Care Home: George Basterfield House

What the care home does well People living in the home we talked with spoke well of the staff and the help and support they get from them. The home provides a homely and informal atmosphere for residents and we saw that staff have a good rapport with them and know them well. The home is kept clean and tidy and many residents have chosen to personalise their bedrooms, to make them more homely with pictures, ornaments and photographs. The home works with other healthcare agencies and gets specialist help for residents when this is needed. This includes the local GPs and District nursing teams as well as specialist services such as the intermediate support team. Care plans and activities are developed with residents to make sure their personal preferences are included and reflect individual`s needs and expectations. There are good systems for handling medication to make sure that people`s medicines are managed safely and that residents receive the correct treatment. There are good protocols for the administration of "when required" medication so that they are given only when residents need them promoting their health and well being. Training and staff development is being given a high priority in the home. The service has robust recruitment systems to ensure they get the right staff and promote the safety and wellbeing of people living there. What has improved since the last inspection? Since the last inspection the service has addressed the areas we highlighted that needed improvement, most significantly in bringing their safeguarding procedures in line with multi agency guidance to promote the safety and welfare of people living in the home. Senior staff in the home are due to undertake training this year on handling complaints as part of their professional development. Care plans are generally good but have been further improved by the implementation of new person centred plans to help reflect the needs of the individual. People living there are being given the opportunity to be more involved in creating and developing their care plans and their personal perspectives on how they want to be supported and their independence maintained. The service has maintained the improvements in medication practices and all medicines received into the home are being accurately recorded so all a person`s medicines can be accounted for. Changes have been made to the way activities are provided, with activity leaders and a programme of activities that reflects what people say they want. There is better provision for both group and individual recreation. Environmentally areas of the home, such as dining areas and some bedrooms have been refurnished and work has been done on the roof to insulate and recover them to provide a better place to live. What the care home could do better: Management and staff do put a lot of effort into their work and several people living there commented on this and on how hard staff work on their behalf. The dependency levels of people living in the home can change quickly and these should be kept under constant review so staffing levels can be adjusted quickly and consistently when people`s individual needs change and additional staff consistently available to respond. CARE HOMES FOR OLDER PEOPLE George Basterfield House Risedale Road Barrow in Furness Cumbria LA13 9BZ Lead Inspector Marian Whittam Unannounced Inspection 16th June 2008 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address George Basterfield House DS0000035198.V365811.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. George Basterfield House DS0000035198.V365811.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service George Basterfield House Address Risedale Road Barrow in Furness Cumbria LA13 9BZ 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) 01229 894549 julie.lowery@cumbriacc.gov.uk www.cumbriacare.org.uk Cumbria Care Mrs Julie Bernadette Lowery Care Home 35 Category(ies) of Dementia (16), Old age, not falling within any registration, with number other category (35) of places George Basterfield House DS0000035198.V365811.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP (maximum number of places: 35) Dementia - Code DE (maximum number of places: 16) The maximum number of service users who can be accommodated is: 35 Date of last inspection 10th September 2007 Brief Description of the Service: George Basterfield House is a care home registered to provide care for 35 residents, including 16 with dementia. The home is in a residential area of Barrow in Furness, close to the local park, leisure centre, shops, post office, public houses and other amenities. The home is on a bus route and is about half a mile from the town centre. The home is on two floors and has a passenger lift for residents .All the bedrooms in the home are single occupancy and 3 have en suite facilities. The home is divided into individual units, Linden and Elmview are EMI units and Ashlea and Oakdale are for physically frail residents. Each unit has its own non smoking lounge, kitchen and dining area in addition to the large communal lounge on the ground floor and the ground floor lounge used by service users who wanted to smoke. The home has secure garden areas that residents may use. Information is available to prospective residents in the combined Statement of purpose and service users guide; this is available and displayed in the home and is available in different formats. A copy of the last inspection report is available. The fees charged by the home range from £386.00 to £449.00 per week as at the date of the inspection and an additional charge is made for personal toiletries, newspapers, magazines, also hairdressing, chiropody services and any personal travel expenses, according to information provided by the home. George Basterfield House DS0000035198.V365811.