Care Home: Holly Lodge Care Home

Similar services:

• Turret Villa Retirement Home
• Mendip House
• Beaconsfield Court Care Home
• Little Sisters Of The Poor
• Manor House
• Middleton Hall Ltd
• Middlesbrough Intermediate Care Centre

What the care home does well The individual files that are used to record residents care needs are well laid out and demonstrate how residents needs are met. A range of social activities both internal and external is arranged for the residents and the home have their own minibus that is used for outings. Good training opportunities are available for staff and the manager ensures that all staff continues to update their knowledge and skills by organising training that is appropriate to their work. The manager is ensuring that staff receives formal supervision and staff meetings are being held. The manager is consulting with residents and their families and seeking their views on how the services can be improved. The company deals quickly and satisfactorily with any issues that are identified during the inspection process. What has improved since the last inspection? An experienced and qualified manager has been appointed to manage the service. Staffing numbers have been increased and staff has been deployed in a way to ensure that there is always sufficient staff to meet residents needs. Recruitment processes are more robust and the necessary documentation is always obtained as part of recruitment. This includes carrying out the necessary criminal record check to ensure that only people who are suitable to work in a care home are employed. What the care home could do better: The copy of the terms and conditions of residence/contract should be legible and photocopies that are currently in place should be replaced with a copy that can be read. The individual written plans of care must include more detailed information particularly about how staff supported with their social needs and what actions staff are taking to achieve this. Daily records should include more information about day-to-day life in the home and how a person spends their day. Prescribed medicines must be administered in accordance with the guidance issued by the Royal Pharmaceutical Society and the administration records must be fully completed at all times. Consideration should be given to ensuring menus are available in different formats in the dining room. And the practices of how tables are set and how meals are served should be reviewed. Though the home meets the space requirements steps should be taken to review theseating arrangements in the first floor lounge in order that more chairs can be provided for the residents. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Holly Lodge Care Home Maddison Street Shildon Co Durham DL4 1BE     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Clifford Renwick     Date: 2 2 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 33 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 33 Information about the care home Name of care home: Address: Holly Lodge Care Home Maddison Street Shildon Co Durham DL4 1BE 01388779265 01388779267 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Dolphin Property Co Ltd Type of registration: Number of places registered: care home 40 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 40 The registered person may provide the following category 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 - maximum number of places 40 Dementia Code DE, maximum number of places 24 Date of last inspection Brief description of the care home Holly Lodge is a new purpose built home situated in the village of Shildon. It provides care for up to 40 older people. Nursing care is not currently provided but may be provided in the near future. At the time of the inspection there were 18 residents who all live on the upper floor of the building. All the rooms in the home have en-suite facilities. There are local shops and facilities in the village of Shildon. Care Homes for Older People Page 4 of 33 Over 65 0 40 24 0 Care Homes for Older People Page 5 of 33 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future if a requirement is repeated, it is likely that enforcement action will be taken. The quality rating for this service is 2 stars. This means that the people who use this service experience good quality outcomes. Before the visit. We looked at. Care Homes for Older People Page 6 of 33 Information we have received since the last visits in July 2006 and from the annual service review that was completed in 2007. How the service dealt with any complaints & concerns since the last visit. Any changes to how the service is run. The providers view of how well they care for people. The Visit. An unannounced visit was made on the 22nd September 2008. During the visit we. Talked with all of the people who live in the home and also staff who were on duty. Held discussion with the manager and also the companys operations manager who was present during part of our visit. Observed staff working practices. Looked at information about the people who live in the home & how well their needs are met. Looked at other records, which must be kept in relation to health and safety and staffing. Checked that staff had the knowledge, skills & training to meet the needs of the people they care for. Looked around the home to make sure it was well maintained, safe and free of any hazards. We also gathered information from looking at care records to assess how staff supports the residents with their assessed needs. We also focused upon looking at care files for 3 residents as a part of the inspection we refer to this as case tracking. And this involves looking at all records of the care for a named individual. The fees are 434.50 to 475.00 per week. The last inspection of this service was in July 2006. What the care home does well: What has improved since the last inspection? What they could do better: The copy of the terms and conditions of residence/contract should be legible and photocopies that are currently in place should be replaced with a copy that can be read. The individual written plans of care must include more detailed information particularly about how staff supported with their social needs and what actions staff are taking to achieve this. Daily records should include more information about day-to-day life in the home and how a person spends their day. Prescribed medicines must be administered in accordance with the guidance issued by the Royal Pharmaceutical Society and the administration records must be fully completed at all times. Consideration should be given to ensuring menus are available in different formats in the dining room. And the practices of how tables are set and how meals are served should be reviewed. Though the home meets the space requirements steps should be taken to review the Care Homes for Older People Page 8 of 33 seating arrangements in the first floor lounge in order that more chairs can be provided for the residents. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 33 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 33 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. A comprehensive assessment is completed prior to a place being offered in the home and this ensures that only those people whose needs can be met are admitted. Each service user is issued with a copy of the terms and conditions of residence so that they know what service will be provided however not everyone had a copy of this in their file. Evidence: Part of this visit focused upon looking at three care files for individual residents and this confirmed that good practices are in place with regards to individual assessments. The residents files contained a standardised assessment document that confirmed an individual assessment of need had been carried out prior to admission into the home and from this the staff had developed written plans of care. Care Homes for Older People Page 11 of 33 Evidence: Staff have carried out the assessment in a persons own home or whilst they have been resident on a hospital ward. The staff also received a social work assessment and care plan from the placing authority and this was used to determine whether an individuals needs could be met in the home. The home do not always confirm in writing to the resident that their needs can be met in the home though there is a standard letter in place that is normally issued once the assessment process is complete. For those three persons who have moved into the home on a temporary basis respite care an assessment of their needs is carried out on admission. Discussion with the manager confirmed that each resident and their relative is issued with a copy of the terms and conditions of residence once they move into the home. Of the three files were viewed one person had an updated copy of the terms and conditions of residence. Another person had a photocopy of the document that could not be read clearly as words were blurred or missing in parts. And for another the copy of the terms and conditions of residence was not available and the administrator was unsure as to why. Care Homes for Older People Page 12 of 33 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. As previously stated within this report three care files were looked at. And this confirmed that following the assessment process a written plan of care is implemented to demonstrate how staff will meet residents assessed needs. Care files are neatly laid out and have separate sections that contain a range of information about an individual. This includes assessments on pressure care, risk assessments, a nutritional screening assessment and a social assessment. The written care plans that are developed from the assessments are well laid out and easy to follow. The care plans are clear about how staff will support people with their individual health needs and some residents have signed their care plans to confirm their agreement of how staff will care for them. It is recorded in the care plans as to how many staff are needed to support a particular area of care and this ensures that staff carry out their work safely. Care Homes for Older People Page 13 of 33 Judgement: It was positive to note that the care plans also include information as to how a resident prefers to be addressed and this is recorded in the care plan for staff to refer to. The health assessments and care plans are detailed whereas the social assessment that covers a persons background and previous lifestyle are not as detailed. And as such the care plans are not clear as to how social needs are to be met. Discussion was held with the manager about the development of the life histories of residents. And it was stated by the manager that he is new in post and is currently reviewing some of the areas of documentation where improvement is needed. In addition to the care plans records are in place that are known as a daily journal. And these are filled in every day by staff that make a record as to how residents health care needs are met. However they do not always contain sufficient information as to how a resident has spent their day. Records are available to confirm that all residents have access to health services and this includes community nurses, G.P.s and the chiropodist. All senior staff have received accredited training in the safe administration of prescribed medicines and for other staff the pharmacist has provided training. The system that is in place in the home is that the qualified nurses administer medicines to the person receiving nursing care. And care staff administer medicines to those persons receiving residential care. There are two administration records systems in use the nursing records and the residential records and these are known as a monitored dosage system and are completed each time a prescribed medicine is administered. These records were looked at during the visit and this confirmed that they are not being completed in accordance with the guidance. For several residents there were gaps on the administration sheet and no recorded reason to give an explanation as to why. Therefore it could not be determined as to whether a resident had been offered their medicine or not. Care Homes for Older People Page 14 of 33 Judgement: Eye drops that were being administered for one person were undated when they were opened so it was not possible to establish whether they had exceeded the discard date from when being opened. For another