Care Home: Jeian

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What the care home does well The home offers comfortable and homely accommodation to a small number of residents. The staff are able to get to know the residents well and try to meet their needs in an individual manner. Following recent refurbishment works the home provides spacious communal accommodation, is well appointed clean and tidy and residents bedrooms have been individually personalised. The home provides a range of activities and a varied nutritious diet. People living in the home said that they enjoyed the various activities and confirmed that the food was very good and had further improved over recent weeks since the completion of the building of a new kitchen and the appointment of new cooks. Comments from residents and relatives were generally complimentary about the care and the manner in which the home was run. These comments included from one relative "They care for people very well my relative is very happy there". Another reported "The Home is very welcoming to family and visitors and there is a lovely feeling of care and concern for the residents". What has improved since the last inspection? Since the last inspection an activity organiser has been appointed and following consultation with the residents the range of activities increased. Two housekeepers / cooks have also been appointed thereby giving full cooking and cleaning coverage throughout the week. New equipment including a heating system, clothes dryer, freezer and fridge, comfortable sitting chairs for the lounge and new dining furniture along with new carpeting and curtains have been provided. Refurbishment and extension building works have just been completed. These have provided additional lounge space with an adjacent dining area. The kitchen and laundry rooms have been renewed. New offices and staff room and bathing facilities provided along with four new en-suite bedrooms with flat level shower facilities to three of these rooms have provided additional attractive accommodation for the home. Works to complete the paving and planting of the secure rear garden are on going depending on the weather. Since the last inspection the care plans have all been revised to record the assessed care needs more comprehensively and to give better detail as to the known wishes of the residents. A wider range of staff training opportunities have been accessed since the last inspection and more staff have achieved or are studying for the NVQ professional qualification. What the care home could do better: Additional training concerning the Mental Capacity Act for senior staff would be beneficial as would further improvement to the detail recorded in the care plans the assessment of the residents needs and how these needs should best be met. CARE HOMES FOR OLDER PEOPLE Jeian Jeian Care Home 322 Colchester Road Ipswich Suffolk IP4 4QN Lead Inspector Mrs Jan Sheppard Unannounced Inspection 10th December 2008 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Jeian DS0000047113.V373495.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. Jeian DS0000047113.V373495.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Jeian Address Jeian Care Home 322 Colchester Road Ipswich Suffolk IP4 4QN 01473 274593 F/P 01473 274593 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) Mr Felix Emejulu Chukwuma Mr Felix Emejulu Chukwuma Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places Jeian DS0000047113.V373495.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th January 2008 Brief Description of the Service: Jeian Residential Home currently offers care and accommodation for thirteen older people. Application has been made to increase this registration to seventeen. The home is situated on the corner of several main roads in a suburb of Ipswich and is close to Ipswich hospital, several local shops, bus routes and other amenities. The building has recently been subject to refurbishment and extension building works which have provided an extended dining and lounge area, new kitchen and laundry facilities and additional en-suite bedrooms. The home has a lift and there is an emergency call bell system in operation in each bedroom, toilet and bathroom. The home offers car parking to the front by the main entrance and has a secure rear garden. The homes fees currently range from £350 to £400 per week. These fees do not cover hairdressing, newspapers, toiletries or chiropody. Jeian DS0000047113.V373495.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 *. This means that the people who use the service experience good quality outcomes. This report follows an unannounced inspection where the core standards of the Care Standards Act 2000 for the care for older people were examined. The inspection took place on a weekday between 10.00 and 16.30 hours. The registered manager was present through out the day to assist with the inspection. During the visit a number of residents and staff files were seen, a tour of the home was undertaken and various policies and maintenance records were looked at. Part of a medication administration round was observed and some medication administration records were examined. A number of staff, visitors and residents were interviewed about the care at the home. Care practice was observed and the serving of the lunchtime meal was seen. The detail in this report reflects the findings on that day and also takes account of information sent periodically to the Commission by the homes management. Information contained in the AQAA (Annual Quality Assurance Assessment) completed by the manager and information given in the seventeen pre inspection surveys completed by staff relatives and residents was also taken into