Care Home: Halcyon House

What the care home does well There was a pleasant friendly atmosphere in the home and residents appeared comfortable with the staff. Staff were seen to spend time talking with residents on a one to one basis or within a group. They offered help with different daily tasks and their approach was gentle and kind. Residents and relatives said they were pleased with the care and that the staff were quick to help and provide support as needed. Comments included, "Very good care" and "The staff are lovely." There was a good social programme for the residents and this included, crafts, music, strawberry tea, themed parties including a wild west evening. A barge trip is planned for the summer. A resident said the staff do their best to arrange events regularly. The activities were displayed in different areas of the home so that residents could choose to take part if they wished. A number of residents attend committee meetings with the board members so they can discuss the service they are receiving and forward any suggestions they may have. A resident made reference to the meetings being beneficial. The home was well maintained and there was a good standard of furniture and fittings in the bedrooms, lounges, dining room and conservatory. The dining room had been decorated and had new furniture. There are plenty of small lounges where residents can benefit from `quiet` time if they so wish or to meet their visitors in private. The home is spacious and has landscaped grounds and an inner courtyard with garden furniture, which the residents use in the warm weather. A resident said, "The home is kept nicely and always very clean." There is hairdressing salon for residents to enjoy this service in comfort and also a room for prayer and worship. Residents said the food was good and that they were offered plenty of choice at each meal time. Menus were available and the dining room tables nicely laid for lunch. A external catering firm were employed and the chef meets with the residents each day to ask them what they would like. Residents said they liked this contact. What has improved since the last inspection? Staff files viewed showed that two references had been obtained for the new staff prior to them commencing employment. This is a recruitment check which evidences a record of past employment. Staff photographs are now kept in staff files for identification purposes. What the care home could do better: The health care needs of the residents must be clearly recorded in their plan of care. This will provide instructions to staff on the care and support each resident needs to enable them to receive person centred care. Resident care files were kept in an office which was not locked when unattended. The office door should be kept locked when not in use or the care files locked away to keep the information secure.Consent to the plan of care should be obtained from the resident and/or their relative where possible and recorded in the care file. This will help to ensure that the resident and their relative are fully informed of the plan of care and agree to it. Where a risk has been identified regarding the resident`s health, the risk assessment should be updated to reflect a change in risk to help keep the resident safe. Residents have access to a good social programme and a record should be kept of the activities they take part in to evidence their participation and enjoyment. Food kept in the fridge should be dated to ensure good standards of food hygiene control in the home. Policies and procedures were in place to protect vulnerable people. Staff should be familiar with local guidelines for reporting an alleged incident and the whistle blowing policy should be displayed for staff to refer to. This will help to ensure they are confident in its use. Cleaning products should be locked away when not in use to help protect people who use the service. The plaster work was chipped in one bathroom identified at the time of the site visit and this should be repaired so that the room is maintained to a good standard. Staff require an induction when they commence employment and also training in safe working so that they are competent and have the skills and knowledge to carry out their work they are employed for. The manager should introduce the Skills for Care Induction Standards as they provide formal learning on induction. The staff training plan should evidence dates of courses attended and their renewal. The chairman of the committee undertakes a monthly visit to the home and produces a written report of his findings. These reports should be kept at the home and be made available for the inspection. A fire officer should be contacted regarding the frequency of fire prevention training so that staff are confident in fire prevention to protect people who use the service. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Halcyon House 55 Cable Street Formby Merseyside L37 3LU The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this full assessment a ‘key’ inspection. Lead inspector: Claire Lee Date: 2 0 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The Commission for Social Care Inspection aims to:     Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 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 Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Halcyon House 55 Cable Street Formby Merseyside L37 3LU 01704833350 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): halcyonhouse@btopenworld.com Abbeyfield North Mersey Society Limited Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration Category(ies): old age, not falling within any other category Additional conditions: The registered person may provide the following category/ies of service only: Care home with nursing - Code N 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 The maximum number of service users who can be accommodated is: 31 Date of last inspection: Brief description of the care home: Halcyon House is registered to provide residential (personal) care and nursing care for up to 31 older people. The home was first opened in 1992. The home is owned and managed by Abbeyfield North Mersey Society Ltd. This is a charitable organisation. Halcyon House is located in a residential area in Formby and is close to local shops and transport links. The home is a single storey building that has a large garden and patio area in the centre. All bedrooms are single rooms and have en-suites. There are adjoining rooms available for married couples or for those who wish to share. There is a large lounge and dining room and the garden area is overlooked by a sun lounge. Other facilities include a small chapel and library. There is a large car park at the front of the home. The range of fees for accommodation is 449.82 pounds a week for Care Homes for Older People Page 4 of 27 care home 31 Number of places (if applicable): Under 65 0 Over 65 31 D D M M Y Y Y Y residential care to 578.97 pounds a week for nursing provision. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Poor Adequate Good Excellent How we did our inspection: An unannounced visit took place as part of the inspection and this was carried out over two days, 20th May 2009 and then on 1st June 2009 for a duration of twelve hours. Thirty residents were accommodated at this time. The term resident is used in this report as this is what the people staying there like to be called. During the time spent at the home different areas were looked at and a number of care, staff and health and safety records were checked to see what care the residents living there received. Discussion took place with five residents, three relative, five staff, the manager and operations manager. The last key inspection took place on 16th May 2006 and requirements and recommendations from these inspections were examined at this time. During the inspection four residents were case tracked (their files were looked at and they were asked for their views of the home). Other residents also took part in the inspection and all the key and other standards were assessed during the visit. Reference is made to them in the report. To find out more about the care provided at the home survey forms called Have your Say About..... were distributed to a number of Care Homes for Older People Page 6 of 27 staff, relatives and residents prior to the inspection. Eight were returned from the residents, four from the staff and four from the relatives. A number of comments from them have been included in this report. An AQAA (annual quality assurance assessment) was completed for the inspection. The AQAA comprises of two self-questionnaires that focus on the outcomes for people. The self-assessment provides information as to how the manager and staff are meeting the needs of the current residents and a data set that gives basic facts and figures about the service, including staff numbers and training. The manager completed this to a satisfactory standard. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: The health care needs of the residents must be clearly recorded in their plan of care. This will provide instructions to staff on the care and support each resident needs to enable them to receive person centred care. Resident care files were kept in an office which was not locked when unattended. The office door should be kept locked when not in use or the care files locked away to keep the information secure. Care Homes for Older People Page 8 of 27 Consent to the plan of care should be obtained from the resident and/or their relative where possible and recorded in the care file. This will help to ensure that the resident and their relative are fully informed of the plan of care and agree to it. Where a risk has been identified regarding the residents health, the risk assessment should be updated to reflect a change in risk to help keep the resident safe. Residents have access to a good social programme and a record should be kept of the activities they take part in to evidence their participation and enjoyment. Food kept in the fridge should be dated to ensure good standards of food hygiene control in the home. Policies and procedures were in place to protect vulnerable people. Staff should be familiar with local guidelines for reporting an alleged incident and the whistle blowing policy should be displayed for staff to refer to. This will help to ensure they are confident in its use. Cleaning products should be locked away when not in use to help protect people who use the service. The plaster work was chipped in one bathroom identified at the time of the site visit and this should be repaired so that the room is maintained to a good standard. Staff require an induction when they commence employment and also training in safe working so that they are competent and have the skills and knowledge to carry out their work they are employed for. The manager should introduce the Skills for Care Induction Standards as they provide formal learning on induction. The staff training plan should evidence dates of courses attended and their renewal. The chairman of the committee undertakes a monthly visit to the home and produces a written report of his findings. These reports should be kept at the home and be made available for the inspection. A fire officer should be contacted regarding the frequency of fire prevention training so that staff are confident in fire prevention to protect people who use the service. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by telephoning our order line – 0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our findings Contents Choice of home (standards 1-6) Health and personal care (standards 7-11) Daily life and social activities (standards 12-15) Complaints and protection (standards 16-18) Environment (standards 19-26) Staffing (standards 27-30) Management and administration (standards 31-38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information was provided to residents and their families to enable them to decide whether the staff could provide the service they needed. Residents needs had been assessed to ensure the staff could provide the care and support they needed. Evidence: There was a service user guide and statement of purpose which provided information to residents living at the home and also those who are looking to take up residency. There was plenty of other information regarding the service displayed in the main hall for residents to see. For example, menus, an activity programme, details of the Abbeyfield Society and 2007 and 2008 Annual Service Reviews completed by the previous care regulator, Commission for Social Care Inspection. The documents helps residents and their families to decide whether the home can meet their needs and what to expect from the staff. A receptionist is on duty to provide a warm welcome to visitors and to help residents and their families with any queries they have. A resident said they had been made welcome by the staff when they arrived and that they were settling into the home. The manager completes a care needs assessment for prospective residents. Assessments for three new residents were looked at and these showed the care and support they needed. Areas seen included past medical history, medicines prescribed and help with washing, dressing and walking. The information is then used to write up a plan of care on an individual basis for each resident. Care Homes for Older People Page 11 of 27 Intermediate care is not provided at Halycon House and therefore this was not assessed. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff must be provided with the information they need regarding the health care needs of the residents. This will ensure they can provide the care and support they need. Evidence: Residents had a care file with an individual plan of care. The care files are kept in the office and it was noted that on occasions this room was not locked when not in use. The care files should be kept secure, as they contain confidential information regarding the residents. Case tracking took place of three residents to review their care documents. They recorded areas such as, assistance with walking, washing, dressing, eating and drinking. Care documents for one resident did not identify the necessary care and support the resident needed in relation to their general well being and also a medical condition which needed support from their doctor to improve their health. The daily care records showed that there was a significant increase in risk to the resident. These details however had not been been updated within the risk assessments or the care plans. Risk assessments help staff to reduce a risk to the residents welfare and promote their safety. The inspector returned on another day to complete the inspection and the residents care file had been updated to include the necessary details within the plan of care to provide person centred care. The risk assessment still needed to be updated and the manager said this would be done. Consent to the plan of care should be obtained where possible and recorded in the care file so that the resident and their relative are fully informed of the plan of care Care Homes for Older People Page 13 of 27 and agree to it. This should include the use of equipment to help protect the residents, for example, the use of bed rails. Residents and relatives spoken with said they were pleased with their care. Residents who were being nursed in bed due to frail health, looked comfortable and staff were attentive to their needs. The AQAA reports that a named nurse has been introduced and the nurses are responsible for a number of residents for overseeing their care. Care staff said they had access to the care files, however, they currently have no input into recording the care they give. This could be looked at as part of their development with their formal learning for NVQ (National Vocational Qualifications) in Care. The manager had a contract with a local chemist for supplying medicines to the home each month. A number of medicines charts were looked at and these showed that the staff had signed for medicines prescribed. Advice was given on recording creams, meal replacement drinks and also handwritten entries on the medicine charts. Handwritten entries should be recorded by two staff. This will ensure accuracy of the information recorded. Residents can administer their own medicines and staff had completed a risk assessment to ensure they could undertake this practice safely. The risk assessment was brief and would benefit from more detail with regard to the medicines that the resident wishes to administer and the risks involved with this practice. Homely remedies were not available for the residents. These are medicines that can be purchased over the counter and staff have a duty of care to respond to people who have symptoms of a minor nature, for example, toothache or a headache. Advice should be sought from the residents GP and the homes chemist regarding their use. had access to the care files, however, they currently have no input into recording the care they give. This could be looked at as part of their development with their formal learning for NVQ (National Vocational Qualifications) in Care. It is good practice to request GPs to endorse their agreement to the documented policy regarding this. There were no checks of the medicines in the home as part of reviewing the medicine procedures. Checks should be undertaken on a regular basis to ensure the medicines are given out safely. The manager said she was going to implement this. Staff were seen to be polite and caring in their approach. As a mark of respect staff knocked on private doors before entering and also addressed the resident with their preferred name. Attention had been paid to making sure clothing was appropriate and ladies were wearing make up and jewelery. Help was given to them in an unhurried manner and time was given for residents to respond. This was seen in relation to, assistance with walking, helping with meals and other