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Care Home: Rest Haven

  • 15 Gussiford Lane Exmouth Devon EX8 2SD
  • Tel: 01395272374
  • Fax: 01395278748
  • Planned feature Advertise here!

Rest Haven is registered to provide personal care for up to 34 older people. It is a Christian home of charitable status run by Rest Haven trustees and managed on a day to day basis by a registered manager. The property is a large Victorian detached house situated at the top of a sloping driveway close to the centre of Exmouth. There is a spacious parking area to the front of the building with a patio area and gardens to the rear of the property. All bedrooms are single, and most are very spacious. One is slightly below 10 square metres. 12 bedrooms have en suite facilities. There is a passenger lift to the first floor and most rooms have level access. There are three large lounges (one of which is a music room), a dining room, a conservatory, a Chapel, a 0 salon/therapy room, and a large entrance hallway with sitting areas.

  • Latitude: 50.618000030518
    Longitude: -3.4079999923706
  • Manager: Mrs Glynis Cockayne
  • Price p/w: -
  • UK
  • Total Capacity: 34
  • Type: Care home only
  • Provider: Rest Haven Charitable Home Trustees
  • Ownership: Voluntary
  • Care Home ID: 12925
Residents Needs:
Old age, not falling within any other category

Latest Inspection

This is the latest available inspection report for this service, carried out on 2nd November 2009. CQC found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

For extracts, read the latest CQC inspection for Rest Haven.

What the care home does well People who are considering moving to a care home are given good information about Restahaven before any decision to move in is made. Trial visits are encouraged and a senior member of staff from the home will also carry out a careful assessment before anyone is admitted to the home to ensure their needs can be met. Not all people spoken to during this inspection were able to recall their admission to the home but all expressed complete satisfaction with the outcome. The home has drawn up care plans covering aspects of care needs and risk assessments have also been drawn up on some aspects of health and personal care. The home has good links with all relevant health professionals and treatment has been provided where needed. Medications are stored safely and only experienced, trained staff carries out the administration. Records of medicines administered have been generally well maintained. Evidence was obtained in various ways through this inspection to show that those living at the home are treated in a dignified manner and their privacy is upheld at all times. Those who were able expressed complete satisfaction in the way they are treated by the staff. The staff were calm and unhurried and assisted people in a friendly, caring and respectful manner. Care plans and daily reports showed that people could exercise choice and control of all aspects of their lives and some people talked about how they are able to lead their lives just as they want without unnecessary rules or restrictions. The home provides a good range of activities. Excellent arrangements are in place to ensure family and friends are made welcome at all times and are kept informed and involved in the daily life of the home. All people we spoke to praised the standard of meals provided. The menus are balanced, varied and nutritious meals and suit all individual dietary needs. The home has a range of policies and procedures that have been regularly updated and staff have been given training and instruction on the policies to ensure they are followed correctly. All areas of the home are comfortable, clean,safe and hygienic. The home employs sufficient staff to meet the needs of those living there. Good recruitment practices ensure people are safeguarded from abuse. Staff are competent and deliver high quality care in a safe manner. The home is well managed. There is an open and positive atmosphere throughout the home. In response to questionnaires sent before this inspection staff confirmed that they felt well supported by the current management at the Home. The manager operates an open door policy that enables people to approach her with any problems as and when they may occur. In response to the question "what does the home do well" we were told "You are treated as someone who matters not just someone whose fees help towards maintaining the home"," Looking after healthy old people"," Excellent at spotting if someone is ill and seeks medical care very quickly" and " To me they do everything well. General care is top of the list". What has improved since the last inspection? People admitted to the home, from places within reasonable reach, have a comprehensive assessment of their health and social needs undertaken to ensure that these can be met at Resthaven.( Please also refer to What the home could do better) Monthly unannounced visits by a representative of the organisation are undertaken, a report is completed and a copy is given to the manager and sent to the CQC. What the care home could do better: Arrangements must be made to ensure the safe recording and administration of medicines received into the home. Care plans should include all health and social care needs. All medications should be stored at the recommended temperatures. This relates to the recorded temperatures of the medication fridge being higher than recommended and no action taken by staff to remedy this. Assessments of individual nutritional needs are not being consistently undertaken when people are admitted to the home. People should be involved in regular reviews of their individual care plans or told of the changes if they choose not to be involved. Care plans should be reviewed regularly and changes in the way care is to be delivered should be recorded. Lockable facilities are not provided in people`s private rooms to enable them to keep valubles and precious possessions safe. Records have not been kept of all complaints made by people using the service, or their representatives, and staff, and the action taken by the registered person in respect of any such complaint. All allegations of abuse should be followed up promptly and action taken should be recorded. (This relates to a sum of money missing from a persons room.) Attention should be made to areas in the home that would benefit from redecoration.Outcomes of surveys undertaken at the home are not published and made available to current and prospective users of the service, their representatives and any other interested parties. Not all records kept at the home are accurate and up to date. