Care Home: Leyland Rest Home

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What the care home does well Health and personal care needs are reviewed regularly and are reflected in resident care plans with their signed agreement. Care plans are easy to follow and some of the residents interviewed confirmed that they were aware of the care plans and understood them. Relatives interviewed stated, "I have seen the care plan. Once a month we go through it and sign the monthly reviews and are advised of Dr`s visits and kept informed".Residents are supported by staff to spend their time as they wish with family and friends made welcome. Residents interviewed stated, "I`m allowed to do what I want to do when I want" and "my son visits a couple of times a week and friends visit, they are made to feel welcome and are always asked if they want a cup of tea". Relatives interviewed confirmed that the service provided residents with good care. One relative commented, "The home provides a warm friendly atmosphere. My mother is well looked after" Health professionals canvassed for their views commented, "They treat people as individuals" and "residents always look happy and relaxed". The service provides a programme of repair and maintenance, which ensures residents are living in a comfortable environment. Residents interviewed gave positive feedback about their bedrooms and stated, "I have a lovely bedroom" and "It`s comfortable and very clean". Pre employment checks are carried out for all new staff therefore ensuring residents are protected. Training records evidence staff have up to date mandatory training. Residents and relatives were complimentary about the staff employed in the service. One resident interviewed stated, "staff are kind to me". The service is managed in the best interests of the residents and staff. All health and safety checks with regard to equipment and services are up to date. Relatives and residents were complimentary about the manger and the management of the service. One relative commented, "I think the staff in general, particularly the manager and immediate support personnel do a difficult job well. I have seen no behaviour which would warrant criticism of them". What has improved since the last inspection? Full and detailed records are now kept of all financial transactions with regard to resident monies. Risk assessments are in place for residents with regard to medication. Resident views have been taken into account with regard to activities. Senior staff have had training with regard to the Sefton Adult Protection Procedure. The sink unit discussed at the last inspection has been replaced. There is no odour problem now. Equality and Diversity training has been implemented for staff. What the care home could do better: Assessments are carried out for most residents to ensure needs are addressed but this needs to include any residents admitted for respite care where limited information is available. During the assessment process pain/discomfort should be addressed so that where needed care plans identify how it will be managed. This will ensure that residents do not suffer pain/discomfort without some support or intervention where agreed. Staff had left a residents morning medication at the side of their bed and it was now lunchtime. All staff needs to ensure residents take their prescribed medication at the correct time. It is recommended that the service should provide a copied receipt of valuables kept on behalf of residents. This will ensure that residents and staff are protected. This was recommended at the last inspection. It is recommended that record keeping with regard to kitchen checks/procedures should be clear and easy to follow. This will ensure records can be audited to ensure compliance. It is recommended that staffing levels be monitored to ensure resident care is not compromised. It is recommended that the storage room for cleaning fluids is locked at all times. This will promote resident safety. CARE HOMES FOR OLDER PEOPLE Leyland Rest Home 109 Leyland Road Southport Merseyside PR9 0JL Lead Inspector Mrs Margaret Van Schaick Unannounced Inspection 12th February 2008 09:00 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 Leyland Rest Home DS0000070734.V353887.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. Leyland Rest Home DS0000070734.V353887.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Leyland Rest Home Address 109 Leyland Road Southport Merseyside PR9 0JL 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) 01704 533184 01704 539948 Prime Care (GB) Ltd Mrs Rosemary Dawson Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33) of places Leyland Rest Home DS0000070734.V353887.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care home only - Code PC to people of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of people who can be accommodated is: 33 Date of last inspection 12th June 2007 Brief Description of the Service: Leyland Rest Home is a care home that is registered to provide personal care and support to 33 older people. The service is a large 4 storey detached property with gardens to the front, sides and rear with a parking facility for visitors. It is situated at the north end of Southport close to the promenade and golf club and is within easy reach of shops, parks and public transport. The communal space provides 3 lounges and a separate dining room. The service has 29 single rooms and 2 double rooms with 16 having en-suite facilities. The service has suitably adapted equipment to assist with the varying needs of the service users. There is ramp access to the gardens for residents. A passenger lift services all 4 floors. A call bell system is in place throughout the service. Leyland Rest Home is owned by Primcare (GB) Ltd and Mr Mohammed Anjum is the registered provider. It is managed by Rose Dawson. Weekly fees are £365. Leyland Rest Home DS0000070734.V353887.