Care Home: Neva Manor Residential Care Home

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What the care home does well Outcomes for the residents are positive. For example five residents spoken with said, "The home is nice, the staff are kind and caring, and the food is good." A good rapport between staff and residents was observed. The home has a warm and pleasant environment with a good standard of fixtures and fittings. The staff work well as a team and ensure the well-being and comfort of the residents` and treat them with great respect and kindness. People living at the home feel valued and cared for. Staff feel well supported and enabled to provide a high standard of care. Meals are varied, healthy and nicely presented offering choice and variety. Residents` health and personal care needs are well met by knowledgeable staff in an understanding way. Residents feel that if they had something to complain about they would speak to a member of staff. All residents spoken with said they had nothing to complain about. One resident said `the home is excellent; I would recommend it to anyone".` What has improved since the last inspection? The provider, manager and staff team have worked hard to implement the requirements and recommendations from the last inspection. Issues regarding medicines management have been addressed and a safer system for the storage and administration of medicines is now in use for the protection of residents. Since the last inspection the kitchen has been renewed and the written food safety system implemented for the safety of residents. Staff have received training in recognising and handling situations of abuse for the protection of residents. Staff demonstrated they have knowledge and understanding of infection control practices for the safety of residents. The system for the management of monies held for residents has been reviewed and more robust system implemented for the protection of residents. Staffing levels have been kept under review and ensure that there are enough staff to meet residents` need. More robust recruitment practices are in place to ensure residents are protected from potential harm. All staff have been provided with training, appropriate to the work they are to do, so residents will be cared for by knowledgeable and competent staff. Regular supervision has been provided to ensure the competence of staff for the benefit and safety of residents. What the care home could do better: Hand transcribed medications to have two signatures when writing them on the Medication Administration Record sheet, to provide accountability and ensure responsibility for the safety of residents. When using bed rails ensure that consent has been given by the resident, to the use of these and documented. If the resident does not have the capacity to agree to their use then consent must be sought in line with the Mental Capacity Act 2005, and documented. Provide new staff with Manual Handling training as part of their induction for the safety and protection of residents and themselves. Ensure all staff access training provided to equip them with the skills and knowledge to meet residents` needs in a safe and understanding way. CARE HOMES FOR OLDER PEOPLE Neva Manor Residential Care Home 4 Neva Road Weston Super Mare North Somerset BS23 1YD Lead Inspector Patricia Hellier Unannounced Inspection 18th September 2008 10:30 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 Neva Manor Residential Care Home DS0000068269.V369105.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. Neva Manor Residential Care Home DS0000068269.V369105.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Neva Manor Residential Care Home Address 4 Neva Road Weston Super Mare North Somerset BS23 1YD 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) 01934 623413 01934 623413 neva.manor@enningsmail.co.uk Dharma Rajoo Bungaroo Mrs Devianee Bungaroo **Post Vacant** Care Home 14 Category(ies) of Old age, not falling within any other category registration, with number (14) of places Neva Manor Residential Care Home DS0000068269.V369105.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: 2. Old age, not falling within any other category (Code OP) The maximum number of service users who can be accommodated is 14 14th November 2007 Date of last inspection Brief Description of the Service: Neva Manor Residential Care Home is a large Victorian house situated in a quiet residential road in Weston-Super-Mare and close to the seafront. The town centre is nearby with a range of shops and recreational activities. The home is registered to provide residential care for up to 14 older persons in a converted property. The accommodation is situated over two floors with a chair lift and stairs for accessing the upper floor. A lounge and dining area is situated at the rear of the property and there is an additional quiet lounge situated at the front of the home. Mr & Mrs Bungaroo own Neva Manor and registered with the Commission in September 2006. The provider makes information available through a brochure and information pack. The information pack contains the Statement of Purpose and Service User guide and all relevant information about the home. The current fee levels are between £369 and £400 per week. Neva Manor Residential Care Home DS0000068269.V369105.