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Rest Haven 15 Gussiford Lane Exmouth Devon EX8 2SD     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: Michelle Oliver     Date: 0 2 1 1 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 35 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 35 Information about the care home Name of care home: Address: Rest Haven 15 Gussiford Lane Exmouth Devon EX8 2SD 01395272374 01395278748 resthavenhome@tiscali.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Rest Haven Charitable Home Trustees care home 34 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Rest Haven is registered to provide personal care for up to 34 older people. It is a Christian home of charitable status run by Rest Haven trustees and managed on a day to day basis by a registered manager. The property is a large Victorian detached house situated at the top of a sloping driveway close to the centre of Exmouth. There is a spacious parking area to the front of the building with a patio area and gardens to the rear of the property. All bedrooms are single, and most are very spacious. One is slightly below 10 square metres. 12 bedrooms have en suite facilities. There is a passenger lift to the first floor and most rooms have level access. There are three large lounges (one of which is a music room), a dining room, a conservatory, a Chapel, a 0 Over 65 34 Care Homes for Older People Page 4 of 35 Brief description of the care home salon/therapy room, and a large entrance hallway with sitting areas. Care Homes for Older People Page 5 of 35 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means that people who use this service experience good quality outcomes. This inspection was undertaken over 9 hours in one day by one inspector. We spoke with people living there and staff and also spent time observing the care and attention given to people by staff. Prior to this inspection we sent surveys to 10 people living at the home, 10 staff and 5 health care professionals. Nine surveys were completed and returned to us from people living at the home expressing their views about the service provided at the home. Their comments and views have been included in this report and helped us to make a judgement about the service provided. Care Homes for Older People Page 6 of 35 To help us understand the experiences of people living at this home we looked closely at the care planned and delivered to three people. Most people living at the home were seen or spoken with during the course of our visit and three people were spoken with in depth to hear about their experience of living at the home. We also spoke with 5 staff, including the manager, care coordinator, carers and ancillary staff, individually. A tour of the premises was made and we inspected a number of records including assessments and care plans and records relating to medication, recruitment and health and safety. The current weekly fees range from £330.00 to £800. Services not included in this fee include Hairdresser, Chiropody, Toiletries, Optician and Dentist. General information about fees and fair terms of contracts can be accessed from the Office of Fair Trading web site at /www.oft.gov.uk . Copies of the inspection report are available from the office. What the care home does well: People who are considering moving to a care home are given good information about Restahaven before any decision to move in is made. Trial visits are encouraged and a senior member of staff from the home will also carry out a careful assessment before anyone is admitted to the home to ensure their needs can be met. Not all people spoken to during this inspection were able to recall their admission to the home but all expressed complete satisfaction with the outcome. The home has drawn up care plans covering aspects of care needs and risk assessments have also been drawn up on some aspects of health and personal care. The home has good links with all relevant health professionals and treatment has been provided where needed. Medications are stored safely and only experienced, trained staff carries out the administration. Records of medicines administered have been generally well maintained. Evidence was obtained in various ways through this inspection to show that those living at the home are treated in a dignified manner and their privacy is upheld at all times. Those who were able expressed complete satisfaction in the way they are treated by the staff. The staff were calm and unhurried and assisted people in a friendly, caring and respectful manner. Care plans and daily reports showed that people could exercise choice and control of all aspects of their lives and some people talked about how they are able to lead their lives just as they want without unnecessary rules or restrictions. The home provides a good range of activities. Excellent arrangements are in place to ensure family and friends are made welcome at all times and are kept informed and involved in the daily life of the home. All people we spoke to praised the standard of meals provided. The menus are balanced, varied and nutritious meals and suit all individual dietary needs. The home has a range of policies and procedures that have been regularly updated and staff have been given training and instruction on the policies to ensure they are followed correctly. All areas of the home are comfortable, clean,safe and hygienic. The home employs sufficient staff to meet the needs of those living there. Good recruitment practices ensure people are safeguarded from abuse. Staff are competent and deliver high quality care in a safe manner. The home is well managed. There is an open and positive atmosphere throughout the home. Care Homes for Older People Page 8 of 35 In response to questionnaires sent before this inspection staff confirmed that they felt well supported