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. A site visit took place as part of the unannounced key inspection. It was conducted over a one-day period for the duration of 8.75 hours. Twenty-five residents were accommodated at this time. As part of the inspection process all areas of the service were viewed including most of the residents bedrooms. Care records and other care home records were viewed. Discussion took place with some of the residents, staff and visitors. The inspection was conducted with Rose Dawson, registered manager. Discussion also took place with the deputy manager and Mr Mohammed Anjum the new provider. During the inspection 3 residents were case tracked (their files were examined and their views of the service were obtained). All of the key standards were inspected and also previous requirements and recommendations from the last inspection in June 2007 were discussed. Satisfaction forms “Have your say about…” were distributed to a number of residents, relatives and health care professionals prior to the site visit. A number of comments included in this report are taken from the surveys and from interviews. An AQAA (annual quality assurance assessment) was completed by the manager prior to the visit. The AQAA comprises of two self-assessment questionnaires that focus on the outcomes for people. The self-assessment provides information as to how the manager and staff are meeting the needs of the current residents and a data set that gives basic facts and figures about the service including staff numbers and training. What the service does well: Health and personal care needs are reviewed regularly and are reflected in resident care plans with their signed agreement. Care plans are easy to follow and some of the residents interviewed confirmed that they were aware of the care plans and understood them. Relatives interviewed stated, “I have seen the care plan. Once a month we go through it and sign the monthly reviews and are advised of Dr’s visits and kept informed”. Leyland Rest Home DS0000070734.V353887.R01.S.doc Version 5.2 Page 6 Residents are supported by staff to spend their time as they wish with family and friends made welcome. Residents interviewed stated, “I’m allowed to do what I want to do when I want” and “my son visits a couple of times a week and friends visit, they are made to feel welcome and are always asked if they want a cup of tea”. Relatives interviewed confirmed that the service provided residents with good care. One relative commented, “The home provides a warm friendly atmosphere. My mother is well looked after” Health professionals canvassed for their views commented, “They treat people as individuals” and “residents always look happy and relaxed”. The service provides a programme of repair and maintenance, which ensures residents are living in a comfortable environment. Residents interviewed gave positive feedback about their bedrooms and stated, “I have a lovely bedroom” and “It’s comfortable and very clean”. Pre employment checks are carried out for all new staff therefore ensuring residents are protected. Training records evidence staff have up to date mandatory training. Residents and relatives were complimentary about the staff employed in the service. One resident interviewed stated, “staff are kind to me”. The service is managed in the best interests of the residents and staff. All health and safety checks with regard to equipment and services are up to date. Relatives and residents were complimentary about the manger and the management of the service. One relative commented, “I think the staff in general, particularly the manager and immediate support personnel do a difficult job well. I have seen no behaviour which would warrant criticism of them”. What has improved since the last inspection? Full and detailed records are now kept of all financial transactions with regard to resident monies. Risk assessments are in place for residents with regard to medication. Resident views have been taken into account with regard to activities. Senior staff have had training with regard to the Sefton Adult Protection Procedure. The sink unit discussed at the last inspection has been replaced. There is no odour problem now. Equality and Diversity training has been implemented for staff. Leyland Rest Home DS0000070734.V353887.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. Leyland Rest Home DS0000070734.V353887.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 Leyland Rest Home DS0000070734.V353887.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): OP3 was assessed. OP6 is not applicable. