Care Home: Sarah Ann Rest Home

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What the care home does well People who are thinking of moving in are given information about the home and their needs are properly assessed so that they can be sure that it is the right home for them. Available at the home was a care plan for each resident, which clearly set out how staff need to meet the persons health, personal, and social care needs. Care plans were signed to show that they were put together with the full involvement of the resident and or their representative. There was also evidence to show that care plans are being regularly reviewed and they are being updated when a persons needs have changed. Staff showed good knowledge and understanding of the needs of the residents, during the inspection visit they were observed talking to residents in a polite manner and treating them with respect. Residents spoken with said that staff are always polite and treat them well they made the following comments to support this: "The staff are always very kind" "They are always polite" "Yes they always knock on my door" "The staff talk to people in a nice way" The home had in place appropriate procedures for responding to concerns complaints and for ensuring that residents are safe from abuse, harm or neglect. The commission have not received any complaints about the home since the last inspection. Everybody spoken with during the inspection said that they had been given information about how to make a complaint if they needed to. People were confident that their complaints would be listened to and dealt with in the correct way. The home was comfortable, well maintained and free from hazards making it a pleasant and safe place for people to live in. More than half of the staff team have achieved or are working towards a National Vocational Qualification in Care level 2 or above and they have all completed or are planning to complete training linked to the aims and objectives of the home and the needs of the residents. The home is managed by a person who is patient, caring and considerate towards the needs of the residents. Residents, their friends and relatives were complimentary about the manager and the way the home is run, they made the following comments: "The manager is great " "You can talk to her about anything" "The manager is very good with the residents, their families and friends" What has improved since the last inspection? The homes statement of purpose and service user guide has been reviewed and updated so that prospective residents have all the information they need about the services and facilities available at the home. The homes pre admission assessments have been improved to include all the information, which is needed to decide if the persons needs can be met at the home. The manager was advised to expand on some details so that they can be sure of meeting peoples needs. All prescribed medications are now signed for immediately following administration to show that medication is given at the time it is prescribed for. Staff have received protection of vulnerable adults (POVA) training and now have access to policies and procedures with regard to whistle blowing, complaints and protection of vulnerable adults, so that they know what to do if they had evidence of abuse. A specialist chair has been bought to enable residents with poor mobility to access the home easily. Staff have received mandatory training and plans are in place for further training so that staff have the knowledge and skills to carry out their work safely. What the care home could do better: Pre admission assessments carried out by the home should be more detailed so that they have enough information to decide if the persons needs can be met at the home and on which to develop a care plan. All the required information must be obtained for all new staff before they are allowed to start work at the home so that the manager can be sure that they are the right for the job and to ensure the full protection of residents. The homes induction programme must be developed to ensure that new staff receive the required level of training within the first 6 weeks of starting their job. CARE HOMES FOR OLDER PEOPLE Sarah Ann Rest Home 15 Abbotsford Road Blundellsands Liverpool Merseyside L23 6UX Lead Inspector Janet Marshall Key Unannounced Inspection 10th February 2008 10:00 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 Sarah Ann Rest Home DS0000005389.V346740.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. Sarah Ann Rest Home DS0000005389.V346740.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sarah Ann Rest Home Address 15 Abbotsford Road Blundellsands Liverpool Merseyside L23 6UX 0151 476 8500 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) Mrs Pauline Joan Mary May Mr James Frederick May Mrs Pauline Joan Mary May Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places Sarah Ann Rest Home DS0000005389.V346740.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 13 OP. Date of last inspection Brief Description of the Service: Sarah Anne is registered to provide personal care for a maximum of thirteen Older People of both sexes. The home has been opened for 20 years and is privately owned by Mr James and Mrs Pauline May. There are 9 single and 2 double rooms, a lounge, and a dining room. A large basement contains the kitchen, laundry, office and a staff flat. The home does not have a ramp from the outside of the building, however people with limited mobility can be easily and safely assisted in and out of the home by the use of specialist equipment. There is a lift to all floors and alarm call systems in all rooms, toilets and bathrooms. Sarah Anne is a converted building in a quiet residential area, close to a number of amenities including easy access to public transport both trains and buses and local shops within walking distance. The home has a mini-bus for transport of residents where required. There are gardens at the front and rear, which are secure and accessible to service users when weather permits. Parking is available at the front of the building and there are double yellow lines outside the Home. Sarah Ann Rest Home DS0000005389.V346740.