Care Home: Firbank

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What the care home does well The service has comprehensive admission procedures that should ensure that only people whose needs can be met at the home are admitted. People have a plan of care that related to the persons assessment. The care plans are person centred and written in plain language providing information as to how needs should be met. Risk assessments in care plans viewed appeared appropriate to the persons needs. Observations of staff interactions indicated that people are treated with respect and their right to dignity maintained. People confirmed that staff listen and act on what they say. The routines for daily living and activities made available are flexible and varied to suit people`s individual needs. Family and friends are able to visit. People receive a balanced diet with choice available at all meals and special diets are catered for. People and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. People are protected from abuse. The home employs appropriate numbers of care staff that ensure that the needs of people living at the home are met. Staff have received training. Good recruitment procedures are in place. The home is well managed in the best interests of the people who live there. What has improved since the last inspection? There were two requirements made following the previous inspection of the home undertaken in July 2006. These had both been met. Liquid soap and disposable hand towels are available in all areas of communal hand washing in order to minimise the risk of cross infection. When telephone references are taken a form is now completed to record information obtained. Two requirements were also made and have been complied with, these being that the home`s induction procedure for new staff now incorporates the common induction standards and the home has produced a training matrix providing the manager with an `at a glance` record of staff training achievements and needs. CARE HOMES FOR OLDER PEOPLE Firbank 8 Crescent Road Shanklin Isle Of Wight PO37 6DH Lead Inspector Janet Ktomi Unannounced Inspection 6th June 2008 09:30 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 Firbank DS0000012491.V365326.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. Firbank DS0000012491.V365326.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Firbank Address 8 Crescent Road Shanklin Isle Of Wight PO37 6DH 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) 01983 862522 01983 863490 firbank@btconnect.com Georgia Rose Residential Care Limited T/A Firbank Angela Joy Hodgson Care Home 26 Category(ies) of Dementia - over 65 years of age (2), Learning registration, with number disability over 65 years of age (2), Old age, not of places falling within any other category (26), Physical disability over 65 years of age (7) Firbank DS0000012491.V365326.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th July 2006 Brief Description of the Service: Firbank is a registered residential home providing care and accommodation for up to 26 people over the age of sixty-five years with a range of physical, social and emotional needs. The home is situated in a quiet tree-lined avenue in Shanklin close to local amenities, shops and public transport. Accommodation is provided on three separate floors all of which may be accessed by a passenger lift. There is level access into the front of the home and a portable ramp to help negotiate the door threshold. The home has installed hand and grab rails at various points around the building to assist people with mobility difficulties. Externally there is a patio area and extensive sea views from some bedrooms and the communal lounges. Parking spaces can usually be found in the Crescent or adjoining roads. The home also provides day care and respite care is available when a bedroom is vacant. The home is owned by Georgia Rose Residential Care Limited and managed by Mrs Angela Hodgson. Weekly fees are in line with local social services rates. Firbank DS0000012491.V365326.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This report contains information gained prior to and during an unannounced visit to the home undertaken on the 6th June 2008. All core standards and a number of additional standards were assessed. The visit to the home was undertaken by one inspector and lasted approximately six and a half hours commencing at 9.30 am and being completed at 4.00 p.m. The inspector was able to spend time with the registered manager and staff on duty. The inspector was provided with free access to all areas of the home, documentation requested, visitors and people who live at the home. Prior to the inspection visit the registered manager had completed the homes Annual Quality Assurance Questionnaire (AQAA), this was received at the Commission within the required timescales and information from it is included in this report. Information was also gained from the home’s service file containing notifications of incidents in the home. Surveys were sent to the home for distribution prior to the inspection visit, at the time of writing the report eight responses from people who live at the home and six survey response from staff members had been received. Following the inspection visit the inspector telephoned a local health professional who regularly visits the home. What the service does well: The service has comprehensive admission procedures that should ensure that only people whose needs can be met at the home are admitted. People have a plan of care that related to the persons assessment. The care plans are person centred and written in plain language providing information as to how needs should be met. Risk assessments in care plans viewed appeared