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessments are carried out for most residents to ensure needs are addressed but this needs to include any residents admitted for respite care where limited information is available. EVIDENCE: Three residents were case tracked (when all documentation relating to residents is examined and where possible residents are interviewed). All three residents had a pre admission assessment carried out. Information recorded on assessment documentation covered many areas including prescribed medication, previous medical history, mobility, skin integrity, sleep pattern, diet, appearance, personal care needs, mental health and family input. Not all three assessments viewed were consistent as some areas had sufficient information and others not enough. Leyland Rest Home DS0000070734.V353887.R01.S.doc Version 5.2 Page 10 One resident who was recently admitted for respite had no assessment in place. This resident was admitted for emergency respite and a copy of their care plan was faxed to the service. In this case the resident had a successful respite. The service need to ensure that if residents are admitted, as an emergency a process is in place to ensure resident needs are assessed so that they can be sure individual residents needs are addressed and met. Resident assessments have not covered pain. It is important to address this as some residents may not tell staff and continue to suffer discomfort or pain. Residents interviewed confirmed they were happy living at Leyland Road. One resident interviewed stated, “I like it very much”. Relatives interviewed stated, “He is happy, we called in and chose this home from a long list, we are very happy that he is here”. One resident commented, “I and another resident both came from another care home, we are quite satisfied here”. Leyland Rest Home DS0000070734.V353887.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): OP7,8,9,10 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Health and personal care needs are reviewed regularly and are reflected in resident care plans with their signed agreement. EVIDENCE: The care documentation viewed evidences all three residents case tracked had care plans in place. There is documented evidence of resident signatures to agree care planned. Where residents are unable to their relative has signed on their behalf. Care plans viewed evidenced the individual needs of the residents are addressed. ‘Things I can do for myself’ this is very detailed, clear, easily understood with resident in put throughout. Care plans are easy to follow and some of the residents interviewed confirmed that they were aware of the care plans and understood them. One resident interviewed stated, “I have discussed my care plan with ….”. Relatives interviewed confirmed they were invited to the service to be involved in the monthly reviews of care. Documented evidence of signed reviews of care confirms this. Relatives interviewed stated, “I have seen the care plan. Leyland Rest Home DS0000070734.V353887.R01.S.doc Version 5.2 Page 12 Once a month we go through it and sign the monthly reviews and are advised of Dr’s visits and kept informed”. Health professional visits and appointments are recorded in individual resident files. Reasons for visits are recorded. This evidences residents have access to the various health professionals including Dentist, Chiropodist, Optician, District Nurse, Diabetic Nurse, GP and Hearing specialist. Residents interviewed confirmed they were happy with the care provided. Residents stated, “Care is good” “They get the Dr when I ask” “I get my medicine on time”. Risk assessments are in place for mobility, risk of falls/injury with regard to hot water, radiators, eating alone and self-medication. Residents weight is recorded and monitored. Pressure relieving aids are in place for residents who need them. Care records evidence how staff support and maintain mobility for residents. Medication records were viewed including individual records for residents (MAR sheets). A sample of resident medication records was viewed. All showed medication prescribed, dosage, order dates and receipt of medication with staff signatures. Staff initials were in place for all medication administered. The records were clear and easy to follow. Photos of individual residents are in place for easy identification. A medication returns book is in use. A lockable storeroom is available to secure medication and a medication trolley is used for staff to administer the prescribed medication to residents. This is secured to a wall when not in use. The trolley was neat, tidy and organised. Senior staff has received training with regard to medications and there is documented evidence to show they are assessed following training. Staff had left a residents morning medication at the side of their bed and it was now lunchtime. All staff needs to ensure residents take their prescribed medication at the correct time. Families canvassed for their views were confident that their relatives were cared for and commented, “My mother has settled well into the home, it is friendly and caring and she feels secure”, “I feel Leyland has a very good caring atmosphere and my mother is looked after well” “I liaise with Leyland regarding any treatment my mother may require and discuss it, if I have any concerns it is always followed through”. “My grandmother is a resident and we have been impressed by the care given” Health professional comments include: “Residents appear well cared for and treated well” Leyland Rest Home DS0000070734.V353887.R01.S.doc Version 5.2 Page 13 “There are good standards of care” “This is a good home” “As far as I know they respect residents privacy and dignity” Privacy, confidentiality and dignity are covered during staff induction. Residents interviewed confirmed that staff were courteous, kind and patient whilst supporting them. Staff were observed to be polite and supportive to residents during the visit. One resident commented, “I find all the staff pleasant and helpful and they go out of their way to put you at ease and I usually take a long time to do anything but most of them are very patient”. Leyland Rest Home DS0000070734.V353887.