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good outcomes. This was a key inspection. The Commission considers 22 standards for Care Homes for Older People as Key Standards, which have to be inspected during a Key Inspection. The report has been put together using information gathered from a number of sources including information that the commission have received about the service since the last inspection which took place in January 2007 and details provided in the Annual Quality Assurance Assessment (AQAA). The AQAA, which is in two parts, a self-assessment and dataset, has replaced the preinspection questionnaire. The document, which was sent out to the service was completed and returned to the commission before the site visit took place. A number of surveys were given out to people as part of the inspection. Responses and comments from those that were completed have been used to as part of this report to help support the judgements, which have been made in the outcome areas. Comments made in a letter sent from a relative of a resident have also been used. The inspection also involved an unannounced visit to the home (site visit). This was carried out with the Registered manager Mrs Pauline May who was on duty at the time. Records that were examined, staff comments and observations made during the visit have also been used as evidence for the report. A number of residents and relatives were spoken with during the site visit and their views and opinions about the service are reflected within the report. A number of residents were case tracked. This process involved talking to staff, looking at the environment and a selection of residents records such as assessments, care plans and daily notes to get an idea about peoples experiences and to find out if they are receiving the care and support that they need and which have been agreed by their representatives. What the service does well: People who are thinking of moving in are given information about the home and their needs are properly assessed so that they can be sure that it is the right home for them. Available at the home was a care plan for each resident, which clearly set out how staff need to meet the persons health, personal, and social care needs. Sarah Ann Rest Home DS0000005389.V346740.R01.S.doc Version 5.2 Page 6 Care plans were signed to show that they were put together with the full involvement of the resident and or their representative. There was also evidence to show that care plans are being regularly reviewed and they are being updated when a persons needs have changed. Staff showed good knowledge and understanding of the needs of the residents, during the inspection visit they were observed talking to residents in a polite manner and treating them with respect. Residents spoken with said that staff are always polite and treat them well they made the following comments to support this: “The staff are always very kind” “They are always polite” “Yes they always knock on my door” “The staff talk to people in a nice way” The home had in place appropriate procedures for responding to concerns complaints and for ensuring that residents are safe from abuse, harm or neglect. The commission have not received any complaints about the home since the last inspection. Everybody spoken with during the inspection said that they had been given information about how to make a complaint if they needed to. People were confident that their complaints would be listened to and dealt with in the correct way. The home was comfortable, well maintained and free from hazards making it a pleasant and safe place for people to live in. More than half of the staff team have achieved or are working towards a National Vocational Qualification in Care level 2 or above and they have all completed or are planning to complete training linked to the aims and objectives of the home and the needs of the residents. The home is managed by a person who is patient, caring and considerate towards the needs of the residents. Residents, their friends and relatives were complimentary about the manager and the way the home is run, they made the following comments: “The manager is great ” “You can talk to her about anything” “The manager is very good with the residents, their families and friends” What has improved since the last inspection? The homes statement of purpose and service user guide has been reviewed and updated so that prospective residents have all the information they need about the services and facilities available at the home. The homes pre admission assessments have been improved to include all the information, which is needed to decide if the persons needs can be met at the Sarah Ann Rest Home DS0000005389.V346740.R01.S.doc Version 5.2 Page 7 home. The manager was advised to expand on some details so that they can be sure of meeting peoples needs. All prescribed medications are now signed for immediately following administration to show that medication is given at the time it is prescribed for. Staff have received protection of vulnerable adults (POVA) training and now have access to policies and procedures with regard to whistle blowing, complaints and protection of vulnerable adults, so that they know what to do if they had evidence of abuse. A specialist chair has been bought to enable residents with poor mobility to access the home easily. Staff have received mandatory training and plans are in place for further training so that staff have the knowledge and skills to carry out their work safely. 