Care Home: Leylands Rest Home

What the care home does well The home has a warm welcoming atmosphere. It feels relaxed and life seems to go at the pace of people who use the service. People who live at the home said they were happy with the service. Comments included: "We couldn`t have chosen better. We saw other places but this was the best". "Mum`s been much better since she came here. She is kept active and stimulated". "They will do anything for you, only have to ask if you want anything doing". "We are well looked after". Staff have very good knowledge of people`s personal and emotional support needs. Staff were thoughtful, discreet and respectful of people`s dignity when attending to any of their needs. People who live at the home and staff get on well. We saw good interaction between people and staff. People also spoke highly of the staff. Their comments included: "They always attend when I call them". "I am happy with the home and what the staff do to help me". "They are absolutely brilliant, keep us well informed on Mum`s health. They visited her every day during a recent hospital stay". "They are absolutely wonderful, care for the whole family" "Staff are really friendly" "Staff are so lovely, so caring" "Always enough staff, always have time for everyone". People who live at the home said they enjoyed life there. These are some of the things they said: "There is always lots of laughter and fun" "I like joining in with activities, I like to sing and dance" "I like to read and watch TV rather than joining in with activities" "I choose not to join in but know that they are available""I like to play dominoes" Staff said they received good training and felt well equipped to do their job. one said, "Training is given and it is ongoing and updated". The manager is supportive of staff and leads by her own good example. Staff said they appreciated the support they are given. What has improved since the last inspection? There were no requirements or recommendations made at the last inspection of the home. In the AQAA, the manager told us of recent improvements made to the service. These included: `We have rebuilt the back porches to improve the outlook from the window for the residents.` `Instigated the one to one outings.` `Staff have undergone refresher course in Adult Protection`. `We have provided a further 2 rooms with en-suite facilities, renovated the porches at the rear of the building. We have purchased a shed in which to keep bicycles to enable residents to exercise. Installed an entry keypad for security of residents.` `Staff have undertaken new training as well as updating`. What the care home could do better: The CSCI must be kept informed of events which affect the welfare of people who use the service. This must be done to protect the health, safety and welfare of people who use the service. Care plans and risk management plans should be reviewed to make sure people using the service have an up to date, detailed care plan. This will make sure that people receive person centred support that meets their needs. Moving and handling practice should be reviewed to make sure it is safe for staff and people who use the service. The practice of hand sluicing soiled linen should stop as this increases the risk of the spread of infection. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Leylands Rest Home 16/18 Leylands Lane Heaton Bradford West Yorkshire BD9 5PX     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Dawn Navesey     Date: 1 7 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 31 Information about the care home Name of care home: Address: Leylands Rest Home 16/18 Leylands Lane Heaton Bradford West Yorkshire BD9 5PX 01274543935 01274770035 info@awafrance.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Ms Annette Nerteley France care home 17 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia physical disability Additional conditions: Date of last inspection Brief description of the care home Leylands Rest Home is a large four-storey inner through terraced property, which has been adapted to provide a care home. It is in Heaton, in Bradford. The home is close to the shops and other community facilities. The home is registered to look after older people who have a diagnosis of dementia or memory loss. The home creates an atmosphere, which allows people and their families to come to terms with, and learn to live with the effects of dementia in a positive way. This is done is a way which preserves peoples dignity and self-respect. Bedrooms are a mix of single and double rooms. These are on three floors of the building. There are stair lifts to bedrooms on the first floor. However at the present time rooms on the second floor can only be reached by climbing a number of fairly steep steps. Therefore these rooms are not suitable for people with limited mobility. There are however handrails to both sides of the stairs to assist people. All the communal areas used by people who live at the Care Homes for Older People Page 4 of 31 1 0 0 Over 65 17 1 1 Brief description of the care home home are on the ground floor. There are two lounges and a dining room. People have a choice of three areas to sit, as the dining room has easy chairs, which are also used. Leylands Rest Home is on a main road and is easy to get to by bus. There is a small garden area to the front of the house. There is a ramp providing level access to the front door. The range of fees is available from the manager of the home. Care Homes for Older People Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The Commission for Social Care Inspection (CSCI) inspects services at a frequency determined by how the service has been risk assessed. The inspection process has now become a cycle of activity rather than a series of one-off events. Information is gathered from a variety of sources, one being a site visit. More information about the inspection process can be found on our website www.csci.org.uk One inspector who was at the home from 10:25am until 6:15pm on 17 October 2008 carried out this unannounced visit. Care Homes for Older