appropriate to the persons needs. Observations of staff interactions indicated that people are treated with respect and their right to dignity maintained. People confirmed that staff listen and act on what they say. Firbank DS0000012491.V365326.R01.S.doc Version 5.2 Page 6 The routines for daily living and activities made available are flexible and varied to suit people’s individual needs. Family and friends are able to visit. People receive a balanced diet with choice available at all meals and special diets are catered for. People and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. People are protected from abuse. The home employs appropriate numbers of care staff that ensure that the needs of people living at the home are met. Staff have received training. Good recruitment procedures are in place. The home is well managed in the best interests of the people who live there. What has improved since the last inspection? What they could do better: Following this inspection two requirements are made. These being that the registered manager must ensure that fridge temperatures are recorded on a regular basis to ensure the viability of the medication stored therein, and that medication dispensed and then not required or refused must not be returned to storage but should be placed with other medication for return to the pharmacist for destruction. The home must ensure that when an assessed need is identified in a care plan that the necessary action is taken to meet the identified need such as the regular weighing of people. Firbank DS0000012491.V365326.R01.S.doc Version 5.2 Page 7 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. Firbank DS0000012491.V365326.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 Firbank DS0000012491.V365326.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, 4 and 5 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The statement of purpose, service users guide and terms and conditions of residency (contract) are provided to all people who live at the home. All people are assessed prior to moving into the home to determine that their individual needs can be fully met. People, or their representatives, are able to visit the home prior to admission to assess the quality, facilities and suitability of the home. Standard 6 is not applicable, as the home does not provide intermediate care. EVIDENCE: The inspector observed copies of service users guides in people’s bedrooms and also in vacant rooms. These contained all the necessary information in a suitable format for the person. People who live at the home confirmed that Firbank DS0000012491.V365326.R01.S.doc Version 5.2 Page 10 they had been provided with information about the home both verbally to the inspector and in surveys completed. The registered manager explained the homes admission procedure and the pre-admission assessment for two people admitted shortly before the inspection visit was viewed. The inspector discussed admissions with care staff and with one of the people whose admission information was viewed. If an initial enquiry from either social services or from a person or their family indicates that the home would be able to meet the persons needs the manager (and where possible the deputy) will arrange to visit the person, either at their home or in hospital. A comprehensive pre-admission assessment is completed including where possible members of the persons family and professionals involved in their care. Care manager assessments were also seen in care plans viewed. The person is provided with information about the home and where practicable is invited to visit the home before making the decision as to whether to move in on an initial trial basis. When the person is unable to visit the home a relative is invited to view the available room and facilities at the home. The manager stated that sometimes people have day care prior to commencing residential care. The home has an assessment tool that covers all the relevant areas necessary for the home to decide if it is able to meet a prospective persons needs. The manager was clear about the level of care needs the home can accommodate. The same procedures are used for respite as well as longer term care. The registered manager stated that she will also visit and if necessary reassess people who have been admitted to hospital before they are discharged back to the home to ensure that their needs can continue to be met. Discussions with care staff confirmed that they felt they had enough information about new people admitted to the home. Staff surveys received also confirmed that they had enough information about new people and that they had the training to meet peoples needs. People living at Firbank tend to be long term, however the home could provide respite or short stay accommodation if a suitable room were available. The home also provides a day service. There was no evidence that this arrangement had any negative impact on people who live long term at the home. The home does not provide dedicated accommodation for, intermediate care or specialised facilities for rehabilitation. Firbank DS0000012491.V365326.