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. Sarah Ann Rest Home DS0000005389.V346740.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 Sarah Ann Rest Home DS0000005389.V346740.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): 3 Standard 6 does not apply to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Peoples needs are assessed before they move into the home so that they can be sure it is the right place for them to live. EVIDENCE: The manager said that the homes Statement of purpose and Service User Guide have been reviewed and updated since the last inspection. Both documents were looked at, the manager pointed out the changes, which have been made to them. Both the homes Statement of Purpose and Service User Guide included all the information, which is required by regulation for example, details of the manager and staff and the services and facilities, which are available at the home. All surveys completed by residents showed: That the people were asked if they wanted to move to this home and people did receive enough information about the home before they moved in. A relatives survey showed: Sarah Ann Rest Home DS0000005389.V346740.R01.S.doc Version 5.2 Page 10 Their relative got enough information about the home before moving in. Two residents have been admitted to the home since the last inspection. Pre – admission assessments for those residents were looked at during the inspection visit. Assessments carried out by the home and other professionals such as social workers were available in both residents personal files. The assessments covered all aspects of the person’s social, emotional and physical care need requirements such as, sight, hearing, communication, health and personal care, daily living skills, medication, mobility and finances. The manager confirmed that the homes assessments are carried out either by the manager herself or the deputy manager. Assessments carried out for the most recently admitted residents were looked at in detail as part of this inspection. Each section of the assessment was complete although some parts could have been completed in more detail. This was discussed with the manager and she was advised to provide more details in some areas of the assessments so that they have enough information to decide if the persons needs can be met at the home and on which to develop a care plan. Sarah Ann Rest Home DS0000005389.V346740.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Peoples health and personal care is well monitored and supported to ensure people stay well. EVIDENCE: A requirement was given as part of the last inspection report to ensure that all residents have an agreed care plan in place that identifies all their health, care and support needs. The manager said that that care plans have been improved since the last inspection. Care plans for 4 residents were looked at in detail as part of the case tracking process. All the care plans looked at were complete although some would benefit from more detailed information about the persons needs and how best to support them. The manager was advised of this. Contained within each persons care files were review records, the records showed that each section of the persons care plan has been reviewed and updated each month. Sarah Ann Rest Home DS0000005389.V346740.R01.S.doc Version 5.2 Page 12 The manager, deputy manager and staff who were spoken with during the inspection visit showed good knowledge and understanding of the residents needs. A relative spoken with said, “I think the staff know and understand my dad very well”. Relative’s surveys showed that the home always meets the needs of their relative. A letter received from a relative of a resident included the following comments: “My Aunt has been a resident at Sarah Ann for the past five years and I am extremely happy with the consistency of care and attention they have shown my Aunt while in their care” All surveys completed by residents indicated that they always receive the medical support that they need. A letter received from a relative of a resident included the following comments: “Pauline always calls me to inform if my aunt requires any medical attention and keeps me updated to any changes in my aunts medication. When my Aunt needs to attend hospital or any medical appointments Pauline always ensures that she accompanies her”. Records of medical appointments were kept in good detail and showed that residents have regular access to specialist medical, nursing, dental, chiropody and GP services. Residents spoken with confirmed that they could see their doctor when they choose. The manager confirmed the arrangements that are in place at the home to enable residents to access other specialist services such as speech therapists and dieticians. During the visit discussion took place with a visiting speech therapist. The speech therapist was very complimentary of the home, the manager and the staff that work there. She said, this is one of the nicest homes I have visited”. The AQAA provided details of a number of policies and procedures, which relate to the health care of residents. They include control, administration, recording, safe keeping, handling and disposal of medication. Medication was stored safely at the home. The blister pack system is used by the home. Medication administration records were examined, they were in good order. Staff were seen knocking on bedroom and bathroom doors before entering rooms and assisting residents with personal care in private. All staff were observed talking to residents in a kind and polite way. Residents spoken with said that staff always treat them well and respect their privacy and dignity. They made the following comments to support this: “The staff are always very kind” “They are always polite” “Yes they always knock on my door” “The staff talk to people in a nice way” Sarah Ann Rest Home DS0000005389.V346740.R01.S.doc Version 5.2 Page 13 A relative of a resident wrote in a letter, “They never waver from their warm and courteous approach toward her”. Sarah Ann Rest Home DS0000005389.V346740.