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This key inspection took place over 6.5 hours on one day. The deputy manager was present throughout and Mr & Mrs Bungaroo arrived at lunchtime. Before the inspection the information about the home was received from the file held in the office, surveys received from six people who uses the service, three members of staff, two GP’s and one Health Care professional. The last inspection report was reviewed together with the completed Annual Quality Assurance Assessment (AQAA) form from the provider. The AQAA is a selfassessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. We (The Commission) also reviewed all correspondence and regulatory activity since the last Key inspection. The accumulated evidence for this report comes from the above and also fieldwork that included discussions with eight residents, one Occupational Therapist and four staff. Practices were observed and documents relating to care, recruitment and health and safety were reviewed. Of the seven resident surveys sent six were returned. The replies indicated that their care needs are met by responsive staff, and they are provided with what they need. Comments from residents were “I love it here and am very happy”; “the home is excellent”; “a very homely home”. No areas of concern were raised. All residents and other professionals spoken with told us that the home was good and the staff very kind. Comments received were “it is very homely and comfortable”; “it provides good person centred care”; “it’s a good staff team”; “they’re the best”. What the service does well: Outcomes for the residents are positive. For example five residents spoken with said, “The home is nice, the staff are kind and caring, and the food is good.” A good rapport between staff and residents was observed. The home has a warm and pleasant environment with a good standard of fixtures and fittings. Neva Manor Residential Care Home DS0000068269.V369105.R01.S.doc Version 5.2 Page 6 The staff work well as a team and ensure the well-being and comfort of the residents’ and treat them with great respect and kindness. People living at the home feel valued and cared for. Staff feel well supported and enabled to provide a high standard of care. Meals are varied, healthy and nicely presented offering choice and variety. Residents’ health and personal care needs are well met by knowledgeable staff in an understanding way. Residents feel that if they had something to complain about they would speak to a member of staff. All residents spoken with said they had nothing to complain about. One resident said ‘the home is excellent; I would recommend it to anyone”.’ What has improved since the last inspection? The provider, manager and staff team have worked hard to implement the requirements and recommendations from the last inspection. Issues regarding medicines management have been addressed and a safer system for the storage and administration of medicines is now in use for the protection of residents. Since the last inspection the kitchen has been renewed and the written food safety system implemented for the safety of residents. Staff have received training in recognising and handling situations of abuse for the protection of residents. Staff demonstrated they have knowledge and understanding of infection control practices for the safety of residents. The system for the management of monies held for residents has been reviewed and more robust system implemented for the protection of residents. Staffing levels have been kept under review and ensure that there are enough staff to meet residents’ need. More robust recruitment practices are in place to ensure residents are protected from potential harm. All staff have been provided with training, appropriate to the work they are to do, so residents will be cared for by knowledgeable and competent staff. Regular supervision has been provided to ensure the competence of staff for the benefit and safety of residents. Neva Manor Residential Care Home DS0000068269.V369105.R01.S.doc Version 5.2 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Neva Manor Residential Care Home DS0000068269.V369105.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Neva Manor Residential Care Home DS0000068269.V369105.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5, Standard 6 is N/A Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Statement of Purpose and Service User Guide is comprehensive and provides prospective residents with information to make an informed choice. The home’s assessment process is satisfactory and ensures that it is able to meet residents’ needs. EVIDENCE: Residents are provided with a comprehensive Residents’ booklet containing the Statement of Purpose, Service User Guide and all the information required to ensure they, or their relatives, have access to the relevant information at all times. The Statement of Purpose includes information regarding equality and diversity issues and the homes philosophy of care that includes meeting cultural and diversity needs. All residents spoken with had a copy of this. All residents were aware they had a contract of residency and were happy with the provision that they receive. The contracts reviewed as part of the case Neva Manor Residential Care Home DS0000068269.V369105.R01.S.doc Version 5.2 Page 10 tracking exercise were signed and contained information about fees and the obligations of the provider and resident. The contract terms and conditions were clear and understandable. The registered manager carries out a needs based pre-admission assessment on all prospective residents. Admissions to the home take place once the registered manager is confident the residents care needs can be met. Two residents assessment documentation were read to find out how well the needs are assessed. The assessments were informative, and showed the residents had been consulted about their range of physical, mental and social care needs. There were assessments in place for each resident, that showed the Home had assessed the persons moving and handling needs and set out how best to support the resident safely with their mobility needs. Residents were able to recall having been visited by the manager prior to admission, and also being invited to visit the home. Thus enabling the prospective residents to meet other residents, see the facilities offered and look around the accommodation available. The residents’ when spoken to said ‘I am well looked after; they know what I need”. Social services care plans had been obtained where relevant. Care practices observed showed that staff were fully aware of the residents needs as stated in their assessments. The home does not provide intermediate care Neva Manor Residential Care Home DS0000068269.V369105.