Care Home: Marine View Rest Home

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What the care home does well The home thoroughly assesses prospective residents prior to them being considered for admission, to ensure that the home can meet their needs. These assessments are then used in the formation of a comprehensive care plan for each individual which details the personal health and social care they require, and details of any risks to the resident, either during care delivery or during their life in the home. Routines around the home are sufficiently flexible to allow residents choice in the activities of daily living. The impression gained on inspection, which was confirmed on talking with residents and looking at the care plans, is that the home operates in a democratic manner with the manager and staff having discussions with residents regarding the menus, activities provided, and any changes that are going to take place in the home. Residents can choose the decor in their rooms and have complete freedom of movement. They have a lock to their individual rooms if their risk assessments permit and can administer their own drugs, again under the auspices of a risk assessment. One resident said: "There is freedom to do what you want, I have been here two years and treat it like a hotel; I go out and about as I choose and can lock my door. Staff are very good and there is a lovely atmosphere in the home. Any changes in the home are discussed with us. They are very aware it is our home". Another said: "There is an incredible ambiance here which goes through the whole home. The staff team is cohesive and there is a team loyalty and affection for the residents". All residents spoken with made positive comments about the food, the activities, the staff, and the flexibility within the home. Staff confirmed that there is a good training programme with over 50% of them having gained the National Vocational Qualification level 2 or above in care. What has improved since the last inspection? All requirements made at the last inspection have been complied with. Risk assessments are comprehensive, and are in place in all care plans and for the general areas of the home. What the care home could do better: Care plans and daily records must include the full names of the residents, and alsoof the completing member of staff, and care plans must show evidence of being completed in consultation with the resident or their representative. Medicines must be signed into the home by the member of staff who receives and checks them, and it is good practice to ensure two members of staff sign handwritten medication records. Staff must ensure that block soap and cloth towels are not left in communal bathroomswhen residents have finished bathing as these are detrimental to the control of infection. Only paper towels and liquid soap should be available for general use. Some resident`s toiletries and communal toiletries were also left in bathrooms. These restrict residents choice and also could put residents at risk of ingesting them or cause an allergy. There were some issues mentioned in the main body of the report which have not been subject to a requirement, the manager has given assurances that these will be done and these will be checked at the next inspection Inspecting for better lives Key inspection report Care homes for older people Name: Address: Marine View Rest Home 277/279 Kingsway Hove East Sussex BN3 4LJ     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: Elizabeth Dudley     Date: 0 8 0 4 2 0 0 9 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. that people have said are important to them: They reflect the things 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 © (2009) 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 31 Information about the care home Name of care home: Address: Marine View Rest Home 277/279 Kingsway Hove East Sussex BN3 4LJ 01273417696 01273272272 marineview@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Mohammed Shareefuddin Ali care home 19 Number of places (if applicable): Under 65 Over 65 19 old age, not falling within any other category Additional conditions: 0 The maximum number of service users who can be accommodated is: 19 The registered person may provide the following category/ies of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Marine View Rest Home is registered as a care home providing services for up to nineteen older people. There is no nursing care provided at the home. District nurses will visit those service users requiring nursing input. The home is located in Hove opposite the Hove Lagoon. There is no parking available at the home, but street parking is available on adjacent streets within the area. Some areas of the home provide views of the sea. There are local amenities within walking distance and access to public transport is nearby. The home is two houses that have been joined together and converted for its current use. Rooms are located over three floors and service users residing in rooms above first floor must be able to independently mobilise. One stairway leading to first floor has a stair lift available. There are eleven single Care Homes for Older People Page 4 of 31 Brief description of the care home bedrooms of which two have ensuite facilities and four double bedrooms, of which one has ensuite facilities. One single bedroom is below ten square metres. There are three bathrooms, one shower, a wet room with toilet and five toilets located throughout the home for service users. There is a dining room and good sized lounge room for service users to use. 