Care Home: Maidstone Care Centre

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What the care home does well There are good organisational structures and the home is well managed. This means that all staff are clear about their roles and responsibilities and there is a clear vision for the future of the home. The registered manager and all the staff have worked well as a team during the first months that the home has been open. They are praised for the hard work they have put in during this period of settling in. The people the service supports are treated with respect. Their privacy and dignity is preserved and their health and well-being is promoted. The care at the home is good. Relatives said that the staff are kind and caring. There has already been a great deal of work with staff to ensure they understand how to keep the people they support safe and free from all forms of harm. Staff training is proactive and very well organised. Staff were very positive about the training they have received since the home opened. They are all very clear about the procedures for safeguarding vulnerable people. There are very thorough recruitment procedures that ensure all staff are properly vetted before starting work in the home. The environment is spacious, comfortable and clean and there is a relaxed and friendly feel to the home. Smoking is not permitted anywhere in the home or its grounds. This maintains a fresh and clean atmosphere in the home and reduces fire risks. Good pre-admission procedures are followed to ensure only those people whose needs can be met in the home are offered a place. There are very good written assessments that are made available to staff prior to admission. This means that staff understand the care needs of new residents before they come to live in the home. The care plans are comprehensive and identify the needs, likes and dislikes of the residents. What has improved since the last inspection? The home is new and this was the first inspection following registration with the Commission for Social care Inspection. Therefore this section is not applicable. What the care home could do better: The home is very new and is in the process of recruiting staff teams and developing systems. The home should continue to do this with the diligence and attention to detail that has been shown since it was commissioned. The home should now see the development of appropriate activities as a priority. It is recommended that better use be made of the gardens. The home should consider providing raised flowerbeds so that the people the home supports can enjoy participating in gardening activities. Whilst it is acknowledged that staff training is of a very high standard, it will be important to ensure staff at all levels keep updated with specialist training, for example, management of continence, diabetes and dementia care. CARE HOMES FOR OLDER PEOPLE Maidstone Care Centre 259 Boxley Road Maidstone Kent ME14 2AR Lead Inspector Wendy Mills Unannounced Inspection 13th May 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 Maidstone Care Centre DS0000071134.V364420.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. Maidstone Care Centre DS0000071134.V364420.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Maidstone Care Centre Address 259 Boxley Road Maidstone Kent ME14 2AR 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) 01622 672 292 maidstone@ranccare.co.uk Ranc Care Homes Ltd Mrs Linda Patricia Jackson Care Home 57 Category(ies) of Dementia (0), Old age, not falling within any registration, with number other category (0) of places Maidstone Care Centre DS0000071134.V364420.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) maximum number of places 15. 2. Old age, not falling within any other category (OP). The maximum number of service users to be accommodated is 57. Date of last inspection N/A Brief Description of the Service: The Maidstone Care Centre is a registered care home. It provides residential care, nursing care and care for people with failing mental capacity. It is registered to provide services for up to fifty-seven older people. The registered provider is Ranc Care Homes Ltd. and the registered manager for is Linda Jackson. She is a qualified nurse with many years experience in both nursing and health care management. The home is approximately one mile away from Maidstone town centre where there are good public transport links and a full range of amenities including libraries, shops, restaurants, pubs, churches, theatres and leisure facilities. Maidstone East Station, one of the town’s two railway stations, is just within walking distance however, it should be noted that the walk from the station to the home is uphill. The M20 motorway is close by and there are good road links to London and the coast. The accommodation is arranged over three floors. Each floor has a spacious lounge/dining room with a kitchenette where there are facilities to make beverages. Each floor is run as a separate unit. The ground floor provides accommodation for people who require nursing care, the middle floor provides accommodation for those who need residential care and the top floor provides accommodation for people with failing mental capacity. Maidstone Care Centre DS0000071134.V364420.R01.S.doc Version 5.2 Page 5 All the bedrooms are for single occupancy and all have ensuite toilets and washbasins. Each floor has specially adapted bathrooms with hoisting facilities so that those with mobility problems can be assisted to take a bath or shower. Outside there are safe and enclosed gardens to the rear and parking facilities to the front. Smoking is not permitted anywhere in the home or its grounds. The weekly fees for this service range between £445 to £848 (exclusive of the nursing element). Fees are dependent on the assessed needs of the individual. Maidstone Care Centre DS0000071134.V364420.