Care Home: Hungerford Care Centre

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What the care home does well The home works closely with other health professionals to ensure that the people who use the service are kept as healthy as possible so that they are able to enjoy a good quality of life. The home has safe medication administration procedures so that people know that they are receiving the right medication, at the right time to maintain or enhance their health. People are treated with respect and dignity and feel that staff always treat them `well` which makes people feel valued and important. People are given good quality food and are given choice of portion size and content. Everyone spoken to said they liked the food and enjoyed the mealtime. Mealtimes are made pleasant by attention to detail, in the environment such as table linen, glasses on the tables and flowerarrangements and by staffs` attention and sensitivity to the needs of the diners. The people who live in the home feel safe and are confident that they can talk to staff or the manager if they have any concerns or worries. The home is kept to a very high standard of cleanliness and hygiene, with great attention paid to it being kept `odour free`, which makes it a pleasant environment for people to live in. Staff are knowledgeable about the work they do and are enthusiastic about their work, they are fully supported and trained to enable them to give the best care possible to the people who use the service. The home is very well managed by an experienced and skilled manager who ensures that the needs and interests of the people who live there are the priority of the service. What has improved since the last inspection? The home is being decorated and there has been the installation of a new `wet room` to increase the variety of bathing opportunities for the people who live in the home. General developments in care matters such as care planning and activities are ongoing in the home and presented in the monthly action plans and Annual Development Plans for the home. What the care home could do better: The home could include details of peoples` activities in the daily notes so that staff can identify peoples` changing preferences and what may keep people interested on a day-to-day basis. The Manager could ensure that staff have an annual appraisal so that their professional development can be monitored in a formal way. CARE HOMES FOR OLDER PEOPLE Hungerford Care Centre Wantage Rd Hungerford Berkshire RG17 0PY Lead Inspector Kerry Kingston Unannounced Inspection 14th July 2008 10.00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hungerford Care Centre DS0000010995.V367523.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hungerford Care Centre DS0000010995.V367523.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hungerford Care Centre Address Wantage Rd Hungerford Berkshire RG17 0PY Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01488 682002 hungerford@schealthcare.co.uk www.schealthcare.co.uk Exceler Healthcare Services Limited Ms Elizabeth Mary McCarthy Care Home 59 Category(ies) of Dementia (0), Old age, not falling within any registration, with number other category (0) of places Hungerford Care Centre DS0000010995.V367523.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Dementia - DE; Old age, not falling within any other category - OP The maximum number of service users who can be accommodated is: 59 6th July 2006 Date of last inspection Brief Description of the Service: Hungerford Care Centre (also known as Hungerford Care Home) is a large extended detached house surrounded by woods and farmland and is accessed from a main road 10 Minutes Drive from Hungerford Town Centre. The house is used to provide nursing care for Older People and residents with memory loss occupy a separate wing called ‘The Martins’. The garden extends around the house; there are flowerbeds and seating and an enclosed sensory garden with patio area for those residents who have memory loss. The accommodation is largely provided in single rooms with en-suite facilities. In the main house the rooms are spacious and individual in arrangement; within the extension all of the rooms have an en-suite facility. The fees are from £851 per week to £951 per week Hungerford Care Centre DS0000010995.V367523.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 stars. This means that the people who use the service experience excellent outcomes. This is a report for the key inspection of the service, which included a routine unannounced site visit. This took place between the hours of 10.00 am and 5.30pm on the 14th July 2008. The information was collected from the Annual Quality Assurance Assessment, a document sent to the service by the Commission for Social care Inspection and completed by the registered manager of the service. Surveys were sent to the residents of the home and to their relatives, a total of 15 were returned to the Commission. Discussions with five staff members, two visitors and the registered Manager took place. Four residents were spoken to individually and others were spoken to for a short time. Observation of practice and interactions between staff and residents was used as a further source of information throughout the visit. A tour of the home and reviewing residents’ and other records were also used to collect information on the day of the visit. What the service does well: The home works closely with other health professionals to ensure that the people who use the service are kept as healthy as possible so that they are able to enjoy a good quality of life. The home has safe medication administration procedures so that people know that they are receiving the right medication, at the right time to maintain or enhance their health. People are treated with respect and dignity and feel that staff always treat them ‘well’ which makes people feel valued and important. People are given good quality food and are given choice of portion size and content. Everyone spoken to said they liked the food and enjoyed the mealtime. Mealtimes are made pleasant by attention to detail, in the environment such as table linen, glasses on the tables and flower Hungerford Care Centre DS0000010995.V367523.R01.S.doc Version 5.2 Page 6 arrangements and by staffs’ attention and sensitivity to the needs of the diners. The people who live in the home feel safe and are confident that they can talk to staff or the manager if they have any concerns or worries. The home is kept to a very high standard of cleanliness and hygiene, with great attention paid to it being kept ‘odour free’, which makes it a pleasant environment for people to live in. Staff are knowledgeable about the work they do and are enthusiastic about their work, they are fully supported and trained to enable them to give the best care possible to the people who use the service. The home is very well managed by an experienced and skilled manager who ensures that the needs and interests of the people who live there are the priority of the service. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Hungerford Care Centre DS0000010995.V367523.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hungerford Care Centre DS0000010995.V367523.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3. People who use the service experience good quality outcomes in this area. The home ensures that a full and detailed assessment is undertaken prior to admission so that people know that it can meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Assessments for five people were seen, these included people with equality and diversity issues and needs. All care plans had a full assessment, which included full dementia and diversity assessments, where appropriate. All prospective residents have a residential assessment, even if they have a Social Work assessment. The Home Manager or a senior sister completes these. Hungerford Care Centre DS0000010995.V367523.R01.S.doc Version 5.2 Page 9 The assessments include assessments for the required amount of nursing input. There is one respite bed, a new full assessment is not always completed for admissions to this but care managers confirm that there have been no significant changes to the needs of the person prior to the short-term admission. The respite bed is used as a trial bed in some instances, so that people can see if the home suits them and is able to meet their needs. Hungerford Care Centre DS0000010995.V367523.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10. People who use the service experience excellent quality outcomes in this area. The home has a comprehensive plan of care for everyone who uses the service, this enables them to fully meet peoples’ personal, emotional and health care needs. The home foster good relationships with other professionals to ensure people can get any additional help they may need from outside the home. There is a robust medication administration procedure to ensure that people receive the right medication at the right time. Staff treat people with respect and sensitivity when meeting their individual needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Hungerford Care Centre DS0000010995.V367523.R01.S.doc Version 5.2 Page 11 Care plans for five people were seen, the detailed assessments and care plans noted how to meet specific individual and special needs. They clearly note equality and diversity issues for everyone. Personal and social care needs including preferences, likes and dislikes are generally noted, but they could be slightly more detailed with regard to activities. Staff complete a weekly report for each person, to ensure any health or wellbeing issues are identified and looked at quickly. The care needs assessment and care plans are reviewed and updated monthly and there is is a three or six monthly review meeting to discuss all elements of the care plans. Families, residents and care managers are invited to the meeting, as is appropriate for the individual. If individuals’ have care management input, the Local Authority review the care on an annual basis. Residents spoken to said that there are always staff around to help them if they need it,one person said, ‘they answer the bell very quickly, even if they are busy’. Four residents and 11 relatives who completed surveys in March 2008 stated that they were happy with the standard of care that people received in the home. staff were able to fully describe how they respected peoples’ privacy and dignity and were observed to be practicing what they had described, throughout the visit. Residents were seen being spoken to with respect and sensitivity. One person said that ‘staff are lovely and always treat you well’. One family member spoken to said that she was ‘totally confident with the care that the family member received.’ She was ‘thrilled’ with the home. Another said that the home ‘give excellent care’. One comment seen in the ‘compliments book’ completed by relatives said, ‘the home has an incredible calming influence on them. Communication methods have a great deal to play in this success’. People have ‘end of life’ plans as is appropriate and if they and their families wish to discuss this sensitive issue. On the day of the visit several bereaved relatives visited the home and were treated with the greatest respect and sensitivity. Peole have full healthcare and nursing plans and all health issues are very well recorded. The home has a Doctor visit weekly and all the residents are seen on a regular basis aswell as when needed. The home also makes referrals to the tissue viability advisor, the physiotherapists, the psychiatric team and speech therapists, as necessary. Hungerford Care Centre DS0000010995.V367523.R01.S.doc