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: This unannounced key inspection took place on the 8th May 2009 over a period of six hours and was facilitated by the homeowner and manager Mr Mohammed Ali. Methods used to collect information about the home included; examination of documentation, in the home observation of staff working with residents, the serving of lunches and conversations with residents and staff. All residents were spoken with during the inspection, and six residents were spoken with in depth and gave their views on life in the home. The inspector sat in on an activities session where a music and exercise session was in progress. Care Homes for Older People Page 6 of 31 Documentation examined included care plans, personnel files, staff training and supervision records, catering records, and health and safety files. Prior to the inspection questionnaires were sent out to relatives, residents and staff. Of these, two were returned from relatives and visitors to the home, five from residents and four from staff members. These gave information about the daily life in the home and helped to inform the judgements made in this report. Thanks are extended to those people who responded. The Annual Quality Assurance Assessment, required by the CQC which gives an overview of what has been achieved in the home and issues to be addressed, was received prior to the inspection. This accurately reflected the current status of the home. This was used as part of the inspection process. Comments received from surveys included: I am very well treated and happy, all the staff are very considerate and the meals nicely cooked and served. I have never been unhappy yet. We were able to come and see the home before my parents moved in and they stayed for lunch. Staff are always to hand and happy to help. My mother has lived there for seven years, and is well fed and warn and happy here. There have never been any problems. No negative comments were received. Current fees charged range between three hundred and twenty two and four hundred and thirty four pounds a week. Services, such as chiropody and hairdressing ,are not included in the fees, and details of these are available from the home. The last inspection took place on the 28th April 2008. What the care home does well: What has improved since the last inspection? What they could do better: Care plans and daily records must include the full names of the residents, and alsoof the completing member of staff, and care plans must show evidence of being completed in consultation with the resident or their representative. Medicines must be signed into the home by the member of staff who receives and checks them, and it is good practice to ensure two members of staff sign handwritten medication records. Staff must ensure that block soap and cloth towels are not left in communal bathrooms Care Homes for Older People Page 8 of 31 when residents have finished bathing as these are detrimental to the control of infection. Only paper towels and liquid soap should be available for general use. Some residents toiletries and communal toiletries were also left in bathrooms. These restrict residents choice and also could put residents at risk of ingesting them or cause an allergy. There were some issues mentioned in the main body of the report which have not been subject to a requirement, the manager has given assurances that these will be done and these will be checked at the next inspection 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 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 10 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. The home provides sufficient information and opportunity for residents to decide whether the home will meet their needs and expectations. All prospective residents are assessed by a senior member of staff before being offered a place at the home. The preadmission assessment documentation was completed to a high standard and gave sufficient information to generate the care plans and inform staff of the persons social and care needs. Evidence: The home produces a Statement of Purpose and Service User Guide which give full and comprehensive information about the home. A copy of the Service User Guide is given to each resident in the home. All residents receive a contract and Terms and Conditions of Residence on their Care Homes for Older People Page 11 of 31 Evidence: admission to the home. These complied with both the National Minimum Standards and the associated regulations. Residents spoken with confirmed that they had received copies of both the Service User Guide and the Terms and Conditions of Residence on admission and also that they had received sufficient information about the home, including having the opportunity to visit and join existing residents for a meal, before making a decision over whether they wished to live at Marine View. Residents receive a full pre admission assessment to determine whether the home can meet their needs. Assessments belonging to three residents were examined, and these contained sufficient detailed information to inform both the care planning process and staff working at the home of the prospective residents care and social requirements. The home only rarely accepts emergency admissions, but the manager said that he or a senior member of staff will assess these residents prior to, or immediately on their admission to the home. The home does not accept residents for intermediate care, but will admit people for respite care and other short term care as well as for permanent residency. Care Homes for Older People Page 12 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. Care plans are person centred and identify any risks to the individual. Residents spoken with said the delivered care meets their needs and expectations. The standard of medication administration safeguards the residents but failure to sign medication records could have implications on resident safety Evidence: During the inspection three care plans were examined, these were formed from a comprehensive assessment of needs and identified the care to be given to meet these needs. Care plans in place for each individual included personal care, health care, nutrition, continence and mobility. They had been reviewed regularly and were supported by daily records. Some care plans showed evidence of the involvement of residents or their representatives. Staff should ensure that all parts of the care plan including daily records can be identified by using the full name of the resident and all records should be signed in full by the member of staff Care Homes for Older People Page 13 of 31 Evidence: completing these. Likewise there should be evidence that residents or their representatives have been involved in the formatting of the care plan. Discussions were held with management regarding the benefits of implementing the Malnutrition Universal Screening Tool in conjunction with the regular weighing of the residents that is currently taking place. Individual risk assessments were in place for each resident and these were comprehensive. There was evidence both from residents and from care plans that staff react promptly residents needs for care from other health professionals, such