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. Maidstone Care Centre is a new home. This was the first inspection of the home since it opened. The visit is called a “Key Unannounced Inspection”. This means that we did not tell anyone at the home that we were coming and that the judgements made as a result of the information we gathered, both before and during the inspection, will result in the home being given a star rating. This report has been compiled using information gained during this visit and information supplied prior to the visit from a variety of sources, including notifications of incidents, the views of relatives and health and social care professionals and the home’s Annual Quality Assurance Assessment (AQAA) that is required by the Commission for Social Care Inspection (CSCI). Throughout this report the service users will be referred to by their preferred term which is, “the people the service supports”. The registered manager assisted throughout the inspection. During the visit time was spent with the people the service supports, their relatives and friends, and staff. On the day of inspection there were seven people resident in the home and it was possible to speak to some of them and carefully observe the others. Four relatives and one friend were spoken to, some in private and some in one of the main lounges, to find out what they thought of the home. A tour of the home was made and documentation, including staff files and care plans, was examined. Direct and indirect observations were made throughout the visit. The home meets the National Minimum Standards. The people the service supports and their relatives say that they are well cared for. They say they are able to make appropriate choices and that the staff are kind and friendly. No requirements were placed following this visit. The people the service supports, their relatives and friends, and staff at the home, are all thanked for the welcome they gave and their help throughout this visit. The overall outcome for users of this service is good. rating for this home is 2 Stars. This means that the star What the service does well: Maidstone Care Centre DS0000071134.V364420.R01.S.doc Version 5.2 Page 7 There are good organisational structures and the home is well managed. This means that all staff are clear about their roles and responsibilities and there is a clear vision for the future of the home. The registered manager and all the staff have worked well as a team during the first months that the home has been open. They are praised for the hard work they have put in during this period of settling in. The people the service supports are treated with respect. Their privacy and dignity is preserved and their health and well-being is promoted. The care at the home is good. Relatives said that the staff are kind and caring. There has already been a great deal of work with staff to ensure they understand how to keep the people they support safe and free from all forms of harm. Staff training is proactive and very well organised. Staff were very positive about the training they have received since the home opened. They are all very clear about the procedures for safeguarding vulnerable people. There are very thorough recruitment procedures that ensure all staff are properly vetted before starting work in the home. The environment is spacious, comfortable and clean and there is a relaxed and friendly feel to the home. Smoking is not permitted anywhere in the home or its grounds. This maintains a fresh and clean atmosphere in the home and reduces fire risks. Good pre-admission procedures are followed to ensure only those people whose needs can be met in the home are offered a place. There are very good written assessments that are made available to staff prior to admission. This means that staff understand the care needs of new residents before they come to live in the home. The care plans are comprehensive and identify the needs, likes and dislikes of the residents. What has improved since the last inspection? What they could do better: Maidstone Care Centre DS0000071134.V364420.R01.S.doc Version 5.2 Page 8 The home is very new and is in the process of recruiting staff teams and developing systems. The home should continue to do this with the diligence and attention to detail that has been shown since it was commissioned. The home should now see the development of appropriate activities as a priority. It is recommended that better use be made of the gardens. The home should consider providing raised flowerbeds so that the people the home supports can enjoy participating in gardening activities. Whilst it is acknowledged that staff training is of a very high standard, it will be important to ensure staff at all levels keep updated with specialist training, for example, management of continence, diabetes and dementia care. 