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to live active and healthy lifestyles. EVIDENCE: Residents are provided with the opportunity to exercise their choice in relation to leisure, social activities, cultural interests, food, meals and mealtimes, relationships and routines of daily living. Care plans which were looked at detailed residents preferences and support needs in relation to social contact and activities. Surveys completed by residents showed that they always live the kind of life that they choose The AQQA listed a variety of activities available for residents both inside the home and in the community. They included bingo, hairdressing, entertainment, and trips out, movies, sing-a-longs and gardening. Surveys completed by residents indicated that there are always activities arranged by the home that they can take part in. Comments made by residents included: “I like to go to my room sometimes and I like to read as long as it is interesting” Sarah Ann Rest Home DS0000005389.V346740.R01.S.doc Version 5.2 Page 15 “If I wish to lie down in the day I can. I watch TV and join in the entertainment if I wish to” A visitor’s book was in place at the home. This showed that residents receive visitors at various times during the day and night. A number of residents received visitors on the day of the inspection visit. They were made welcome and offered refreshments. Residents and visitors spoken with said: “My family visit me every week” “There are no restrictions placed on visiting times, I can visit my dad at any time” “The staff are always very welcoming” “We can sit in the lounge or in my dads bedroom” Surveys completed by relatives/friends showed that the home always help their relative to keep in touch. During the inspection visit residents were offered choices and supported to make decisions about such things as were to sit, what to do and what to eat. Surveys completed by residents showed that people always make decisions about what they do each day and they also showed that the people can do what they want, during the day, of an evening and at the weekends. For safety reasons there are certain restrictions placed on residents for example, use of keys, access without support to certain parts of the home and the community, management of money and medication. There are also instances when some decisions and choices have to be made for residents by others. Restrictions placed upon people and choices, which need to be made by others and the reasons why, were recorded in each person’s plan of care. The quality, quantity and choice of the food at the home is good. This was supported by the following comments made by residents during the inspection visit: “The food is very good” “The food is tasty” “I can have as much as I want” “I have a choice of food each day” The menu, which was viewed during the inspection visit, included a variety of nutritious and well-balanced meals. It showed that residents have a choice of meals each day. On the day of the inspection visit the serving of the lunchtime meal was observed. The meal was well presented and served hot. Staff served residents individually with their meals and assisted with those who needed help, staff did not rush residents with their meals. Food stores were examined, there was a good variety and plenty of fresh, frozen and tinned foods. The dining room was decorated and furnished to a good standard, it was bright and cheery. Dining tables were attractively laid with good quality cutlery and Sarah Ann Rest Home DS0000005389.V346740.R01.S.doc Version 5.2 Page 16 crockery and each table was decorated with a small vase containing a flower arrangement. Sarah Ann Rest Home DS0000005389.V346740.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area good. This judgement has been made using available evidence including a visit to this service. The homes policies and procedures ensure the protection of residents and people are confident about making a complaint if they need to. EVIDENCE: There has been no complaints received by the Commission about the home since the last inspection. Information provided in the AQAA and discussion with the manager and staff showed that there have been no complaints made at the home in the last 12 months. There was a complaints procedure on display at the home. It is also available in the homes Statement of Purpose and Service User Guide. Residents and relatives spoken with during the inspection said that have the information that they need to make a complaint if they wish to and they would feel confident about making a complaint. The following results of surveys and comments made by residents and relatives supported this: People know who to speak to if are not happy People do know how to make a complaint Carers always act on what people say “I can talk in private if I am worried about anything” “Speak to Pauline or a member of staff” “I would speak to Pauline