Version 5.2 Page 12 The manager has meeings with the G.P surgery on a regular basis to discuss any issues or concerns there may be. Local residents are given the choice to remain with their own G.P, if they prefer, on admission to the home. The home keep detailed records for people who need them such as nutritional intake, fluid intake/ouput , peronal hygiene, and everybody is weighed monthly. Pressure sores are monitored monthly and a specialist tissue viability advisor is accessed if a pressure sore is growing worse or not healing. The home had only one person with a pressure area on the day of the visit. One lady who has been bed-bound for at least three years is kept pressure area free. Any drugs issued to help people control their behaviour are prescribed by the psychiatric team and people have access to a Community psychiatric nurse, as is necessary. The home uses’ the Boots monitored dosage system which means that the pharmacist packs the medication which is then administered directly to the people who need it. The pharmacist visits evry six months, the last visit was in january 2008 when they made no significant recommendations. The manager completes monthly medication audits and there have been no recorded errors in the last six months. Only nurses adminsiter medication and the staff member spoken to had a very thorough knowledge and understanding of the medication procedure and process. He explained that he was able to discuss any issues with the G.P surgery or pharmacy and there was a good working relationship between all concerned. Hungerford Care Centre DS0000010995.V367523.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. People who use the service experience good quality outcomes in this area. The people who live in the home are helped to live as pleasant and interesting a life as is possible. They are encouraged to make as many decisions for themselves as they are able and families and visitors are welcomed into the home. Mealtimes are calm, social occasions and attractive meals are presented in comfortable and pleasant surroundings. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Activity plans for each individual are not clearly recorded but a section in care plans notes social and recreational needs. Peoples’ culture and religion is clearly noted. The home has a dedicated activities co-ordinator who organises group activities and does one-to-one work with people. The Co-ordinator keeps a record of activities participated in by individuals, but these are often not Hungerford Care Centre DS0000010995.V367523.R01.S.doc Version 5.2 Page 14 included in much detail on daily notes, which focus on peoples’ physical/emotional well being rather than ‘social’. Visits by family and friends are entered in detail on the daily notes and most residents have regular visitors. A weekly Activities plan is displayed around the home and families often take people out. One person told me that there were plenty of activities available but that she preferred ‘her own company’. They also said ‘it is a good place to live’. Two other residents said ‘it is very nice here, as good as it can be and not be home’ and ‘we do very well here’. The home has a minibus and trips are offered but the manager explained that few residents want to access the community with other residents however one lady was taken shopping on a one- to- one basis. Two ministers and dogs, which the residents can interact with, visit the home on a regular basis. There is good access to the gardens, particularly the dementia unit where the garden is positively used as a daily recreational pursuit. People can access the garden unaccompanied, if they wish, as it is enclosed and safe. The home has a sensory room and sensory garden in the ‘Martins’ unit. Staff were observed spending time talking to people and accompanying them into the garden. The visitor’s book showed a large amount of visitors and family members, one person said ‘people can come and visit when they like’, ‘visitors are always made welcome whatever time’, ‘staff listen if I have any worries and always have time to talk to me’, (a visiting family member). Peoples’ independence levels are noted on care plans and people were seen to be asked what they would like to do and when. Staff described how people were asked what food they wanted, what time they would like to go to bed, what clothes they would like to wear and generally encouraged to make as many decisions for themselves as possible. People are encouraged to look after their own possessions and money, if appropriate. Some people who are not able to independently look after possessions are assisted by staff such as jewellery that is held in the safe and got out for special occasions when the person wants to wear it. The menu seen was varied and nutritious, the home uses a system supplied by the provider to ensure that meals contain all the necessary nutrients and are properly balanced. The dining rooms, including the ‘Martins’, where those people with dementia eat, are very comfortable and welcoming. The mealtime observed was very pleasant and calm. People were helped if necessary, with sensitivity, two Hungerford Care Centre DS0000010995.V367523.R01.S.doc Version 5.2 Page 15 people said that they enjoyed mealtimes and could have a choice of food, which is ‘good’. One person said the food is ‘very good’. The food sampled was of very good quality, fresh and attractive and people asked and were asked if they would like more or different food. Hungerford Care Centre DS0000010995.V367523.