Care Home: Four Winds Residential Home

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What the care home does well The service achieves good outcomes in all but one of the 7 standard areas covered by the National Minimum Standards. The area where it falls short of `good` and is only `adequate` is: `choice of Home`. This is due to further work being required to the written information it is legally obliged to supply to service users and prospective service users. Service users enjoyed living at Four Winds and typical comments received included: "I felt I had all the information I needed to decide to come here." "My family dealt with most of the paperwork and I trusted their judgement." "I am very happy here, with very good care workers; if I`m ill, the doctor or nurse will come straight away, within hours." "It`s excellent here; we are a happy crowd and all the staff are very helpful; they try to know your likes and your dislikes and treat you accordingly." "The staff are very supportive and allow me to spend time in my room and have my meals in my room as well; I do go into the lounge at times and last night there was a party with a singer which was very good; I enjoy reading and word puzzles." "The staff here are all friends; I enjoy reading and I get a daily paper plus 4 books per fortnight from the Library; I`m very comfortable in my room and staff respond straight away if I need assistance with anything. Last night there was a good party and a singer and we all joined in!" "I go out regularly with my sister and I often visit Church, which I enjoy." "The staff here are all very friendly and helpful.""Staff listen to me if I have a problem and always try to help." "I like it here and I am very pleased with my bedroom." "There is a very nice atmosphere and I am very comfortable here." What has improved since the last inspection? A number of fire safety improvements have been made. Management are carrying out quality assurance surveys and a suggestions box has been installed, to encourage feedback from service users and their representatives about the quality of the service. The frequency of staff supervision sessions has increased and refresher training in key areas of care practice, such as moving and handling, has been carried out. A large, flat screen television has been provided in the lounge and residents said they enjoyed watching it. An activities coordinator has been appointed and she organises a wide range of social and recreational activities that are much appreciated within the home. What the care home could do better: The home`s service user`s guide needs to be a separate document to the statement of purpose. It must include all of the items specified in regulation 5 and be made available to all service users and prospective service users. The previous timescale for action of 28/02/07 was not achieved. In the home`s terms and conditions of residence/contract, the information about fees needs to be elaborated further, explaining that fees are paid in arrears, only for service received. The previous timescale for action of 28/02/07 was not achieved. Sitting Scales should be considered by the Provider as a worthwhile addition, because of the comparatively large number of residents who have difficulty standing and whose weight needs to be monitored. Life-story work with residents is desirable, helping to promote a deeper understanding of individual service users and their personal fulfilment. The first floor bathroom would benefit from being upgraded to permit assisted bathing and/or provision of a level entry shower should be considered to provide service users choice and convenience. Wall-mounted paper towel dispensers should be provided in all communal toilets and bathrooms, in line with best practice in infection control. It is desirable for suitable locks to be fitted to bedroom doors as a quality feature, helping to promote privacy, dignity and choice.The home should consider installing curtains or blinds in the en suite toilets in the interest of promoting privacy and dignity, plus homeliness. The Registered Manager should achieve National Vocational Qualifications (NVQ) at level 4 in management and care within a reasonable time (for example, by mid 2008 for Care and by mid 2009 for Management). The findings of quality assurance consultations should be published and shared with service users and others within the home (for example, by way of a newsletter). Management should consider issuing monthly health and safety bulletins to staff (for example, via the staff notice board) to ensure that health and safety issues are regularly identified and discussed within the staff group, reinforcing existing measures that the home has in place. CARE HOMES FOR OLDER PEOPLE Four Winds Residential Home Elwick Road Hartlepool TS26 0DD Lead Inspector Mr Stephen Ellis Unannounced Inspection 20th December 2007 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 Four Winds Residential Home DS0000045233.V354526.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. Four Winds Residential Home DS0000045233.V354526.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Four Winds Residential Home Address Elwick Road Hartlepool TS26 0DD 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) 01429 869019 01429 233715 Mr Matt Matharu Sally Anne Sharples Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places Four Winds Residential Home DS0000045233.V354526.