Care Home: Ramsgate Care Centre

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What the care home does well People are given written information about the home in an informative guide that explains all about the home and what they should expect if they move in. Prospective residents have their needs thoroughly assessed. Great care is taken to see that the home will be right for them and can provide the right sort of care that they need. People staying for respite care are supported to get back on their feet and return to their own home if that is their wish. Each resident has a written plan of care, which makes sure they get the support that they need and the right health care. Residents like the staff and made positive comments such as: "We`re well looked after here, the staff are lovely." "They`re excellent here, nothing is too much trouble." "It`s very good here.""This home is a cut above the others." "Staff are brilliant." "They are looking after me well." Residents have opportunities to take part in a variety of activities organised by the home. They can choose whether to join in, or do things on their own. Residents enjoy good food and mealtimes are relaxed sociable occasions. Residents can talk to staff if they have any worries or complaints. They know that they will be listened to and their concerns taken seriously and acted upon. The home is comfortable, attractive and well maintained. It is well adapted to encourage independence and is clean and hygienic, safeguarding people from the risk of inspection. Residents are looked after by well-trained staff that have excellent training opportunities. Ninety percent of the whole staff group have achieved a recognised qualification. This means that residents can be confident that staff know how to look after them properly and keep them safe. The home is well managed. The management team continuously looks at the service it provides and how they can improve what they do, for the benefit of the residents. What has improved since the last inspection? They have developed the care plans to make them even clearer and easy for staff to follow. They have introduced development forms for each resident that key workers complete each month. This helps them to monitor how people`s diverse needs are being met and makes sure that people are treated equally. They have developed their activity and entertainment programme to provide more opportunities for stimulation. This happens on a regular basis. They have continued with their programme of routine maintenance, redecoration and renewal of the fabric of the premises and equipment, to keep the home looking attractive and safe. They have expanded their domestic staff team to make sure that the home is kept tidy and hygienic at all times. More staff have been trained in infection control and we observed high standards of cleanliness throughout the home. They have continued with their staff training programme, providing lots of opportunities for staff to go on courses to develop their knowledge and skills. A number of staff have completed a dementia care course and a palliative care course. This has helped to increase their skills in dealing with confusion and caring for people that are dying. They have developed their quality monitoring processes to include a number of additional health and safety audits that are completed on a weekly, monthly and quarterly basis, with an overall annual home audit taking place. This helps to keep people safe. What the care home could do better: They have achieved good outcomes for residents in all areas assessed at this visit and have shown that they continually seek to improve upon the standards being achieved. There are no requirements or recommendations in this report. We did speak to the manager about developing aspects of the care plan records, particularly in the daily records, to show more person centred elements. This would provide better supporting evidence that care has been given in a unique way for each resident and is individual to them. We discussed the continuing development of the quality assurance questionnaires. Data from the whole quality monitoring process needs to be collated into a report that makes sure it is meaningful and shows where action has been taken to bring about any improvements identified. CARE HOMES FOR OLDER PEOPLE Ramsgate Care Centre 66-68 Boundary Road Ramsgate Kent CT11 7NP Lead Inspector Christine Grafton Unannounced Inspection 24th February 2009 10:20 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 Ramsgate Care Centre DS0000023710.V374265.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. Ramsgate Care Centre DS0000023710.V374265.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ramsgate Care Centre Address 66-68 Boundary Road Ramsgate Kent CT11 7NP 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) 01843 585444 01843 853736 ramsgatecare@btconnect.com Choicecare 2000 Ltd Ms Julie Cuthbert Care Home 41 Category(ies) of Old age, not falling within any other category registration, with number (0) of places Ramsgate Care Centre DS0000023710.V374265.