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8.9.10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ are well cared for and care plans show how to support residents with their range of needs. Residents benefit from well managed personal and environmental risks that are well managed. Residents’ are protected by satisfactory medication administration and practices. Respect and dignity for residents’ is well maintained by kind and caring staff. EVIDENCE: Care provision for residents at Neva Manor is good, with staff being aware of the individual needs of residents and how best to meet them for their health and well being. The residents with whom we spoke said that they were very satisfied with the standards of care and felt the staff were good. One resident told us that the staff are “always understanding about their needs and wishes. They told us “I can do what I like and they support me. They are very good”. Neva Manor Residential Care Home DS0000068269.V369105.R01.S.doc Version 5.2 Page 12 Individual records are kept for each of the residents, which include all key personal information. Two care plans were inspected and all reflected clearly current identified health and social care needs. Clear actions to met identified needs were recorded and regular evaluation noted. In one care plan it was noted that the potential for pressure sores and prevention did not have all the key actions to minimise the risk, for the well being of the resident. In discussion with staff they were aware of the actions and how best to prevent the development of pressure sores. Residents are weighed on admission, and regularly following this, to ensure they are receiving enough nutrition to maintain their health and well being. Both of the care plans inspected showed resident’s involvement. In discussion with residents although they were not aware of their care plans they talked of discussions with the staff about their needs. Staff when interviewed were clearly able to describe the needs of the residents being case tracked and demonstrated person centred approach to care. This is good practice. Health care professionals such as GP’s and district nurses visit the home as required to carry out health care checks and offer advice to staff. Evidence was seen of residents being taken to other appointments as needed. Resident’s comments supported this. All care plans contained well-formulated risk assessments for Manual Handling and falls. Other personal and environmental risk assessments were present to ensure the safety of the resident while promoting independence as able. One resident said, “It is just nice to have the reassurance of someone there to help”. Daily records were up to date and written in a respectful manner. Care practices observed showed caring interactions and good communication skills from staff. Choices and preferences were observed being discussed and offered. Detailed conversations with eight of the residents confirmed a good standard of personal care. Two residents said, “it’s homely” another resident said, “people are very kind, we are well looked after” and a third said “they are very respectful and helpful”. Another resident told us “I would recommend the home to anyone- they’re the best”. During the inspection an Occupational Therapist was seen visiting and resident and advising stave about new equipment. Moving and Handling issues were discussed and arrangements made for appropriate equipment to be provided with training for the staff. This good practice is to be commended. Medication storage, receipt and disposal are well managed for the safety of residents. A full audit trail of medicines entering and leaving the home showed that one medication had been signed as administered when it had not been. This is poor practice and does not provide for the health and well being of the resident. The deputy manager told us she was aware of the issue and had spoken to staff. Neva Manor Residential Care Home DS0000068269.V369105.R01.S.doc Version 5.2 Page 13 The Medication Administration Record (MAR) sheets had been well completed with no gaps. The staff who administer medication have received appropriate accredited training and a list of specimen signatures were recorded in the medicine administration record. Hand written prescriptions had not been signed for accountability purposes. Good practice guidelines recommend two signatures for hand transcribed entries on medication Administration Record (MAR) sheets. The home does not have a policy for the administration of homely remedies. The have decided that in the best interest of residents if homely remedies are required they would seek medical advice. The interactions of the care staff observed demonstrated respect for individuals and their right to privacy. Residents spoken to say, “the staff are very thoughtful and kind and treat you very well”. All residents spoken with felt that kind and caring staff respected their dignity and privacy. The home has an Equality and Diversity policy that recognises the cultural and social needs and differences that are present in society. Both management and staff demonstrated clear knowledge and desire to meet cultural and diversity needs as and when they should arise. Neva Manor Residential Care Home DS0000068269.V369105.