by the current management at the Home. The manager operates an open door policy that enables people to approach her with any problems as and when they may occur. In response to the question what does the home do well we were told You are treated as someone who matters not just someone whose fees help towards maintaining the home, Looking after healthy old people, Excellent at spotting if someone is ill and seeks medical care very quickly and To me they do everything well. General care is top of the list. What has improved since the last inspection? What they could do better: Arrangements must be made to ensure the safe recording and administration of medicines received into the home. Care plans should include all health and social care needs. All medications should be stored at the recommended temperatures. This relates to the recorded temperatures of the medication fridge being higher than recommended and no action taken by staff to remedy this. Assessments of individual nutritional needs are not being consistently undertaken when people are admitted to the home. People should be involved in regular reviews of their individual care plans or told of the changes if they choose not to be involved. Care plans should be reviewed regularly and changes in the way care is to be delivered should be recorded. Lockable facilities are not provided in peoples private rooms to enable them to keep valubles and precious possessions safe. Records have not been kept of all complaints made by people using the service, or their representatives, and staff, and the action taken by the registered person in respect of any such complaint. All allegations of abuse should be followed up promptly and action taken should be recorded. (This relates to a sum of money missing from a persons room.) Attention should be made to areas in the home that would benefit from redecoration. Care Homes for Older People Page 9 of 35 Outcomes of surveys undertaken at the home are not published and made available to current and prospective users of the service, their representatives and any other interested parties. Not all records kept at the home are accurate and up to date. 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 10 of 35 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 11 of 35 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. Resthaven has information available which, if provided to all people prior to them making a decision about moving to the home, provides comprehensive information about the home. The initial assessment procedure does not always ensure accurate information is provided prior to people moving into the home. Evidence: The manager said that she or the assistant manager, sometimes both, visit all people who may be considering moving to the home. This is to ensure that the environment, staff competencies and the homes registration category are able to meet individual health and social care needs. Three residents files, two of which had recently moved to the home, were looked at. A comprehensive assessment of needs had been undertaken for one person that Care Homes for Older People Page 12 of 35 Evidence: included details of their past medical history and evidence that they had been involved in the assessment. However, two people had been admitted to the home from overseas and their admission was not straightforward due to language difficulties and communication between the service and the service which was caring for them at the time of the enquiry. We saw an abundance of information provided to the home following their request but unfortunately it was not written in English. Considering the difficulties associated with this admission it was carried out well. We spoke to several people, all of whom confirmed that their admission to the home had been managed well. Several could not recall if they had been given information about the home bit were very happy with their like at Resthaven. The home does not admit people who need intermediate care. Care Homes for Older People Page 13 of 35 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 do not include sufficient information to ensure that individuals health and social care needs are met, or that all potential risks to people have been assessed and managed. People are generally safeguarded by good methods of administration and recording of medicines. Attention to communication, and in recording, needs to be improved. People are treated with dignity and their privacy is respected. Evidence: Surveys received from people who had used the service told us their needs had always or usually been met and people we spoke to during our visit said staff met their needs well. Outside professionals told us peoples needs were always or usually, met. Care Homes for Older People Page 14 of 35 Evidence: Care plans are the end point of the assessment of the persons health and social care needs and should show what care must be delivered in accordance with the service user plan for that individual. The plan becomes the yardstick for judging whether appropriate care is delivered to the individual and will reflect changes as regular assessment of the person shows changing needs. Care plans are in place for all people who use the services at Resthaven, however, information relating to individual health and personal care needs are inconsistent. The plans have improved since the last inspection and now show how the home considered the goals they hoped to achieve when assisting people to maintain or regain independence. Records did not show that individual plans of care are reviewed at least once a month or additionally when changes take place. This means that staff may not be provided with up to date information about how to meet peoples changing needs. The documents are stored in files which staff have daily access to and the manager said that people living at the home, or their relatives with consent, can look at the plans at any time they wish. None of the 3 files we looked at included care plans for existing health problems such as depression or of acute needs such as loss of appetite or some infections or the need for dressings. This potentially puts people at risk of not having all their health care needs met, or monitored at the home. However, when