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 only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Old age, not falling within any other category (OP). The maximum number of service users to be accommodated is 41. Date of last inspection 6th March 2007 Brief Description of the Service: Ramsgate Care Centre is a detached property that provides accommodation for up to 41 older people. Bedrooms are on two floors and all rooms are en suite. There is a shaft lift in use to access the first floor. The home is located in a residential area of the town with easy access to public transport, shops and amenities. A number of parking spaces are available on site and there is on street parking available close by. The home is spacious and has wide corridors throughout the building, giving easy access for wheelchair users. There are a number of lounge areas sighted around the building. There is an open-air courtyard with seating for service users in the centre of the home plus a large garden to the rear. The current fees for the service at the time of the visit range from £320.63 to £550.00 per week. Information on the homes services and the CSCI reports for prospective service users will be detailed in the Statement of Purpose and Service User Guide. Ramsgate Care Centre DS0000023710.V374265.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 3 star. This means that people who use this service experience excellent quality outcomes. This report takes account of information received since the last inspection, including a visit to the home. An unannounced visit took place on 24th February 2009 between 10:20 hours and 17:05 hours. The visit included talking to the manager, staff, residents, visitors and observing the home routines and staff practices. Some records were looked at and we looked round some parts of the home. Information sent to us by the manager prior to the visit, in the form of the home’s annual quality assurance assessment, has been used and information from the previous inspection referred to. At the time of the visit there were 40 residents living at the home. The atmosphere in the home was welcoming and relaxed. What the service does well: People are given written information about the home in an informative guide that explains all about the home and what they should expect if they move in. Prospective residents have their needs thoroughly assessed. Great care is taken to see that the home will be right for them and can provide the right sort of care that they need. People staying for respite care are supported to get back on their feet and return to their own home if that is their wish. Each resident has a written plan of care, which makes sure they get the support that they need and the right health care. Residents like the staff and made positive comments such as: Were well looked after here, the staff are lovely. Theyre excellent here, nothing is too much trouble. Its very good here. Ramsgate Care Centre DS0000023710.V374265.R01.S.doc Version 5.2 Page 6 This home is a cut above the others. Staff are brilliant. They are looking after me well. Residents have opportunities to take part in a variety of activities organised by the home. They can choose whether to join in, or do things on their own. Residents enjoy good food and mealtimes are relaxed sociable occasions. Residents can talk to staff if they have any worries or complaints. They know that they will be listened to and their concerns taken seriously and acted upon. The home is comfortable, attractive and well maintained. It is well adapted to encourage independence and is clean and hygienic, safeguarding people from the risk of inspection. Residents are looked after by well-trained staff that have excellent training opportunities. Ninety percent of the whole staff group have achieved a recognised qualification. This means that residents can be confident that staff know how to look after them properly and keep them safe. The home is well managed. The management team continuously looks at the service it provides and how they can improve what they do, for the benefit of the residents. What has improved since the last inspection? They have developed the care plans to make them even clearer and easy for staff to follow. They have introduced development forms for each resident that key workers complete each month. This helps them to monitor how peoples diverse needs are being met and makes sure that people are treated equally. They have developed their activity and entertainment programme to provide more opportunities for stimulation. This happens on a regular basis. They have continued with their programme of routine maintenance, redecoration and renewal of the fabric of the premises and equipment, to keep the home looking attractive and safe. They have expanded their domestic staff team to make sure that the home is kept tidy and hygienic at all times. More staff have been trained in infection control and we observed high standards of cleanliness throughout the home. They have continued with their staff training programme, providing lots of opportunities for staff to go on courses to develop their knowledge and skills. A number of staff have completed a dementia care course and a palliative care Ramsgate Care Centre DS0000023710.V374265.R01.S.doc Version 5.2 Page 7 course. This has helped to increase their skills in dealing with confusion and caring for people that are dying. They have developed their quality monitoring processes to include a number of additional health and safety audits that are completed on a weekly, monthly and quarterly basis, with an overall annual home audit taking place. This helps to keep people safe. 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. Ramsgate Care Centre DS0000023710.V374265.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 Ramsgate Care Centre DS0000023710.V374265.