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ benefit from routines, and menus, that are flexible to meet their needs. A variety of activities is offered, and residents’ right to choice and control over their lives is well respected, and encouraged. Friendly staff always welcome relatives and visitors. EVIDENCE: Many residents commented on the atmosphere of the home. One person described it as nicely informal, and residents’ felt that their visitors are also helped to feel relaxed and at home. When asked about activities and their daily routine two residents said, “we have singing sometimes”. Another told us “we go out sometimes”. Staff were observed arranging transport for one resident to go to their weekly bingo session in the town. The deputy manager has taken on the organisation of activities to ensure they are the things residents would like to do. A survey of all residents was undertaken and from this a weekly calendar has been organised to provide activities for residents’ enjoyment. This includes board games, chair exercises, reading, bingo, drawing. Outings are also arranged with a recent visit to the Neva Manor Residential Care Home DS0000068269.V369105.R01.S.doc Version 5.2 Page 15 sea front to see the Red Arrows display. We were also told of the recent sponsored walk by all staff and residents around the block, which was enjoyed by all. The home have also linked up with the local Older People’s partnership organisation to assist in activity provision and outings. People who use the service told us they can see their visitors at any time, helping them to feel this is their home. Relatives spoken with told us they feel “welcomed” when they come, and that “there is a warm, caring feel to the place”. The dining room is homely and tables well presented providing an atmosphere that is conducive to an enjoyable meal. All residents said they liked the meals, and felt a good and balanced diet is provided. At coffee time on the day of inspection residents were provided with a fresh fruit snack that was nicely presented and made easy to eat. We were told that this is provided on alternate days at coffee time, however fresh fruit is always available at other times if desired. Choices are offered and the cook is well aware of allergies, special diets and individual’s likes and dislikes. Choices are always offered. On the day of inspection residents were observed enjoying their lunch which looked nutritious and well cooked. All meals are home-made from fresh ingredients. In addition to the usual cups of tea and coffee, a choice of cold drinks was regularly offered throughout the day. Neva Manor Residential Care Home DS0000068269.V369105.R01.S.doc Version 5.2 Page 16 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. Residents’ are protected from abuse, and they can be confident that complaints are taken very seriously. EVIDENCE: The home has a comprehensive complaints procedure and all residents receive a copy on admission. There have been four complaints since the last inspection. These were appropriately investigated and handled, to provide the best outcome for the residents. Residents stated that if they were not happy about anything they would speak to the manager. A complaint, comments and compliments leaflet is available in the front hall for any resident or visitor to complete if they so wish. Residents said that the manager and staff are “very approachable” and they would always raise any concerns with them. One resident said ‘I’ve nothing to complain about, it’s just like home – we are one family”. A system for keeping clear records of complaints received, with actions taken, and outcomes are available should any complaints be received. The home has a copy of the ‘No Secrets’ in North Somerset guide and a comprehensive local policy and procedure for responding to allegations of abuse for the protection of residents. Staff interviewed were conversant with the home’s policy for protecting residents’ from abuse and demonstrated good Neva Manor Residential Care Home DS0000068269.V369105.R01.S.doc Version 5.2 Page 17 knowledge of the adult protection procedure that should be followed, if abuse is suspected for the protection of residents. The home also has a Whislteblowing policy and staff are aware of this and their duty of care in relation to whistle blowing for the safety of the residents. Since the last inspection staff have received formal training regarding Safeguarding Adults and how to whistle blow should the need arise. Staff when interviewed were aware of the policy, had an understanding of what constitutes abuse and how best to respond to any allegations or incidents, should they occur for the protection of residents. All residents said, “The staff are very kind and take time”. “I can’t fault them”. Neva Manor Residential Care Home DS0000068269.V369105.R01.S.doc Version 5.2 Page 18 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 good. This judgement has been made using available evidence including a visit to this service. Residents are provided with homely, safe and comfortable surroundings. Outdoor space is attractive and accessible for residents to enjoy. The home has suitable equipment to maximise resident independence. Satisfactory Infection Control practices are followed. EVIDENCE: Many parts of the home are welcoming and comfortable with homely communal spaces. Residents’ rooms are personalised and comfortable. The lounge is furnished with a variety of suitable and comfortable chairs to suit residents’ needs. Refurbishment and redecoration of the home has taken place since the last inspection and is ongoing. A maintenance and development plan for the home was seen showing how the provider is