the owner or Sue if I was unhappy about something” Sarah Ann Rest Home DS0000005389.V346740.R01.S.doc Version 5.2 Page 18 “If I had a complaint I would go to the manager first” “The service has always responded to any concerns in the past” A requirement was given as part of the last inspection report for all staff to be provided with a copy of the homes policies regarding complaints, whistle blowing procedure and Protection of Vulnerable Adults and for training to be arranged for staff in recognising the signs of potential abuse and reporting them appropriately. Discussion with staff and details provided in the AQAA showed that since the last inspection staff have been given the above policies and have received protection of vulnerable adults training. Also since the last inspection and in response to a requirement given a copy of the Local Authority Protection of Vulnerable Adults policy has been obtained and put in the office for people to refer to. A staff member who was interviewed during the inspection visit described correctly the procedures that they would follow if they thought a resident was being or had been abused. Sarah Ann Rest Home DS0000005389.V346740.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe and comfortable home. EVIDENCE: The home is located in a popular residential area of Crosby Liverpool, close to public transport links. Community facilities including churches, shops, cafes and community health centres are within close distance of the home. Parking is available at the front of the building and on the road outside the home. There are attractive and well maintained gardens to the front and back of the house, which were planted out with various plants, shrubs and trees including fruit trees. The back garden was furnished with a number of benches, tables and chairs and there was a BBQ, which the handyman said is used regularly during the warmer weather. The outside of the house has recently been painted, it looked clean and tidy. A requirement was given as part of the last inspection report for a ramp to be fitted to the outside of the home so that people with limited mobility can easily Sarah Ann Rest Home DS0000005389.V346740.R01.S.doc Version 5.2 Page 20 get in and outside of the home. The owner/manager has since purchased an automatic chair, which is specially made to transport people up and down steps. The manager reported that staff have received training in the use of the chair and she said residents that have used it say it works very well. Residents have shared use of a lounge and dining/sitting room both on the ground floor. Both rooms were furnished and decorated to a good standard. A new large screen plasma TV has been bought for the lounge since the last inspection. A number of residents bedrooms were looked at during the visit. They were furnished and decorated to a good standard. Some residents have chose to bring some items of furniture from their previous homes, which is encouraged by the manager. Other personal items such as pictures photographs, ornaments and plants were also displayed in residents bedrooms making them look homely and comfortable. Most parts of the home were clean, peasant and hygienic, however a carpet in one residents bedroom was heavily stained and should be cleaned or replaced. This was pointed out to the deputy manager during a tour of the home. Residents spoken with said that their rooms and other parts of the home are always kept clean and tidy. They made the following comments: “My room is always kept clean and tidy” “The home is always clean” “Yes, my room is always kept clean and so is the rest of the home” All the people who completed surveys commented that the home is always fresh and clean. The laundry, which is located in the basement, was equipped with sufficient washing and drying machines and ironing facilities. The laundry was clean and well organised. Detailed in the AQAA and available at the home were a number of policies and procedures, which aim to ensure a clean and safe environment, they include infection control and disposal of soiled waste. Sarah Ann Rest Home DS0000005389.V346740.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Recruitment procedures do not fully protect the residents putting them at risk. EVIDENCE: There was two care staff the manager and a cook on duty at the time of the inspection. One member of the care team was interviewed during the inspection. General discussion also took place with other staff at intervals throughout the visit. The staffing rota, which was examined as part of the inspection showed that there are sufficient staff on duty throughout the day and the night. It showed a minimum of two care staff and a manager on duty during the day and one care staff awake and one sleep in during the night. Staff spoken with said that there is always enough staff on duty to look after the residents. One member of staff said, “the home is never short staffed, if someone is off there is always somebody who will cover the shift”. Staff spoken with showed a good understanding of their roles and responsibilities and were very knowledgeable about the needs of the residents. One carer said, “We all work well together as a team” Residents and relatives spoken with during the inspection visit were all complimentary about the staff group and were confident that they are able to Sarah Ann Rest Home DS0000005389.V346740.R01.S.doc Version 5.2 Page 22 do their jobs well, this was supported by the following comments made by people during the visit: “The staff are lovely. Since I have been here I am very content and happy with the staff. In my opinion I class the staff as angels” “The staff are Excellent” Surveys