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. Maidstone Care Centre DS0000071134.V364420.R01.S.doc Version 5.2 Page 9 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 Maidstone Care Centre DS0000071134.V364420.R01.S.doc Version 5.2 Page 10 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): 1&3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides the people it supports, their relatives and supporters with the information they need to help them make an informed decision about their choice of home. The home has sound admissions procedures that include a thorough preadmission assessment. This ensures that only those people whose needs can be met are cared for in the home. EVIDENCE: There home has a comprehensive Statement of Purpose and Service User Guide. These documents are displayed, along with other information, in a prominent place on each floor of the home. Inspection of the care plans and pre-admission documentation showed that all those people already living in the home had received a thorough assessment prior to admission. The registered manager said that these assessments are Maidstone Care Centre DS0000071134.V364420.R01.S.doc Version 5.2 Page 11 carried out either by herself or another senior staff member. On the day of inspection a senior staff member was about to leave to visit a prospective resident at home. Some assessments take place at the hospital as the home provides nursing care and admits some people directly from hospital. The pre-admission assessments contain a great deal of information and record not only the health and care needs of the individual but their likes and dislikes, their religious needs and their preferred activities. Care plans are developed gradually, based on the pre-admission assessment and information gathered as the home gets to know the individual better. Care plans are important documents. This is because they form one of the means by which the residents and their supporters can tell that they will receive their care in the manner of their choice. Also, the plans are a source of reference information for the care workers who need to ensure that they assist people in a consistent and appropriate manner. Maidstone Care Centre DS0000071134.V364420.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 & 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home positively promotes the health and well-being of the people it supports. EVIDENCE: Policies and procedures for the protection of the privacy and dignity of the people the home supports are in place. Staff were observed to be kind and respectful towards the people they support and their friends and relatives. One person said, “The care is wonderful, - couldn’t be better” Care at the home is specialised. Nursing care, including palliative care, is provided on the ground floor, the needs of people requiring residential care will be provided on the middle floor, although this floor is not yet open, and care for people with failing mental capacity is provided on the top floor. Each floor is staffed separately. This means that the staff team caring for each group of Maidstone Care Centre DS0000071134.V364420.R01.S.doc Version 5.2 Page 13 people have specialist knowledge of their conditions and how to care for them. It also means that the staff can get to know individual residents much better and that care can be given in a homely environment. Nursing care is provided by qualified nurses who are registered with the Nursing and Midwifery Council (NMC). The qualified nurses are supported by trained care staff. On admission each resident has an initial care plan but this is continuously being developed as more information is gathered. The care plans were examined. All were found to be very thorough. Appropriate assessments, such a nutritional, continence and dependency level assessments have been carried out. Action plans have been drawn up based on the information in the assessments. Record keeping is very good and up-to-date. All the people the service supports have been registered with local health care services. The home experienced some initial difficulties with this; for example, it took some time before a District Nurse was allocated. These difficulties are gradually being overcome as the home becomes more established. The home is very well equipped to deal with the needs of those people who are not very mobile. There are new electric hoists, bathrooms are equipped with special baths with chair lifts and there are facilities to store oxygen. Pressure relieving equipment, such as special mattresses and cushions, is available if required. Policies and procedures for the management and administration of medicines in the home are sound. Each floor of the home has a clinical room and all medicines are stored very securely in line with the recommendations made by the Royal Pharmaceutical Society of Great Britain. A monitored dose system is used in the home. This means that medicines are supplied in monthly blister packs with the dose already in place when it comes from the pharmacy. All staff who have responsibility fro the administration of medicines have received appropriate training. Nursing care is provided on one floor of the home and qualified nurses are responsible for the administration of medicines on this floor. One mediation trolley was inspected. It was very neat and well organised. The Medicines Administration Records (MAR) were inspected and seen to be in very good order. All hand written entries were signed and countersigned. There have been no mediation errors to date. The senior carers on the floor Maidstone Care Centre DS0000071134.V364420.R01.S.doc Version 5.2 Page 14 where the systems for administration of medicines were inspected are commended for their diligence in the administration of medicines. The home is commended for the way in which it manages medicines. It will be important to ensure these very high standards in this area are maintained as more people are cared for by the service. In particular the home should ensure that the medicines trolleys still remain as neat and tidy when there are more residents with more medication. There are clear polices and procedures for the care of terminally ill people and appropriate training and support is given to staff who deliver palliative care. Religious beliefs, end of life wishes and customs are noted on the care plans. Maidstone Care Centre DS0000071134.V364420.R01.S.doc Version 5.2 