Care Home: Fermoyle House Nursing Home

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What the care home does well The staff work hard to ensure that residents` needs are appropriately assessed and that their care is planned to ensure that these needs are met, whilst encouraging and enabling residents to maintain their independence where possible. Residents spoken with expressed their satisfaction with their quality of life at the home. Comments received from residents included: `It is a very happy place and the staff are wonderful and kind` and `The staff are excellent and caring`. All interactions observed between the management, staff and residents evidenced that the home has a close and caring staff team. The manager has worked hard to ensure that all the requirements made at the previous inspection were met, one requirement however is still in the process of being met. Privacy locks are required on all toilets and bathroom doors, and there are still two bathrooms without locks, these locks are in the process of being fitted. It was nice to see residents paintings hanging in the hallway, one resident stated he really enjoyed painting and he felt proud the staff had hung his work on the wall. What has improved since the last inspection? The ongoing maintenance, redecoration and refurbishment programme provides residents with a comfortable and homely environment in which to live. The home has a redecoration programme in place, when bedrooms become empty the bedrooms are redecorated and if necessary a new carpet is laid. The seven requirements and four recommendations made at the last inspection have been met, except for one which is in the process of being completed. The manager assured the inspector the privacy locks required on a bathroom and toilet door would be completed. The manager stated that the maintenance person, who looks after two homes has been very busy decorating a number of bedrooms, both entrance halls and the dining area at Fermoyle House Nursing Home. This work was observed at the time of the inspection. New carpets have also been laid in some bedrooms and new flooring in a toilet and bathroom. New metal plates have been fitted to the bottom of some bedroom doors and corners of walls where wheelchairs have damaged walls in the past. A new call bell system has been fitted two days before the inspection. Several new wheelchairs have been purchased and some digital weighing scales specifically for residents who use the hoist. On the day of inspection, staff were busy dressing three new Christmas trees, one for each lounge and the dining area, decorations for the home had recently been purchased by the manager and the staff were in the Christmas spirit of decorating the home for the forthcoming festivities. What the care home could do better: The building has been adapted to accommodate residents requiring nursing care andthe property would not be viable to make drastic changes to the layout of the home or bedrooms. The staff currently walk through the kitchen to the office or the small area where staff can sit and eat their meals during their breaks. The Environmental Health Officer had made some requirements to the kitchen previously, and would at some stage be following up the requirements, the only way into the office is to walk through the kitchen or the lounge patio door making it very cold for the resident`s every time the door is opened as the chairs where the residents sit are situated in front of the doorway. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Fermoyle House Nursing Home 121-125 Church Road Addlestone Surrey KT15 1SH     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Vera Bulbeck     Date: 2 7 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Fermoyle House Nursing Home 121-125 Church Road Addlestone Surrey KT15 1SH 01932849023 01932847183 angela.partridge1@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Pinebird Ventures Limited care home 32 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users that can be accommodated is 32 The registered person may provide the following category of service only:Care home with Nursing(N) to service users of the following gender :Either whose primary care needs on admission to the service are within the following category : Old age, not falling within any other categry (OP) Date of last inspection Brief description of the care home Fermoyle House has been adapted to provide accommodation and nursing care for thirty-two residents who are elderly. The home is located in a residential area within easy access to the local shops and community facilities. There is also access to a local bus service. Accommodation is provided in single and shared rooms. The home has two lounges, and a small dining area. The garden to the rear of the property is well maintained and is overlooked from the lounge. Car parking is available at the front of the home. 0 Over 65 32 Care Homes for Older People Page 4 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This unannounced visit formed part of a key inspection and was carried out by Vera Bulbeck, Regulation Inspector. Mrs Angela Partridge, the Registered Manager was present, Mr Graham Samuels, the proprietor was not present on this occasion. The inspection took into account detailed information provided by the manager and any information that CSCI has received about the service since the last key inspection on 6th November 2007. Service users at this home prefer to be referred to as residents. For clarity and consistency this term will be used throughout this report. Care Homes for Older People Page 5 of 28 A tour of the premises took place. On the day of this visit the inspector spoke with the majority of the thirty-two residents and most of the staff on duty. The inspector also spoke with three relatives on the day of inspection and three relatives by telephone following the inspection. Positive comments were made regarding the home, comments