resident medicines were being administered without the label clearly stating what dose should be taken, for example take as directed. This was discussed with the manager and resulted in staff consulting with the G.P to ensure the correct information about the dose was immediately entered onto the administration sheet. On one record staff were recording the pulse rate of a resident and records of fridge temperatures that are to be tested daily had stopped being tested on the week before the visit. Discussion was held with the operations manager and the homes manager about the administration records and this resulted in the company carrying out an immediate audit of the medicines systems. Following the visit the company provided us with an action plan and written evidence to demonstrate how the above have been addressed in order that staff follow the correct guidelines when administering and recorded medicines. Evidence: As previously stated within this report three care files were looked at. And this confirmed that following the assessment process a written plan of care is implemented to demonstrate how staff will meet residents assessed needs. Care files are neatly laid out and have separate sections that contain a range of information about an individual. This includes assessments on pressure care, risk assessments, a nutritional screening assessment and a social assessment. The written care plans that are developed from the assessments are well laid out and easy to follow. The care plans are clear about how staff will support people with their individual health needs and some residents have signed their care plans to confirm their agreement of how staff will care for them. Care Homes for Older People Page 15 of 33 Evidence: It is recorded in the care plans as to how many staff are needed to support a particular area of care and this ensures that staff carry out their work safely. It was positive to note that the care plans also include information as to how a resident prefers to be addressed and this is recorded in the care plan for staff to refer to. The health assessments and care plans are detailed whereas the social assessment that covers a persons background and previous lifestyle are not as detailed. And as such the care plans are not clear as to how social needs are to be met. Discussion was held with the manager about the development of the life histories of residents. And it was stated by the manager that he is new in post and is currently reviewing some of the areas of documentation where improvement is needed. In addition to the care plans records are in place that are known as a daily journal. And these are filled in every day by staff that make a record as to how residents health care needs are met. However they do not always contain sufficient information as to how a resident has spent their day. Records are available to confirm that all residents have access to health services and this includes community nurses, G.P.s and the chiropodist. All senior staff have received accredited training in the safe administration of prescribed medicines and for other staff the pharmacist has provided training. The system that is in place in the home is that the qualified nurses administer medicines to the person receiving nursing care. And care staff administer medicines to those persons receiving residential care. There are two administration records systems in use the nursing records and the residential records and these are known as a monitored dosage system and are completed each time a prescribed medicine is administered. These records were looked at during the visit and this confirmed that they are not being completed in accordance with the guidance. For several residents there were gaps on the administration sheet and no recorded Care Homes for Older People Page 16 of 33 Evidence: reason to give an explanation as to why. Therefore it could not be determined as to whether a resident had been offered their medicine or not. Eye drops that were being administered for one person were undated when they were opened so it was not possible to establish whether they had exceeded the discard date from when being opened. For another resident medicines were being administered without the label clearly stating what dose should be taken, for example take as directed. This was discussed with the manager and resulted in staff consulting with the G.P to ensure the correct information about the dose was immediately entered onto the administration sheet. On one record staff were recording the pulse rate of a resident and records of fridge temperatures that are to be tested daily had stopped being tested on the week before the visit. Discussion was held with the operations manager and the homes manager about the administration records and this resulted in the company carrying out an immediate audit of the medicines systems. Following the visit the company provided us with an action plan and written evidence to demonstrate how the above have been addressed in order that staff follow the correct guidelines when administering and recorded medicines. Care Homes for Older People Page 17 of 33 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents generally lead fulfilling lifestyles with support from staff to exercise choice and control over how they spend their day. Peoples lifestyle is good with regular contact being maintained with relatives and friends and the residents receive a wholesome appealing balanced diet at times convenient to them. Evidence: In discussion with three residents they confirmed that they are able to take part in religious services that are carried out by a visitor from the church of their choice. They went on to say that this is important for them as all three people had been members of the same church for over 40 years. Residents also confirmed that it was good that they were able to maintain contact with their relatives and friends and that staff always made them feel welcome when they visited. Observations made confirmed that the residents followed their own routines with some residents preferring to spend time in their rooms until the mealtime. Care Homes for Older People Page 18 of 33 Evidence: In discussion with relatives who were visiting they