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, 3 & 6 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People considering moving into the home benefit from being given all the information they need to decide if it is right for them. They have a thorough assessment that tells staff about them and the support they need. This makes sure that their needs can be met. People who stay for respite or recuperation are helped to go back home if that is their wish. The home does not admit people for specialist intermediate care so standard 6 was judged as not applicable at this inspection visit. EVIDENCE: An informative statement of purpose and a service users guide have been developed that explain all about the home, including what is provided and anything that residents have to pay for themselves. Both documents are Ramsgate Care Centre DS0000023710.V374265.R01.S.doc Version 5.2 Page 10 written in a clear and understandable manner that makes interesting reading. They are typed in a good font size, making them easy to read. Copies of both documents are kept in every bedroom so people can read them at any time when they move in. They have been reviewed and updated to show some minor changes that have occurred, making sure that people have accurate information upon which to base their decision about moving into the home. Great care is taken before a person moves into the home to see if it will be right for them and their needs can be met. The manager makes sure that a prospective resident has their needs thoroughly assessed. If they have been referred by social services, a copy of the care management assessment is obtained first. Next, the manager goes to meet the person where they are living, to assess their needs for herself and complete the homes own assessment. This includes gathering a detailed background history and carrying out various risk assessments, so that things can be put in place ready for when the person moves in, to reduce risk. For instance, skin integrity and mobility risks. The manager is very careful when a private referral is made to gather as much information as possible. This might be from the person, family members, and any other carers, or health care professionals involved, to make sure that all the information normally obtained from the care management assessment has been covered. We looked at a new residents assessment documentation and saw that it covered a wide range of diverse needs, including, disability needs such as difficulty in moving around, risk of falls and the persons ability to feed themself. Personal goals and expectations are recorded and there is emphasis on the maintenance of independence and choice. All of this gives staff the information they need to know about the person and the care they need. The homes assessment documentation clearly shows that they have satisfied themselves that they can provide the right care for the person. We also looked at the care records for two more residents and saw that they each contained detailed assessments and care plans that look at residents as individuals. They show that all needs are well considered from the outset and action plans are recorded for staff to follow. All of this makes sure that peoples needs are properly met. We spoke to a person staying for a period of respite care. They described their stay as being very positive in helping them get back on their feet, ready to return to their own home. Another resident spoke about moving into the home as a warm experience, saying how staff had been very supportive in helping them settle in. Other people we spoke to each praised the home and one person summed it up saying that they feel well cared for and fortunate to have found this particular home. Ramsgate Care Centre DS0000023710.V374265.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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from having their own individual plan of care that has all the right information to make sure they get good personal care and good health care. People can be confident that their medication will be dealt with safely, that staff will understand their needs and that their dignity will be respected. EVIDENCE: Each resident is fully involved in drawing up their own individual care plan, which contains details of their needs, personal aims for the future and expectations. The care plans give staff the right guidance to help the individual with their daily living, for example, how to assist with washing and bathing and how to look after a persons skin to prevent pressure damage from occurring. Because the care plans were judged as good at the last inspection we selected just three to look at and saw that the good standards evident at our last visit have been continued and developed. Ramsgate Care Centre DS0000023710.V374265.R01.S.doc Version 5.2 Page 12 Care plans focus on maintaining and maximising independence. A range of risk assessments form part of the care planning process, for example, where there are mobility and dexterity problems, risk assessments cover the risk of falling, with strategies in place to reduce risk. There is specific guidance about the little things that are pertinent to each individual with moving around. Nutritional risk assessments detail what staff should do so that a person can eat without help, such as making sure they are sitting up straight, stating how they should be positioned at the table and reminding staff about cutting up their food. We saw other examples showing that plans are in place to address various different needs. Care plans are well organised and easy to follow through with detailed action plans for each need identified. Peoples health is closely monitored and doctors and community nurses are consulted as necessary. A relative commented that they are kept well informed about any changes in their parents health, or care needs and went on to say how their loved one is well looked after. Care staff write daily records for each resident that provide useful detail about how the resident has been on a particular day. These feed into the ongoing reviewing process. We