account. What the service does well: The home offers comfortable and homely accommodation to a small number of residents. The staff are able to get to know the residents well and try to meet their needs in an individual manner. Following recent refurbishment works the home provides spacious communal accommodation, is well appointed clean and tidy and residents bedrooms have been individually personalised. The home provides a range of activities and a varied nutritious diet. People living in the home said that they enjoyed the various activities and confirmed that the food was very good and had further improved over recent weeks since the completion of the building of a new kitchen and the appointment of new cooks. Jeian DS0000047113.V373495.R01.S.doc Version 5.2 Page 6 Comments from residents and relatives were generally complimentary about the care and the manner in which the home was run. These comments included from one relative “They care for people very well my relative is very happy there”. Another reported “The Home is very welcoming to family and visitors and there is a lovely feeling of care and concern for the residents”. What has improved since the last inspection? Since the last inspection an activity organiser has been appointed and following consultation with the residents the range of activities increased. Two housekeepers / cooks have also been appointed thereby giving full cooking and cleaning coverage throughout the week. New equipment including a heating system, clothes dryer, freezer and fridge, comfortable sitting chairs for the lounge and new dining furniture along with new carpeting and curtains have been provided. Refurbishment and extension building works have just been completed. These have provided additional lounge space with an adjacent dining area. The kitchen and laundry rooms have been renewed. New offices and staff room and bathing facilities provided along with four new en-suite bedrooms with flat level shower facilities to three of these rooms have provided additional attractive accommodation for the home. Works to complete the paving and planting of the secure rear garden are on going depending on the weather. Since the last inspection the care plans have all been revised to record the assessed care needs more comprehensively and to give better detail as to the known wishes of the residents. A wider range of staff training opportunities have been accessed since the last inspection and more staff have achieved or are studying for the NVQ professional qualification. Jeian DS0000047113.V373495.R01.S.doc Version 5.2 Page 7 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. Jeian DS0000047113.V373495.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Jeian DS0000047113.V373495.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to the service. People who use this service can expect to receive an assessment of their care needs prior to their admission to the home. Standard 6 does not apply as the home does not accept referrals for intermediate care. EVIDENCE: Good information about the home and the level of services offered is given to all prospective applicants. The homes Statement of Purpose and Service User Guide was displayed in the entrance hall of the home and this was seen to include all the elements required by regulation including information about Jeian DS0000047113.V373495.R01.S.doc Version 5.2 Page 10 staffing and staff qualifications, private and communal facilities and space. The manager has commenced revising this information so that it more accurately reflects the new refurbishment of the building. All the residents have a contract and information concerning terms and conditions of residency. New residents all enter the home on a trail basis. People wishing to move into the home will have a full assessment of their care and social needs carried out by the Manager who will visit them at their home or in hospital. Relatives or representatives may be involved in this assessment if the applicant wishes them to be. Information from medical and social care services are gathered so that the home can be fully informed about all aspects of the applicants needs. The home uses the Roper, Logan and Teirney model of assessment that covers twelve activities of daily living; maintaining a safe environment, breathing, eating and drinking, elimination, dressing and undressing, controlling body temperature, mobility, working and playing, expressing sexuality, sleeping and dying. The records of three recently admitted residents were seen during this inspection and each one had a pre admission assessment where their initial care needs their preferences and likes and dislikes were recorded. Some aspects could have been recorded with better detail and this additional information could perhaps be added during the initial days of their admission as the staff get to know the resident better. Residents and relatives spoken with all said that they had had the opportunity to visit the home and to assess the service before making the decision to move in. One resident explained to the inspector that she came to the home from the local hospital where she had been resident for one year. “The Manager came to see me on the ward I was just about to eat my lunch so he offered to come back again after I had completed lunch and when he did he bought a wheelchair and offered to walk me to visit the home “ (which is close to the hospital) “ I was very impressed with his manner he answered all my questions about the home but gave me every opportunity to make my own decision”. “I am very glad that I came here the staff were very helpful in enabling me to settle in and I have a lovely room with all my things around me”. Jeian DS0000047113.V373495.