People Page 6 of 31 The purpose of the inspection was to make sure the home was providing a good standard of care for the people who use the service. Before the inspection, evidence about the home was reviewed. This included looking at any reported incidents, accidents or complaints. This information was used to plan the visit. The manager of the home completed an Annual Quality Assurance Assessment (AQAA) before the visit to provide additional information. We looked at a number of documents during the visit and visited areas of the home used by the people who live there. We spent a good proportion of time talking with the people at the home, staff and the deputy manager. Comments made to us during the day appear in the body of the report. Survey forms were sent to people living at the home and staff. People who use the service had been assisted by staff to complete the surveys. Information from those returned is reflected in this report. Feedback at the end of the visit was given to the manager and deputy manager. The last inspection of this home was 1st November 2007. What the care home does well: The home has a warm welcoming atmosphere. It feels relaxed and life seems to go at the pace of people who use the service. People who live at the home said they were happy with the service. Comments included: We couldnt have chosen better. We saw other places but this was the best. Mums been much better since she came here. She is kept active and stimulated. They will do anything for you, only have to ask if you want anything doing. We are well looked after. Staff have very good knowledge of peoples personal and emotional support needs. Staff were thoughtful, discreet and respectful of peoples dignity when attending to any of their needs. People who live at the home and staff get on well. We saw good interaction between people and staff. People also spoke highly of the staff. Their comments included: They always attend when I call them. I am happy with the home and what the staff do to help me. They are absolutely brilliant, keep us well informed on Mums health. They visited her every day during a recent hospital stay. They are absolutely wonderful, care for the whole family Staff are really friendly Staff are so lovely, so caring Always enough staff, always have time for everyone. People who live at the home said they enjoyed life there. These are some of the things they said: There is always lots of laughter and fun I like joining in with activities, I like to sing and dance I like to read and watch TV rather than joining in with activities I choose not to join in but know that they are available Care Homes for Older People Page 8 of 31 I like to play dominoes Staff said they received good training and felt well equipped to do their job. one said, Training is given and it is ongoing and updated. The manager is supportive of staff and leads by her own good example. Staff said they appreciated the support they are given. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get Care Homes for Older People Page 9 of 31 printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 10 of 31 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 11 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be sure that the home will meet their needs following assessment. Evidence: We looked at the assessments for the most recently admitted people to the home. Referrals had been made from care managers and the manager had made sure an up to date care management assessment of peoples needs was obtained. The manager said this information was then used as part of their assessment in making sure they were able to meet peoples needs. The manager and the deputy manager complete the assessments for people. They are both trained and qualified to do this. In the AQAA the manager said, Domiciliary visits are carried out prior to new residents being admitted to the home. This means they will visit anyone thinking of using the service in their own home or in hospital prior to Care Homes for Older People Page 12 of 31 Evidence: them being admitted to this home. The manager makes brief notes during these visits and explores any areas of need identified in the care management assesment. People can visit the home before deciding to move in. Staff said people often visit for a meal before they move in. One said, Its good for them to see how they think they will get on. One person who lives at the home said they remembered coming to look round the home with their family. We spoke to some peoples relatives. One said, We couldnt have chosen better. We saw other places but this was the best. A person who uses the service said, It was hard not to like it, so clean and tidy and everyone so willing. Care Homes for Older People Page 13 of 31 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Overall, the health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: People look well cared for clean, tidy and well groomed. Attention had been paid to detail. People had clean glasses, women had their nails painted if they wanted and people had their hair styled as they wished. Staff were patient and kind when interacting with people. They were discreet and respectful of peoples dignity when attending to any personal care needs. They gave reassurance and explanations for any tasks that they needed to support people with. This seemed to give people confidence in the staff. We looked at care plan and risk assessment records for some people who live at the home. In the AQAA, the manager said, Every resident has an individual file which contains all elements of their care package and records continuous changes daily. Care Homes for Older People Page 14 of 31 Evidence: There were however, some shortfalls with the care plans and risk assessments. Some plans did not give the detail of how care needs are carried out. Terms such as monitor, needs support and needs assistance do not tell staff how much support a person needs and could lead to needs being overlooked. Some risks had been identified for people but were not supported by a risk management plan. For example, a person at risk