Page 15 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 & 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provides some activities for the people it supports but the provision of meaningful activities requires further development EVIDENCE: The home is very new and, on the day of inspection there were only seven residents in the home. Staff were observed to spend time with the people who they support but there was little evidence of meaningful activities going on. The gardens are not yet fully ready for use. Contact has been made with the local church that is very near the home. A representative from the church visits regularly to give communion and keep everyone informed about church activities. The home has adequate outside space with two separate garden areas however; relatives said that they had not seen these areas used yet as there were health and safety issues. The grass was long and required cutting, there were no sunshades and, although, there are steps leading down to the gardens these were not yet gated. The registered manger said that the grass should Maidstone Care Centre DS0000071134.V364420.R01.S.doc Version 5.2 Page 16 have been dealt with by contractors but as yet they had not come. Therefore she has instructed the maintenance person to purchase a lawnmower and tackle the grass. Sunshades were on order and due to be delivered the day following this visit. There is no date as yet for the fitting of the gates. As there is seating in place in the gardens there it would be possible for residents to enjoy the gardens provided a member of staff accompanies them and protection against the sun is provided. There are plans to appoint an activities co-ordinator in the near future but at present the care staff are involving the people they support in the daily life of the home as much as possible. Introducing a programme of meaningful activities and making the garden accessible should now be seen as a priorities. The home should consider putting raised flower beds or planters in the garden so people who enjoyed gardening whilst still at home can continue to participate in this activity. Visitors said they are always made very welcome when they come to the home. There are quiet lounges where they can have more privacy if they wish. They all knew that they could visit at any reasonable time. Food services at the home are good. The dining rooms have plenty of space and the tables are properly laid with linen tablecloths and napkins for mealtimes. The chef said that there is plenty of fresh meat and vegetables and that menus are planned in conjunction with the registered manager. There is a four-week menu plan and there is always a choice of to main meals. Observation of a mealtime showed that people were offered alternatives should the choice they had made not be to their liking. Fresh produce is purchased locally. Special diets are catered for and there is good nutritional monitoring with monthly weighing, risk assessments and additional food supplements if necessary. The people the service supports said that the food is, “Very good”. Maidstone Care Centre DS0000071134.V364420.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 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has sound policies and procedures for handling complaints, concerns and safeguarding issues. This means that the home does all it can to protect the people it supports from harm EVIDENCE: There are sound procedures in place for handling and learning from complaints and concerns. The Statement of Purpose and the Service User Guide explain how to make a formal complaint. These are displayed on each floor along with a variety of CSCI information and leaflets. Posters are displayed, reminding everyone of the “Open door” policy that operates in the home. Relatives said they knew how to complain but had not any need to make any complaints. They said that they could easily talk to staff should they have any concerns. One said, “You know, minor worries about how he’s settled, what he’s like when I’m not here, that sort of thing, not complaints really, just concerns”. Staff who were spoken to said they were aware of the complaints procedures and said that they would always be prepared to complain on behalf of the people they support. They said that the manager listens to what they have to say and acts promptly when necessary. One staff member said, “You never Maidstone Care Centre DS0000071134.V364420.R01.S.doc Version 5.2 Page 18 have to nag her to do things, if we mention something is needed she sorts it right away”. The registered manager said that there have been no formal complaints since the home opened. She said that she encourages the people the home supports and their relatives to raise any concerns as they arise. Staff training in safeguarding is of a very high standard. All staff, including housekeeping, kitchen and maintenance staff, have received training in the Protection of Vulnerable Adults (POVA) from an external trainer. All staff spoken to were very conversant with the POVA policies and procedures that operate in the home. They were able to identify all the potential forms of abuse and to say to whom they would report concerns. The home has a dedicated training room which contains a great deal of resource information about POVA. This is both in written and DVD forms and is available to all staff at all times. This means that they can refresh their knowledge or look up anything they are not certain about at times convenient to themselves. Staff spoke very positively about their induction training and all the other training that has been made available to them since they started work in the home. Staff files show that all staff have been very carefully vetted. This means that the people the home supports are protected from unsuitable staff who might apply for a job working in the home. Staff recruitment is dealt with more fully in this report under the outcome area for staffing. Health and safety is given very high priority in the home. This means that the home does everything possible to protect the residents from coming to any physical harm in the home’s environment. Health and Safety is dealt with more fully later in this report. The registered manager demonstrated a very good understanding of the importance of keeping all the people the home supports safe from harm. She talked knowledgeably about safeguarding issues, including recruitment processes, staff supervision and training and day-to-day monitoring. Maidstone Care Centre DS0000071134.V364420.