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9and 10. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use this service can expect to receive planned care to meet their assessed needs and that this will be delivered in a responsive and dignified way. Residents are protected by the safe administration and storage of medication. EVIDENCE: The Manager explained that since the last inspection all the care plans had been reviewed and the three examined were all found to be well recorded with information in clearly defined sections. Jeian DS0000047113.V373495.R01.S.doc Version 5.2 Page 12 Following comments given in the last inspection report attention had been given to recording not just the physical needs of the residents but their emotional needs also along with information about their preferred daily routines and their choices of individual social and leisure activities. Information given in the AQAA and by relatives in their pre-inspection surveys confirmed that the home maintains close working contact with health and social care practitioners and a social worker and a GP were seen to visit the home during this inspection. It was noted that they were able to interview the resident in private. Residents and relatives who completed pre-inspection surveys all felt that they received the care and support that they needed including medical support. Residents records evidenced that they are also supported to access the services of the district nursing, chiropody, dental and audio service and that any resident needing to attend the hospital outpatient appointment is accompanied to do so. Detailed notifications had been sent to the Commission where required when an out of hours doctor had been called or where a resident had been admitted to hospital. Residents spoken with and observations made during this inspection indicated that residents are treated with respect and dignity by caring staff who treated them in a kindly and patient manner. Staff were seen to knock on residents doors and to wait for an answer before entering and care was taken to ensure that residents had access to their call bells at all times. Where required appropriate risk assessments were completed which evidenced that consultation with GPs and with relatives had taken place and where they are able residents are encouraged to sign their care plan. The home continues to use a MDS monitored dosage system for medication this being supplied from a local pharmacy. The home has created a new area for medication storage and administration as part of the rebuilding works this was seen to be of an adequate size and to have all the required facilities although it would be advantageous to have a small medicines fridge also in that area. The home has a medication trolley which was seen to be properly secured to a wall clasp, a wall mounted lockable medication cupboard and a controlled drugs cupboard. The MAR administration records were seen to be well recorded with no omissions and audit records kept of medications received into and disposed out of the home. The records of medication administered was generally clear and complete with appropriate identification codes and a written explanation of variations recorded on the reverse of the MAR sheet. The manager explained how he regularly checks the accuracy of these records and it was discussed with the inspector how he should maintain records to evidence that such checks are being carried out. Jeian DS0000047113.V373495.R01.S.doc Version 5.2 Page 13 A check of the controlled medication found that the correct amount of medication measured against the recorded record was remaining. The homes records evidenced that all staff who administer medication had been trained to do so. Jeian DS0000047113.V373495.R01.S.doc Version 5.2 Page 14 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 this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use this service can expect to be provided with a range of activities to meet their various choices and interests. People who use this service can be confident that they will be offered choices from a varied diet of nutritious home cooked food. EVIDENCE: The home provides daily activities for residents who wish to participate. A plan of activities for the next period including the special Christmas events was seen displayed in the home. This evidenced a mixture of group and individual activities along with visits from outside entertainers and musicians and outings into the local area. Since the last inspection the home has employed an activity organiser and evidence of her recorded assessment of each residents activity needs interests and preferences along with records of their attendance at Jeian DS0000047113.V373495.R01.S.doc Version 5.2 Page 15 various activities was seen to be well maintained. During the day of this inspection a small card making group activity took place and staff were seen to give individual attention to one resident who was knitting and to have one to one discussion about local events with another resident who was reading her daily paper. Another resident told the inspector that he liked to keep busy and had arranged various duties with the homes manager including the cleaning of his own room that he much enjoyed. Another resident who was still very mobile and able to go out into the locality explained that he often went out with the manager when he went to the local shops and that he enjoyed having a coffee at Tesco. A number of comments on the pre inspection surveys from residents relatives which were completed earlier in the autumn said that they wished that the programme of activities could be enlarged. Residents and relatives spoken with on the day of this inspection confirmed that activity choices