aspects of personal care. A resident said, The staff are always polite. Daily life and social activities Care Homes for Older People Page 14 of 27 These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social activities and meals were well managed to ensure residents enjoyed their day. Evidence: Residents appeared comfortable with the staff and there was a pleasant, friendly atmosphere. Residents interviewed said the routine was fine and that staff respected their wishes regarding their preferred routine. This was discussed in relation to time of getting up, choice of meals and time of retiring. Residents were seen to be encouraged to maintain good family contact and visitors were made welcome at different times of the day. A relative said, I can visit at any time and always speak to one of the staff. Residents were able to meet their visitors in their own room and the home has plenty of lounges for residents to sit in comfort if they wish to socialise in communal areas. The AQAA reported that residents can take part in a good social programme and this was seen at time of the inspection. A list of activities was displayed in various parts of the home for the residents to see. Events included singing, crafts, a wild west evening, strawberry tea, exercise to music and special themed events. A resident said there was a Very creditable social programme. Residents can continue with their chosen faith and take Holy Communion with visiting clergy. The hairdresser has a salon at the home and residents said they can see her regularly. It would be beneficial to record the activities to evidence the residents participation and enjoyment. An external firm provide a catering and domestic service to the home. Residents interviewed said the food was very good and there was always plenty of choice. The chef visits the residents each day to discuss the meal options and an alternative is always provided if the menu is not to their liking. A resident said they welcomed this. The menu is based over four weeks and was displayed in various parts of the home. The main meal is served at lunch time and the dining room tables were laid for lunch. Care Homes for Older People Page 15 of 27 The majority of residents attend the dining room and lunch was seen as a social occasion for residents to get together. A list was available of foods the residents like and dislike and also specially adapted crockery was available to help promote their dignity when receiving their meals. The kitchen was found to be well stocked with fresh produce to provide a well balanced diet for the residents. Records for maintaining good standards of hygiene in the kitchen were looked at and they were up to date. A number of food items in the fridge were covered but not dated. This was brought to the catering supervisors attention to be rectified. Food kept in the fridge should be dated to ensure good standards of food hygiene control in the home. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff should be confident in their knowledge regarding contact details for reporting a safeguarding concern. This will help protect the people who use the service. Evidence: There is a complaints procedure and this was displayed for residents and their families to see. The procedure should be updated with contact details for the Care Quality Commission so that people know who to contact if they have a concern. The AQAA reported that no complaints have been received by the home and none have been received by the previous care regulator, Commission for Social Care and Inspection. Residents and relatives said they were pleased with the home and that they would speak to the matron or the staff if at all worried. A policy was seen on protecting people from abuse and also Seftons Protection of Vulnerable Adults policy for safeguarding people. Staff received safeguarding training in 2007 and dates have been booked for June 2009. Staff interviewed discussed the concept of abuse however their knowledge was limited regarding the different agencies involvement. Staff should be confident in their knowledge regarding contact details for reporting a safeguarding concern. This will help protect the people who use the service. It is recommended that a copy of the whistle blowing policy be displayed in the staff room to help staffs understanding of this The manager agreed to incorporate the local guidance within the safeguarding training planned this month. One safeguarding referral was received by the previous care regulator, Commission for Social Care and Inspection in 2008 and this was not upheld following an investigation. Information was available regarding residents who may have a disorder or a disability, such as dementia and may lack capacity to agree to their treatment and how this is managed. The manager has undertaken training in this to increase her understanding. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in safe, well maintained, clean and comfortable accommodation. Evidence: Halcyon House was found to be clean, warm and pleasantly decorated. The home is on one floor only and residents have access to all areas. Disabled access is provided and there are spacious grounds for the residents to enjoy. This includes an inner courtyard with garden furniture. The doors are alarmed to help keep the residents safe. A number of resident bedrooms had been decorated and corridors painted. The AQAA reported that a redecoration schedule is being put together to help keep the home in good order. Bedrooms seen were pleasantly decorated and residents had brought items in from home to make their room feel cosy and homely. This included certain items of furniture. A resident said, My room is just fine and always kept clean and tidy. Likewise another residents said their bed was very comfortable and they slept well. The standard of bedroom furnishings was good and the rooms were bright and airy. Residents had the use of a locked drawer for storing valuables. Residents who were being nursed in bed had been provided