talked about developing the daily records to show more person centred elements, rather than bland statements of full assistance given. We looked at the way that medications are managed and found that things are in order. Medicines are stored safely in two dedicated rooms and medication trolleys are used to administer peoples medicines to them. Medication rooms and trolleys were clean and well organised. We observed part of the lunchtime medication round and saw that this was done in a safe way, with administration records signed. Only staff that have been trained are allowed to administer the medications. We saw that medication administration records were up to date with no gaps. The manager carries out regular audits of the medication records. We spoke to a carer about their work and observed staff going about their daily tasks. We saw that residents privacy and dignity is upheld. There are good laundry procedures that keep peoples clothing looking nice and care plans emphasise to offer choice and let people make their own decisions. Residents that we spoke to confirmed that their care needs are being met and they said that they get good care. Here are some of their comments, Were well looked after here, the staff are lovely. Theyre excellent here, nothing is too much trouble. Its very good here. Ramsgate Care Centre DS0000023710.V374265.R01.S.doc Version 5.2 Page 13 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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from having opportunities to take part in a variety of activities, being able to keep in contact with families and friends and being offered good food. They are encouraged to lead their lives the way that they want and they will know that mealtimes are relaxed and sociable. EVIDENCE: The manager told us in the annual quality assurance assessment (AQAA) about the social activities they have in the home. We saw that what she said in the AQAA matches what we found at our last inspection and at this visit. People can choose to take part in a range of activities that take place on a regular basis. These include, a twice-weekly exercise activity session run by an outside person that was taking place during our visit. Residents told us how much they had enjoyed this activity. The manager told us that the sessions used to be run on a weekly basis, but they have been increased to twice weekly, as she had noticed such an improvement in residents mobility and dexterity. Ramsgate Care Centre DS0000023710.V374265.R01.S.doc Version 5.2 Page 14 Another popular event is the visiting entertainer known as the music man who comes once a month. Some residents spoke of their enjoyment in taking part in the weekly bingo and of having their hair done in the homes own wellequipped salon. A hairdresser visits twice weekly and was at the home during our visit. Residents spoke about these events as being stimulating for them and joked about socialising with each other and being able to engage in light banter with the staff. Some residents prefer their own company and spend their time in their own rooms. We saw people pursuing their own interests, such as arts and crafts, listening to music, reading, or watching television. We saw lots of visitors to the home, coming and going and talked to two, who said how they are always welcomed and commented on the friendly atmosphere in the home. There are quiet rooms where people can meet in private if they wish, rather than in their own bedroom. Care plans show that residents are encouraged to be as independent as possible and make their own decisions and choices about their lives. This was confirmed in discussion with a carer. Residents are encouraged to make their bedrooms homely, by bringing in their own possessions. We saw that the menus provide a varied diet and we were told that special diets are catered for. Residents that we spoke with say they enjoy good food and have plenty to eat. The dining room is pleasantly decorated and provides a congenial setting. The days menu is displayed in the dining room and staff go round each morning to tell residents what the days meals are and ask if they would like any alternatives. The lunchtime and teatime meals were seen to be leisurely affairs with people socialising with each other. Ramsgate Care Centre DS0000023710.V374265.R01.S.doc Version 5.2 Page 15 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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents can be confident that any complaints will be listened to and acted upon, and they will be protected by the home’s procedures and practices to safeguard them from abuse. EVIDENCE: The home has a very well written complaints policy and procedure that is displayed on the notice board. In addition to this, the statement of purpose and service users guide that each resident has in their bedroom, tells them what to do if they have a complaint. Residents that we spoke with praised the home, saying that they do not have any complaints. They said that all the staff are very approachable and they are confident that if they had a concern it would be dealt with properly. The manager stated in the AQAA that the home welcomes complaints and looks upon them as an opportunity to learn, adapt, improve and provide a better service. The manager indicated that there have been no formal complaints in the past year, but there is a mechanism for recording complaints should the need arise. An area manager visits the home at least once a month and checks to see if there have been any complaints. Ramsgate Care Centre DS0000023710.V374265.R01.S.doc Version 5.2 Page 16 There are other ways that residents can raise any concerns, such as, via their