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named individual who is in the category (MD) mental disorder is allowed to reside in the home. 17th November 2006 Date of last inspection Brief Description of the Service: Four Winds is a care home for older people who require personal care. The home is situated in its own grounds in a residential area close to Ward Jackson park in Hartlepool. The home is a large converted house, which has been extended to give 18 single bedrooms (10 with en suite toilet and wash hand basin) and two double bedrooms for those who choose to share (both with en suite facilities). A passenger lift connects both floors. The home provides lounge and dining facilities for residents’ use. Car parking is available at the front of the building. There is a patio area and landscaped garden to the rear. The weekly charge is £354, although the amount service users pay depends on their personal circumstances. They may also be required to pay a contribution towards the costs associated with voluntary activities. For example, hairdressing is available, with costs varying between £2.50 and £15, and chiropody at £10. Four Winds Residential Home DS0000045233.V354526.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced fieldwork visit to Four Winds Care Home took place over 5.5 hours as part of the statutory inspection of the service. Information received prior to the fieldwork visit was used in preparation and during the visit. The visit to the home included a tour of the building, a meal with service users, examination of some of the records that the home is required to keep, and interviews with service users and staff. Comments were received during the visit and from surveys carried out before the visit. In total, there were comments received from 10 service users and 6 staff. The overall quality rating for this service following the fieldwork visit is judged to be ‘good’. What the service does well: The service achieves good outcomes in all but one of the 7 standard areas covered by the National Minimum Standards. The area where it falls short of ‘good’ and is only ‘adequate’ is: ‘choice of Home’. This is due to further work being required to the written information it is legally obliged to supply to service users and prospective service users. Service users enjoyed living at Four Winds and typical comments received included: “I felt I had all the information I needed to decide to come here.” “My family dealt with most of the paperwork and I trusted their judgement.” “I am very happy here, with very good care workers; if I’m ill, the doctor or nurse will come straight away, within hours.” “It’s excellent here; we are a happy crowd and all the staff are very helpful; they try to know your likes and your dislikes and treat you accordingly.” “The staff are very supportive and allow me to spend time in my room and have my meals in my room as well; I do go into the lounge at times and last night there was a party with a singer which was very good; I enjoy reading and word puzzles.” “The staff here are all friends; I enjoy reading and I get a daily paper plus 4 books per fortnight from the Library; I’m very comfortable in my room and staff respond straight away if I need assistance with anything. Last night there was a good party and a singer and we all joined in!” “I go out regularly with my sister and I often visit Church, which I enjoy.” “The staff here are all very friendly and helpful.” Four Winds Residential Home DS0000045233.V354526.R01.S.doc Version 5.2 Page 6 “Staff listen to me if I have a problem and always try to help.” “I like it here and I am very pleased with my bedroom.” “There is a very nice atmosphere and I am very comfortable here.” What has improved since the last inspection? What they could do better: The home’s service user’s guide needs to be a separate document to the statement of purpose. It must include all of the items specified in regulation 5 and be made available to all service users and prospective service users. The previous timescale for action of 28/02/07 was not achieved. In the home’s terms and conditions of residence/contract, the information about fees needs to be elaborated further, explaining that fees are paid in arrears, only for service received. The previous timescale for action of 28/02/07 was not achieved. Sitting Scales should be considered by the Provider as a worthwhile addition, because of the comparatively large number of residents who have difficulty standing and whose weight needs to be monitored. Life-story work with residents is desirable, helping to promote a deeper understanding of individual service users and their personal fulfilment. The first floor bathroom would benefit from being upgraded to permit assisted bathing and/or provision of a level entry shower should be considered to provide service users choice and convenience. Wall-mounted paper towel dispensers should be provided in all communal toilets and bathrooms, in line with best practice in infection control. It is desirable for suitable locks to be fitted to bedroom doors as a quality feature, helping to promote privacy, dignity and choice. Four Winds Residential Home DS0000045233.V354526.R01.S.doc Version 5.2 Page 7 The home should consider installing curtains or blinds in the en suite toilets in the interest of promoting privacy and dignity, plus homeliness. The Registered Manager should achieve National Vocational Qualifications (NVQ) at level 4 in management and care within a reasonable time (for example, by mid 2008 for Care and by mid 2009 for Management). The findings of quality assurance consultations should be published and shared with service users and others within the home (for example, by way of a newsletter). Management should consider issuing monthly health and safety bulletins to staff (for example, via the staff notice board) to ensure that health and safety issues are regularly identified and discussed within the staff group, reinforcing existing measures that the home has in place. 