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, 20, 21, 22, 23, 24, 25 & 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is new and the environment is safe, spacious, well decorated, well furnished and spotlessly clean. This gives the people the service supports a very pleasant place in which to live EVIDENCE: The home gives a high priority to Health and Safety and all staff have received Health and Safety training. The home employs a full time maintenance person and a full time housekeeper. They are both commended for the way in which they have applied themselves to their roles and the diligence with which they carry out their work. Cupboards containing anything that might be dangerous to health, for example, cleaning materials, are kept very tidy and all cupboards were locked on the day of inspection. The housekeeper and maintenance person both said that they are very careful to ensure that any cupboard containing substances or tools, that could be harmful if found by someone who was unable to understand the danger, are kept locked. Maidstone Care Centre DS0000071134.V364420.R01.S.doc Version 5.2 Page 20 All areas of the inside of the home were safe on the day of inspection. The registered manager pointed out some minor health and safety concerns in the gardens, for example, gates have yet to be fitted to the stairway leading from the ground floor to the garden; however, none of these should stop the people who are supported by the service using the facilities providing they are accompanied by a member of staff. All the bedrooms in the home have en suite toilets and washbasins. On each floor there are specially adapted bathrooms with hoisting facilities. The bathrooms are well appointed and attractively tiled. In addition to the hoists in the bathrooms there are portable electric hoists that can be used throughout the home. Corridors are of a good width so wheelchair users can pass each other easily and there are handrails in the corridors to help those who are unsteady on their feet. The bedrooms are colour co-ordinated and attractively decorated. The people the service supports are able to bring in items from home so that they can personalise their rooms and make them more homely. Relatives said that they were very pleased with the environment, especially the bedrooms. The home is kept immaculately clean. The housekeeper has strict cleaning schedules. She ensures the cleaning staff carry these out and sign each task off when it is complete. The housekeeper and her staff are commended for the way they keep the home clean. Smoking is not permitted anywhere in the home or grounds. This means that the people the home supports can live in a fresh and clean atmosphere and are protected from the adverse effects of passive smoking. It also reduces fire risks. The manager makes it clear to all prospective residents and their supporters that the no smoking rule must be adhered to by staff, visitors and residents alike. There are sound infection control measures in the home. Soiled linen and clothing is sent directly to the laundry via a laundry chute. This means that no soiled laundry is carried through the communal areas. The laundry is large, well organised and has very strict infection control measures in place. Maidstone Care Centre DS0000071134.V364420.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): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels are sufficient. Staff training and staff recruitment are of a very high standard. This means that competent and carefully vetted staffs provide the care at the home. EVIDENCE: On the day of inspection there were only seven residents in the home. Four were being cared for on the nursing floor and three were on the floor for people with failing mental capacity. A fourth person was admitted to this floor late in the afternoon of this visit. A qualified nurse, assisted by a carer, was on duty on the nursing (ground) floor and a senior carer was on duty on the top floor. An additional senior member of staff was available to help where needed. Whilst the staffing levels were sufficient to meet the needs of the people in the home, they will need to increase as more people come to live in the home. There is a very thorough vetting process for staff who apply for work at the home. There are stringent recruitment policies and procedures. Inspection of staff files showed that Criminal Records Bureau (CRB) checks have been carried out on all staff. In addition, at least two references had been taken up for each prospective employee. Once satisfactory references have been received there is a careful interview process. Prospective staff are invited to Maidstone Care Centre DS0000071134.V364420.R01.S.doc Version 5.2 Page 22 make an informal visit and then attend a formal interview with to senior staff members. The registered manager said that she is involved in many of the interviews. Because the home is new and