key worker, in residents meetings, or in the quality assurance questionnaires. Visitors can write any suggestions in a comments, compliments, or concerns book that is kept in the entrance hall. Staff can raise issues at staff meetings and in their regular one to one supervision meetings with the manager. As well as all this, the manager operates an open door policy and we saw residents, visitors and staff going up to her, receiving attention and being listened to. The manager is an adult protection trainer and provides regular, ongoing training for staff so that they know what to do to protect vulnerable adults from abuse of any sort. The staff-training matrix indicates that the majority of staff have completed this training. We spoke to one staff member who had good awareness on this topic and knew what procedures to follow if they were suspicious that something might not be right with a resident. Ramsgate Care Centre DS0000023710.V374265.R01.S.doc Version 5.2 Page 17 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 & 26 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a clean, comfortable, well-equipped environment that enhances their independence. The programme of ongoing redecoration and maintenance makes sure that it stays homely and safe. People are protected by the practices followed by staff to maintain hygiene and prevent the spread of infection in the home. EVIDENCE: The home was purpose built in 1995 and has been well designed, having wide corridors and doorways throughout, with easy access to the small garden areas. Bedrooms are all of a comfortable size, with ensuite facilities and are well furnished. There are a variety of communal areas, including quiet rooms Ramsgate Care Centre DS0000023710.V374265.R01.S.doc Version 5.2 Page 18 on both floors. There is also a well-equipped hairdressing salon. Bathrooms and toilets are equipped to aid people with disabilities and the home has additional facilities, such as a shaft lift and mobile hoists, to aid residents with moving about and to maintain their independence. There is a full time maintenance person who carries out weekly safety checks and attends to the ongoing redecoration and maintenance of the building. Residents that we spoke with said they like their bedrooms and were appreciative of the spacious corridors and room to move about easily. They complimented the cleaning staff, saying that they always keep the home looking nice. We saw that the home has a well-qualified and experienced domestic team that maintain high standards of cleanliness throughout the home. Since the last inspection, they have expanded their domestic team, which has ensured that cleaning tasks are completed promptly and efficiently. Training in all areas of infection control continues to be a priority and as well as the care staff, eighty percent of the domestic staff team have achieved their National Vocational Qualification (NVQ) level 2, with the remaining staff that are new to the team currently working towards their qualification. There is a well-equipped laundry room and we saw that there are good procedures for segregating laundry and keeping peoples clothing looking nice. The home also employs a laundry assistant in addition to the domestic workers. There are good procedures to control the spread of infection. There are dedicated sluicing facilities on each floor and appropriate foot operated clinical waste bins. There are plentiful supplies of protective clothing for staff to use and liquid soap and paper towel dispensers. Ramsgate Care Centre DS0000023710.V374265.R01.S.doc Version 5.2 Page 19 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 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents can be confident that they will be cared for at all times by staff that are well trained and have the right skills to meet their needs. They will know that they will be protected by the homes good recruitment practices and commitment to staff training. EVIDENCE: We looked at the numbers of staff on duty and saw that the rota is sensibly worked out so that there will be enough care staff and ancillary workers on duty during the day and at night. It is arranged to manage the various workflows, covering the peaks and troughs of busy and quieter times. For example, on the morning of our visit, there was a total of thirteen staff on duty, comprising of, six carers, four domestic assistants, one cook, plus the manager and an administrator. There would have been more, but two people were on leave and one was training. Rotas show that there are usually seven carers in the morning and between three and four in the afternoons, with three waking staff on duty at night. In addition to this there would also have been a laundry assistant, a kitchen assistant and a maintenance person on duty. Ramsgate Care Centre DS0000023710.V374265.R01.S.doc Version 5.2 Page 20 There has been a stable staff team over the past year, only five staff having left and new staff that have been recruited have brought new skills to the home, for example, the home now has its own manual handling trainer. Staff were seen going about their work in a competent way. A carer commented on the good team working, saying, Its absolutely fantastic here, and went on to say, We have fantastic training here. The carer also said they feel that the staff look after the residents well and they have developed a good rapport with residents and relatives. Our observations and discussions with residents and relatives confirm that this is right. Staff are encouraged and supported to achieve their National Vocational Qualification (NVQ) in care, level two or above. The AQAA states that over ninety percent of staff have