confirmed that they very satisfied with the service. On the day of our visit a visiting entertainer was carrying out a musical show in the upstairs lounge. However there is an issue about the seating in this lounge and this is discussed in more detail in sections 19 and 26 of this report. The residents said that they were looking forward to the musical show and some residents families had come into the home for the show. The activities coordinator who works four hours per day Monday to Friday is responsible for organising activities and has recently organised a fashion show to take place. The home have their own minibus and dependent on the weather this is used for outside excursions by the residents. The activities coordinator has also developed a personal file for each resident and this includes information as to what activities residents would like to do. At present there is no plan of activities circulated to inform residents what is happening on any given day. Though when an event is happening in the home such as an entertainer then a poster is put up on display. Positive comments were offered about the new manager who residents stated, he comes around at least once every day to see if you are alright. They said that the manager has also introduced a beer shandy with the Sunday lunch and they thought this was good. Families spoken to described the manager as approachable and stated that this made it easy for you if you wanted to discuss anything. A meal was taken with the residents during the visit and the residents confirmed that the food is very nice. Breakfast arrangements are flexible and can start from 7am and last up until 11am. Cereals and drinks are available from the time of getting out of bed but if you want a full cooked breakfast then this available from 8am when the cook is on duty. It was good to see that residents chose whether to have a mug or a cup and saucer for their hot drink. Care Homes for Older People Page 19 of 33 Evidence: The lunch was tasty, hot and of sufficient quantity however there were some matters observed during the meal that require addressing. There were no menus available that could be looked at by residents. Though staff confirmed staff had asked them the day before about their choice of meal. Should someone change their mind about what they want to eat from the meal they have previously chosen there are some limitations as this is dependent upon how much food the cook puts on the food trolley. It was confirmed in discussion that an alternative meal could always be provided to the main choices. Not all of the tables had sufficient condiments, which resulted in staff having to take condiments from one table to another. Staff did not put out the plate of bread and butter that was to accompany the meal so consequently residents were not offered this with the full plate being returned to the kitchen. Whilst people were sitting waiting for their meal staff were still setting some tables with cutlery. There was a choice of desserts but staff did not always offer people the full information about the choices available. However when a resident asked for something different to what was being offered this was provided by staff. Apart from these matters listed above the meal was unhurried and enabled the residents to have an opportunity to chat. One resident said The food is so nice that I have put weight on Where the residents required support to eat their meal staff provided this. Care Homes for Older People Page 20 of 33 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. A clear accessible complaints procedure gives residents and their relatives confidence that they will be listened to and taken seriously. Furthermore it provides information that is effectively used to improve the service. The manager and staff have a good understanding of local adult protection procedures, which helps to ensure the protection of residents from abuse. Evidence: The manager has completed training in the protection of vulnerable adults and in turn has ensured that staff have received in house training, as part of their work. Good policies and procedures are in place for dealing with any potential incidents of abuse and also procedures that are known as whistle blowing. This is a policy that enables and encourages staff to report any concerns they have. Discussion with one member of staff confirmed that they are aware of the whistle blowing policy and explained how all staff can use it. The complaints procedure is on display and information is also given out to residents and their families when first moving into the home. Care Homes for Older People Page 21 of 33 Care Homes for Older People Page 22 of 33 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean, well maintained and this promotes a positive image for residents and furthermore ensures that they remain safe and well. Evidence: At the time of our visit only the first floor was being occupied so all communal areas were viewed and a representative number of bedrooms. The first floor has 24 bedrooms and there are 16 bedrooms on the ground floor. Each floor has its own lounge and own dining room. The dining room on the first floor has seating for 24 people however the lounge is equipped with 14 armchairs with very little space to provide any extra seating. This was noticeable during the afternoon when a visiting entertainer carried out a musical show in the upper lounge and there were insufficient seats should every resident wished to attend. Though the home is purpose built there is very little space available to supply more chairs to the first floor lounge and this was discussed with the manager. Care Homes for Older People Page 23 of 33 Evidence: There is an additional room on the first floor that has been designated as an area that can be used by residents whom smoke. The ground floor lounge though not currently occupied is equipped with 13 comfortable armchairs but does have capacity for extra chairs to be provided to seat 16 people. Discussion with the manager and staff indicated that there was insufficient storage space for some of the specialist equipment in use and as such this was being stored in a recess at the end of the corridor. There is the potential for this to be a