we spoke to staff they were generally well aware of the needs of these people and provided us with information that was not recorded but showed that they were aware of individual needs and how to work towards meeting them. One member of staff responding to surveys felt that they were sometimes provided with up to date information about people they support and said they were usually told of changes to peoples condition at hand over between each shift. Assessments of individual nutritional needs are not regularly carried out when people move into the home, but have been undertaken where necessary. For example an assessment had been undertaken for a person when it was noted their normal, healthy, appetite had decreased. Not undertaking nutritional assessments when people are admitted potentially puts people at risk of their needs not being met or monitored. Care Homes for Older People Page 15 of 35 Evidence: People living at the home have access to healthcare services that meet their needs including chiropody, opticians, dentists and community nurses. During this inspection a community nurse came to the home and told us that they are confident that the service provides good care, they are called to see people when appropriate and staff follow instructions, to continue care, well. Moving and handling risk assessments have been completed with clear instructions on how staff should move people safely. Staff told us they have received appropriate training to ensure they understand such needs but there was no evidence in training files to confirm this. The management of medication at the home was looked at. All staff who administer medication have received training on the safe handling and administration of medicines, therefore protecting peoples health and welfare. However, when looking at medication administration records we saw some potentially unsafe methods of staff communication in individual medicines. For example changes of doses or times of giving medicines had been written on sticky notes, which did not include the name of the person the instructions related to and were not dated. We saw that a member of staff had increased the dosage of a medication which meant that staff were to give one tablet instead of half a tablet. When we looked at the medication record we noted that the member of staff who had given the tablet had recorded that they had given 2, therefore quadrupling the prescribed dose. However, when we checked the number of the tablets it was clear that only one had been given. This inaccurate recording potentially puts people at risk of not receiving the correct prescribed medication. Unused or unwanted medicines are disposed of correctly. Medicines with a limited shelf life once open, such as creams had not been dated to ensure it was used within the appropriate timescale. The medicines fridge had not been maintained at the necessary temperature to ensure that medication was safe and effective. All medication is securely stored in locked cabinets, one for each floor, in a locked room. Peoples privacy and dignity are met and promoted by the staff and management at the home. Staff are aware of the homes guidance on respecting peoples privacy and dignity and were seen treating people kindly and gently during the inspection. People confirmed that all staff are friendly, kind and treat them as they wish to be treated. Care Homes for Older People Page 16 of 35 Evidence: Throughout the visit good interactions were seen between people living at the home and staff, they were patient, gentle and kind when providing assistance. Care Homes for Older People Page 17 of 35 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. Social needs and meals are generally well managed. A varied balanced diet is provided and served in a pleasant atmosphere. People are encouraged to maintain contact with their families or friends as they wish and to take control of their lives during their stay at Resthaven. Evidence: Several people said they are told of activities going on in the home and are able to choose whether to take part or not, others said they enjoyed spending time in their rooms and chose not to take part. Questionnaires received from people stated there were always (3) usually (4) or sometimes (2) activities arranged by the home that they can take part in. In response to how could the home improve one person commented possibly more social activities. A weekly programme of activities taking place at the home is posted on a notice board and includes games, trolley shop and occasional sing a long. On the day of this visit some people enjoyed a game of bingo. Care Homes for Older People Page 18 of 35 Evidence: When asked if they could change one thing to improve the way the care works, one staff member commented A permanent activities coordinator would be a wonderful asset as the time consuming physical demands of the job leave little time for organising and supervising activities. Several peoples rooms were looked at during this visit and all were well decorated, warm and comfortable. People said they were able to bring many of there cherished possessions to Resthaven when they moved into the home. Most bedrooms visited had been personalised with items such as pictures, photographs and various pieces of furniture. Two people were very upset that they were not aware that they could bring personal possessions with them and wished they had brought pictures and some treasured possessions to the home with them. We discussed this with the manager and were told that information relating to this had been given to the person arranging the peoples admission. People living at the home are encouraged and supported to look after their own financial affairs. Secure storage is provided for their money and valuables if they wish, which is safely handled by the home. However, lockable facilities are not provided in individual rooms for items which are precious to their owners. The home is a Christian home and people are supported to maintain their religious beliefs by staff at the home and several people attended a morning service during this visit. There is no restriction on visiting times and throughout the day visitors came to the home and were made to feel welcome. Staff greeted them in a kind, friendly