will soon be providing services for up to fifty seven people, many with complex needs, there has been a need to recruit a large number of staff in a relatively short period of time. This has sometimes been a difficult process as it is not easy to recruit nursing and care staff in the area. However, it is very good to note that the registered manager refuses to compromise standards in order to recruit quickly. Staff training is of a very high standard. There is a dedicated training room with a range of resource material. Staff files and training records show that there has been a great deal of training provided for staff both before and since the home opened. Staff spoke very positively about the training opportunities and the support they have received from the manager. One-to-one supervision has been established for all staff and training needs are identified during these sessions. Maidstone Care Centre DS0000071134.V364420.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): 31, 32, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and there are sound quality assurance systems. This means that the views of the people the home supports, their relatives and staff are listened to and acted upon. EVIDENCE: The home is under the ownership of Ranc Care Homes. This company own six other registered homes. The responsible individual is Mr Robinder Singh Rai. He has the responsibility for making monthly visits to the home to make sure quality is being maintained throughout. Linda Jackson is the registered manager. She has the responsibility to ensure that the home is run well and that quality is maintained on a day-to-day basis. Maidstone Care Centre DS0000071134.V364420.R01.S.doc Version 5.2 Page 24 She said that she has been well supported by her line management during the commissioning period before the home opened and since it has opened. Linda Jackson is very well qualified for the post of registered manager. She has extensive experience in the nursing and care profession, having qualified as a nurse over thirty years ago. She has maintained her professional development and professional registration with the Nursing and Midwifery Council. She has worked in hospital, community and care home settings both in this country and abroad. Previously, she held a position as registered manager in another care home with nursing. Conversation and observation throughout the day showed that Linda has an extensive knowledge of best nursing and care practice. In particular she showed a good knowledge of relevant legislation, safeguarding, equality and diversity and the National Minimum Standards. She demonstrates very strong leadership qualities and does not compromise on care standards. Staff said that she is strict but open and treats everyone fairly. They were especially positive about the way she promotes staff learning and listens to their ideas. The home has clear, accountable management structure and provides a professional and positive service to all the people it supports. Equality and diversity underpins the philosophy of the home and is positively promoted. The registered manager is well supported by senior staff and an administrator. There are clear reporting mechanisms and positive team leadership. Documentation in the home is very well organised and the registered manager was able to find, without delay, all documentation requested during this visit. There is an open and accountable system for valuables and monies kept on behalf of the people the home supports. The home does not act as appointee for any resident. Health and safety is given a very high priority. Smoking is not permitted anywhere in the home or grounds. This reduces fire risks and risks to the health of residents and staff from passive smoking. Fire safety checks are made and there is a fire plan for the home. All staff have received health and safety training and there are very regular, recorded health and safety checks in all areas, these include temperature monitoring and checks to ensure substances hazardous to health and stored correctly. There are sound quality assurance systems in place. As there are only a few people in the home at present informal ways for seeking the views of the people the home supports and their relatives are being used. The manager talks to residents and staff individually and listens to the views of staff both at meetings and in one-to-one supervision. A suggestion box is being set up and a formal questionnaire is to be sent out soon. The home has only been open a short time and the formal mechanisms for seeking peoples’ opinions, such as Maidstone Care Centre DS0000071134.V364420.R01.S.doc Version 5.2 Page 25 questionnaires and relatives groups, are in place. However, these have not yet been put into practice. Maidstone Care Centre DS0000071134.V364420.R01.S.doc Version 5.2 Page 26 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 3 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 3 4 4 4 4 4 4 STAFFING Standard No Score 27 3 28 3 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X 3 3 Maidstone Care Centre DS0000071134.V364420.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? N/A 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 Refer to Standard OP12 Good Practice Recommendations The home should work to ensure there are enough meaningful activities for the people it supports. Preparing the garden areas so residents can enjoy the outside space during the summer months should be seen as a priority. Maidstone Care Centre DS0000071134.V364420.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Maidstone Care Centre DS0000071134.V364420.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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