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. Four Winds Residential Home DS0000045233.V354526.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 Four Winds Residential Home DS0000045233.V354526.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, 2, and 3. People who use the service experience adequate quality outcomes in this area. Prospective residents and their representatives have most of the information needed to choose a home that will meet their needs. They have their needs assessed and a contract which tells them much about the service they will receive. Intermediate care is not provided. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Comments received from residents and staff confirmed that full assessments of needs were carried out prior to admission to the home. Also, the initial period of residence following admission was regarded as a trial period, so that new residents could take time to consider whether they wanted to continue living at the home, or make other arrangements. Family, friends, Social Workers from the Local Authority and/or healthcare professionals from the Primary Care Trust would normally support prospective residents in these deliberations. Most residents felt there was enough information from which to make a choice about being admitted. Four Winds Residential Home DS0000045233.V354526.R01.S.doc Version 5.2 Page 10 Typical comments included: “I felt I had all the information I needed to decide to come here.” “My family dealt with most of the paperwork and I trusted their judgement.” A statement of purpose and statements of terms and conditions of residence are supplied routinely. These are helpful documents and the content is generally good, but some further detail is required. For example, in the home’s terms and conditions of residence/contract, the information about fees needs to be elaborated further, explaining that fees are paid in arrears (that is only for accommodation and personal care actually received). A separate service user’s guide needs to be provided, including all of the items referred to in regulation 5 of the Care Homes Regulations 2001. The home is reviewing these documents. Service user plans of care revealed comprehensive, detailed assessments of need being carried out prior to admission, with regular evaluations and reviews of care needs and care plans at appropriate intervals following admission. These assessments showed that the home only admitted people whose assessed needs it could meet. Intermediate care (for the purpose of intensive rehabilitation back to the service user’s own home) is not provided, although respite care for short breaks is available. Four Winds Residential Home DS0000045233.V354526.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 quality outcomes in this area. The health and personal care, which a resident receives, is based on their individual needs. The principles of respect, dignity and privacy are put into practice. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Residents said that their health and social care needs were well known by staff and were being fully met. Health and social care assessments are being carried out, with input from local doctors, community nurses and social workers. Residents said that the community nurse or doctor would see them whenever required and they were very satisfied with the quality of service they received. Residents’ personal, social and health care needs were well known, understood and respected by the staff team. Residents said that they felt they were treated with respect and sensitivity. Typical comments received from residents included: “I am very happy here, with very good care workers; if I’m ill, the doctor or nurse will come straight away, within hours.” “It’s excellent here; we are a happy crowd and all the staff are very helpful; they try to know your likes and your dislikes and treat you accordingly.” Four Winds Residential Home DS0000045233.V354526.R01.S.doc Version 5.2 Page 12 Service users’ plans of care and associated risk assessments were detailed and comprehensive about service users’ health and social care needs, providing clear guidance to staff. Plans of care were subject to regular review and evaluation, involving service users, relatives and social workers where appropriate. In October 2007, there were two instances where the standard of care fell short of the usual quality expected. The home has taken significant steps to address the issues identified following the investigation of these events, including a programme of staff training and extra support for the management of the service. However, this deviation from normal practice should be seen in the context of the home’s general good standard. Hartlepool Borough Council will continue to monitor progress until it is satisfied that the required standard is being sustained. Sitting Scales should be considered by the Provider as a worthwhile addition, because of the comparatively large number of residents who have difficulty standing and whose weight needs to be monitored. Staff training, such as National Vocational Qualifications (NVQ) in health and social care at level 2 or above, has included the important issues of privacy and dignity and over 78 of permanent care staff have achieved these important qualifications. There are good arrangements for the safe administration of medicines. All care