as district nurses and General Practitioners, and evidence in the care plans showed that specialist practitioners, such as Community Psychiatric Nurses, had been accessed for individuals needing these. Residents can be accompanied to the GP surgery or on hospital visits by members of staff if relatives are not available and resident unable to go alone. The homes chiropodist provided information prior to the inspection, that staff follow his guidance and share information with him. Very positive comments were received about the care given by the home from both surveys and from a relative who telephoned the inspector during the inspection:Everything is lovely at the home, I am more than satisfied. Surveys received stated Staff always give my mother the support she needs and the doctor is contacted as needed, Staff always take good care of us and are quick to contact the doctor or nurse if we need to see them. The staff come and help you as soon as you ring your bell, day or night. There was evidence that residents are enabled to make choices around the activities of daily living and the tempo at which personal care takes place. One resident said They always ask me what I want to wear and they take their time over helping you, not a rush like it used to be where I lived before. The standard of medication generally safeguards the residents although there were a few omissions of signatures following administration of medication. Staff have received medication training, and medications have been audited on a regular basis. Residents can maintain their own medication if they so wish, and there are policies and risk assessments to support this. The home uses the blister pack medication system, and although a drug trolley cannot be used due to the lack of shaft lift, staff were seen Care Homes for Older People Page 14 of 31 Evidence: taking medications individually to residents It was recommended that two people sign hand written prescription sheets and all medications must be signed on receipt in to the home. Staff gave assurances that this would take place. There are no controlled drugs used in the home at the current time, discussions were held with the manager on the necessity to provide a controlled drug cupboard which meets legislation should they commence holding this type of medication. Whilst staff have a basic knowledge of end of life care, this is currently undertaken by the district nurses. Some care plans included the individuals wishes regarding resuscitation and preferred place of death and this should be extended to all care plans following involvement of the General Practitioner. Care Homes for Older People Page 15 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. Sufficient leisure activities are provided to ensure that residents receive adequate mental and physical stimulation in a manner that meets their expectations. The home provides a nourishing and varied diet and the menus are formed with residents participation. Residents spoken with were fully satisfied with the standard of catering provided. Evidence: Leisure activities are available to residents and are provided on an informal basis by care staff at the home, with one member of staff being responsible for coordinating these. An activities programme and records were in place. Whilst some activities are provided by a visiting musician and poetry man, with the latter enabling residents to compose poetry as well as reading and discussing poetry with them, the care staff provide arts and crafts, visits to the local shops and seafront for coffee, quizzes and board games. Staff said that the residents particularly appreciated film afternoons where they are provided with packets of crisps whilst watching a chosen film. The Poetry man also provides reminiscence therapy which Care Homes for Older People Page 16 of 31 Evidence: most of the residents enjoy. The provider has a mobility van and this is used to take residents on outings in the summer and summer parties are held in the small garden. Residents spoken with said that there were sufficient activities in place to meet their needs and that in addition staff spend time talking with them. A phone call from a relative received said that the Home is a lovely place, but I wish staff could spend more time talking to my relative who cannot leave her room, staff said that they do ensure that they spend time with this resident and this was shown in the care planning process. Six residents were spoken with during the inspection and comments received included We have plenty to do here, a poetry man and a music person and the care staff do lots with us We have activities most afternoons, with residents making it clear that there is no obligation for them to take part in the activities if they choose not to do so. One resident said There is not a lot for me to do although the others all seem to enjoy it, but to be fair I treat this place like a hotel, and a good one it is too, and I go out most of the time, we are all free to come and go as we please, and can choose what we do in all areas of our lives here. Choice in all areas and activities of daily living was confirmed by all residents spoken with. Residents said that they could have visitors whenever we like and the homes policies and Statement of Purpose confirmed this. Staff facilitate residents to attend church if they wish to go, and ministers of religion visit on request. Meals can be taken either in the dining room or in residents rooms. The menus are formed in consultation with residents and they are made aware of the daily menus by staff. There is a choice of two options at every meal, although the cook said that being a small home, she often provides choices outside of the days menu according to whether people change their minds, sometimes you fancy something and sometimes you dont. She said that residents were quick to tell her if they didnt like a particular meal offered and that she knows their individual likes and dislikes. Menus examined were varied and nutritionally sound and all residents said that they enjoyed the meals provided Very nice food, I eat like an elephant. Plenty of choice and they know what I like. Breakfasts are served from 7-10am and the evening meal is 16.45. Discussions were held with management regarding the timing of supper,but residents spoken with said they were happy with the time of this meal, and that they could always have a sandwich or other food