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 stars. This means the people who use this service experience good quality outcomes. This site visit to George Basterfield House forms part of a key inspection. It took place on 16.06.08 and we (The Commission for Social Care Inspection, CSCI) were in the home for six and a half hours. Information about the service was gathered in different ways: • Annual Quality Assurance Assessment document completed by the manager identifying what the service does well and what could be improved. This was returned to CSCI before the visit. • The service history. • Interviews with residents and staff on the day of the visit. • Observations made by us in the home during the visit. • Completed questionnaire survey forms from people living in the home, staff working there and from healthcare professionals coming into contact with the service. During the visit we spent time with people living in the home and talking to them about their experiences. We looked at care planning documentation and assessments to ensure the level of care provided met the needs of those living in the home and made a tour of the building to inspect the environmental standards. Staff personnel and training files were examined and a selection of the service’s records required by regulation. We assessed the handling of medicines through inspection of relevant documents, storage and meeting with the manager, other staff and residents. What the service does well: People living in the home we talked with spoke well of the staff and the help and support they get from them. The home provides a homely and informal atmosphere for residents and we saw that staff have a good rapport with them and know them well. The home is kept clean and tidy and many residents have chosen to personalise their bedrooms, to make them more homely with pictures, ornaments and photographs. The home works with other healthcare agencies and gets specialist help for residents when this is needed. This includes the local GPs and District nursing teams as well as specialist services such as the intermediate support team. Care plans and activities are developed with residents to make sure their personal preferences are included and reflect individual’s needs and expectations. George Basterfield House DS0000035198.V365811.R01.S.doc Version 5.2 Page 6 There are good systems for handling medication to make sure that people’s medicines are managed safely and that residents receive the correct treatment. There are good protocols for the administration of “when required” medication so that they are given only when residents need them promoting their health and well being. Training and staff development is being given a high priority in the home. The service has robust recruitment systems to ensure they get the right staff and promote the safety and wellbeing of people living there. What has improved since the last inspection? What they could do better: George Basterfield House DS0000035198.V365811.R01.S.doc Version 5.2 Page 7 Management and staff do put a lot of effort into their work and several people living there commented on this and on how hard staff work on their behalf. The dependency levels of people living in the home can change quickly and these should be kept under constant review so staffing levels can be adjusted quickly and consistently when people’s individual needs change and additional staff consistently available to respond. 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. George Basterfield House DS0000035198.V365811.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 George Basterfield House DS0000035198.V365811.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): NMS 1, 2, 3, 4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessments of people’s needs are done before they come to live in the home to make sure they can be met and relevant information is provided to help people make an informed decision about living there. EVIDENCE: Information is available about the service for prospective residents and their families in the combined statement of purpose/ service users guide to help them make an informed choice about the service. A copy of the latest inspection report is included in the information given to people. Residents do not have their own personal copy given on admission; the document is kept on display in the foyer and available from the office. Survey responses and conversations with people living in the home indicate that people feel they had enough information about the home to help them choose before they came in. George Basterfield House DS0000035198.V365811.R01.S.doc Version 5.2 Page 10 This information can be made available in other formats if required by people. The statement of purpose/service user guide was in the process of being updated by the manager to include changes in personnel and staff qualifications. The notice boards in the foyer of the home also gives information of what is going on in the home, information on advocacy services and support organisations as well as general information about Cumbria Care. Individual care plans show that before coming to live in the home the residents have there personal, health and social needs assessed. We looked at four people’s care plans and the pre admission assessments that had been done to make sure the home was able to meet an individual’s needs before they came to live there. The pre admission assessments we looked at contained the relevant information from which to develop a basic individual care plan. Specific healthcare needs are being identified during the assessment. This information ensures the staff are aware of the level of care required to meet the different needs. Assessments are done by social workers under care management arrangements and by the home manager or senior staff to try to ensure they are able to meet people’s individual needs. We saw that the manager had visited one person in hospital to reassess their needs before they returned to the home to be sure that they could still meet their changes needs. Where the assessment has been done by social services a copy is included in the care plan. Where appropriate other care agencies and professionals have been involved in providing information before admission and advice after admission. The home has an eight week introductory/trial period followed by a full care review to make sure needs are being met and the home suits the resident. Residents are given a statement of terms and conditions of residency or a contract if they fund themselves, setting out the rights and obligations of the individual. The service does not provide intermediate care. George Basterfield House DS0000035198.V365811.