are flexible in allowing residents to choose the level of activities they attended. Comments received by the commission regarding the activities offered by the home included ‘My choice is that I don’t wish to join the activities’. ‘Lots of activities are arranged for them to join in with’. ‘ Overall care for residents health and welfare, provide recreational needs for residents social well being and communication skills.’ ‘Organising many events to finance their crafts, outings, and entertainments programmes they so kindly provide throughout the year’. ‘The care service, try to stimulate the clients with a variety of weekly activities, reminiscence therapy’. ‘Patients are encouraged to go out as much as they wish and maintain their hobbies and interests’. ‘More encouragement for people to go into the garden’ (is needed.) The home offers themed days which are based upon individuals memories for example the seaside, schooldays, radio and television and at the farm. Fish and chip suppers, visits to the theatre, coach trips and barbeques in the summer and the use of the homes bar which is open four times a week. Evening activities include quizzes or skittles. The home are currently using several vacant rooms in the Carnation and Gardenia unit as a reminescence room sensory/aromtherapy room, a crafts room and a library where residents can sit quietly and read or borrow a book to read. Robbie and Murphy the P.A.T. dogs visit the home and along with the homes cat the manager told the inspector that residents enjoy having animals around the home. The home also has a computer which some residents use to correspond with family and friends. Links have been maintained with the local clergy who visit the home, one resident told the inspector through signing that the priest was kind and had visited her at the home recently. The local Alzheimers Society hold meetings at the home and offer support and training to staff should the need arise. Students from the Art College across the road continue to have contact with the home and one resident told the inspector that they had been asked if they wanted to assist a student in a project which they really enjoyed doing. The midday meal served at lunch time was well presented with each resident being able to sit up to a dining table to have their meal. The dining room was bright and spacious with vases of spring flowers on each table and appropriate crockery and condiments available. Visitors to the home had been welcomed and were enjoying their meal with their relative. A menu was available for residents to see what was on the days menu and one resident told the inspector that the home provides them with a special diet and there are always plenty of choices. Comments regarding the standard of the food served and Cobgates DS0000033558.V359245.R01.S.doc Version 5.2 Page 16 prepared by the home included ‘The food always sounds and smells good. Always a choice and a bowl of fruit is available should it be needed’. The AQQA states that residents are encouraged to make their views known about the services offered at Cobgates through residents meetings and questionnaires and if any changes are being planned which involve residents they are consulted initially in order that they feel thay have inclusion in the running of the home. Cobgates DS0000033558.V359245.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, 18. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The residents are protected by the homes complaints and safeguarding adults procedures. EVIDENCE: The home has an established complaints procedure. The managers advised that all complaints received by the home are fully investigated and the records kept by the home evidenced this. No complainant has contacted the Commission with information concerning a complaint made to the service since the last inspection. Several residents told the inspector that they were confident that the manager or staff would deal with any concerns or complaints they may have. Records sampled indicated that some staff had attended safeguarding vulnerable adults training and for newly recruited staff this had been included in the induction programme. Records sampled indicated that Criminal Record Bureaux checks (CRB) and Protection of Vulnerable Adult (POVA) checks are carried out on all new staff. The home has a copy of the Surrey County Council Multi-agency Procedures for Safeguarding Vulnerable Adults. One safeguarding referral had been have been made since the previous inspection and had been satisfactorily concluded. Cobgates DS0000033558.V359245.R01.S.doc Version 5.2 Page 18 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, 24, 26. People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home provides accommodation for residents that is safe, personalised homely, hygienic and odour free, whilst infection control procedures are adhered to at all times. EVIDENCE: The location and layout of the home remains suitable for its stated purpose. The home is well maintained and all areas of the home, including the enclosed garden are accessible to residents. The home was viewed as pleasantly decorated and providing a homely environment for residents. Residents spoken with said that they liked their bedrooms, which were viewed during the tour of the premises to be clean and personalised. The communal Cobgates DS0000033558.V359245.R01.S.doc Version 5.2 Page 19 areas of the home were bright, spacious and comfortable offering a homely environment. The home has an infection control policy in place and staff are trained in infection control procedures and were observed adhering to infection control measures for example wearing protective clothing, washing their hands and using hand gels to prevent the spread of infection in the home. There is a daily cleaning schedule in place and the home was exceptionally clean and odour free throughout. Visitors and residents commented that the standard of cleanliness and hygiene was excellent and ‘provides a safe secure and happy environment’ and ‘ each client is treated as an individual and their individual needs are tried to be met. They are very caring and try and make Cobgates feel like home to the clients’. ‘They provide a good homely environment for the residents’. Cobgates DS0000033558.V359245.R01.S.doc Version 5.2 Page 20 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, 30. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The staffing levels of the home were considered adequate to meet the current needs of residents. EVIDENCE: The home had a relaxed atmosphere and staff were observed to undertake their tasks in a quiet and orderly manner. The inspector observed staff interactions with residents all of which were supportive and friendly. Opinions about the staff were expressed by residents and visitors during the day and written comments received by the commission included that the staff were always supportive and kind ‘All needs are met well’, ‘Looks after my mother very well’, ‘The staff are excellent and are kind and friendly to residents and visitors’ ‘In this residential care home there are a variety of personalities and I believe that the care staff deal with each personality very well’. ‘How they could improve is to continue to train, develop and support staff’. ‘This is a very caring residential home with caring and hard working care staff’. Cobgates DS0000033558.V359245.R01.S.doc Version 5.2 Page 21 The staffing levels of the home were evidenced and considered adequate to meet the current needs of the residents and staff were at hand promptly to support residents who required immediate assistance. The home employs a care staff group of twenty nine and has an Equal Opportunities policy in place and is an equal opportunities employer. Whilst sampling the care plans the inspector observed that there was written evidence to support that the residents were offered respect of their privacy and dignity through the home offering gender specific care. The AQAA advises that the majority of the staff have a National Vocational Qualification (NVQ) in Level 2 or above. Two staff recruitment files were viewed and it was evidenced that these files did not contain all items required under the Care Homes Regulations 2001 (as amended 2006). One staff file evidenced that the home had obtained two verbal references, which had not been signed by the person receiving them. It was noted that the folders containing the recruitment documents were untidy and in disarray. The deputy managers explained that the staff files were in a folder as they were newly recruited staff and the documents would then be put into a file, which was more manageable. It has been required that all staff must have two written references, including where applicable, a reference relating to the persons last period of employment, which involved work with children or vulnerable adults, of not less than three months duration. The staff training files were also disorganised and it was difficult for the inspector to ascertain that all staff had received mandatory training due to the lack of orderly documentation. The inspector was assured that all staff had received mandatory and safeguarding training. It has been required that there is clear recorded evidence to support that all staff have received training appropriate to the work they are to perform including induction training. Cobgates DS0000033558.V359245.R01.S.doc Version 5.2 Page 22 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, 38. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The management of the home is robust to ensure the safety and wellbeing of residents. Residents are consulted regarding the running of the home and their health and financial interests are safeguarded. EVIDENCE: The registered manager of the home has many years of experience caring for older people and is supported by two deputy managers who demonstrated a good knowledge of the care home and the support needs of the residents and staff. Cobgates DS0000033558.V359245.R01.S.doc Version 5.2 Page 23 There were clear lines of management accountability during the day of the inspection and staff demonstrated an understanding of the roles and responsibilities of people employed. All persons spoken with during the inspection spoke highly of the abilities and knowlegde of the registered manager and the deputy managers and staff morale was good. It was noted that the registered manager and deputy managers had a good rapport and knowledge of each of the residents and were seen to listen to the resident’s views and opinions. Residents and visitors confirmed that the managers were friendly, approachable and always took the residents or their representatives concerns or comments about the home seriously. The homes bursar explained that residents all have an individual account with Surrey County Council and the home takes some responsibility for resident’s finances. The records sampled were well recorded and clear in evidencing that appropriate safekeeping and regular auditing of the accounts was undertaken in order to safeguard residents from financial abuse. Records indicated that health and safety checks are maintained, fire safety equipment and records were documented and equipment serviced. The sluice and laundry areas were noted to be clean and tidy. Cobgates DS0000033558.V359245.R01.S.doc Version 5.2 Page 24 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 3 X 3 X 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X 4 X 4 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Cobgates DS0000033558.V359245.R01.S.doc Version 5.2 Page 25 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. 1 Standard OP29 Regulation Schedule 2 (3) Requirement All staff must have two written references, including where applicable, a reference relating to the persons last period of employment, which involved work with children or vulnerable adults, of not less than three months duration. Clear recorded evidence must be available to support that all staff have received training appropriate to the work they are to perform including induction training. Timescale for action 03/04/08 2 OP30 Schedule 4 (6) (g) 03/04/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Cobgates DS0000033558.V359245.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Cobgates DS0000033558.V359245.R01.S.doc Version 5.2 Page 27 - 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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