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 and 10. People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People’s health, personal and social care needs are set out in an individual plan of care that clearly states how peoples needs should be met. The home must ensure that needs identified and actions required to meet these needs are carried out. Medication is generally correctly stored and administered with full records maintained however the home must ensure that the temperature of the homes medication fridge is regularly recorded and that medication dispensed and then not required or refused is not returned to storage for administration at a later date. People are treated with respect and their dignity maintained. Firbank DS0000012491.V365326.R01.S.doc Version 5.2 Page 12 EVIDENCE: Three care plans were viewed two for people admitted to the home in the six months prior to the inspection visit and the other for a person who had been living at the home for a longer time. The inspector discussed with staff, a visitor and people who live at the home how care needs are met. The inspector telephoned a health professional who regularly visits the home. Information from surveys completed by staff and people who live at the home is also considered. Care plans contained all the necessary information for staff to ensure that all aspects of health, personal and social care needs could be individually met. People have a detailed plan of care that related to the persons assessment. The care plans follow an activities of daily living format and although preformatted are individualised and person centred being written in plain language providing detailed information as to how needs should be met. Plans are reviewed on a monthly basis. Photographs were seen in care plans. Care plans contained relevant risk assessments and management plans including nutrition, falls and any individual risks such as resulting from age related memory loss. Risk assessments viewed appeared appropriate to the persons needs. It was noted in one care plan that there was a need to monitor a persons weight. In the section of the care plan where visits and action from health professionals is recorded the persons GP had also requested that weight be monitored. The person had been weighed on admission and a weight chart was in the care plan. However since admission in January 2008 there was no indication or record that the person had been weighed again. The persons care plan had been reviewed on a monthly basis by the key worker including the section relating to concerns about weight. This was discussed with the registered manager who stated she would follow this up with the key worker and ensure that the persons weight was checked. Whilst viewing the home suitable sit on scales were seen to weigh people who may be unable to stand on traditional weighing scales. The failure to monitor the persons weight has placed her at risk. Care staff spoken with said that communication about residents needs was good, with regular shift handovers, staff meetings and supervision. Where there are concerns that people may not be eating or drinking sufficiently records of food and fluid intake were seen. The inspector was able to talk with some of the people who live at the home who stated that they always received the care and support (including medical care) they need. This was also the opinion of the people who completed surveys. A relative met during the visit to the service confirmed that they felt that the needs of their relative living at the home were met. A health professional who regularly visits the home was telephoned following the Firbank DS0000012491.V365326.R01.S.doc Version 5.2 Page 13 inspection visit. They stated that they had no concerns about the home and felt that staff had knowledge about the people who live there and that peoples health needs were met. During the inspection visit a GP visited who had been requested by care staff as they had identified that a person was unwell. The GP arranged for a prescription. Care plans contained individual manual handling assessments. Manual handling equipment was viewed in the home and care staff stated that they had received manual handling training and this was recorded on the homes training matrix. A member of staff has completed a manual handling train the trainer course. A visitor and people who live at the home stated that they felt that staff always treated them with dignity and respect. Observations of staff interactions indicated that people are treated with respect and their right to dignity maintained. All people confirmed that staff listen and act on what they say. All bedrooms are for single occupancy ensuring privacy during personal care. Care staff confirmed that they had sufficient time to meet people’s needs and discussions indicated that they had a good understanding of individual peoples needs and how these should be met. Care staff have received training to meet the specific needs of people. At the time of the inspection visit nobody was self administering his or her medication. The manager stated during the inspection and on the homes AQAA that staff have undertaken training with regard to the safe administration of medication. Care staff confirmed that they have undertaken medication training. Medication is stored in a locked medications trolley, which is secured to the wall in the treatment room when not in use. With the exception of liquids the local pharmacist dispenses most medication into blister packs. The home uses medication administration record sheets supplied by the pharmacist. These were viewed and seen to be fully completed. The home has the necessary storage and recording books for controlled medications. The home has a fridge within the treatment room for the storage of medication that must be kept at cooler temperatures. This was seen to contain a range of medications that must be stored at between 2 and 8 degrees Celsius in order to be effective. The inspector viewed the book in which the fridge temperatures is recorded. These had not been recorded for one month prior to the inspection visit. The inspector was informed that the thermometer had been lost, however no action had been taken to report this to the registered manager or replace the thermometer. The thermometer was located during the inspection. The registered manager must ensure that fridge temperatures are recorded on a regular basis to ensure the viability of the medication stored therein. Whilst viewing the storage arrangements for medications the inspector noted two tablets in a pot in the locked cupboard. The inspector was informed that Firbank DS0000012491.V365326.R01.S.doc Version 5.2 Page 14 these were pain relief tablets that had not been required by the person and had been left in case they were requested later. Medication dispensed and then not required or refused must not be returned to storage but should be placed with other medication for return to the pharmacist. Firbank DS0000012491.V365326.