had been increased following their consultation with the new activities organiser and they said that they felt that they now had good choices. Feedback from residents and relatives confirmed that the standard and variety of meals and the food at the home had improved this particularly since the completion of the building of a new kitchen and the appointment of new catering staff. A sample of their menu evidenced that regular choices are available at each meal and one resident told the inspector that “if I ask for something not on the menu for that day the cook will usually prepare it for me.” A selection of cereals toast or a cooked breakfast is available daily, a main cooked mid day meal and choices of hot or cold lighter dishes are available at teatime. All the residents without exception were very complimentary about their meals and confirmed that they were consulted on a daily basis as to their choices. Fresh vegetables are used daily and home baked cakes and puddings also being regularly available. The serving of lunch was observed during this inspection. Residents commented on the spaciousness of the new dining area and staff were observed to be assisting residents in a discrete manner which preserved their dignity and at a pace which suited them. The tables were nicely laid with a range of condiments and fresh drinks. The meal looked appetising and residents confirmed that hot food is usually served at the correct temperature. Lunch appeared to be a happy and relaxed occasion where residents could take time over their meal and were not hurried. The homes daily records evidenced that family and friends make regular visits to the home and relatives confirmed that they are always made welcome. The resident’s files contained good details of family contacts and their relationship to the resident. One resident told the inspector that “ The staff always ask me what I would like giving me good opportunity to make my own choices, and I do appreciate that”. Jeian DS0000047113.V373495.R01.S.doc Version 5.2 Page 16 Jeian DS0000047113.V373495.R01.S.doc Version 5.2 Page 17 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 this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use this service can be confident that the policies and procedures in place will ensure that their concerns and complaints are listened to and investigated. The home has trained staff and policies and procedures which should ensure that the people who use this service are protected from abuse. EVIDENCE: The complaints policy was on display in the home. Pre-inspection surveys from the residents and relatives and those spoken with during the inspection said that they would know what to do if they had reason to make a complaint. Residents spoken with told the inspector that they would immediately speak to the manager and that they had confidence that he would sort it out. One said that “ he is a kind and fair man and does all he can to ensure that I am well cared for and happy”. The Commission has not received any complaints about care in this home since the last inspection and neither have the home received any such complaints. One issue raised relating to an employment matter was Jeian DS0000047113.V373495.R01.S.doc Version 5.2 Page 18 dealt with formally by an external regulatory authority which found that there was no case to answer. Since the last inspection the home has reviewed its policy and procedures concerning Adult Protection and Whistle Blowing and the Suffolk Joint Agency policy and procedures handbook was seen to be available in the home for all staff. Training by all staff concerning adult protection was undertaken in September 2008 and staff questioned during this inspection showed a good awareness of what their role and responsibilities would be if they ever had any concerns relating to the safety and protection of a resident. There have been no POVA incidents in the home since the last inspection. Jeian DS0000047113.V373495.R01.S.doc Version 5.2 Page 19 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 this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use this service will find that it is homely comfortable clean and with one exception has a fresh atmosphere and is of a physical design and layout where their needs can be safely met. EVIDENCE: A tour of the building was undertaken as part of this inspection. The building was found to be clean and tidy and well arranged and with one minor exception (in one bedroom) it did not have any unpleasant odours. The task to re-clean the carpet in this room was taking place during this inspection and the resident was receiving treatment for an infection. Jeian DS0000047113.V373495.R01.S.doc Version 5.2 Page 20 The home was found to be well appointed throughout with the recently completed refurbished spacious communal areas and new bedrooms being well presented with attractive decorations. The fresh new appearance of these new areas did however contrast with the original accommodation of the home where the decorations looked tired and overall had a less attractive appearance although these rooms were all found to be well appointed and clean. The manager was well aware of this unfavourable contrast and spoke of his plans to redecorate the older rooms as soon as possible so as to provide a more uniform standard through out the home. One resident told the inspector that she hoped that her bedroom could be redecorated soon. Residents bedrooms were all found to be well personalised in a homely manner which reflected their individual tastes and styles. In each room the radiator was covered with a low surface temperature cover and each had a lockable storage area. Call bells were seen to have extension leads so as to be accessible in every