ensuring a safe and comfortable environment for the benefit of residents. Neva Manor Residential Care Home DS0000068269.V369105.R01.S.doc Version 5.2 Page 19 All rooms are provided with en suite facilities for the comfort and privacy of residents. The décor, fixtures and fittings are in good order. The lounges are furnished with a variety of suitable and comfortable chairs to suit residents’ needs. The home has a well maintained garden for residents to enjoy. Residents’ rooms are personalised and comfortable to suit their needs. All rooms have en suite facilities for residents’ comfort. There are plenty of toilets within easy access of all communal rooms, for the comfort of residents. The home has grab rails situated at relevant points and a stair lift to all floors that is easily used to assist resident mobility, and aid independence within the home. The home has sufficient bathroom facilities with aids for the benefit of residents. Equipment was clean and well maintained to ensure the protection of residents from cross infection. Hot water outlets supply water at scalding temperatures. Notices by the communal taps warn people of this but the potential for harm remains. A system of thermostatic valves for hot water outlets, or the control of the temperature of supply at source, is required for the safety of people who us the service. Thermometers were present for staff to check the water temperature before baths for the safety and protection of residents. Equipment to assist residents in bathrooms was observed to have cracked and flaking paintwork and to be rusting, providing potential for cross infection and should be replaced. Not all radiators in the home have been covered and risk assessments for these have not been undertaken to safeguard residents from potential harm. The home was clean and free from offensive odours throughout. The laundry facilities were well organised to minimise potential cross infection. Staff interviewed and observed demonstrated good understanding of Infection Control procedures and practices and maintained a clean and hygienic environment. Dispenser soap and paper towels are provided in communal areas, to facilitate good hand washing practices, between caring for residents and reduce risk of cross infection in the home. Neva Manor Residential Care Home DS0000068269.V369105.R01.S.doc Version 5.2 Page 20 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. Residents are cared for by a sufficient number of competent trained staff. Residents are protected by safe recruitment practices. EVIDENCE: The staffing rotas for the two weeks prior to the inspection were reviewed. Staffing levels appear to provide sufficient care staff to meet residents’ needs. A good team of ancillary staff supports them. In discussion with residents they told us “the staff are very good and always there when you need them.” Other comments received were “staff know their job and do it well”. Staff interviewed, and surveys responses from staff, told us “we seek to provide a high standard of care to residents” and “there are good relationships between staff, residents and their families”. Feedback from the Health Care Professional told us “the home provides good all round care”. The home currently has more than 50 of staff with a National Vocational Qualification (NVQ). Since the last inspection a further five staff have commenced the qualification to ensure they have the skills and knowledge to care for the residents in a safe and competent manner. Neva Manor Residential Care Home DS0000068269.V369105.R01.S.doc Version 5.2 Page 21 Since the last inspection safe recruitment practices have been implemented to ensure residents are protected from potential harm. Two recruitment files were inspected and all required documentation was present to ensure residents are protected from harm. All staff interviewed stated they had contracts of employment and job descriptions. Evidence was seen of staff induction in the files of two new members of staff to ensure they have the skills and knowledge to care for residents appropriately. Moving and Handling training is not included in the induction. It is recommended that this is provided for the safety and protection of residents and staff. When interviewed we were told that the induction “was helpful and covered all the things I needed to know”. We were also shown the files containing the Common Induction Standards that new staff are working through to ensure they are provided with the relevant knowledge and assessed as competent for the benefit of residents. Since the last inspection the home have worked hard to provide training in a number of areas, both mandatory and specialist to ensure staff have the skills and knowledge to meet residents’ needs. Records inspected showed that some staff have not attended training, while others have attend a wide variety of training offered including falls awareness, continence care, diabetes and dementia. Evidence of this was seen in the training records inspected. The staff spoken with confirmed they had undertaken training and demonstrated good knowledge and understanding in the areas of food hygiene, fire precautions and safeguarding adults, thus ensuring that residents are cared for by competent and knowledgeable staff. Neva Manor Residential Care Home DS0000068269.V369105.R01.S.doc Version 5.2 Page 22 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): 31.32.33.35.36.38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ benefit from a well run home which has their interests and safety at the heart of decision-making. Quality assurance processes in the home are formal demonstrating that the home consults with residents, families and visiting professionals. Resident’s can be confident that monies held for them by the