manner and visitors confirmed that this was always the case. People may choose where they want to spend time with their visitors, either in the privacy of their rooms or the public rooms. The home caters for all dietary needs including vegetarian and diabetics. All those spoken to said they generally enjoyed the food served at the home and during the visit good quality, fresh, fruit and vegetables were seen. People are given the choice of being served their meals either in their rooms, the lounge or the dining room. Staff consult with all people daily telling them the meal planned for the day and offering an alternative if requested. Menus were not freely available to inform people of choices but the main meal was advertised in the dining Care Homes for Older People Page 19 of 35 Evidence: room. The dining room is bright with good lighting and ventilation making it comfortable. Tables were attractively laid with cutlery and napkins and people confirmed they could choose where they wanted to sit. People were offered a choice of drinks including wine and sherry. The meal seen during this inspection was tasty, well cooked, very attractively presented, with portions to suit individuals. A comprehensive record of peoples likes and dislikes are recorded and included in individual plans of care and the cook told us a record is also available in the kitchen and is regularly updated. A questionnaire returned stated the menus could be better for lunches. Although the food is good they could include different dishes occasionally, another, As far as I am concerned I cant think of anything (the home could do better) except perhaps smaller helpings so that food is not wasted and On special occasions such as Xmas they provide wonderful entertainment that all the carers join in. People who responded to surveys that staff listen and act on what people say. During our visit there were several occasions where staff offered people choices in a meaningful way. Staff responded to peoples requests in a polite way, saying things like of course and thats no problem. Care Homes for Older People Page 20 of 35 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Resthaven feel protected by the homes complaints procedure, however, improvement is needed to ensure that all issues are taken seriously and that the complaints procedure is complied with. Staff are well informed about protecting people from harm. Procedures for safeguarding people from the risk of potential abuse are not complied with consistently. Evidence: The home has a complaint procedure that is displayed on a notice board outside one of the lounges at the home. A copy is also included in the homes statement of purpose, a copy of which is available in the rooms of each person staying at the home. However, we looked at one and some of the details were not accurate. All but one of those who responded to questionnaires confirmed that they knew who to speak to if they were unhappy about anything at Resthaven and wanted to make a complaint. We spoke to 12 people during this inspection and all said they would feel comfortable making a complaint, as they were sure that all staff at the home would take issues seriously. We saw no records of any complaints made by people living at the home. However, Care Homes for Older People Page 21 of 35 Evidence: we were told by one person that they had complained several weeks ago about items of clothing which have been missing since they were taken to the laundry. We were told that this issue has not been resolved. No complaints have been made to the Care Quality Commission (CQC) since the last inspection. Two issues were reported to Devon Social Services Safeguarding Adults team in relation to concerns about the care of two people living at the home. These issues were investigated and outcomes discussed with the manager. The outcomes have resulted in providing staff with some additional training. Staff confirmed they had received training in safeguarding adults and were aware of safeguarding adults procedures, which helps to protect people in their care. Staff showed a good understanding of issues and confirmed they would report any suspicions of poor care to a senior member of staff or the manager. We spoke to one person who was concerned that a sum of money had disappeared recently. We were told that staff looked everywhere when it was first reported but that no further action was taken when it couldnt be found. This issue had not been recorded in the persons plan of care or complaints book, no further action had been taken and no referral had been made to the appropriate authority. This means that the homes procedures to ensure that people are not put at risk of harm or the risk of abuse at the home are not being consistently complied with. Care Homes for Older People Page 22 of 35 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The standard of the environment within the home is good providing people with a safe, attractive and homely place to live. Attention is needed in some areas where the decor is looking tired. The cleanliness and standard of hygiene maintained at the home is excellent. Evidence: The home was spotlessly clean at the time of this inspection and information about cleanliness was displayed for all to read. People spoken to say the home is always clean and fresh and the domestics work very hard and have high standards. The home pays exceptional attention to cleanliness and the prevention of infection, and encourages visitors to do the same. A good supply of protective clothing, hand washing facilities and hand cleansing gel are provided throughout the home for staff and visitors. Staff spoke about precautions taken to prevent spread of infection, confirmed that equipment is always available and were aware of, and understood, the homes health and safety policy. The home has an open, welcoming reception area. Decor is of a generally good standard, and refurbishment is on-going to ensure the home remains comfortable and Care Homes for Older People Page 23 of 35 Evidence: homely. Some areas of decoration in the home continue to look tired and would benefit from redecoration. For example, paintwork on several doors and skirting boards has been scuffed and look unsightly. This could also