staff members responsible for the administration of medicine have completed Safe Handling of Medicines courses. There is good support from a local Pharmacist who supplies medication in bottles and other containers (not a Monitored Dosage System). There are good storage systems and care staff check all medication when it is received into the home. Medication is kept securely in lockable cabinets and trolley. Residents may attend to their own medication but in practice most prefer to delegate this responsibility to staff. Unwanted medicines are returned promptly to the Pharmacist and the home is careful not to stockpile large quantities. Members of senior care staff carry out medicine audits routinely. It is commendable that a photograph of the service user is kept next to their Medicine Administration Record, along with their name, date of birth and room number, to aid identification. Four Winds Residential Home DS0000045233.V354526.R01.S.doc Version 5.2 Page 13 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 quality outcomes in this area. Residents are able to choose their lifestyle, social activity and keep in contact with family and friends. Social, cultural and recreational activities meet residents’ expectations. Residents receive a healthy, varied diet according to their assessed requirement and choice. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: All residents spoken with said they enjoyed living at Four Winds and described the staff as being caring and helpful, and the atmosphere in the home as being friendly and supportive. They were free to use any lounge, dining area, or their own bedroom just as they wished. All were satisfied with the arrangements for daily life in the home and were able to exercise choice, such as what meals to have (staff ask each day), when to get up and go to bed and what to do. Typical comments from residents and relatives included: “The staff are very supportive and allow me to spend time in my room and have my meals in my room as well; I do go into the lounge at times and last night there was a party with a singer which was very good; I enjoy reading and word puzzles.” “The staff here are all friends; I enjoy reading and I get a Four Winds Residential Home DS0000045233.V354526.R01.S.doc Version 5.2 Page 14 daily paper plus 4 books per fortnight from the Library; I’m very comfortable in my room and staff respond straight away if I need assistance with anything. Last night there was a good party and a singer and we all joined in!” “I go out regularly with my sister and I often visit Church, which I enjoy.” They said that there were different things to do in the home if they wished, including musical bingo; board games; needlework; music and movement; clothes parties; seasonal events; occasional visiting entertainer (about 4 times per year); quizzes; raffles; chair exercises; outings to the local park and Town Hall; baking; films; plus recall and reminiscence. A hairdresser visits weekly and her charges were described as offering good value. There is an Activities Organiser who arranges the varied programme of social and recreational activities and she keeps a record of activities and events enjoyed by residents each day. She is hoping to develop individual profiles of residents’ interests and hobbies, plus a newsletter/magazine. She would also like to try doing some life-story work with residents and this could prove very worthwhile and rewarding for all involved. Residents pursue individual interests if they wish, such as reading or television. Most residents have a television in their own rooms as well as access to sets in the lounges, including one large, flat-screen television. People’s religious needs were being addressed to their satisfaction. Residents said that visitors were always made welcome and could call at any reasonable time. Some residents went out with relatives or friends for part of the day. All the residents spoken to said the catering was good. There was a wide choice and the Cooks understood their preferences, including special diets. Residents mainly dined together in the dining room. They could, however, eat their meals elsewhere and at different times if required. Records are kept of meals served, available for inspection. The Cook confirmed the varied, appetising menu. Four Winds Residential Home DS0000045233.V354526.R01.S.doc Version 5.2 Page 15 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 quality outcomes in this area. Residents have access to a robust, effective complaints procedure and are protected from abuse. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: All residents and relatives who commented said that they were confident about approaching staff and management about any concerns or complaints they might have. They described the staff and management as being very approachable, helpful and friendly. Typical comments included: “The staff here are all very friendly and helpful.” “Staff listen to me if I have a problem and always try to help.” A complaints procedure is provided in the statement of purpose, which is readily available to service users. Staff and management are aware of the need to safeguard adults from abuse or neglect and have undergone training in these issues. Staff confirmed they are aware of the home’s ‘whistle blowing’ policy and confident to speak out about any suspected abuse or neglect. The home had been involved in a safeguarding adults procedure earlier this year and cooperated, fully with the appropriate authorities. Four Winds Residential Home DS0000045233.V354526.R01.S.doc Version 5.2 Page 16 All staff members have had enhanced Criminal Records Bureau (CRB) checks and Protection of Vulnerable Adults (POVA) checks carried out as required by law. Also, two references are obtained in respect of each new employee, with special attention given to the last employment. This is to ensure that unsuitable people are not employed to care for vulnerable adults. Staff confirmed that new staff members go through induction and foundation training so that they have the right knowledge and skills to do their jobs competently. Four Winds Residential Home DS0000045233.V354526.R01.S.doc Version 5.2 Page 17 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 quality outcomes in this area. The physical design and layout of the home enables residents to live in a safe, well-maintained and comfortable environment, which encourages independence. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: There were no unpleasant odours and the home was found to be clean in all the areas inspected. The majority of staff members have completed relevant training in health and safety, fire safety, infection control and food safety. Most bathrooms and toilets were supplied with liquid soap and paper towels, to help prevent cross infection, but wall-mounted dispensers for paper towels were not usually present. It is strongly recommended that these devices be supplied, in keeping with infection control best practice. All residents have their own personal towels and flannels, which they keep in their rooms. Residents said they were pleased with the premises, finding them comfortable and homely as well as practical. They also described the home as being clean. Four Winds Residential Home DS0000045233.V354526.R01.S.doc Version 5.2 Page 18 Typical comments received from residents included: “I like it here and I am very pleased with my bedroom.” “There is a very nice atmosphere and I am very comfortable here.” The home is well decorated and maintained, with repairs and servicing being carried out according to schedule and generally in a timely manner. Since the last inspection, a large, flat-screen television has been installed in the lounge and a number of fire safety improvements have been carried out. Consideration should still be given to fitting suitable locks to bedroom doors in the interest of privacy, choice and dignity (although the absence of this quality feature was not an issue of concern for service users). A second assisted bathing facility should be provided, ideally on the first floor, to complement the assisted bathroom on the ground floor. The current first floor bathroom does not permit assisted bathing. Alternatively, or in addition, a walk in, level entry shower should be considered, in the interests of service user choice and convenience. The home should consider installing curtains or blinds in the en suite toilets in the interest of promoting privacy and dignity, plus homeliness. Four Winds Residential Home DS0000045233.V354526.R01.S.doc Version 5.2 Page 19 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 quality outcomes in this area. Staff in the home are trained, skilled and in sufficient numbers to fulfil the aims of the home and meet the changing needs of residents. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: On the day of inspection, there were 18 service users being accommodated. Residents said that they got on well with staff and felt that there were sufficient numbers of staff to meet their needs. This view was reflected in staff comments. Staff morale was reported to be good. During the day (7am to 10 pm) there are at least two care staff members on duty, one of whom is a senior. In addition, between 8 am and 1 pm, and between 4 pm and 8 pm, a third carer is deployed. At night, there are 2 care staff members on duty, one of whom is designated as being in charge. The manager and/or senior member of staff are on call at night. The home’s manager is full time, with 40 of her time being dedicated to management duties and 60 to care, when she provides direct care to residents. A senior Manager from within the group and the registered provider, Mr Matharu, provide management support. Also, within the last two months, an assistant manager has been appointed, providing further management support (for example, with administration). Catering and domestic hours are appropriate. A full staff training and development programme is in operation. Staff confirmed that they had undergone induction and foundation training, plus refresher training in a variety of topics, including moving and handling, Four Winds Residential Home DS0000045233.V354526.R01.S.doc Version 5.2 Page 20 infection control and skin integrity. Fifteen out of the 19 permanent members of care staff had completed National Vocational Qualifications (NVQ) in care at level 2 or 3 (78 ) with the remaining staff working towards their qualifications, which is commendable. Staff also confirmed that they participate in regular supervision sessions, as recorded in individual staff files. Four Winds Residential Home DS0000045233.V354526.R01.S.doc Version 5.2 Page 21 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, 32, 33, 35, and 38. People who use the service experience good quality outcomes in this area. The management and administration of the home is based on openness and respect, has effective quality assurance systems and is basically competent. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The registered manager is becoming increasingly experienced and competent in her new role, having worked at senior and deputy levels for many years. Residents and staff spoke well of her support and guidance, plus commitment to good outcomes for residents. She was described as being approachable and caring. She intends to register for the Registered Manager’s Award at NVQ level 4 in the near future. She is working towards her NVQ qualification in care at level 4, having previously achieved NVQ level 3 in care, and expects to achieve it by mid 2008. Management arrangements are reinforced by a senior manager within the group of homes, who visits several times per week, and by Four Winds Residential Home DS0000045233.V354526.R01.S.doc Version 5.2 Page 22 an assistant manager (part time) who helps with some of the administration and supervisory duties. Good accounting procedures are followed, with receipts and signatures being provided for all financial transactions involving residents’ personal monies, in which the home is involved, wherever practicable. Relatives look after the personal monies of many residents. In those situations where the home helps look after residents’ monies, such as pocket monies, clear individual accounts and records are maintained and service users have ready access to such funds. Comments received from staff and management confirmed that there are good health and safety policies and practices that promote the health, safety and welfare of residents and staff. All staff members do refresher training in Health and Safety, such as moving and handling, fire safety and food hygiene. Health and Safety issues are also discussed at staff supervision and other meetings. In the Autumn 2007, there were two incidents where health and safety standards slipped and Hartlepool Borough Council carried out an investigation. The home takes pride in its normally good standards of operation, and it designed and implemented a programme of staff training and support to address the issues raised. It is also implementing a competency appraisal procedure for all staff, which will involve assessments of specific tasks being carried out by staff. Residents and staff expressed satisfaction with the way the home was run and the good standards that were evident in many instances. They said they believed the home was safe and run in the best interests of residents. Formal consultation with service users and their representatives takes place, via meetings and surveys, to ensure that management receives feedback on the home’s performance and suggestions for improvement. However, the findings of such consultations should be shared with service users and others within the home (for example, by way of a newsletter). Four Winds Residential Home DS0000045233.V354526.R01.S.doc Version 5.2 Page 23 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 2 2 3 X X N/A 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 2 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 X 3 3 X 3 Four Winds Residential Home DS0000045233.V354526.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP1 Regulation 5, 6 Requirement The home’s service user’s guide needs to be a separate document to the statement of purpose. It must include all of the items specified in regulation 5 and be made available to all service users and prospective service users. The previous timescale for action of 28/02/07 was not achieved. In the home’s terms and conditions of residence/contract, the information about fees needs to be elaborated further, explaining that fees are paid in arrears, only for service received. The previous timescale for action of 28/02/07 was not achieved. Timescale for action 31/03/08 2 OP2 5, 6 31/03/08 Four Winds Residential Home DS0000045233.V354526.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP8 Good Practice Recommendations Sitting Scales should be considered by the Provider as a worthwhile addition, because of the comparatively large number of residents who have difficulty standing and whose weight needs to be monitored. Life-story work with residents is desirable, helping to promote a deeper understanding of individual service users and their personal fulfilment. The first floor bathroom would benefit from being upgraded to permit assisted bathing and/or provision of a level entry shower should be considered to provide service users choice and convenience. Wall-mounted paper towel dispensers should be provided in all communal toilets and bathrooms, in line with best practice in infection control. The home should consider installing curtains or blinds in the en suite toilets in the interest of promoting privacy and dignity, plus homeliness. It is desirable for suitable locks to be fitted to bedroom doors as a quality feature, helping to promote privacy, dignity and choice. The Registered Manager should achieve National Vocational Qualifications (NVQ) at level 4 in management and care within a reasonable time (for example, by mid 2008 for Care and by mid 2009 for Management). The findings of quality assurance consultations should be published and shared with service users and others within the home (for example, by way of a newsletter). Management should consider issuing monthly health and safety bulletins to staff (for example, via the staff notice board) to ensure that health and safety issues are regularly identified and discussed within the staff group, reinforcing existing measures that the home has in place. 2 3 OP12 OP21 4 5 6 7 OP26 OP24 OP24 OP31 8 9 OP33 OP38 Four Winds Residential Home DS0000045233.V354526.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Darlington Area Office St Nicholas Building St Nicholas Street Newcastle upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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