from falls, agitation and skin tears had no plans in place to tell staff how they were to managed or minimised. This could lead to needs being overlooked. We recommend that care plans and risk management plans are reviewed to make sure people using the service have an up to date, detailed care plan. This will make sure that people receive person centred support that meets their needs. Despite the gaps in care plan and risk management documentation, staff were familiar with peoples needs and could talk confidently about the support they give. Staff were able to describe peoples preferred routines with regard to their personal care and what works well for people. Staff have a good knowledge of peoples individual needs. Staff talked about the importance of understanding the way in which people communicate their needs and wishes. And also the importance of listening to people and the different ways in which they may communicate. Staff said this was particularly important for people with memory loss. Staff have also gathered information on peoples life history. Staff said it was good to have this information to be able to talk to people about their families and friends and past lives. This is good person centred practice. People who use the service and their relatives spoke highly of the care received. These are some of the things they said: Mums been much better since she came here. She is kept active and stimulated They will do anything for you, only have to ask if you want anything doing They are absolutely brilliant, keep us well informed on Mums health. They visited her every day during a recent hospital stay. We are well looked after. They always come when I call. Help and advice is sought from health care professionals to make sure that people get Care Homes for Older People Page 15 of 31 Evidence: the special help they need to maintain their health. People are escorted to appointments or health care professionals such as district nurses, attend the home as required. Staff have been trained to meet the specific health needs of people who use the service. In the AQAA, the manager said they had improved the service in the last year and said, Staff have undertaken training in oral hygiene, palliative care and first aid. During our visit we noticed that some moving and handling techniques used by staff are out of date and no longer considered to be a safe way of assisting people. We discussed this with the manager and deputy manager and recommend that peoples needs regarding their moving and handling are re-assessed to make sure their needs are properly met. The home uses a monitored dosage, pre-packed system for medication. All staff have been trained to use the system. A record is kept in the home of medication ordered. This is checked against medication delivered and recorded as correct before any medicines are dispensed. The medication folder was not very well organised. Many of the MAR (Medication Administration Record) sheets were loose in the file and could easily have fallen out. This could then lead to people not receiving their medication. Staff said they would make sure the file was tidied up and actually did this during the visit. Care Homes for Older People Page 16 of 31 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to make choices about their lifestyle. Social, cultural and recreational activities meet peoples individual expectations. Evidence: In the AQAA the manager said, We have a planned daily activity programme. We have a programme of organised trips to local beauty spots and stately homes during the summer months and trips to theatres. Professional entertainers visit the home. People who use the service and their relatives spoke highly of the activities on offer in the home. They said: There is always lots of laughter and fun I like joining in with activities, I like to sing and dance I like to read and watch TV rather than joining in with activities I choose not to join in but know that they are available Care Homes for Older People Page 17 of 31 Evidence: I like to play dominoes Mum is encouraged to do things like wash up and make a cup of tea Staff said they base the activities on peoples likes and interests. On the day of the visit staff organised singing and dancing and exercise sessions. It was clear from peoples engagement in these activities that they enjoyed them. Staff were respectful of peoples choice not to join in or to just join in for a limited amount of time. Staff worked very well with people and clearly understood what people wanted and enjoyed. Staff always seemed to have time to sit and chat with people or just give a reassurring pat of the hand as they went past people. People who use the service really responded well to this sort of interaction. Staff said they felt they have enough staff on duty to be able to meet peoples needs well and provide stimulating activity. The atmosphere in the home is relaxed and life seems to go at the pace of people who use the service. People are free to move about the home as they wish and are able to have their things around them. Everyone we spoke to said it felt like home. Meal times are not rushed and are seen as a social occasion. There are two sittings available at mealtimes so that people can sit in small social groups and there be fewer distractions. The daily menu is displayed on a large board in the dining room. People who need to have a soft diet are referred to by name on this board as softs. This does not promote the dignity or confidentiality of those people. The manager said they would re-consider how this information is made available more sensitively. Menus are arranged based on likes and dislikes of people. This information is gained from people at the home, their relatives and staff. If people refuse food, alternatives can be prepared quickly for them. Meals can be served in peoples bedrooms, sitting rooms or in the dining areas. Staff are sensitive to the needs of people who find it difficult to eat and need help and encouragement with this. Staff sit with people helping them feel comfortable and unhurried which helps people