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): OP12,13,14,15 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported by staff to spend their time as they wish with family and friends made welcome. EVIDENCE: During the visit some of the residents were noted to be spending time with the activities lady. Other residents spent time with their visitors, in the garden, reading or spending some private time on their own. Activities provided for residents includes, quizzes, bingo, readings, exercise, trips out, meals out, the book club and art. Residents care documentation evidences likes and dislikes and residents interests. Care documentation also evidences previous lifestyles and present lifestyle. Religious needs are recorded. There is also a list recorded in each resident file of people they wish to see and any they do not wish to. Residents interviewed were satisfied with how they lived their lives. Residents stated: “I do a bit of art myself, drawing and painting” “I go to the exercise class and the book club” “I go to bed at 12.30am and get up at 10am” Leyland Rest Home DS0000070734.V353887.R01.S.doc Version 5.2 Page 15 “I’m allowed to do what I want to do when I want” “We could do with more outings” “I prefer my own company” “I can go to bed and get up when I want” Residents confirmed that their families/visitors could visit when they wish and there are no restrictions on visiting times. One resident stated, “my son visits a couple of times a week and friends visit, they are made to feel welcome and are always asked if they want a cup of tea” Residents are encouraged to eat their meals in the dining room. It is set up with smaller dining tables and suitable chairs. Residents can have their meals in their bedroom if wished. The menu is set up on a four weekly rota. There is a choice of main course and other meals. Home baking is in evidence. Residents interviewed confirmed that they were fairly satisfied with the meals served to them and were offered alternative choices. Residents stated: “The food is very good you get a choice and enough to eat” “I have breakfast in my bedroom” “We have cups of tea, they give you so much all the time that you don’t need to ask for more” “Some of it is alright” Families interviewed confirmed they were happy with the care and support provided for their relatives and stated, “They do activities, exercises, and craft on Fridays” “He loves his food, if it is something you don’t like, they will bring him something else, there are always cups of tea and biscuits” “Staff are flexible and get …up later and …has a rest in bed after breakfast” “All the residents seem happy” “All the residents look well cared for” Relative comments: “My mother is encouraged to take part in the activities undertaken in the home. She likes the bingo. She is comfortable and secure and is able to move around and also go into the garden in the summer”. “The home provides a warm friendly atmosphere. My mother is well looked after. Drinks and biscuits are provided between meals and the food is good. Activities are encouraged and entertainment provided” “Staff help put on her jewellery and match her clothing up” “Residents look well groomed”. Health professionals canvassed for their views commented, “They treat people as individuals” and “residents always look happy and relaxed”. Leyland Rest Home DS0000070734.V353887.R01.S.doc Version 5.2 Page 16 Other visitors to the service stated: “I think it’s wonderful” “Residents are looked after, if I had to go anywhere it would be here” “They take residents out and sit them out in the garden” Leyland Rest Home DS0000070734.V353887.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): OP16,18 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service needs to provide a copied receipt of valuables kept on behalf of residents. This will ensure that residents and staff are protected. EVIDENCE: A complaints procedure is in place. This is in the statement of purpose and on display in the front hall. The complaints record was viewed, there are no complaints recorded since the last inspection. The manager stated that there have not been any complaints and any little niggles are dealt with straight away. Residents and families interviewed confirmed they had no complaints to make. Residents stated, “I would never need to talk with anyone, I’m alright” and “yes, I’m aware of how to complain”. Families interviewed stated, ““I would go to Rose or Lynsey” and “we are aware there is a complaints procedure”. No issues were raised during the visit or through the questionnaires sent out by the commission. The financial records of three of the residents were viewed. Each resident has an individual book with records of all financial transactions. Receipts are kept for all items in individual envelopes. Leyland Rest Home DS0000070734.V353887.R01.S.doc Version 5.2 Page 18 An administrative person manages the financial records for residents and carries out monthly audits with the manager assisting on some of the checks. Accurate records are kept. The records evidence financial transactions with resident and staff signatures. Where wished and agreed some residents have support from families/power of attorney. A valuables record is kept but there is no carbon copy for residents or their relatives to ensure they are in receipt of a copy of a list of any valuables held. Where families remove valuables from residents each party needs to have a record of this. Advocacy service contact details are available for residents. Leyland Rest Home DS0000070734.V353887.