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who use the service experience good quality outcomes in this area. The home makes sure that people know how to complain and people are confident that if they express any concerns or worries they will be listened to and it will be acted upon. People feel safe and are kept safe from all forms of abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has received four complaints in the last year, they have all been properly reported and responded to. A book is kept which ‘logs’ all complaints and very detailed records of the complaints and responses to them are kept in a file for reference. Three people who live in the home said that they would know who to talk to if they were not happy, one said ‘I can always talk to staff or the manager, they all listen’, a family member said that ‘staff will always listen to me if I have any concerns’. Staff have received training in Protection of Vulnerable Adults (Safeguarding) and staff spoken to knew what they would do if they encountered abuse or poor practice. Some staff had excellent responses but some may benefit from Hungerford Care Centre DS0000010995.V367523.R01.S.doc Version 5.2 Page 17 some refresher training, all were clear about their role of protecting those in their care. The manager agreed to look at how to ensure all staff are fully aware of the procedures for reporting any Protection issues. Two people said that they always ‘feel safe and are always well treated’. One safeguarding issue had been investigated, since the last inspection, it was properly dealt with and thoroughly investigated. The home does not deal with peoples’ finances, in general but keeps personal allowances for some people. This is properly recorded and safely administered, receipts are kept for all expenditure and individual records are kept. The money is kept in one account but interest is shared between all the people whose money is in the account. The home does not use any form of restraint for people who may have some difficult behaviours. There are some instructions for staff to follow if people display difficult or aggressive behaviours but more detailed behavioural plans may be of benefit to people. However people who do have some difficult and distressing behaviours were seen to be being supported in very effective ways, with staff communicating well and responding to peoples’ individual needs. The Commission for Social care Inspection has received no information with regard to complaints or Protection issues about this home. The home keeps a ‘compliments’ log which showed 32 letters of thanks and praise for the care given by the home, in the last year. Hungerford Care Centre DS0000010995.V367523.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. People who use the service experience good quality outcomes in this area. The home provides people with a pleasant, clean and homely environment. It is well maintained and work to enhance peoples’ living environment is undertaken. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of the visit all areas of the home were clean and hygienic with no unpleasant odours, the home was extremely well presented. It looked homely and the people who live there seemed comfortable and ‘at home’. Hungerford Care Centre DS0000010995.V367523.R01.S.doc Version 5.2 Page 19 A survey from a family member/visitor to the home commented ‘it provides a clean and cheerful environment’. The home has good quality furniture and fixings and people are able to bring some of their own possessions when they are admitted to the home. The home is organised into three units and all have their own lounges and dining rooms. The communal lounge in the unit ‘Martins’ is small and cannot accommodate all the residents who live there. There are plans for an extension to this area, which the manager confirms, will be started this year. The extension will enhance the lifestyle of the people who live in this unit as they make good use of this pleasant area that opens directly onto the enclosed and safe garden. Parts of the home were in the process of redecoration on the day of the visit and the manager reported that a new ‘wet room’ had been installed in the past year. The laundry was seen to be well ordered and the correct equipment was available. All staff are trained in infection control and the use of appropriate protective clothing was observed. Peoples’ private space was seen to be individualised according to their personal taste and choices. The home has a housekeeping staff team who take great pride in their work and keep the home to a very good standard of cleanliness. Hungerford Care Centre DS0000010995.V367523.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30. People who use the service experience good quality outcomes in this area. There are enough staff to meet the needs of the people who live in the home. Staff are well trained, motivated and knowledgeable about their roles and are consequently able to offer good care to the people who use the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has 21 care staff and 11 registered nurses plus ancillary staff, including a housekeeping team. It operates in 3 units and there are three nurses and seven carers on duty per shift. During the night there are two nurses and four carers in the home. The ‘Martins’ has the highest staffing ratio. People spoken to said that ‘staff answer the bells quickly’ and there are ‘always staff to help if you need it’. Staff were seen spending time with people chatting and doing activities. The home is currently has only one staff vacancy. One of the four staff spoken to said that they felt there should be more care staff but the other three felt that there were enough staff to perform their duties and spend time with residents. Two staff said that on occasion it felt Hungerford Care Centre DS0000010995.V367523.R01.S.doc Version 5.2 Page 21 very busy and extra staff would be nice. There is always a registered nurse on duty in each unit. The recruitment files of three staff were seen and they included all the necessary information required, they also included an interview checklist and an equal opportunities monitoring form. The home has various means of supporting staff such as supervision on a regular basis, robust disciplinary procedures, and informal ‘counselling’ sessions to help people with any work related difficulties they may have. Annual appraisal has not been totally established yet but the supervisions act as appraisals and are used to plan individual staff members’ development. The manager said that they are in the process of ensuring an appraisal programme is instigated. The senior management team have a weekly meeting, nurses have a three monthly meeting and staff have occasional meetings when they can be ‘got together’. Staff can input into the other meetings, there was evidence that the manager asks staff what they would like to be discussed and that something is done about it if they have concerns. 