with special mattresses to ensure their comfort. Other aids were also seen in use to help with promoting their independence, for example, hand rails, raised toilet seats and moving and handling hoists. The bathrooms had equipment to help residents bathe safely. The plaster work was chipped in one bathroom identified at the time of the site visit. This should be repaired so that the room is maintained to a good standard. The temperature of the hot water had been recorded to ensure it was at a safe temperature for residents to use. Residents said there was always plenty of hot water for bathing. The staff have signed up to local infection control procedures so that they maintain good standards of cleanliness in the building. This was seen whilst looking round and staff said they were provided with plenty of gloves, aprons and hand gel to use as needed. Bathrooms had Care Homes for Older People Page 18 of 27 paper hand towels and liquid soap to reduce the risk of contamination. There are plenty of small lounges including a sun lounge, so that residents can sit in small groups in different parts of the home. This means that the residents have a choice of where to sit quietly, or to sit with other residents or meet their family members. The lounges and dining room room were pleasantly decorated and the dining room tables laid for lunch. A resident said, The home is kept very nicely. The dining room has recently been decorated and new furniture purchased. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A lack of induction and staff training may place residents at risk as staff will not have the necessary skills and competent to care for them. Evidence: At the time of the inspection sufficient numbers of staff were on duty to provide the necessary care and support to the residents. The staffing rota showed the staff on duty and the hours they worked. As the home provides nursing care, trained nurses are employed. During the day two trained nurses were on duty with six carers, domestic, kitchen, maintenance and administrative staff. In the afternoon four carers were on duty. At night there is one trained nurse and two carers. Residents said the home was busy, however the staff responded to calls for assistance as soon as possible. Comments included, The staff seem pleasant and well motivated (resident) and There is always matron or one of her assistants to speak to if I need to speak to someone about something my mother requires (relative). An external company is responsible for the cleanliness of the building and residents said the home was always clean and tidy. Three staff files were looked at and these showed that staff had completed an application form for their care position and references had been sought from past employers. Police checks had been obtained however documentation relating to them, Criminal Record Bureau disclosures and Protection of Vulnerable Adults checks (POVA), were not available on the first day of the site visit. These documents are required to evidence robust recruitment practices to keep resident safe. The inspector returned on another day to look at these records and the staff files seen showed that police checks had been obtained prior to them commencing employment at the home. One staff file did not show a written induction and the others had a brief checklist for new employees. New staff require an induction and this must include information regarding care practices at the home, details of their job role and safe working in the Care Homes for Older People Page 20 of 27 care home. It is recommended that the Skills for Care Induction Standards be implemented as they provide formal learning for staff in the care setting. The manager agreed that the induction needs to be improved. The AQAA reported that of the fifty seven carers, eighteen have achieved an NVQ (National Vocational Qualification ) in care and Level 2 and above. This training should continue so that 50 staff have achieved this qualification in care as part of their development. Training had been given to staff in safe working, for example, moving and handling, infection control, first aid and food hygiene. A number of courses however took place in 2006 and the manager must ensure all staff receive the appropriate training so that they have the skills and are competent to care for the residents. Other courses offered to staff included care planning, record keeping and dementia care. These are all relevant to caring for the older person. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management of the service ensures the home is run in the best interests of people accommodated. Evidence: Ms Annmarie Roberts was appointed as the manager in 2008. Ms Roberts is a trained nurse and has many year experience in caring for the elderly. She has the necessary NVQ in management and is a registered nurse. Ms Roberts has commenced her application for the position of registered manager and this should continue so that she is registered as soon as possible. Ms Roberts is supported in her role by three deputy matrons and an active committee. Residents are encouraged to attend the regular committee meetings and a resident said they found them beneficial. The manager said that at this time residents have not requested separate meetings with her. Staff meetings had also been held and records seen showed that staff receive supervision of their work. The manager has completed a course in how to provide staff supervision to support the staff. A staff member said the meetings enabled her to discuss different aspects of working in the home and also staff training. Staff made the following comments regarding the overall management, The needs of the residents are always met. We have no complaints and all our residents are very happy. It is a lovely home to work in and The service provides a highly tailored programme of care. The resident is always the focus and their opinions are always taken into consideration. Care Homes for Older People Page 22 of 27 In 2008 the staff were