relax and respond in time. Food looked appetizing and people were offered as many choices as required to encourage them to eat. Special equipment is used such as plate guards, to help people maintain their independence. Refreshments and snacks are available throughout the day. The manager said food can be provided at any time of day for people if this is what they need. People said they enjoyed the food. One person said, Always lovely, always get what Care Homes for Older People Page 18 of 31 Evidence: we want. Another said, We dont tend to get the 5 fruit and veg a day. Menus looked healthy and looked to give plenty of variety. People who live at the home were encouraged to make choices throughout the day. Staff said they always ask people what they want to do, what to wear and make sure people can get up and go to bed when they want. Staff said there are no rigid routines for people. This is good person centred practice. The manager of the home is readily available to people who use the service and their relatives. She said she encourages an open door policy where people can tell her what they want or need. Relatives of people who use the service said the manager was always asking them if everything was to their satisfaction when they visit. Care Homes for Older People Page 19 of 31 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to express their concerns and are protected from abuse. Evidence: In the AQAA, the manager said,We have a complaints policy and procedure which is accessible to residents and their families. In surveys returned to us people said they knew how to complain. Their comments included, If I did have cause to complain I know who to go to, tell the carer, I have not been unhappy but I know there is someone there if needed and I will tell the staff. It was clear from staffs interactions with people that the people who live at the home seemed confident to raise their wishes or concerns. A relative said she had been given information on how to complain if she needed to. The home has not received any complaints since the last inspection. Also in the AQAA, the manager said, Staff trained in Adult Protection and No Secrets. and Staff have undergone refresher course in Adult Protection. Care Homes for Older People Page 20 of 31 Evidence: Staff were able to say what action they would take if they suspected abuse or had an allegation of abuse made to them. They were also able to describe the different types of abuse. All staff were clear on their responsibility to report abuse or allegations of abuse. The manager and deputy manager were familiar with the local authority safeguarding referral system. This means people are properly protected. Care Homes for Older People Page 21 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Overall, the environment is homely, comfortable and safe for people who live at the home. Evidence: In the AQAA, the manager said, We undertake a rolling programme of renovation and refurbishment to ensure the home is clean and fresh. She also said, We have provided a further 2 rooms with en-suite facilities, renovated the porches at the rear of the building. We have purchased a shed in which to keep bicycles to enable residents to exercise. Installed an entry keypad for security of residents. A tour of the building was carried out. Communal areas, bathrooms and bedrooms were visited. The home was clean, tidy and homely. Some of the paintwork in the home is looking a bit tired and worn in places. The manager and deputy manager are aware of this and have prioritised where is most in need of re-decoration. Staff work hard to make sure the home is kept clean. There are no malodours in the home. The manager has made sure there are good cleaning routines in place to make sure the home is clean and fresh smelling. People who live at the home were pleased with their bedrooms and had personalised them with their own things such as furniture and pictures. Some bedroom doors had pictures on them to help people who have Care Homes for Older People Page 22 of 31 Evidence: memory loss to orientate themselves. Staff said that some people who live at the home sometimes got lost in the corridors. The manager should consider some other ways of using signage or colour contrasting in the home to help people find their way around better. There are three lounges available for people to sit in. This means that people can socialise in small groups. They are also able to receive and entertain their visitors here. A room on the second floor of the home has been set aside to be used as a computer room. The deputy manager said that Help the Aged were going to run some training for people who use the service so they can use the computer. People spoke highly of the home. They said: the home is always smelling nice and clean my bedroom is always clean It has a very homely feel. The kitchen was clean and proper procedures were being followed to promote safe food hygiene practices. The home has separate laundry facilities to attend to peoples personal clothing. In the main, clinical waste is properly managed and staff wear protective clothing when attending to the personal care needs of people who live at the home. However, the practice of hand sluicing soiled linen should stop. This increases the risk of the spread of infection. Most staff have received training in infection control as part of their induction and were able to say what infection control measures are in place. Hand washing and hand drying facilities were available in all areas of the home. Liquid soap or paper towels were available. This ensures good hygiene practice. Care Homes for Older People Page 23 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to support people who use the service and to support the smooth running of the home. Evidence: In the AQAA, the manager said, We have highly trained and skilled staff on duty to support residents with good staff to resident ratio both day and night. Staff interact well with residents at all times. There are usually three care staff on duty throughout the day on each shift. The manager is also available