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): NMS 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care which people using this service receive is based on their individual needs. Privacy, dignity and personal choice are promoted at all times. EVIDENCE: All residents have an individual care plan, based on initial assessments and risk assessments, setting out assessed health, social and personal care needs and these are being reviewed and updated. The care plans are clearly set out and easy to follow. The information provided covered areas such as a person’s mobility, diet, health needs, personal care and their social and religious preferences. Appropriate equipment to prevent pressure sores is in use, individual’s mental health is monitored and effective nutritional screening is being done and weights recorded. The care plans have continued to be developed and improved and this is seen in the new ‘person centred’ George Basterfield House DS0000035198.V365811.R01.S.doc Version 5.2 Page 12 documentation that underpins care approaches. We looked at some care plans where this had been started and found them to present more clearly what is important to the individual, what they feel they need to support them and what they felt their emotional as well as physical needs were and what made them anxious. There was an ‘all about me section’ giving a clear insight into the lives of individuals and what was important to them to help staff support them. We talked to several care staff who evidently knew the people living there well and their individual needs and discussed their support role and approaches in a way that reflected people’s individuality. Observations during the visit, including moving and handling practices, checking of records of care planning and conversations with residents suggests that they feel they are treated as individuals and their privacy respected. One person told us “They don’t rush me, I get up when I want”. We looked at medication handling, records and practices and found that the residents are protected by safe systems for handling and administering medication and staff keep consistently accurate records of the medicines it administers to residents. There were systems in place for storage ordering and checking medication to make sure that medicines and the quantities received were correct before administration to residents. Protocols are in place for the administration of ‘as required’ medicines to help make sure that people only get medication that they need. Training records show that staff who administer medicines have been given training in handling medication and clear procedures are in place. Controlled drugs are not kept for people in any quantity and are recorded accurately and kept separately. George Basterfield House DS0000035198.V365811.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): NMS 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service are able to make choices about their lifestyle and are supported to maintain their independence. EVIDENCE: Activities and recreational preferences are included in the individual care plans and individual records are kept of what people have taken part in. Care plans include personal profiles that have been developed with residents and /or their families where possible. This provides useful information for those supporting residents with activities that are meaningful to them and suit their capabilities. We looked at records of activities and spoke to people about the things they had been doing. Activities are advertised on the notice board. The home encourages relatives and friends to visit and residents say there are no restrictions on when people can visit them. The service has a ‘Friends of George Basterfield’ that encourages family and friends to be involved in the life and activities of the home. Some people told us that they went out with their George Basterfield House DS0000035198.V365811.R01.S.doc Version 5.2 Page 14 families and that staff also took them out sometimes, one had been for a ‘walk’ in the park to listen to the band. The manager and staff have been working to improve recreational opportunities for people living there that are more tailored to individual preferences and capabilities as well as providing more group activities. To help maintain an active programme of activities four care workers have been identified in the staff team to lead the activities programme. These hours have been incorporated into the rotas for Wednesdays with the intention they are just for activities and entertainments and spending time supporting people to follow their interests. One person was putting together a photograph album, others did baking and one person just liked having “a trip to the shops”. On one unit people had enjoyed a takeaway meal one evening whilst watching the football. Staff told us that as they had ‘Freeview’ television sometimes people would watch a film or play bingo or have a chat in the afternoon. The home has been successful in encouraging wider community links with local schools and residents as well as local churches. Some people told us they chose not to attend some activities and were not made to feel they had to and staff would “pop in to chat”. Records show and residents confirmed the kind of things they have enjoyed doing. There have been regular bus trips out, one to Grizedale Forest, another to the Lake District and another to the local coast for ice creams. People we talked to who had gone on these had enjoyed them and one said it was “good to have a change of scenery”. There is a four weekly menu in place and menus are available on the units. Minutes of resident’s meeting show that food and activities are both discussed at their meetings. People we spoke to said that staff asked them what they wanted each day and could have an alternative if they didn’t like the daily choices offered. We spent time with people at lunchtime on Elmview and on Ashlea. The meals were given out by staff and well presented with ‘seconds’ offered. People commented at the time that they had enjoyed their meal, especially the Cumberland sausage. One told us “We can’t complain about the food” and another said, “This dinner is lovely”. Surveys indicate that generally people are satisfied with the food provided. The meal time was relaxed and sociable on both units, residents were able to take their time over lunch and on Elmlea the ladies chatted over lunch about shopping and where they used to buy food and different varieties of sausage and included staff in their conversations. Staff helped people who needed some assistance sensitively, promoting them to be independent where they could. This was evident for one person who was very restless and needed a lot of support. Meals are served either in the lounge/dining areas or in the resident’s rooms depending on the their preference. The service has a 4 star rating from the Environmental Health officer. George Basterfield House DS0000035198.V365811.