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The routines for daily living and activities made available are flexible and varied to suit people’s individual needs. Family and friends are able to visit. People receive a balanced diet in pleasing surroundings at times convenient to them. EVIDENCE: The inspector spent time talking with people in the homes lounge, met people who had chosen to remain in their bedrooms, observed part of the lunchtime meal and met with a relative. The routines for daily living and activities made available are flexible and varied to suit people’s individual needs. People living at the home confirmed to the inspector that they are able to choose where in the home they spend their day, many were seen to spend time in the homes lounge’s with others remaining in their bedrooms. Firbank DS0000012491.V365326.R01.S.doc Version 5.2 Page 16 Care plans contained individual information such as times people like to get up. Many of the people living at Firbank have age related memory loss and care plans contained life history information and recorded peoples likes and dislikes. People confirmed to the inspector that they are given choice over their meals. Bedrooms seen contained personal items brought into the home. Care plans and assessments include information about leisure activities, hobbies/interests, catering and religious needs. People stated that they are able to get up and go to bed at times of their choosing. The home has a visiting singer on alternative weeks and a monthly visit from a slide show and another from an external reminisces worker. Care staff stated that they have time to take people out and as the inspector was arriving at the home she observed a person being taken for a walk by a member of care staff. Care staff and people living at the home confirmed that staff also organise activities such as bowels, large board games and discussions/residents meetings. The home also organises outings with a trip to a garden centre with afternoon tea included planned for the week following the inspection visit. People living at the home also commented on a lunch outing they had recently enjoyed. Records of activities undertaken are kept by the home. Information about religious needs is included in care plans and the manager stated that she has contact details and would arrange visits from appropriate ministers/clergy if this were requested/identified as a need. The inspector was able to meet one visitor who stated that she was able to visit at any time. The home does not have a private room for visitors however the home does have two lounges one of which is often used only by one person and could offer a degree of privacy for visitors. The home has a separate dining room. Many people were seen to have chosen to have their lunchtime meal at the dining tables however others stated that they preferred to have their meals in their bedrooms and this was accommodated. People stated that the food is always/usually good and choice provided. The inspector was present for the main lunchtime meal. People stated it tasted good. Drinks and snacks are also available throughout the day with people confirming this as well as the inspector observing people being given morning and afternoon hot drinks and biscuits. The need for special diets or supplements is recorded pre-admission. The pre-admission form included information about people’s food likes and dislikes. One of the care plans viewed stated that the person is a vegetarian and discussions with the person indicated that she is provided with vegetarian food. The cook was aware of the dietary needs of people. Care staff stated that most people are able to eat independently and there is sufficient time to provide any support required. Firbank DS0000012491.V365326.R01.S.doc Version 5.2 Page 17 Firbank DS0000012491.V365326.R01.S.doc Version 5.2 Page 18 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. People are protected from abuse. EVIDENCE: The home has a clear complaints policy and procedure and a copy is in the statement of purpose/service users guide, available in the hallway and provided to all prospective people and their relatives in the service users guide. Discussions with staff confirmed they were aware of what to do if a person complained or raised an issue. The manager identified in the homes AQAA that the home had received no complaints in the past year. The minutes of residents meetings indicated that people felt able to raise issues and within care plans specific requests had been recorded. An example being the presence of a particular washing powder in the laundry identified as the make preferred by one person and that this should be used for their laundry. The home has a policy and procedure relating to safeguarding adults and ensuring that people are not at risk of abuse. Care staff have had safeguarding adults training as part of their induction and as specific update training as seen in the homes training matrix and confirmed by staff. Discussions with care staff indicated they had an understanding of safeguarding and what they should do if they suspected abuse may have occurred. People stated they felt safe at the Firbank DS0000012491.V365326.R01.S.doc Version 5.2 Page 19 home. Since the previous inspection a safeguarding investigation has been undertaken by the local social services department with which the home fully cooperated. The homes policies and procedures in respect of people’s personal finances and recruitment should ensure that people should not be financially abused. Firbank DS0000012491.V365326.