at any time of evening or during the night. The kitchen received four stars in the Environmental Health Authoritys Scores on Doors initiative and catering staff have the food hygiene certificate Care Homes for Older People Page 17 of 31 Evidence: Care Homes for Older People Page 18 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. Residents are comfortable in making a complaint and are confident that any complaints or concerns would be addressed in an open and transparent manner. Staff have received training in the safeguarding of those in their care and were aware of the actions they should take in the event of discovering an adult safeguarding issue. Evidence: There is a complaints policy included in the Statement of Purpose and Service Users Guide and displayed around the home. Records of any complaints received or minor concerns are available. There have been no complaints in the past twelve months and all residents were aware of how to make a formal complaint and whom to contact. However residents spoken with said that they would ask the manager to address any concerns they may have in preference to making a formal complaint. He would always sort things out. All staff have received training in the safeguarding of those in their care and were fully aware of the actions they should take. There have been no adult safeguarding issues in the home. Care Homes for Older People Page 19 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Marine View provides a homely and clean environment for residents but some areas are in need of refurbishment. There were some practices taking place which may compromise the control of infection. Evidence: During the tour of the building it was seen that whilst the home is decorated and furnished in a homely style, there were some areas in need of refurbishment. Some carpets require replacement and some maintenance was needed in a ground floor room. Residents spoken with were generally satisfied with both the decor and the furnishing of the home and did not mention any need for improvement. The AQAA told us that new kitchen flooring has been laid, there has been a new carpet in one room, and some new curtains and bedding have been purchased, and that new net curtains have been supplied in rooms at the front and back of the house. On the day of the inspection the home was in the process of being repainted externally. Communal accommodation consists of a lounge; separate dining room which is also used as a care office; and a small but pleasant courtyard garden. Staff must ensure that residents are not using the dining room when giving staff handover or discussing Care Homes for Older People Page 20 of 31 Evidence: residents, in order to maintain confidentiality. Currently there is no shaft lift in the home but a stair lift is in place between ground and first floor. There is, however, one step which has to be negotiated ,which therefore restricts the occupancy of these rooms to residents who are fully mobile. The top floor is only accessible by stairs. Residents accommodation is provided by eleven single bedrooms on three floors, one of which is below ten square metres, two of which have en-suite facilities and four double bedrooms of which one has en suite facilities. The manager stated that double rooms are only occupied by two people following full agreement from the existing resident. Residents are encouraged to bring in possessions to make their rooms more homely and are provided with lockable storage and a lock to their room doors, if their risk assessment permits this. All radiators are guarded and have temperature controls in the rooms. Hot water temperatures to residents outlets are monitored and records showed that these were kept within recommended parameters. Two of the single rooms and one of the double rooms have en suite facilities consisting of a washbasin and toilet and there are adequate assisted bathrooms including a shower and wet room, and w.c.s for the needs of the residents. The home provides grab rails and assisted baths and shower facilities. Moving and handling equipment is in place although hoists are provided by district nurses if required. All areas of the home were clean, however one room was malodorous and this was discussed with the manager. Some staff have undertaken basic infection control training and it was noted that gloves and aprons were being used where applicable. However staff, including the manager, were going into the kitchen without protective clothingthis was discussed with the manager who gave assurances that this practice would cease. Although senior staff were aware that block soap and cloth towels and washcloths should not be left in communal bathrooms, these were found in two bathrooms along with personal toiletries. Block soap and cloth towels could prevent the control of infection and leaving toiletries in bathrooms may impact on resident choice and put Care Homes for Older People Page 21 of 31 Evidence: residents at risk. There was evidence of alcohol hand gel being used. Residents spoken with said that the laundry facilities were good, with clothes being returned to them in a timely manner. Soiled laundry is washed separately in red bags. It is recommended that a senior member of staff undertakes the course provided by the Health Protection Agency to become Infection Control Champion for the home, and this was discussed with management. Care Homes for Older People Page 22 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. There are sufficient staff employed with suitable training to meet the needs of the residents in the home. Staff are encouraged to pursue further training with over 50 of the staff having a National Vocational Qualification in Care, which ensures that residents benefit from staff who have a sound knowledge of how to care for them. Evidence: The off duty rotas and discussions with staff identified that there were sufficient staff on duty to meet the needs of the current residents in the home. The home employs three members of staff in the mornings, two in the afternoon and one awake care staff at night. The manager and senior staff said that there is an on call rota and one of them would come in if there was a problem at night. The manager stated that this is reviewed continually according to resident need. Three personnel files belonging to recently employed staff were examined, these showed that the home practises a robust recruitment