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): NMS 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is an accessible complaints procedure and adult protection procedures are in place. People who use this service are able to express their concerns knowing they will be listened to and acted upon. EVIDENCE: There are clear procedures in place for dealing with complaints and concerns. Since the last inspection the home has made three Safeguarding Adults referrals to protect people’s welfare and these have been investigated and addressed by the home manager in line with multi agency guidance with other relevant agencies. The home has recorded two complaints made to them, which they have investigated and recorded and the Commission for Social Care inspection (CSCI) has not received any concerns or complaints about the service. Senior staff in the home are due to undertake training this year on handling complaints as part of their professional development. There are suitable procedures in place for dealing with complaints and we looked at the complaints file. This was in order with copies of complaints forms, any associated correspondence and details of investigation and if it had been referred to social services under safeguarding procedures. The complaints George Basterfield House DS0000035198.V365811.R01.S.doc Version 5.2 Page 16 policy and procedure is in the guide for the people using this service and there is also a copy on display. The service has internal policies and procedures for the Protection of Vulnerable Adults (POVA) and a copy of the Local Authority’s procedure was also seen to be available and information on whistle blowing for staff. The service now has clearer guidance on actions it needs to take in safeguarding vulnerable adults to improve this for the people living there. Training is given on adult protection, reporting and preventing abuse to the care staff. We spoke with staff and they were aware of the procedures and what they would need to do if they suspected abuse. Survey responses and comments from people living in the home indicated that they were aware of the complaints process and how to make a complaint although all we spoke to said they felt that staff listened to what they had to say. Survey responses supported this view as well. One person told us “ If I was unhappy I would talk to the staff, the girls are wonderful”. The home did not deal with any resident’s personal finances only small amounts of spending money for safekeeping and practices and procedures are in place to protect resident’s financial interests. An external financial audit by Cumbria Care annually. Care staff we spoke to told us they have had training on recognising abuse and the adult protection procedures and on dementia awareness. They told us what they would do if they suspected abuse. Training records support this. This subject is also covered in National Vocational Qualification (NVQ) training, which over 50 of staff have done. The service has procedures in place to help staff deal with aggression by people living there, any missing persons and a policy on restraint. George Basterfield House DS0000035198.V365811.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): NMS 19, 20 21, 22, 24, 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents enjoy a comfortable, safe and homely living environment. The premises are being maintained and kept to a good standard of cleanliness. EVIDENCE: The home is being well maintained with an overall good standard of decoration and provides a clean, tidy and homely environment for residents with no lingering odours evident. Some bedroom furniture has been replaced and people we spoke with said they liked their rooms. New curtains and blinds have been ordered for most of the home to further improve the environment for people. There is an annual programme of maintenance and improvement for the home and there are cleaning rotas for the domestic staff. George Basterfield House DS0000035198.V365811.R01.S.doc Version 5.2 Page 18 There are ample dining and lounge areas for people in the home and a large lounge downstairs where musical entertainments and bingo take place. New dining furniture has been provided on the units. The dining and lounge areas on the units were clean, homely and well decorated and used for daily activities and some residents were sitting in them reading their papers, knitting and watching television. There are telephone facilities available for residents to use. All bedrooms are single occupancy and vary in size and furnishings. Bedrooms that were seen had a satisfactory standard of decoration, furnishings and soft furnishings and had locks on the doors if people chose to use them. Many residents have brought into the home their own possessions, personal items and this helped to make their bedrooms more personal and homely. There are separate toilets close by resident’s rooms and bathrooms with assisted bathing aids and some bedrooms have en suite toilets. There are suitable adaptations inside the home to promote people’s independence and moving and handling equipment is in place to make people comfortable and safe. If needed specialist equipment such as nursing beds and pressure relieving devices is accessed for people following assessment by District Nurses Call bells are in resident’s bedrooms, toilets, bathrooms and communal areas. Records show that equipment being used, including the lift, is regularly serviced. Outside the grounds were tidy and ‘the Friends of George Basterfield’, families and friends of residents, plant hanging baskets and pots. We talked with one person who was sitting outside “getting some fresh air”. They said they enjoyed sitting out and watching what was going on “across at the shops”. There are infection control procedures in place in the home and staff were observed using protective aprons and gloves where needed. Training records indicate that staff are being given training on infection control and in safe food handling. There is a small laundry on site and care staff on the different units are responsible for doing the laundry and taking it back to residents. It was clean and tidy. There is a sluice area on each floor and these are kept locked. George Basterfield House DS0000035198.V365811.