area of the room. The residents spoken with all said they were happy with the accommodation of the home. They were particularly appreciative of the larger lounge and dining facilities and the ease of access that they would have to the garden area which the manager explained was to be laid with patio and planted as soon as the weather permitted. One resident who because of illness is often confined to her room told the inspector of her great appreciation of the effort the home staff had put in when she was initially admitted to the home “ I had been in the hospital for a long time she said, They helped me go back to my flat to get the things, ornaments and small items of furniture that I did not want to part with, and then they helped me fit and arrange them into this room. The manager also helped me to get a small fridge and kettle so that I can keep my own special food that I particularly like and have drinks when I want them. I really do appreciate this and it really helped me settle into the home very quickly”. Another recently admitted couple who had also come to the home via hospital explained how happy they were to be given two rooms “ the staff moved everything round so that we can have a bedroom and this sitting room, we are very comfortable and relieved to be well cared for here” they said. The kitchen was visited as part of this inspection and discussion was had with the cook about the revision of the menus that she had arranged following consultation with the residents as to their likes and dislikes. The kitchen is part of the new build it is spacious airy and well appointed. The cook described it as a lovely working environment and commented on the benefits of having it located next to the lounge dining room so that the residents could safely view the cooking process and feel part of the general domestic arrangements. A report from the Ipswich Borough Council environmental health department who visited it on fourth of November described it as “ An excellent new kitchen”. Jeian DS0000047113.V373495.R01.S.doc Version 5.2 Page 21 The new building works had also included a new laundry room with direct access to the garden drying facilities. Separate sluice facilities have been installed along with a large dryer and washing machines with sluice wash programmes. Red bags are used for soiled items. The room provides sufficient storage areas for the clothes of each resident to be stored separately. Supplies of protective clothing and gloves were seen to be available along with locked facilities for the safe storage of laundry products. This new laundry has been built with impermeable floor and wall surfaces. The training records evidenced that training on Infection Control had been undertaken since the last inspection. The residents asked were all complimentary about the standard of their laundry and on the day of this inspection they were seen to be well dressed with freshly ironed clothing. Jeian DS0000047113.V373495.R01.S.doc Version 5.2 Page 22 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 this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use this service can expect to be cared for by sufficient numbers of trained staff and to be protected by the homes recruitment procedures. EVIDENCE: During this unannounced inspection it was seen that there were sufficient staff on duty to meet the residents needs in an individual manner. Information given by the residents and their relatives on the pre inspection surveys confirmed that there were enough staff to meet their needs. One said “ They look after me very well carers always ask me what food I would like and the Doctor is called promptly if I need him.” Three recruitment records for newly appointed members of staff were examined as part of this inspection. They were found to contain the required information, an application form, two references, copies of certificates, personal identification records evidence of address. Jeian DS0000047113.V373495.R01.S.doc Version 5.2 Page 23 Criminal Record bureau and POVA first checks along with recorded evidence of the interviews were all seen to be maintained. The Manager said that references were always obtained from the last employer. He also explained that all new staff complete the common induction training in line with the Skills for Care standards at Ipswich College and then work initially shadowing another member of staff so as to be able to get to know the residents and the ways in which the home operates. The individual training needs of staff are identified during their personal supervision meetings and teaching on particular subjects is carried out during hand over meetings. Since the last inspection staff have attended training on medication, fire awareness, Osteoporosis, moving and handling, Dementia, food hygiene and infection control. The manager said that the annual training budget £3000 remains and this year had been exceeded. The home is fortunate in retaining a stable core group of care staff and since the last inspection the percentage of carers holding NVQ qualifications has increased to 86 . A number of care staff also hold nursing qualifications. Staff confirmed both in speaking with the inspector and in their written survey replies that they have good training opportunities. One staff member told the inspector that with the manager and the other nurses there are always qualified staff available for discussion and to explain about various illnesses. Another said that she would like to learn more about the early effects of dementia as she felt that this would enable her to give better care to some of their residents. Jeian DS0000047113.V373495.R01.S.doc Version 5.2 Page 24 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 