11 of the care staff have an N.V.Q. qualification and the home has a number of additional training courses available such as dementia awareness. A full induction is completed by staff, which includes Health and Safety and Protection of Vulnerable Adults Training. The home has internal trainers to give staff the opportunity for enhanced training and there is a trainer provided by the Local Authority. Senior staff were observed to give staff ‘on the job coaching’ during the course of the day. One staff member said that if you found a course that would be of benefit to you and your work the manager would do her best to facilitate you being able to access it. Four staff spoken to said that they had very good training opportunities and felt supported by the management team. One visitor commented that the staff ‘are very kind and sensitive to the needs of the residents and their families.’ A survey noted ‘staff really know their patients well’. Staff spoken with, were competent, articulate and had good knowledge of their roles and responsibilities and what their work involved. Shortfalls in staffing are generally covered by people doing overtime or by bank staff. Hungerford Care Centre DS0000010995.V367523.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38. People who use the service experience excellent quality outcomes in this area. The home is well managed and the needs of the people who use the service are the priority. Health and Safety is of paramount importance and people are kept as safe as possible. This judgement has been made using available evidence including a visit to this service. Hungerford Care Centre DS0000010995.V367523.R01.S.doc Version 5.2 Page 23 EVIDENCE: The Manager has been in post for approximately three years, she is well qualified and experienced. The home does not have a deputy manager but has two senior sisters and a care co-ordinator, who share management responsibilities. The Manager delegates responsibilities very effectively such as to the housekeeper to oversee the domestic running of the home. Staff spoken to said ‘ she is a very good manager, supportive, she always has time to discuss any issues with you and she listens to what you have to say’, ‘the home is very well managed and the manager is approachable, she is a good person to work for’, ‘she is a very good manager’. People who live in the home said ‘she is a very, very good manager and will always listen to you’, ‘you can always talk to the manager’. The home has several quality assurance processes, these include a monthly visit by someone on behalf of the provider. The manager completing a detailed audit of the home every month, which includes medication, finances, health and safety, environment and care plans. Weight charts included comments by the manager identifying if there was any reason for concern and what action should be taken. The manager writes a monthly action plan as a result of the audit. People complete an annual satisfaction questionnaire and there is a relatives committee, which supports the home and/or looks at any issues around the care in the home. An annual development plan is produced as a result of the different processes and it was seen that many of the actions noted from last year had been instigated, notably the extension to the lounge in the Martins. The financial systems and records for peoples’ personal monies and belongings are well kept and receipts are kept for all expenditure. Families or advocates, generally, act as appointees for residents. Health and Safety records show that all necessary checks and maintenance are completed appropriately. A fire officer visited in May 2007 and made two requirements, on his return in July 2007 he was satisfied that the home had met them. The homes’ recent environmental health report stated the home had ‘meticulous record keeping’ and ‘Good cleaning systems.’ The home received a satisfactory report. Records of accidents and incidents are kept on peoples’ files and are recorded generally so that the manager can monitor them and take any action necessary to reduce the risk of recurrence. The provider also completes regular Health and Safety audits of the home. Hungerford Care Centre DS0000010995.V367523.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 4 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 4 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 3 Hungerford Care Centre DS0000010995.V367523.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP12 OP30 Good Practice Recommendations To include more detail of activities in daily notes, to give a fuller picture of peoples’ lifestyle and the things they enjoy on a daily basis, for future reference. To initiate an annual appraisal for all staff to ensure that their development needs are met and their working practice is enhanced. Hungerford Care Centre DS0000010995.V367523.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Hungerford Care Centre DS0000010995.V367523.R01.S.doc Version 5.2 Page 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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