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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are robust recruitment procedures being followed to safeguard residents and appropriately trained staff offering care and support to people living in the home. EVIDENCE: The inspector discussed the staffing arrangements with the manager. We looked at staff rotas, spoke with staff and observed staff levels during the visit. Generally the home has adequate staff on duty with a range of skills and experience to provide personal care for the number of people currently living in the home. On Linden and Elmview where 16 people with dementia live there are 3 care staff on day duty. On Oakdale and Ashlea there is 1 carer to attend to the people on each unit. The rota shows that sometimes there is a ‘floater’ who works between Oakdale and Ashlea to help staff. That was the case during the visit and it was necessary as care plans and observation indicated that there was one person whose condition was deteriorating and another who needed additional support due to behavioural needs and 2 staff for safe moving and handling. Staffing levels should be kept under constant review so levels can be adjusted promptly in response to people’s changing needs. Rotas indicated and staff confirmed that due to sickness or holidays there was not always a floater George Basterfield House DS0000035198.V365811.R01.S.doc Version 5.2 Page 20 to give extra help when it was needed. We asked staff what they did when they needed a second person to assist and they got them from the other unit, leaving that unattended during that time. People may also have to wait for assistance until someone is free to help. Rotas showed that vacant shifts due to holidays, sickness or training are being covered and agency staff have been used at times. People we talked to felt the staff did work hard for them and more than one person said they are “very busy”. Care staff also deal with the laundry for residents and staff on late shift have some light cleaning duties, such as mopping the kitchen. Night staff are also required to clean toilets and bathrooms. The expectation that these tasks will be done by care staff may detract from their support and care role. The home has 2 domestics that cover 7 days. All staff have continuous professional development plans and these show all training they had attended and development needs. Staff have an initial 5 day induction period. Training is being well supported in the home and is being planned and organised to make sure mandatory training is up to date and individual training needs prioritised. Records show that staff are given training in dementia awareness and equality and diversity and staff confirmed this. The service has training objectives for 2008-9, that include care plan training and in palliative care. NVQ training courses are well established with a good percentage of staff achieving level 2 or 3 and several staff are still doing the course. There are clear recruitment and selection procedures being followed and overseen by the manager. Application forms are completed, references taken up and interviews arranged. Records show that new staff are appointed and begin work only after all the required legal checks have been completed and that they have a period of induction training. George Basterfield House DS0000035198.V365811.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): NMS 31, 32, 33, 35, 36, 37 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service live in a home that is well managed and run in their best interests. EVIDENCE: The home has an experienced manager in post who is registered with the Commission for Social Care Inspection and has completed the Registered Managers Award. The manager is clear about her role and responsibilities and the ways in which the service can continue to develop and improve for people living there given the budgets she works within. This was clear and evidenced George Basterfield House DS0000035198.V365811.R01.S.doc Version 5.2 Page 22 in the service’s annual quality assurance assessment that the manager completed and sent to us. Regular staff meetings for both day and night staff are being held with staff contributing to the agenda. This allows staff feedback as well as internal reviews of policies and procedures and information sharing. Staff spoken with found that the manager was and senior staff were generally approachable and supported them in their roles and training. Although some felt the organisation could be more supportive and value staff more. Staff told it was “generally a happy place to work”. Those we spoke to felt they could raise concerns about practice with the management and be supported. Records show that staff are given regular supervision and staff surveys and staff we spoke with also confirmed this as the case. There had been a recent night staff meeting to agree rotas and a recent day staff meeting. There are also residents meetings to get feedback from those using the service and their ideas and the next one is due at the end of the month, the agenda is displayed in the foyer. The service also does its own quality monitoring using satisfaction surveys and these go out to residents, relatives and advocates. We looked at the responses and outcomes of the survey, which are collated and presented in a graph as well as stating the range of comments and suggestions people made. Areas that scored highly were privacy, family inclusion, the respectful attitude of staff and the friendly atmosphere in the home. The home has a policy for the safe handling of residents money and all financial dealings are witnessed and recorded by 2 people and spot checked periodically and audited annually. We checked some of the individual money files and these were in order and accurate. On the whole the records required for the operation of the home that were examined on this occasion were up to date and accurate to help ensure the home is a safe and comfortable place to live. Records of hoist and emergency equipment checks and servicing contracts indicate that the home has systems and practices to promote resident health and safety. Fire training for staff is being given and recorded and there has been a recent fire inspection where no concerns were raised. Moving and handling training is being done with staff. Checks are in place and recorded for water temperatures and Legionella. George Basterfield House DS0000035198.V365811.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 3 3 3 3 3 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 3 3 3 X 3 3 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 3 George Basterfield House DS0000035198.V365811.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action 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 OP27 Good Practice Recommendations The dependency levels of people living in the home should be kept under constant review so staffing levels can be adjusted quickly and consistently when people’s care needs change. George Basterfield House DS0000035198.V365811.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Manchester Local Office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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 George Basterfield House DS0000035198.V365811.R01.S.doc Version 5.2 Page 26 - 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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