system, and they included all documentation and checks required by regulation. All staff receive a copy of the General Social Care Code of Conduct on commencement Care Homes for Older People Page 23 of 31 Evidence: of employment. The home employs an outside training agency for staff training and records showed that following the Skills for Care induction course, staff complete mandatory and other training relating to the needs of the residents in the home. Over 50 of the staff have the National Vocational Qualification level 2 or above in Care. The manager has attained both the National Vocational Qualification level 4 and the Registered Managers Award and a senior carer is in the process of studying for the National Vocational Level 4 qualification in care. Staff were aware of the implications of the Mental Capacity Act and the manager is registered to attend training in the Deprivation of Liberty safeguarding. Care Homes for Older People Page 24 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. Management systems within the home ensure that the delivery of services and the maintenance of the health and safety of residents, safeguards the residents and meets their expectations. Evidence: The registered manager is also the owner of the home. He is registered with the CQC and holds the National Vocational level 4 in Care and the Registered Managers experience and has experience of owning and managing the home for a number of years. He participates in all of the ongoing training provided for staff and is registered to attend a course in Deprivation of Liberty safeguarding with Brighton and Hove local authority. There are currently no residents in the home for whom Deprivation of Liberty Safeguarding applies. Care Homes for Older People Page 25 of 31 Evidence: All of the residents spoken with, the surveys received and staff spoken with spoke to the good ambiance in the home. One resident said The team loyalty and affection they have here is very good. This staff team have an incredible ambiance which goes through the whole home. Another resident said It is a real luxury living here, the food is good and the management and staff are like a lovely family. Comments from surveys included I am very well treated and happy; all the staff are very considerate and I never been unhappy yet. The manager and staff are superb. This ambiance was evident during the inspection and staff said this was due to the manager who was willing to help them with anything and was both supportive and very approachable. The Annual Quality Assurance Assessment (AQAA) was received when we asked for it and gave clear and concise information across all areas. The home has a quality monitoring process which involves residents and their relatives. Views are gained by way of anonymous questionnaires and responses were available to be seen at the inspection. The home had also sought the views of health care professionals. All the responses were very positive and where suggestions to improve service had been made, there was evidence that these had been followed up. The home also holds residents meetings on a monthly basis, which further enables the home to gain views of the residents. Residents are included in decisions relating to the menus and leisure activities, are able to choose the decor in their rooms, and are also kept informed and their opinions sought on any changes that may take place within the home. The home does not deal with any residents monies. There was evidence that all care staff have regular supervision and appraisal, these were taking place at times directed by the National Minimum Standards. Staff supervision is undertaken by the manager and a management consultant. All records were up to date and stored securely if required. Certificates relating to the servicing of utilities and equipment were in place and in date. There was evidence of fire training and a fire risk assessment, and the manager has recently had seals put on all doors as advised by the fire officer. All doors required to be open, have closures which act on the fire alarm sounding. Staff have had mandatory training which includes moving and handling, fire training, safeguarding adults and health and safety, and one member of staff has a full first aid certificate. Training records are in place to support this. Care Homes for Older People Page 26 of 31 Evidence: One ground floor room had electrical cables trailing across it and in one room on the top floor the resident had removed the window restrictor and told the inspector he neither wanted nor needed it - the manager said that a risk assessment would be put in place. He also gave assurances that he would address the issue of the cables. The manager must ensure that window restrictors are checked on a regular basis and a comprehensive risk assessment is in place which takes into consideration the needs of the other residents living around The manager gave assurances that this would be put in place. Care Homes for Older People Page 27 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 28 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 7 15 That all parts of the care 30/05/2009 plan include the full name of the service user and are signed by the member of staff completing the documentation and that there is evidence that care plans have been formed in consultation with the service user or their representative To ensure that there is suffcient information on the care plans for identification and to show that service users are in agreement with the care to be delivered 2 9 13 The manager must ensure that all areas of medication receipt and administration are signed by a member of staff. To prevent risks to service users. 30/05/2009 Care Homes for Older People Page 29 of 31 3 26 13 That block soaps, cloth 30/05/2009 towels and washcloths and personal toiletries are removed from communal bathrooms To maintain a robust system of infection control. To ensure service users have choice and are not put a risk from toiletries left in bathrooms 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 2 9 26 That all handwritten prescriptions are signed by two members of staff to ensure accuracy. That a senior member of staff undertakes study with the health protection agency to become Infection Control Champion. Care Homes for Older People Page 30 of 31 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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