this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to the service. People who use this service can expect it to be responsively managed including the addressing of any concerns or worries by a qualified and experienced Manager and supporting management team. Residents can expect that their health safety and welfare will be promoted and protected. EVIDENCE: Jeian DS0000047113.V373495.R01.S.doc Version 5.2 Page 25 The home benefits from a stable management team who are well qualified and experienced and whose ethos is very clearly to put the needs of the residents first. The proprietor, Mr. Felix Chukwuma is also the homes Registered Manager. He is a registered nurse and also holds the NVQ level 4 Registered Managers Award qualification. He is assisted by an experienced and qualified deputy who holds qualifications in care NVQ levels 2,3 and 4 and who is currently studying for the assessors training D32 course. She has worked at the home for the past thirteen years. Being a small home the Managers presence was very evident throughout the day of this inspection. Staff and residents confirmed that the managers were always available and very approachable. It was observed that they had an easy rapport with the residents and would carry out care tasks themselves for particular residents. Visiting relatives confirmed this to the inspector and spoke appreciatively of the good communication that the home maintains with them. “ If there is anything wrong with Mum they are on the phone immediately” one said. Staff on duty told the inspector that they thought that the home was well managed and confirmed that they were well supported that they had regular supervision meetings good training opportunities and that their opinions were listened to. All the staff commented very favourably on the new building works one said “The home is so much lighter and brighter and the residents have so much more communal space. The new bathrooms kitchen and laundry facilities are such an improvement and we also have better staff room and office accommodation which are a pleasure to work in.” Another commented “ This is a happy place I really enjoy coming to work here and I find it a rewarding job”. The manager confirmed that the home does not manage resident’s money. Where needed relatives or representatives support residents who are not able to exercise full responsibility for their own finances. All the residents have a locked facility in their room for the secure keeping of valuables and money. The home gives good priority to promoting the health safety and welfare of the residents through the regular maintenance of safety checks, training and record keeping. The records relating to fire bell testing and the monitoring of water temperatures were found to be regularly completed along with the servicing and safety checks for the homes equipment. Jeian DS0000047113.V373495.R01.S.doc Version 5.2 Page 26 The manager explained that following the concerns raised at the last inspection all the thermostatic valves for the hot water outlets had been checked or replaced and the temperature records evidenced that the water temperatures are now maintained within safe limits. Low surface temperature radiator covers have now been fitted to all radiators in the home. The Manager submitted their Annual Quality Assurance Assessment (AQAA) to the Commission as required and on time. It provided good information on the present position of the home with details of improvements made since the last inspection and plans for further development and improvements to be made. The document evidenced the Managers good awareness of the issues that may arise when the home increases its registration by four places. The additional staffing requirements of this increase had already been anticipated and the Manager was to interview new staff on the afternoon of this unannounced inspection. The Manager submits Regulation 37 Notifications to the Commission as required giving appropriate detail. Regular quality audits are carried out in the home. The Manager discussed with the inspector how this is done and could show evidence of the surveys from residents relatives and other professional staff returned in October 2008 and how this information was being analysed. He discussed with the inspector how this information could be usefully shared with the staff and prospective service users and placing social workers. He also discussed with the inspector measures that he had taken to ensure that his own management training and development needs were being met along with those of his deputy manager. Further training on the developing implications of the Mental Capacity Act would be advantageous. Internet access is now available from the home for up to date guidance and information. Jeian DS0000047113.V373495.R01.S.doc Version 5.2 Page 27 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 3 9 3 10 3 11 N/A DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Jeian DS0000047113.V373495.R01.S.doc Version 5.2 Page 28 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. 1 Standard OP26 Regulation 16 (2) (k) Requirement All areas of the home must be kept free of odours at all times this to ensure full dignity for the service users. Timescale for action 31/01/09 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP30 Good Practice Recommendations It is recommended that further training concerning the Mental Capacity Act is undertaken by senior staff. Jeian DS0000047113.V373495.R01.S.doc Version 5.2 Page 29 Jeian DS0000047113.V373495.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Jeian DS0000047113.V373495.R01.S.doc Version 5.2 Page 31 - 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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