most days too. At night there are two staff on duty. Staff said they felt they had enough staff, that they never felt rushed and could meet peoples needs well. In addition to this there are two cleaners and a cook on duty every day. People who live at the home said there were enough staff and they didnt have to wait long for staffs attention if they needed them. They also said: they always attend when I call them. I am happy with the home and what the staff do to help me. Care Homes for Older People Page 24 of 31 Evidence: We looked at the recruitment processes for people working at the home. The files had the relevant information to confirm these recruitment processes were properly managed. This included application forms, references and CRB (criminal records bureau) checks. It is recommended that notes of interviews and any verification of references are kept to show clearly how the process has been managed. Staff confirmed their recruitment had been carried out properly. One said, We cannot start work without 2 references and CRB check. People who use the service and their relatives spoke highly of the staff. These are some of the things they said: They are absolutely wonderful, care for the whole family Staff are really friendly Staff are so lovely, so caring Always enough staff, always have time for everyone. In the AQAA, the manager said,We ensure all our staff are well trained and their training is constantly updated in order to maintain a high quality of care. Staff said they were pleased with their training. Comments included: We had a full induction when I started and also 2 weeks in house training where are shown how to do everything Training is given and it is ongoing an updated Get training to make us better trained carers All staff go on courses, and we do NVQ which helps make us qualified carer or senior. Training records showed staffs training to be up to date. Courses included, health and safety, food hygiene, first aid, dementia awareness, diabetes and depression. Senior staff have also undertaken training in supervising and coaching staff. One staff member said they had found this very useful. Staff were able to talk with confidence about how trainig had affected their practice. Care Homes for Older People Page 25 of 31 Evidence: One said, they felt much better equipped to support people who have dementia since doing the awareness training. They said, It tells you how dementia affects people, how best to communicate and how important it is for people to kep active. Over half of the staff team have achieved an NVQ (National Vocational Qualification) in level 2 or above. Staff said they are then given opportunity to go on to level 3 if they wish. This is good practice and means the home keeps staff who are qualified to carry out their job. Care Homes for Older People Page 26 of 31 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Overall, the home is well managed. The interests of people who use the service are seen as important to the manager and staff and are, in the main, safeguarded and respected. Evidence: In the AQAA, the manager said, The manager, deputy manager and senior supervisor all hold NVQ4 Registered Managers Award and We base the management of the home on openness, respect and commitment. The home has an experienced manager who also works alongside staff to make sure of good practice. This shows she has good leadership skills. Staff spoke highly of the support they get from the manager. Their comments included: If we have problems the manager is always there to provide help and support Care Homes for Older People Page 27 of 31 Evidence: She is really good support She has given me so much experience, passed on her skills and knowledge. The manager sends out annual questionnaires to relatives of people who live at the home asking for their views on any improvements that could be made. She then develops an improvement plan from any suggestions that people have made. An enclosed garden area has been developed, extra lighting has been provided on the stairs and security doors have been added to the home from suggestions made recently. Arrangements are in place to make sure of safe working practices. The home has a comprehensive range of health and safety policies and procedures in place. In the AQAA, the manager said that all policies were reviewed and up to date. She also said that all equipment used in the home has been serviced or tested as recommended by the manufacturer or other regulatory body. For example, the hoist and electrical wiring. Accident or incident reports are completed and kept in the home. However, the manager has not been notifying the CSCI of events which affect the welfare of people who use the service. This must be done promptly in future to make sure the health, safety and welfare of people who use the service is protected properly. The manager agreed to do this in the future. Care Homes for Older People Page 28 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 29 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 38 37 The CSCI must be notified 22/10/2008 promptly of any deaths, illness or other events which affect the welfare of people who use the service. This will make sure that the health, safety and welfare of people who use the service is protected properly. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 Care plans and risk management plans should be reviewed to make sure people using the service have an up to date, detailed care plan. This will make sure that people receive person centred support that meets their needs. Moving and handling practice should be reviewed to make sure it is safe for staff and people who use the service. Some consideration should be given to the provision of suitable signage in the home. This will help people to find their way about the home better. The practice of hand sluicing soiled linen should stop as this increases the risk of the spread of infection. 2 3 8 19 4 24 Care Homes for Older People Page 30 of 31 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. 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