home are well managed. Health and safety issues are monitored in the home to ensure that issues are identified and addressed where they arise. EVIDENCE: Since the last inspection there has been a change of manager. The new manager has been in post for six months and is currently in the process of registering with the Commission. She has good skills and knowledge and is currently studying for her registered Manager’s Award. Neva Manor Residential Care Home DS0000068269.V369105.R01.S.doc Version 5.2 Page 23 Since the last inspection the manager has developed her management style and appointed a deputy manager to ensure the smooth running of the home for the benefit and comfort of residents. The manger seeks to give leadership, guidance and direction to staff to ensure that staff are knowledgeable and competent to meet the needs of people who use the service. The providers both hold qualifications as a registered nurse and are very involved in the running of the home. Residents told us “they are often here and are very nice”. “They always listen”. People who use the service and other professionals feel the manager is approachable, available and seeks to ensure the needs of all residents are met. One resident said she ‘can’t do enough’, ‘she is always helping”. Staff interviewed stated that they felt supported by an approachable manager. Since the last inspection policies have been reviewed and best practice guidance included in them, for the benefit of residents. Staff are aware of the policy folder and can access it as needed. A formal quality assurance tool was available for inspection in order to demonstrate that the home consults with residents and relatives. A summary report of the most recent survey was seen together with action points to share the information with residents and staff and clear actions to implement changes and suggestions. Feedback seen in the comments book in the hall tolls us “Neva Manor is a delight to visit it is always welcoming and has a professional manner”. “My relative is so well and happy being here”. Pocket monies, for people who use the service, held by the home, were inspected and found to be accurate and to have clear records for the protection of residents. All entries were supported by two signatures for any transactions made for the safeguarding of all concerned. Since the last inspection records inspected showed staff have received regular supervision to ensure they have the skills and knowledge to meet resident needs. Staff spoke of receiving this and it’s helpfulness in identifying areas of training they would like, and would benefit their care provision to residents. Records inspected indicated regular safety and fire checks are carried out. Staff spoken to confirmed that fire instruction and drills had taken place. Not all staff have received fire training within the prerequisite timescales. This must be provided for the safety of residents. The home stores records securely and uses them in accordance with the Data Protection Act 1998. Records are accurately maintained to ensure clear information for the provision of knowledgeable and consistent care to residents. Neva Manor Residential Care Home DS0000068269.V369105.R01.S.doc Version 5.2 Page 24 Records indicating regular maintenance to gas and water systems were seen, together with servicing records for all equipment except the stair lift. Recommendations raised by these professionals are responded to in a timely manner. Neva Manor Residential Care Home DS0000068269.V369105.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A 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 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 3 X 3 3 3 3 Neva Manor Residential Care Home DS0000068269.V369105.R01.S.doc Version 5.2 Page 26 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP30 Regulation 18.1 (c) Requirement The registered person must ensure that all staff are provided with the appropriate training for the work they are to perform to ensure they have the skills and knowledge to meet residents needs. This relates to staff that do not access the training. The registered person must ensure that all equipment is maintained regularly for the safety and protection of residents. This relates to the stair lift’s need for servicing. Timescale for action 30/11/08 2 OP38 13.4(a) 30/10/08 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 OP3 Good Practice Recommendations To ensure that full information obtained at the initial assessment is recorded to inform care planning for the DS0000068269.V369105.R01.S.doc Version 5.2 Page 27 Neva Manor Residential Care Home residents well being and safety. 2. 3. OP7 OP9 That all action to minimise risk and promote healing and well being are recorded in the care plans. To ensure that all staff follow the medication administration policy for the safety and well being of residents. To ensure that all hand transcribed medicines have two signatures for the safety of residents and accountability and responsibility purposes. 4. 5. 6. OP18 OP19 OP29 To ensure that consent is obtained and recorded for the use of bedrails, in line with the Mental Capacity Act 2005. The installation of a system of controlling the temperature of water supplied from the hot water taps. Voluntary staff that have unsupervised access within the home and residents should have all safeguarding checks undertaken for the protection of residents. Ensure the availability of the fire risk assessment in the home and staff awareness of it. 7. OP38 Neva Manor Residential Care Home DS0000068269.V369105.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Neva Manor Residential Care Home DS0000068269.V369105.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. 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