achieved their NVQ level 2 and those that have not achieved it are currently working towards their qualification. We looked at training records and certificates and saw that what they say is correct. The home carries out a number of security checks on new staff before they start work to make sure they are trustworthy and safe to be around the people living in the home. We looked at two staff files and saw that the checks specified in the National Minimum Standards and legislation had been done, including, past employment history, two references and criminal records bureau (CRB) checks. We saw that new staff complete a thorough induction programme when they start working at the home. Training records and the staff training matrix show that staff are encouraged to attend a wide variety of training courses to develop their knowledge and skills. These include, NVQ level 3 in care, diabetes and insulin administration, continence promotion, dementia care and palliative care courses. A staff member spoke about their training with enthusiasm, saying it helps them to do their job well for the benefit of residents. Ramsgate Care Centre DS0000023710.V374265.R01.S.doc Version 5.2 Page 21 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, 33, 35 & 38 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is well managed in a way that safeguards the best interests of the people living there, promoting and protecting their health, safety and welfare. People can be confident that the management regularly monitors the quality of service it provides and will listen to their views. EVIDENCE: The manager has been in post for six years and has many years experience in the care sector. She has the qualifications and skills necessary to manage the home and has continued to develop her knowledge by attending a variety of Ramsgate Care Centre DS0000023710.V374265.R01.S.doc Version 5.2 Page 22 short training courses. She has qualified as a trainer in adult protection issues and trains all new staff, plus gives update training to existing staff. Recent courses she has completed include one on dementia awareness and a palliative care course. Staff spoke positively about her, saying she is very supportive and that the home has developed under her leadership. Residents and relatives say she is very approachable and a good listener. The manager has created an open culture where peoples views are regularly sought to make sure that things are being done in the way that they want. The manager has day to day contact with residents and relatives, she holds residents meetings, staff meetings, has one to one meetings with staff, has occasional meetings with care managers, and sends out surveys. An area manager visits the home monthly to carry out a formal visit, where they write a report as part of the homes quality monitoring process. Copies of the reports are kept available at the home and we saw that these visits form an integral part of the homes quality monitoring processes. Since the last inspection, the homes quality monitoring system has been developed to include a number of other quality audits that are carried out monthly, quarterly and annually. These include, health and safety, medications, infection control and cross infection and an annual home overview audit. All of this, together with the weekly inspections of the home carried out by the maintenance person, make sure that things are safe and in order. The AQAA was well completed and clearly shows the things they do well and where they have improved. From the records seen and discussions with staff, residents and relatives, we saw that what has been stated in the AQAA matches what we found. Everything we have seen shows the managers commitment to ensuring the home provides a good service to the residents. Where things were done well at the last inspection, the good standards have been sustained and they have continued to develop the service. At the last inspection we saw that the home follows a good system for safeguarding peoples financial interests. Information in the AQAA and discussion with the manager indicates that this is being maintained. The AQAA indicates that the homes equipment has been serviced at appropriate intervals and no safety hazards were observed. The staff training matrix and discussion with the manager indicates that staff training on safety things such as, fire safety, first aid, food hygiene and moving and handling is kept up to date, so they keep people safe. The maintenance of the building and cleanliness and hygiene within the home are excellent. The commitment to staff training is also excellent. There are no requirements or recommendations in this report, but we did speak to the manager about continuing to develop the quality assurance questionnaires and to collate the data into a report that makes sure it is Ramsgate Care Centre DS0000023710.V374265.R01.S.doc Version 5.2 Page 23 meaningful and shows where action has been taken to bring about any improvements identified. Ramsgate Care Centre DS0000023710.V374265.R01.S.doc Version 5.2 Page 24 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 4 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 4 x x x x x x 4 STAFFING Standard No Score 27 4 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 3 x 3 x x 3 Ramsgate Care Centre DS0000023710.V374265.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ramsgate Care Centre DS0000023710.V374265.R01.S.doc Version 5.2 Page 26 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 Ramsgate Care Centre DS0000023710.V374265.R01.S.doc Version 5.2 Page 27 - 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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