safety hazard should residents wander in to this area and this was discussed with the manager who stated plans are in place to address this. Good housekeeping standards are in place and there were no noticeable defects. Furniture is of good quality and the building is in good decorative order. All rooms are fitted with their own en suite toilet and bedroom doors are fitted with magnetic catches that enable the doors to be kept open without compromising fire safety. Care Homes for Older People Page 24 of 33 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels are sufficient to ensure that residents needs are met. Furthermore staff receive sufficient training to support them in their work, to ensure residents receive good quality care. Robust recruitment procedures are in place to prevent unsuitable people being employed. Evidence: There were sufficient nursing and care staff on duty during the visit and staff rotas confirmed the number of staff that are allocated to work on each shift. In addition to the above the home also have housekeeping staff that have responsibility for all housekeeping tasks and dealing with residents laundry. The home also employ qualified catering staff to deal with all matters relating to food. Discussion held with the manager confirmed that all staff have undergone NVQ training. The manager is also a qualified NVQ work based assessor and can also carry out training with staff. Care Homes for Older People Page 25 of 33 Evidence: Good training opportunities are available for staff and training has covered first aid, manual handling, food hygiene, NVQ and health and safety. All of the senior staff have had training in caring for people with dementia. The manager confirmed that he would also be involving the community psychiatric nurse in providing training in challenging behaviour for all staff. The training plan confirmed that training was also being carried out on the week of the visit with staff about to receive training in catheter care and continence management. Good recruitment procedures are in place and all references and documentation are thoroughly checked before someone is employed to work in the home. Once employed all new staff undergo induction training that includes safeguarding adults. Care Homes for Older People Page 26 of 33 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. An experienced and qualified manager is in post, which ensures that the service is effectively run in the best interests of the residents, that they are safe and well cared for and their rights are safeguarded. Evidence: The manager is new in post and as yet has not applied for registration with the commission. He is experienced and qualified and has previously managed care homes for older people. The manager is also supported by an experienced qualified nurse who is the deputy manager and is responsible for offering management oversight in the absence of the manager. In addition to this the companys operations manager is carrying out weekly visits to the home to offer support to the manager. Care Homes for Older People Page 27 of 33 Evidence: The operations manager joined us during our visit and they took part in the inspection process. Since commencing work in the home the manager has been reviewing the service and is looking at where improvements can be made as part of the ongoing quality assurance programme. All staff are receiving formal supervision and a recent staff meeting has been held so that staff can contribute to the ongoing developments within the home. Discussion with the manager confirmed that good systems and records are in place monies held on behalf of the residents. All staff are taking part in mandatory fire training and discussion with staff confirmed that they are clear of the homes fire procedures and what to do in the event of the fire alarm sounding. Records are kept of all accidents in the home and these confirmed that staff follow appropriate procedures when dealing with accidents. As previously stated in this report the manager is ensuring that all staff receive regular and updated training that also includes health and safety training. Care Homes for Older People Page 28 of 33 Are there any outstanding requirements from the last inspection? Yes R 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 1 1 5 The home must provide 01/10/2006 additional information to residents about fees payable by October to comply with amended Regulations . Care plans must include information on residents recreational needs and how the home will meet these . Information on residents dietary needs and preferences must be available in the kitchen. Records must be kept of meals taken by residents in enough detail to show whether they receive a satisfactory diet and if any special needs are met . 01/09/2006 2 7 15 3 15 12 & 17 01/09/2006 4 27 18 Staffing numbers and deployment must be kept under review and increased when necessary. 01/09/2006 5 29 18 Arrangements for supervising 01/09/2006 staff who begin work before a full Criminal Records Bureau is received must be recorded. The companys recruitment Care Homes for Older People Page 29 of 33 procedures must include guidance on Criminal Records Bureau and Protection of Vulnerable Adults checks. Care Homes for Older People Page 30 of 33 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 4 14 The home must confirm in 31/10/2008 writing to the prospective service users that on the basis of the assessment that their needs can be mt in the home. service users and their representatives will know that the home they enter can meet their needs 2 7 15 The written care plans must continue to be developed and include information as how staff supports people with their social needs. This will demonstrate that staff are meeting peoples needs in a way that suits them. 31/12/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 31 of 33 1 2 The copies of the terms and conditions of residence/contracts should be legible with a copy being kept in each residents file. The mealtime practices as identified in this report should be addressed. 2 15 Care Homes for Older People Page 32 of 33 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 33 of 33 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!