received on the day of inspection were shared with the manager. Care was taken to exclude any comments that could identify the person who made the comments. The manager demonstrated a very pro active attitude to the results of the comments and plans to explore the results further as part of the homes quality assurance process. Some of the comments made to the inspector are quoted in this report. The home had completed an annual quality assurance assessment (AQAA) and residents care plans, staff recruitment and training records, menus, health and safety check lists, activity records, policies, procedures, medication records and storage were all sampled on the day of this visit. Fees range from 559.71 to 728.80 pounds per week. This information was provided on 27th November 2008. The inspector would like to thank the residents and staff for their time, assistance and hospitality during this visit. What the care home does well: What has improved since the last inspection? What they could do better: The building has been adapted to accommodate residents requiring nursing care and Care Homes for Older People Page 7 of 28 the property would not be viable to make drastic changes to the layout of the home or bedrooms. The staff currently walk through the kitchen to the office or the small area where staff can sit and eat their meals during their breaks. The Environmental Health Officer had made some requirements to the kitchen previously, and would at some stage be following up the requirements, the only way into the office is to walk through the kitchen or the lounge patio door making it very cold for the residents every time the door is opened as the chairs where the residents sit are situated in front of the doorway. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each resident is only admitted to the home following a comprehensive needs assessment to ensure that the home can meet the residents identified needs. This home does not offer intermediate care. Evidence: In their AQAA the home described their admission procedure: On enquiry to the home, details of the prospective residents needs is noted and the Manager will assess, based on the verbal information supplied, if Fermoyle House has the facilities to meet prospective residents needs. The home encourages prospective residents to visit and stay at the home for several hours, so that they can give their own opinion on whether the home is what they are looking for. During this stay, the manager assesses the prospective residents needs further to check that the home has the facilities, experience and staff to provide appropriate care. Information is also obtained from Care Homes for Older People Page 10 of 28 Evidence: relatives, social worker, GP and any other agency involved. Two care plans were sampled during this visit. In each case a comprehensive pre admission assessment had been carried out to ensure that the home could meet the residents identified needs, prior to the person moving into the home. Data provided in the homes AQAA does not identify any residents with specific religious, racial or cultural needs at this time. However, from the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. Relatives spoken too felt they had received enough information prior to moving to the home. One relative commented that: The staff were very helpful, showed us around and how they operated. Care Homes for Older People Page 11 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal care and health care support and assistance is planned and was seen to be provided, where needed, in a respectful and sensitive manner. Policies, procedures and practises are in place to ensure the safe administration of medication. Evidence: The home has a close and supportive care team and the staff demonstrated an in depth knowledge of each individual residents needs, abilities and preferences in how they wish their care to be delivered. One resident attends Hammersmith Hospital three times a week for dialysis. The resident informed the manager that he did not wish to attend the hospital anymore as it was a long day. The manager spoke with the GP with the permission of the resident and asked if there was any chance of the resident attending a more local hospital. The GP has contacted the hospital and is hoping the resident will be able to attend a more local hospital in the very near future. Care Homes for Older People Page 12 of 28 Evidence: Some of the residents spoken to said they always receive the care and support they need and one resident answered the staff are lovely nothing is too much trouble. Another resident commented There is nothing the staff will not do for me and another resident stated that The staff are excellent and caring. A relative informed the inspector he was more that happy with the home, he stated its not Buckingham Palace but my wife is treated like royalty. The two care plans sampled during this visit were both based on pre admission assessments and had been drawn up shortly after each residents admission to the home. These care plans set out the actions which need to be taken by the qualified nurse and care staff to meet the health and personal care needs of the residents. Care plans are reviewed on a monthly basis and daily notes are kept that reflect the care given. The daily notes demonstrated that any changes or new concerns are promptly acted upon and newly identified needs are added to the care plans. The care plans also included risk assessments relating to falls, skin condition and nutrition. Relatives confirmed they are involved with care planning and are asked to sign care plans. At the last inspection a requirement was made that residents risk assessments be undertaken by an appropriate health professional to ensure the needs of an identified resident was fully met, this requirement has been met. The manager explained that they are constantly reviewing and improving their care planning system. Care planning