make them difficult to clean. This was discussed with the manager who said that some parts of the house are due to be changed and during this process several areas will be redecorated. The service has continued to improve facilities at the home and a new parking area to the front of the building has been completed since the last inspection. The kitchen has also been refurbished and updated with stainless steel fitments making it easier to keep clean. A passenger lift and stair lift ensure that all areas of the home are accessible to people living there. comments received in questionnaires included As there is only one lift in Resthaven I feel that the installation of either another lift or chair lift at the other side of the building would be extremely beneficial to both residents and staff and Recent breakdowns in our equipment and lift have left staff feeling overworked and under appreciated. Not everyone had a clear idea of how things were being organised to cope with the equipment being out of action so this sometimes meant jobs were doubled up or not done at all. Also some of the residents suffered as a result of not being able to come downstairs for such long periods of time. We discussed this with the manager who told us that staff had informed all those whose rooms are on the first floor about the lift and some were happy staying in their rooms and some were able to come downstairs. A small lounge on the first floor was made into a dining room/ lounge for the time the lift was out of order. All those we spoke to about this episode told us it had been well managed and staff had been cheerful and helpful throughout as usual. One person, although able to use the stairs, was fearful of undertaking this. Their family were unhappy about them being confined to the first floor and we were told that the manager had spoken to them and explained the situation. The laundry is well equipped and appeared to be well organised. We were told by some people that some of their clothes are missing since being taken to the laundry. we spoke to the manager about this and they assurred us the matter would be looked into. The home has ample specialist equipment to help maximise peoples independence. Corridors have handrails to help people walk; there are a number of hoists and standaids, and various walking aids to assist people. Care Homes for Older People Page 24 of 35 Evidence: The home is generally safe for people; radiators are covered to reduce the risk of burning to people. Windows on the upper floors are restricted to prevent accidents from falls, and water temperatures are regulated to prevent harm from scalding. Care Homes for Older People Page 25 of 35 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. The number of staff on duty throughout the day and night meets peoples personal and health needs. People living at Resthaven benefit from being cared for by staff who are qualified and competent and are protected by the robust recruitment practice followed at the home. Evidence: On the morning of the inspection the manager, six carers, a cook, a kitchen and a pantry assistant, cook, two domestics, a maintenance person and an administrator were on duty. In the afternoon this changed to four care staff, care coordinator , a cook and a dining room assistant.The rota shows that there are two waking and one sleeping staff on duty throughout the night until 8 am. There is always a senior carer on duty throughout the day and night at the home. Three people who returned questionnaires felt there are always ( 8) or usually (2) enough staff to care for them at all times. Comments included Staff are very caring, never complaining they are encouraging, always ready to listen and Staff have patience and time for you. Care Homes for Older People Page 26 of 35 Evidence: All newly employed staff undergo a period of training when they start working at the home to enable them to get to know people living there, the homes philosophy of care, safety procedure, care procedures, and the general layout of the home. The time taken to complete this training will depend on past experience and individual ability. All staff have received a good level of training and over 50 of the team have completed a nationally recognised qualification (NVQ) at level 2 or above, which is commendable. Training provided during the last 12 months included administration of medicines, food hygiene, Safeguarding Adults, diabetes, managing challenging behaviour and first aid. The manager said that training would continue be be provided according to the needs of people living at the home as and when necessary. Planned training included one person undertaking activities organiser training and first aid refresher training for those staff who need it. Although the service provides regular training and each member of staff receives 3 days paid training days a year, not all staff undertake training other than that which is mandatory. We discussed this with the manager who told us that although these staff choose not to undertake training information is cascaded to all staff. Ensuring that people are cared for by a competent team of staff further promotes person centred care and safety. The home operates a good recruitment procedure that clearly highlights the processes to be followed. Three staff recruitment files were looked at during this visit. The documentation was consistent with evidence of a safe and robust recruitment process being carried out before a person is employed at the home. This protects people living at the home, as only people who have undergone this robust procedure will be employed to work at their home. Communication between the manager and staff is generally effective, which ensures peoples needs are fully understood at all times. However, comments made in questionnaires included communication from manager to staff could be improved on. When things are reported to the manager it is not always clear if it has been acted upon or dealt with. During this inspection we saw the manager responding to staff and people living at and visiting the home, with patience and understanding. Care Homes for Older People Page 27 of 35 Evidence: Care Homes for Older People Page 28 of 35 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. The