completed by relatives and residents showed the care staff always treat people well and they have the right skills and experience to look after the residents properly. A resident’s relative wrote in a letter “I have nothing but praise and gratitude for the staff at Sarah Anne”. Two staff have started work at the home since the last inspection. A requirement was given as part of the last inspection report for the manager to ensure that information for all new staff is obtained before they are allowed to work at the home. Personal files for the new staff were looked at they both contained completed application forms and evidence of a satisfactory CRB check but they did not contain copies of two references which are required when employing new staff. The manager was advised that before starting a new member of staff she must obtain satisfactory references to show that they are the right person for the job. The manager confirmed that all new staff receive induction training. Induction training records were looked at for one member of staff who has recently started work at the home. These showed that new staff receive very basic induction training. The manager was advised to develop the homes induction training programme for new staff to so that it includes training on the principles of care, safe working practices, the organisation, the worker role and the needs of the residents. The last inspection report also required the manager to carry out an audit with regard to staff training needs, produce a training and development plan for each of them and ensure they are trained to meet the needs of the residents. Discussion with staff and copies of certificates which were looked at showed that since the last inspection staff have completed training to update their knowledge and skills and that the training is linked to the aims and objectives of the home and the needs of the residents. Staff spoken with said that they have completed a lot of training and gave the following examples, health and safety, first aid and lifting and handling. Sarah Ann Rest Home DS0000005389.V346740.R01.S.doc Version 5.2 Page 23 A training programme, which was displayed on the wall in the main office, showed that staff are now receiving a good level of training. The AQQA and staff training records held at the home evidenced that at least half of the staff team have achieved or are currently undertaking a National Vocational Qualification in care level 2 or above. Sarah Ann Rest Home DS0000005389.V346740.R01.S.doc Version 5.2 Page 24 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed to the benefit of the residents and staff. EVIDENCE: Mrs Pauline May is the owner/manager of the home. The manager is experienced and has a number of relevant qualifications that are required to meet the stated purpose and aims and objectives of the home including The Registered Mangers Award NVQ Level 4. Information detailed in the AQAA and examination of a selection of records during the inspection showed that most of the records required by regulation Sarah Ann Rest Home DS0000005389.V346740.R01.S.doc Version 5.2 Page 25 are available, up to date and accurate. Those that are not including staff records have been identified in the relevant sections of this report. Residents and staff spoken with during the inspection were complimentary of the manager and the way she runs the home, the following comments made during the inspection and in a letter from a relative of a resident, supported this: “The manager is great ” “You can talk to her about anything” “The manager is very good with the residents, their families and friends” “I will always be indebted to Pauline for all her care and support she has given to my Aunt and myself over the years.” The health safety and welfare of residents are well protected this was supported by a set of policies and procedures, which were detailed in the AQAA and available at the home. Information provided in the AQAA and examination of a selection of health and safety records showed that the required health and safety checks have been carried out on the environment at the required intervals, for example fire system checks, gas and electricity checks and environmental risk assessments. Staff and residents spoken with confirmed that they hear the fire alarm system regularly being tested. Sarah Ann Rest Home DS0000005389.V346740.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 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 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Sarah Ann Rest Home DS0000005389.V346740.R01.S.doc Version 5.2 Page 27 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. 1. Standard OP29 Regulation 19 (1) (5) Requirement The registered provider must 2 references are obtained for all new staff to show that they are right for the job. Induction training for new staff must be developed so that they receive the required training within the first 6 weeks of starting work at the home. Timescale for action 10/03/08 2. OP30 18(1)(i) 10/05/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP3 Good Practice Recommendations Pre admission assessments carried out by the home should be more detailed so that they have enough information to decide if the persons needs can be met at the home and on which to develop a care plan. Sarah Ann Rest Home DS0000005389.V346740.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection North West Regional Contact Team Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ 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 Sarah Ann Rest Home DS0000005389.V346740.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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