training sessions have been undertaken for all staff with the aim that all staff will gain confidence and become more involved in planning,updating and reviewing care plans. The lunchtime medication round was observed and the medication administration records, medication storage, policies and procedures were all sampled and found to be in order. The home have also reviewed the stock control system for meeting a recommendation made at the last inspection. The Qualified nurse on duty is aware of the new legislation relating to the storage of controlled drugs in care homes and plans to double check that their current storage arrangements still meet the requirements of the new legislation. In the AQAA, to demonstrate what the home does well, the manager stated that: Personal care is provided according to residents needs and preferences. We respect residents right to privacy and their dignity is supported. Each resident is encouraged to maintain their independence and staff will provide assistance where needed. Appropriate aids and equipment are provided to encourage maximum independence, however, staff remain observant to offer assistance where needed, when they wish to retire to bed and personal care is provided in a friendly, unrushed manner. Care Homes for Older People Page 13 of 28 Evidence: During the tour of the home staff were observed to always knock before entering the residents bedrooms and all interactions observed between staff and residents were seen to be caring and respectful. There are currently no locks on bedroom doors, the manager stated she has done a risk assessment for each resident, identified the reason for not fitting locks, and these have been signed by the relatives as well. However when discussed with the manager she did comment that she would re consider. There is a bathroom and toilet without locks, these are to be fitted as soon as possible the manager stated. Both areas have recently been redecorated and have had new flooring. They are waiting for the maintenance person to finish the doors which are due to be painted white. This was a requirement at the previous inspection to have suitable locks fitted to toilet and bathroom doors which can be opened by staff in an emergency. The majority of locks have been fitted. Therefore this requirement has been met. All residents spoken with felt that their privacy was always respected. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent 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 varied activity programme that includes contact with the local community both within and outside the home. Contacts with family and friends are encouraged. Meals are well balanced and varied with individual choices and preferences catered for. Evidence: The activity programme was sampled at this visit. In their AQAA the manager stated that: A weekly activity timetable is provided for residents on the notice board in the hallway and they are reminded and offered each day to participate. All staff respect residents wishes to decline to participate. An activity timetable is drawn up with the current individuals interest at the forefront, also taken into consideration is the time of year and local and national celebrations. Residents are offered to participate in a range of activities from painting and colouring, flower arranging, manicure and hand massage. Both lounges have a music afternoon session and all residents are encouraged to play an instrument, with the staff involvement. Two days a week an activity organiser visits the home for more painting and making items for example three residents had made a castle, and several paintings the residents had undertaken were on display in the hallway. On a monthly basis there are exercises for health to Care Homes for Older People Page 15 of 28 Evidence: music, and a monthly quiz. There is also monthly massage and aromatherapy for head and feet. Also an organist visits the home monthly to play music, which the residents enjoy. Several residents commented they enjoy the activities, and like to participate. One relative stated they would like to see more activities. Residents individual rooms were all seen to contain many personal possessions, which were arranged to suit their individual wishes. There are no restrictions to visiting times and staff support and encourage residents to maintain family links and friendships inside and outside the home. Menus sampled showed that the home offers a varied and well balanced menu, with residents able to choose alternatives if they do not want the dish that is on the menu on the day. The lunchtime meal was taking place during this visit, the food was nicely presented, there was a calm atmosphere in the dining room with staff feeding some residents in the lounge and staff offering assistance where needed or requested. Several residents commented how good the food is, and relatives also commented on the food being home cooked and nourishing. The cook was advised to record any changes to the menu and any alternative meals need to be recorded on a daily basis. Two relatives informed the inspector that they have been invited to Christmas lunch in the home. One relative stated in October it was his and his wifes 49th wedding anniversary and he was invited to join his wife for a meal. He said the cook, cooked a wonderful meal, however he was not able to remember exactly what it was, but could remember it was good and he stated he wanted to express the kindness shown by the manager and staff was second to none. In the AQAA, to demonstrate what the home does well, the manager stated that: Residents are encouraged to participate in decisions running the home, such as choice of meals, activities and being involved in choice of decoration for communal rooms. A few residents enjoy eating meals in the dining room, which has a comfortable relaxed atmosphere and tables are nicely laid. For those who have difficulty cutting, chewing or swallowing food, staff provide assistance discreetly and sensitively. The manager stated that napkins are provided to all residents. The majority of the residents eat in the two lounges from small tables. Residents who require protective clothing during meal times have been assessed and it is documented, and those residents who are able to feed themselves without spilling food are mainly seated at the dining tables. A recommendation was made at the previous inspection for protecting residents clothing at meal times needs to be reviewed. This recommendation has been addressed. Several residents commented on the quality of Care Homes for Older People Page 16 of 28 Evidence: the food being very good all home made. Relatives also commented on the standard of food their relatives received. It was also observed by the inspector fresh vegetables and fruit was plentiful. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a simple, clear and accessible complaints procedure which includes timescales for the process. Policies and procedures are in place to protect residents from potential harm or abuse. Evidence: There is a whistle blowing policy in place and the home have a copy of the latest Surrey Safeguarding Adults Policy and Procedure. Training in safeguarding adults is included in the homes staff induction. The training log showed that the majority of staff have had safeguarding adults update training this year. The manager, confirmed training is being undertaken and a letter was seen regarding several staff training courses are booked for 2009. In the AQAA, to demonstrate what the home does well, the manager stated that: We encourage residents and relatives to provide views of their experiences, especially if they are not happy with the service provided. We take complaints seriously and like to deal with them quickly. Complaints are logged and dealt with efficiently and confidentially. All staff are trained in Safeguarding Adults and the whistle blowing policy. All residents spoken with said that they felt safe at the home with one resident adding very and another commenting I feel very safe here. Care Homes for Older People Page 18 of 28 Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The location of the home and gardens are suitable for their stated purpose. An ongoing maintenance and redecoration programme provides the residents with clean, pleasant and homely surroundings in which to live. Evidence: Residents spoken with expressed their satisfaction with the accommodation provided at the home. Residents stated the home was always fresh and clean with one resident adding: They do their very best to keep the home clean and tidy.Several relatives commented on the home with reference to the premises and one relative stated he is not looking at the state of the premises, it does not smell of urine like some homes he went to, the care and the staff in Fermoyle could not be replaced they are wonderful, that is more important to him than the home having chandeliers. The home was toured during this visit. Communal areas were all well presented and a number of relatives commented on the hallways, and other areas including bedrooms being painted. The residents bedrooms seen had been personalised to suit each individual residents wishes. The maintenance and redecoration programme for the home was seen to be ongoing. Since the last inspection there have been a number of improvements, in their AQAA the manager stated that they have: Redecorated upstairs and both downstairs hallways, replaced curtains and bed covers and laid some Care Homes for Older People Page 20 of 28 Evidence: new carpets. Redecorated and replaced carpets in vacant rooms. Replaced flooring in a bathroom and toilet. The inspector noted while walking around the home a TV was on in a bedroom whereby the manager had stated the occupant was in hospital, the inspector went into the bedroom to check and found the TV had been left on for the benefit of two love birds. The manager informed the inspector every morning the staff go into the bedroom pull back the curtains and switch the TV on to enable the birds to have some company, and the reverse happens at night. The staff are looking after the birds until the resident returns home. There is one area that could be improved, currently the staff and visitors have to walk through the kitchen to the office and small area where staff are able to eat their meals. The Environmental Health Officer is aware of the problem and suggested other alternatives. For example to walk round the garden to the office, however this would be difficult this time of the year because staff and visitors would need to walk through the residents lounge to the patio door having access to the garden and walk round the garden to the office. Also residents currently sit in front of the patio doors and they would get very cold with the door opening all the time. On the day of inspection the glass in the patio door of the small lounge was shattered on the outer side of the double glaze. The manager stated the gardeners had been in the day before cutting the grass and picking up the leaves with an electric blower and this had caused a stone to fly up and make a hole in the glass. The glass panel has been ordered but will take a couple of days to be made and fitted. Laundry facilities are sited on the ground floor. The washing machines have sluicing facilities. The manager described the current procedure is in line with recognised best practise guidance and recommendations for infection control. The inspector would advise management to seek the advice of the Fire Officer with respect to the fitting and closing of residents bedroom doors. Some of the doors appear to be not closing appropriately and some are fitted with a ball bearing. On the day of this visit the home was found to be warm and bright with a homely atmosphere and a good standard of housekeeping apparent. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The numbers and skill mix of the staff meets residents needs. Current staff recruitment policies, procedures and practices meet the requirements of legislation and are potentially ensuring residents are safe from harm or abuse. The home has a staff training programme, which is designed to ensure that residents are supported by competent and qualified staff and that, as far as reasonably possible, they are protected from harm. Evidence: The current staff group consists of the manager, RGNs and a number of carers, Housekeeper, cleaners, maintenance person, cook and assistant cook. The staff rota evidenced that staff are provided in sufficient numbers to meet the needs of the residents at the home. The day (7.30am to 2pm) shift is covered by one RGN and six carers plus the manager, plus ancillary staff. One RGN four carers plus ancillary staff cover the afternoon/evening shift (2pm to 8pm) and the night staff consists of one RGN and two carers waking night, with the manager and proprietor on call if needed. Eight staff hold a National Vocational Qualification (NVQ) level 2 in care. Four staff hold a National Vocational Qualification (NVQ) Level 3. Extra places have been requested and applied for more staff to complete NVQs. Several other courses have been applied for including mandatory courses. Management to ensure all staff are up to date with Care Homes for Older People Page 22 of 28 Evidence: mandatory training, and specialist training for staff, example dementia care, to enable staff to meet the needs of the residents living at the home. Training is provided in house and is performed according to the changing needs of the residents and to ensure that staff are competent and confident in providing the necessary care and understand resident needs. The home have an established staff team and low staff turn over. During this visit the files of the two most recently recruited carers were sampled. Both files were seen to contain proof of identity and a completed application form. A recent photograph, references and there was evidence that an enhanced Criminal Record Bureau (CRB) and Protection of Vulnerable Adult (POVA) list checks had been obtained. The manager was aware of new regulations that came into force in July 2004.The home need to review their policies and procedures on a regular basis relating to staff recruitment. Staff induction is in line with the new, mandatory Skills for Care common induction standards and the inspector was advised that staff are supervised until they have completed their induction. In the AQAA, to demonstrate what the home does well, the manager stated that: Staffing levels are good to ensure the good levels of service provided, however we are currently reviewing staffing levels to coincide with the changing needs of residents. The Proprietor and Manager support all staff including night staff by being available on call for any emergencies. All interactions observed between the management, staff and residents evidenced that the home has a close and caring staff team. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from the clear management approach at the home providing an open, positive and inclusive atmosphere. The home has an effective quality assurance and monitoring system in place that is based on seeking the views of the residents. Policies and procedures are in place to protect residents financial interests. All policies, procedures and practices are in place to ensure, so far as is reasonably practicable, the health safety and welfare of residents and staff. Evidence: The manager has completed her Registered Managers Award (RMA) training. Her management style is inclusive and the residents benefit from the ethos, leadership and clear management approach of the home. The home has an effective quality assurance and monitoring system in place that is based on seeking the views of the residents and their relatives. The inspector was Care Homes for Older People Page 24 of 28 Evidence: advised that the home carry out yearly resident and relative surveys, correlate the responses and then formulate an action plan to address any issues that are raised. The recent quality assurance report from July 2008 was seen at this inspection and showed the improvements the home have made, based on the findings of their survey. Policies and procedures are in place to protect residents financial interests. The manager stated that the home does not handle the financial affairs for residents. At the last inspection a requirement was made that Regulation 26 visits be undertaken, door guards to be fitted to bedroom doors of residents who prefer their bedroom door open, suitable records to be maintained in respect of the testing of portable appliances. The three requirements have been met. The inspector advised the manager to contact the fire officer for advice regarding residents bedroom doors, and the homes fire risk assessment needs to be reviewed to ensure it is suitable for the home. Health and safety monitoring check sheets were sampled and found to be well maintained and up to date. All staff have received required safe working practice training and updates. Staff were observed to be following appropriate health and safety practices as they went about their work. There was some discussion regarding the testing for Legionella, the inspector advised the manager to seek professional advice to ensure the procedure currently being used is appropriate and safe for the residents and staff. In the AQAA, to demonstrate what the home does well, the manager stated that: Staff follow infection control procedures and are monitored. Some staff have commenced infection control training. Any urgent safety matters are dealt with promptly by the manager or proprietor. One resident commented It is a very happy place and the staff are wonderful and kind, and everywhere is so clean. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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