home is generally well managed, run in the best interest of those living there. The home ensures that peoples health and safety are properly attended to. Attention is needed to ensure that some records are accurate and up to date. Evidence: The manager has been in post since May 2006, and has been involved in elder care since 1993 and in the field of nursing, NVQ assessing and residential care since 1982. The manager is a qualified level 2 nurse and has completed the Registered Managers Award and City & Guilds in Advanced Management and Care. She says she enjoys training and will request to go on courses if she feels a need to do so. She also enjoys undertaking staff training and is able to recognise her own limitations. She described ways in which she has updated her knowledge since the last inspection. Care Homes for Older People Page 29 of 35 Evidence: Having a competent registered manager ensures that those who choose to live at Resthaven are cared for by an experienced and qualified person, therefore protecting their health, welfare and safety. Several residents said that they felt the manager was approachable and is always available During the inspection the manager demonstrated good knowledge about the current health and social care needs of people living at Resthaven. However, the manager had not kept records of actions taken to address some issues at the home. ( Please refer to Standards 16 & 18) Although staff confirmed they had received up to date training to enable them to safely move and transfer people there were no records to confirm this. The manager told us the manual handling trainer had these records at their home. One carer we spoke to clearly described good infection control procedures and they had received recent updates in the procedures. A quality audit has been undertaken since the last inspection to gather views of people living at the home, in relation to the running of, and the quality of life experienced at, the home. This included comments about standards of care, quality and variety of food, activities, cleanliness, laundry, privacy and management and administration at the home. Comments made in the returned surveys included Resthaven is a very nice place to live in. Management ans ALL staff are most kind and helpful and do their best for us. Food is good and plentiful. Giving up ones independence is a big step in life, but when you arrive at Resthaven you are welcomed and soon helped to settle in. The results of the survey have not yet been made available to current or prospective residents, or their representatives/ interested parties or the CQC. One of the services trustees visits the home and undertakes unannounced monitoring visits, a copy of which is given to the manager and to the Commission. Some people retain responsibility for their own cash and valuables during their stay at Resthaven. However, inventories of personal belongings brought to the home had not been recorded in individual care plans. Care Homes for Older People Page 30 of 35 Evidence: The service manages personal allowances for some people. Clear records of incoming monies and money spent on peoples behalf are maintained. These were accurate and up to date. The temperature of hot water in bathrooms is checked before a person is bathed to ensure they are protected from the risk of scalds. All first floor windows checked were fitted with window restrictors promoting safety within the home by reducing the risk of residents falling from them. Fridge and freezer temperatures are recorded which is good practice. Staff involved in food preparation confirmed that they had food hygiene qualifications. All radiators seen during this visit radiators had been covered to promote the safety of people living at Resthaven. Care Homes for Older People Page 31 of 35 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 32 of 35 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 9 13 arrangements must be made 09/12/2009 to ensure the safe recording and administration of medicines received into the home. To ensure people are not put at risk of receiving the wrong medication or incorrect dosage. 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 3 The service should ensure that they receive sufficient information to enable them to make a decision as to whether the needs of people can be met by the service before agreeing to people moving to Resthaven. Care plans should be reviewed regularly and changes in the way care is to be delivered should be recorded. People should be involved in regular reviews of their individual care plans or told of the changes if they choose not to be involved. Care plans should include all health and social care needs. Page 33 of 35 2 3 7 7 4 7 Care Homes for Older People 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 5 6 8 9 Assessments of individual nutritional needs should be undertaken when people are admitted to the home. All medications should be stored at the recommended temperatures. This relates to the recorded temperatures of the medication fridge being higher than recommended and no action taken by staff to remedy this. Lockable facilities should be provided in peoples private rooms to enable them to keep valubles and precious possessions safe. A record should be kept of all complaints made by people using the service, or their representatives, and staff, and the action taken by the registered person in respect of any such complaint. All allegations of abuse should be followed up promptly and action taken should be recorded. This relates to a sum of money missing from a persons room. 7 14 8 16 9 18 10 11 19 33 Attention should be made to areas in the home that would benefit from redecoration. Outcomes of surveys undertaken at the home should be published and made available to current and prospective users of the service, their representatives and any other interested parties. All records kept at the home should be accurate and up to date. 12 37 Care Homes for Older People Page 34 of 35 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). 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. Care Homes for Older People Page 35 of 35 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!

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