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): OP19 and 26 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service provides a programme of repair and maintenance, which ensures residents are living in a comfortable environment. EVIDENCE: The environment for the residents is well maintained with continuous improvement of the service through decoration of bedrooms and public areas. A health professional commented, “The environment is excellent”. New flooring has been replaced in some of the bedrooms and bathrooms and further plans are in place to replace in other areas. There are no odorous smells and the service was clean in all bedrooms and public areas of the service. One resident interviewed stated, “It’s always fresh and clean”. Maintenance records evidence jobs carried out. Recommendations made at the last inspection with regard to the environment have been carried out. Leyland Rest Home DS0000070734.V353887.R01.S.doc Version 5.2 Page 20 Residents interviewed gave positive feedback about their bedrooms and stated, “I have a lovely bedroom”, “It’s comfortable and very clean” and “I like this bedroom as it is out of the way, I can look out of the window”. Some of the residents interviewed advised the inspector that they had been offered alternative bedrooms if they wish with some taking up this offer and others happy to stay where they are. Public space for residents is situated on the ground floor. The service provides three sitting rooms on the ground floor, which gives residents a choice. These sitting rooms offer television or quiet areas for reading or chatting. A separate dining room is also available with smaller tables pleasantly set up for residents use. Comfortable seating is available for residents and all areas of the public rooms are pleasantly decorated with domestic furnishings suited to residents needs. The garden grounds are well maintained, providing mature shrubs, planting and seating areas. One of the residents interviewed stated, “the garden is lovely, I like the garden, I like sitting out in the garden”. Ramp access to the gardens is in place. Bathrooms/toilets are fitted throughout the service and many of the floors have been replaced or are about to be. Making this easier to keep clean. A number of bedrooms have been redecorated and look very nice with personal items of residents in place. The service employ a handy person full time and they carry out the daily maintenance of the service plus redecorate and carpet the bedrooms as they are empty. The kitchen and laundry room are placed separately in the basement floor. Both were viewed during the visit. The kitchen was in a satisfactory condition. Further work has been identified to provide re surfacing to the floor of the large kitchen storeroom. This will enable easier cleaning. Freezer/fridge and hot food temperatures have been recorded. The record keeping was not very clear therefore this needs addressing to ensure correct checks and procedures are carried out. The laundry room has had some work carried out to give additional storage of residents clothing. The room needs further work to ensure all surfaces are easy to keep clean. Individual baskets are in place for resident personal laundry. Hand washing facilities are available for staff. The cleaning store was unlocked therefore this needs to be locked at all times to protect residents as cleaning materials and fluids were in stock. Leyland Rest Home DS0000070734.V353887.R01.S.doc Version 5.2 Page 21 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): OP27,28,29,30 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Pre employment checks are carried out for all new staff therefore ensuring residents are protected. EVIDENCE: The staffing rota evidences sufficient staff are on duty. The manager is supernumerary. One resident commented, “Just occasionally I have a long wait, usually one of the busy days”. None of the other residents or relatives expressed any concerns regarding staffing. One staff interviewed stated, “there is not enough staff on duty, residents get rushed too much, quite a few are very frail and need longer time spent with them”. The service needs to monitor this situation to ensure resident care is not compromised. Eight of the care staff is qualified to Level 2 NVQ and the two chefs have the NVQ Level 2 qualification in food. Two care staff has commenced this qualification and one senior carer is to be commenced on Level 3 soon. Three staff files were viewed including training records. Staff files evidence all pre employment checks have been made and application forms and reference checks. All three staff has a POVA (Protection of Vulnerable Adults) first in place and one has received their CRB (Criminal Records Bureau) check. The other two staff are working under supervision until their CRB check has been returned. Leyland Rest Home DS0000070734.V353887.R01.S.doc Version 5.2 Page 22 Staff interviewed confirmed that training needs were met and residents were well cared for. Staff comments and statements include: “I’ve not seen or heard any staff be nasty to residents” “We are very happy in our work” “It is lovely to work here”. Induction is evidenced in staff files and staff interviewed confirmed they were inducted on commencement of employment. One staff commented, “I had a very good and easy to follow induction when I first started my job”. Training records are in place and evidence all mandatory training is carried out including first aid, fire, dementia, health and safety, manual handling infection control, cosh (control of substances hazardous to health), food hygiene, equality and diversity, abuse, food hygiene, medication and infection control. Recommendations made at the last inspection with regard to staff