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People live in a clean, safe, well-maintained home that meets their individual and collective needs. EVIDENCE: The inspector viewed the home with the registered manager towards the start of the inspection visit and viewed records related to services such as gas and electric and fire safety equipment. Firbank many years ago was a hotel. It was converted to a care home providing accommodation on three floors, accessible via a passenger lift. One bedroom with ensuite facilities is located on a mezzanine level and must be accessed via a short flight of stairs. Both lounges and a number of bedrooms have outstanding views across the bays of Sandown and Shanklin. All rooms Firbank DS0000012491.V365326.R01.S.doc Version 5.2 Page 21 are reasonably decorated; some are quite large and well personalised. All bedrooms are for single occupancy and have either en-suite facilities or a wash hand basin in the room. There is limited off road parking to the front of the home with additional parking available in the road outside the home. The ground floor lounge opens onto a rear patio areas and another popular outdoor seating area can be found at the front of the home. The registered manager stated that some new lounge chairs have been provided. The home was clean and tidy throughout and, with the exception of one vacant room awaiting a new carpet to be fitted, there were no unpleasant odours. At the time of the visit the home was comfortably warm throughout. The visitor and people who live at the home confirmed that the home is always warm and clean. The home employ’s a cleaner five days a week with care staff undertaking essential cleaning tasks at the weekend. The home has the necessary moving and handling equipment and the baths are fitted with hoists. The registered manager stated that a number of bedroom windows have been replaced, bathrooms have been upgraded or refurbished, upgraded both lounges with new chairs and flat screen television provided, new carpets and furniture to some bedrooms and improvements made to fire exits and signs around the home. Some new laundry equipment has also been provided. The homes laundry was visited and is appropriate and fit for purpose with machines capable of washing to disinfection standards. Members of staff spoken with confirmed they had received infection control training and had access to all the necessary equipment to prevent any risk of cross infection such as disposable gloves and aprons, supplies of which were seen during the visit to the home. Substances hazardous to health (COSHH) were stored securely. Certificates seen confirmed that the homes services such as gas and electric have been checked and serviced as appropriate. Portable electric appliances are regularly checked. The registered manager has instigated a walk around check of the home with the maintenance person to pick up issues requiring attention. The records of these were seen with timescales and completion dates. During the previous inspection visit it was noted that there was a lack of liquid soap and paper towels in WC’s and bathrooms causing a potential problem with cross infection. Bathrooms and WC’s were seen to contain the necessary liquid soap and hand towels on this occasion therefore this requirement has been met. Firbank DS0000012491.V365326.R01.S.doc Version 5.2 Page 22 Firbank DS0000012491.V365326.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home employs appropriate numbers of care staff that ensure that the needs of people living at the home are met. Staff receive the necessary training and above fifty percent have a recognised qualification in care. EVIDENCE: All comments from people who live at the home, visitors and professionals were positive about care staff. Duty rotas were seen during the visit to the home. Duty rotas stated that three care staff are provided throughout the day and two care during the evening and at night with the registered manager and deputy manager also being present and supernumerary. The home also employs a cook, housekeeper, administration and maintenance staff. During the inspectors visit staff on duty corresponded to those on the duty rota. Care staff stated that they generally have sufficient time to meet people’s needs and throughout the inspection care staff appeared to have time to meet people’s needs. Surveys from people who live at the home stated that staff are available when they need them and raised no concerns about staff. Firbank DS0000012491.V365326.R01.S.doc Version 5.2 Page 24 The manager provided training and qualification information during the inspection and on the AQAA. The home employs seventeen care staff of whom eleven have at least and NVQ with three additional staff undertaking an NVQ. Following the previous inspection a recommendation was made that the home produce an ‘at a glance’ matrix of training undertaken and planned for care staff. A training matrix was seen on the homes office wall stating what qualifications and training staff had and that required. A member of staff is a manual handling trainer. As well as mandatory training care staff have undertaken relevant training specific to the needs of people who live at the home such as dementia and diabetes. Care staff stated that they felt they had