awarded an external quality award for the service they provided. The review that took place of the comments received were positive. Comments received at the time of the inspection included, The service generally seems to be of a good standard (relative), On the whole a very satisfactory home (resident) and Each resident is treated as an individual and his/her needs assessed accordingly (resident). A committee member conducts formal monthly visits to the home and writes a report of their findings. These are called Regulation 26 visits. The Regulation 26 reports were not available at the time of inspection, as they were locked away. These reports provide an overview of the home and the committee member meets with residents and staff to discuss the service provided. The reports should be made availabe for inspection. Administrative staff held some monies on behalf of residents. It is recommended that financial records held on behalf of residents evidence two staff signatures to protect residents financial interests. Documentation relating to police checks (Criminal Record Bureau disclosures and POVA checks) were not available on the first day of the site visit. This is required to evidence robust recruitment practices to keep resident safe. The inspector returned on another day and the staff files seen showed that police checks had been obtained prior to them commencing employment at the home. The managers personnel file was not available and the manager was advised that this should be kept at the home to evidence her recruitment. The manager said that this would be arranged. Records required for inspection should be made available at all times. The AQAA gave details of safety checks for equipment and contracts such as gas, electric and fire prevention. A spot check of a number of contracts showed that they were in date to help protect the residents. The contract for maintenance of the hoists was not available and this was followed up with a call to the contractor and a visit conducted to ensure they were working safely. It was agreed that a copy of the new safety certificate for the hoists would be sent to the Care Quality Commission once issued. Fire alarms had been tested each week and emergency lighting checked to ensure it was working safely. Staff received fire training in 2008 and 2007 and further training has also been arranged for this summer. A fire officer should be contacted regarding the frequency of the training to ensure staff are confident with the fire precautions in the home. Staff had completed accident forms where an incident had affected the health of a resident, for example, a resident falling. The deputy manager said that incident forms were available for reporting general incidences in the home however these could not be located. The staff had access to a good range of policies and procedures to ensure they worked safely. As stated under staffing, staff must receive training appropriate to their work so that they have the skills and are competent to provide the necessary care and support to the residents. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes No Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 Residents health care needs must be recorded in a plan of care. This will provide the necessary information to the staff to ensure the residents health and social care needs are met. 20/08/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 Care files should be locked away when not in use to keep residents’ information secure. Consent to the plan of care should be obtained where possible and recorded in the care file so that the resident and their relative are fully informed of the plan of care and agree to it. Care Homes for Older People Page 25 of 27 2 8 Resident risk assessments should be updated to reflect any change in risk that may affect a residents safety and welfare. Handwritten entries on the medicine charts should be recorded by two staff, this will ensure accuracy of the information recorded. Risk assessments for self medication would benefit from more detail with regard to the medicines that the resident wishes to self administer and the risks involved. Homely remedies should be made available to residents as staff have a duty of care to respond to people who have symptoms of a minor nature. Advice should be sought from the residents GP and homes chemist regarding their use. Checks should be undertaken on a regular basis to ensure medicines are given out in safely by the staff. 3 9 4 5 6 12 15 18 A record should be kept of the activities residents take part in to evidence their participation and enjoyment. Food kept in the fridge should be dated to ensure good standards of food hygiene control in the home. The whistle blowing policy should be displayed for staff to refer to so that they are confident in its use. Staff should be confident in their knowledge regarding contact details for reporting a safeguarding concern. This will help protect the people who use the service. Cleaning products should be locked away when not in use to help protect people who use the service. The plaster work was chipped in one bathroom identified at the time of the site visit and this should be repaired so that it is maintained to a good standard. Regulation 26 reports should be made available for inspection as these help to provide a quality review of the service. Financial records held on behalf of residents should record two staff signatures to protect the financial interets of the residents. A copy of the safety certificate for the hoist should be forwarded to the Care Quality Commission for our information. A fire officer should be contacted regarding the frequency of the training to ensure staff are confident with the fire precautions in the home. 7 8 26 26 9 33 10 37 11 38 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. ©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. Care Homes for Older People Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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