training in equality and diversity has been taken up. Residents and relatives were complimentary about staff employed in the service. Residents interviewed stated: “Staff are very nice”, “Staff are kind to me” “Staff are very good, I have no complaints about staff, they do their best”. Relatives stated: “Staff seem to be good with the residents” “I could talk with them if I were worried” “Staff are excellent, the carer is very caring, he is lovely” Health professionals canvassed for their views on how the service was run gave positive feedback and one commented, “Staff don’t appear stressed by demands on their time”. Leyland Rest Home DS0000070734.V353887.R01.S.doc Version 5.2 Page 23 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): OP31,33,35,38 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service is managed in the best interests of the residents and staff. EVIDENCE: The registered manager has been employed for approximately 8 years and has attained the RMA (Registered Managers Award) in 2003. The manager has kept up to date with mandatory training and also attends additional training specific to the needs of the older person. Relatives and residents were complimentary about the manger and the management of the service. One relative commented, “I think the staff in general, particularly the manager and immediate support personnel do a difficult job well. I have seen no behaviour which would warrant criticism of them” and “the manager sets a very high standard”. Leyland Rest Home DS0000070734.V353887.R01.S.doc Version 5.2 Page 24 Residents and their relatives are canvassed for their views on how the service is run. The service has an external quality assurance award. Questionnaires are distributed to residents and their relatives during the year on two occasions. A sample of their responses was viewed and showed positive feedback. The service has residents meetings and the minutes from last years one was viewed. Issues discussed included resident and relatives surveys, star ratings and the complaints procedure. The service also receives letters and thank you cards from relatives about the care provided. Staff meetings are also held throughout the year with minutes published. Staff interviewed confirmed that meetings were held regularly. The most recent meeting discussed various issues including staff meals and breaks, uniforms/protective clothing and sickness. Staff commented, “I work closely with my manager and meet with other staff regularly” and “we have plenty of staff meetings and appraisals/supervisions”. The service now has a new provider who was present during the inspection visit. Discussion took place with regard to the monthly provider visits. Mr Anjum stated he regularly visits the service and speaks with staff residents and relatives. One of the relatives interviewed stated, “we have met the new owner, he had a welcome party and brought in his family, he is here quite a lot”. Staff confirmed they had met the new owner and commented, “I have met the new owner he is nice, he likes to have a lot of plans for the future” and “I think the new owner is a very nice person very supportive”. The manager carries out 6 monthly audits with records kept. This includes the building and garden grounds. Financial records have been addressed earlier in this report. The training matrix evidences all staff training plans for the year ahead. All mandatory training has been addressed. A sample of some of the servicing and health and safety checks of equipment in the building evidences all checks are carried and are within date. A fire assessment of the building has been carried out. Fire training and equipment checks including emergency lighting are in date. Small appliances are tested with records kept. Accident record viewed all accidents are recorded completed ok Leyland Rest Home DS0000070734.V353887.R01.S.doc Version 5.2 Page 25 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 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 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 Leyland Rest Home DS0000070734.V353887.R01.S.doc Version 5.2 Page 26 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 3 4 5 6 7 Refer to Standard OP3 OP3 OP9 OP18 OP26 OP27 OP38 Good Practice Recommendations It is recommended that the service should ensure when residents are admitted for respite that assessments are carried out to ensure needs are addressed. It is recommended that during the assessment process pain/discomfort should be addressed so that where needed care plans identify how it will be managed. It is recommended that staff should ensure residents take their prescribed medication at the correct time. It is recommended that the service should provide a copied receipt of valuables kept on behalf of residents. This will ensure that residents and staff are protected. It is recommended that record keeping with regard to kitchen checks/procedures should be clear and easy to follow. It is recommended that staffing levels are monitored to ensure resident care is not compromised. It is recommended that the storage room for cleaning DS0000070734.V353887.R01.S.doc Version 5.2 Page 27 Leyland Rest Home fluids is locked at all times. Leyland Rest Home DS0000070734.V353887.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection North West Regional Contact Team Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ 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 Leyland Rest Home DS0000070734.V353887.R01.S.doc Version 5.2 Page 29 - 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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