the necessary skills to meet people’s needs and were not expected to undertake activities for which they had not been trained. Responses in surveys from staff all confirmed that they received training to met the needs of the people who live at the home. Following the previous inspection a requirement was made that the home maintain a record of telephone references taken. The recruitment records for the two people recruited shortly before the inspection visit were viewed. These contained all the required information and confirmed that all staff are fully checked including references, CRB and POVA checks prior to commencing employment at the home. The registered manager showed the inspector the form she has produced for when telephone references are taken. The manager explained the homes induction procedure that that conforms to the common induction standard, copies of essential policies and procedures and a copy of the General Social Care Code of Conduct. A new member of care staff confirmed that the above recruitment procedures and induction had occurred. Firbank DS0000012491.V365326.R01.S.doc Version 5.2 Page 25 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, 37 and 38 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The provider/registered manager has the necessary skills and experience to ensure that the home is appropriately managed and run in the best interests of the people who live there. People’s financial interests are safeguarded. Records are well maintained. The health, safety and welfare of people and staff are promoted. EVIDENCE: Since the previous inspection a new manager has been registered for the home. The current registered manager was previously the deputy manager at Firbank and was registered as the manager in September 2006. She has the Firbank DS0000012491.V365326.R01.S.doc Version 5.2 Page 26 necessary skills and qualifications having the NVQ level 4 in care and the Registered Managers Award. Throughout the inspection visit the manager demonstrate knowledge of the people who live at the home and the mechanisms by which support can be obtained when necessary. Care staff, people who live at the home and visitors were clear that they felt able to discuss any issues/concerns with the manager. The manager confirmed that she has access to the necessary budgets and is able to make decisions about spending in the home. Following the previous inspection two requirements and two recommendations were made. These have all been met. A representative of the provider undertakes visit to the home providing monthly reports for the manager. These were seen during the inspectors visit. Copies of service user and staff meeting minutes were also seen. Since the previous inspection the manager has commenced some formal quality assurance work with monthly audits seen. The home has attained the investors in people award. The home undertakes comprehensive quality assurance work including questionnaires to people who live at the home, relatives and external professionals. These were seen during the inspection visit. The manager explained that where responses identify issues she aims to clarify these and takes action to address the issues. Evidence of this was seen. The homes registered manager completed the AQAA that was received on time and contained the necessary information asked for The home does not become the appointee for people who live at the home and will hold small amounts of money for some people (this is used for small personal expenses such as hairdressing and newspapers). The systems in place and records seen re people’s personal money are robust and well maintained. Various records were viewed during the inspectors visit. All records were appropriately stored with access only available to people who should have access. During the inspectors visit there were no concerns in respect of health and safety identified. The home is generally well maintained and clean, with staff having relevant training to meet people’s needs. The home undertakes weekly checks of the fire detection equipment, however it was noted that these are done by the maintenance person on a Monday and the weekly test had not been completed on bank holiday Mondays in May and April 2008. the manager stated that in order to prevent this occurring in future the day of the fire detection equipment check would be changed to another day of the week. A requirement is therefore not made as the manager has taken the necessary action immediately. Portable Electrical Appliance Tests (PAT), electrical wiring Firbank DS0000012491.V365326.R01.S.doc Version 5.2 Page 27 and gas certificates were seen. The local environmental health department has awarded the home four stars (maximum being five stars) for food hygiene. Firbank DS0000012491.V365326.R01.S.doc Version 5.2 Page 28 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 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 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 3 X 3 X 3 X 3 3 Firbank DS0000012491.V365326.R01.S.doc Version 5.2 Page 29 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 OP8 Regulation 12 (1) Requirement Action must be taken to ensure that assessed and changing needs of people living at the home to protect their health and wellbeing. The registered manager must ensure that medication is suitably stored and disposed of when not required. Timescale for action 10/08/08 2. OP9 13 (2) 10/08/08 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 Firbank DS0000012491.V365326.R01.S.doc Version 5.2 Page 30 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 Firbank DS0000012491.V365326.R01.S.doc Version 5.2 Page 31 - 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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