Care Home: Seahorses

What the care home does well The home completes an assessment of any prospective new people to the service, prior to offering them a place. The home then confirms in writing, whether they are able to meet the person`s individual needs. People are provided with a copy of the home`s brochure, a Statement of Purpose and a service user guide, which contains information about the service. A key worker system is in place and discussion with staff demonstrated an awareness of the needs of the people they support. Peoples` health care needs are being addressed and there is two weekly Doctors surgery held at the home. People told us that they are offered choices in daily routines, such as what they eat and whether they spend time in their room or in the communal areas. The staff team at Seahorses praised the service and the management. They told us that they enjoy working at the home. During the day staff were observed interacting positively with the people they support and spending one to one time with people when they needed it. The home has good mechanisms in place for monitoring quality assurance. What has improved since the last inspection? Daily notes no longer use inappropriate judgements and terminology. Health and safety checks are completed. Fire drills are regularly taking place. The home now has a complaints log in place, however, Mr Coleman confirmed that they have not received any complaints over the last twelve months. Mrs Cole has now attended training in the Mental Capacity Act. Bathrooms have been fitted with new flooring. All upstairs hot water outlets have been fitted with thermostatic valves. All radiators are guarded. Fly screens have been fitted to the kitchen windows. What the care home could do better: Care plans could be further developed to provide more information, in relation to health care needs and how they are to be managed. It would be good practice to collate further information where possible, and to develop `Life Books` for people using the service. Documents such as Environmental risk assessments need to be dated and signed, to evidence that they have been kept under review. The registered provider is aware that some areas of the home require re-decoratingand re-carpeting. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Seahorses 73 Draycott Road Chiseldon Swindon Wiltshire SN4 0LT     The quality rating for this care home is:   one star adequate 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: Pauline Lintern     Date: 2 1 1 0 2 0 0 8 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. the things that people have said are important to them: They reflect 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 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Seahorses 73 Draycott Road Chiseldon Swindon Wiltshire SN4 0LT 01793740109 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Shirley Cole Type of registration: Number of places registered: Mr Peter Coleman care home 15 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users who can be accommodated is 15 The registered person may provide the following category of service only; Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Dementia (Code DE) Date of last inspection Brief description of the care home Seahorses is a private 15 bed home that provides care and accommodation for men and women aged over 65 years who have dementia. The home is situated on the outskirts of Swindon in the village of Chiseldon. Close by is Junction 15 of the M4.The accommodation is mainly on the ground floor with two bedrooms on the first floor. It consists of two shared rooms and 11 single rooms. The homeowner takes a keen and personal interest in the running of the home and resides on the premises most of the time. The homes manager has the day to management responsibility of the service. Support staff give personal care and provide for the welfare needs of the people living Care Homes for Older People Page 4 of 30 Over 65 0 15 Brief description of the care home in the home. Their duties also include cooking, cleaning and administration as part of their job role. The home provides a garden with flat level access. The fees charged for this service are £430 to £650 per week. Care Homes for Older People Page 5 of 30 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: one star adequate 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 last key inspection on this service was completed on 23/10/2007 The site visit of this key inspection was completed in six hours. The pharmacist inspector examined the medication records and procedures. We used an expert by experience with this inspection. An expert by experience is a person who, because of their shared experience of using services, and/or ways of communicating, visits a service with an inspector to help them get a picture of what it is like to live in or use the service. The registered was not available on the day of our visit, however Mr Coleman, the registered provider, was available during the day. There was the opportunity to meet with people living at the home to obtain their views. This took place in private and in communal areas. Care Homes for Older People Page 6 of 30 As part of our inspection, we sent out survey forms to the people using the service and their relatives. We had no response from these. Three care plans were examined in detail. In addition, medication records, staff recruitment files, health and safety documents and a sample of risk assessments were also examined. A tour of the building was made and the majority of peoples bedrooms were viewed. Three staff were interviewed in private. A friend of a person using the service was visiting the home at the time of the site visit and shared their views on the care provided. Comments received were positive and complementary. We sent Mrs Coleman an Annual Quality Assurance Assessment (AQAA) to complete. Information from the AQAA is detailed within this report. The home is currently in the process of being extended to provide a new conservatory/dining room and ensuite accommodation for five more people. The gardens will continue to be secure. They will be landscaped, to provide pleasant surroundings for the people living there. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of the people who use this service. What the care home does well: What has improved since the last inspection? What they could do better: Care plans could be further developed to provide more information, in relation to health care needs and how they are to be managed. It would be good practice to collate further information where possible, and to develop Life Books for people using the service. Documents such as Environmental risk assessments need to be dated and signed, to evidence that they have been kept under review. The registered provider is aware that some areas of the home require re-decorating Care Homes for Older People Page 8 of 30 and re-carpeting. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is assuring peoples care needs are assessed prior to admission and they have the opportunity to visit, before deciding to move. Information is provided to allow prospective new residents the opportunity to make an informed choice about moving. Evidence: The records of three most recently admitted people were examined in detail. Each person had a completed assessment of need and a pre admission assessment completed by the manager. One person had previously lived a distance away from the home. It was recorded on their file that as the manager had been unable to carry out the assessment herself, she had arranged for the social worker and a relative to undertake this task. The person told us that they had also had the opportunity to visit and stay overnight at Seahorses before they made their decision. They added that they had heard that Seahorses had a good name and this had been why they had chosen it. They Care Homes for Older People Page 11 of 30 Evidence: commented I came and spent a few days here. It is a well run home. As part of the assessment process, individual care needs are identified. These include dietary needs, social and emotional needs, health needs, mobility, personal care, skin care, continence and medical needs. The home then confirms in writing whether they are able to meet the persons needs. A copy of this is kept on the persons file. The home has recently produced a new colour brochure to send out to prospective new people. This includes a copy of the Statement of Purpose and service user guide. The home does not provide intermediate care. Care Homes for Older People Page 12 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person living at the home has a care plan in place, which is kept under review. However, some plans do not provide sufficient information on specific health care needs which could place people at some degree of risk. People told us that they are treated respectfully. People are generally protected by the homes systems for the safe handling of mediaction, however staff must not transfer medicines from their original container. Evidence: The records of three people were examined in detail. Care plans are reviewed monthly. Daily recording has improved since the last inspection. Each person living at the home had a plan of care that directed staff on how their needs should be met. Some plans did not provide sufficient information about the persons specific health care needs. For example, one care plan for a diabetic person does not detail how this is managed, Care Homes for Older People Page 13 of 30 Evidence: who is responsible for taking blood tests and what adverse signs which may indicate poor health staff should be aware of. Another person has fairly complex mental health needs, however there was no mention of this or the intervention and support provided by the Mental Health Team. The section on eating and drinking did not include information on what food should be avoided when providing care for a person with diabetes. This should be included within the care plan. The care plans do, however cover, mobility, washing and dressing, skin care, eating, social and emotional needs. Instruction for carrying out daily routines is documented. One persons plan asks staff members to observe for any decline in the persons communication skills. One area of their behaviour has been risk assessed and staff are reminded not to confront the individual if they display certain behaviours but to be supportive. One person has a hearing impairment and staff are reminded that when they speak to the person, they need to face them and talk slowly and clearly.Staff were observed following this guidance. There are individual risk assessments in place.These are kept under monthly review. Weights are monitored and recorded. Caring and patient staff members address peoples emotional needs. During our visit one person became very confused, upset and emotional. A member of staff was observed encouraging the person to move, to a more quiet and private location in the dining room. They then spent a considerable amount of time reassuring and comforting the person.They then offered to make them a cup of tea. Another member of staff was observed during the afternoon, taking time to sit and chat to a person, who had previously been unwell and had been bed bound. The person was smiling and talking and appeared happy to be able to access the communal areas in their wheelchair. During discussion with staff members, regarding the benefits of developing Life Books for some people, one staff member showed us a book that is already in place for one individual. It contained many photographs from their past and other information on their likes and dislikes. Books such as these can be a very useful resource for the staff. The home holds two weekly surgeries in house, when the GP visits. Staff confirmed that they receive good support from the local community health services. The district nurse visited on the day of our inspection. One person has regular visits from the Mental Health team, however this was not documented within their care plan. It was noted that one person had a tube of cream in their bathroom, which had been Care Homes for Older People Page 14 of 30 Evidence: prescribed to another peron using the service. Prescribed creams must not be used for anyone other than the person it identifies on the label. Within their report, the expert by experience stated I got the impression that the residents there were as happy as they could be, in view of their mental problems and I am sure that the owner is more than willing to do as much as he can, to make their lives comfortable. People we spoke to told us that they are happy living at the home. One person said, I like it here really, but Im unsettled as I cant see my mother. Another person commented, It is a very,very good home and the girls (staff) are really nice, helpful and kind. Our Pharmacist Inspector looked at the handling of medication in the home. All medicines were stored securely, however they were kept in the kitchen which does not have ideal temperature and humidity controls and there was no legal controlled drug cupboard in case of need. The manager explained that new storage arrangements are being considered with the registration of some new rooms in the home. All medication records were correctly completed. Staff could explain the safe procedure that they used to administer the medicines and records showed that two staff check the process at all times. All staff have had training in the safe handling of medication from a recognised source. Staff keep clear records of all medicines in the home and all changes to medication made by the doctors. One persons medicine had been put into a dossett system by care staff. This had been done to help staff to give the medicine but it was unlabelled and is not a safe method of administration. Staff spoken to appeared knowledgable about the medicines they were using and the processes used to ensure safe handling. Care Homes for Older People Page 15 of 30 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. The majority of activities are in house and provided on a daily basis. Visitors are made to feel welcome. Meals are home cooked and well presented. Evidence: When we arrived at the home all but two people were up and dressed, some were dozing in the armchairs. During the morning staff played old songs and people using the service joined in for a singsong. Staff told us that the people they support really enjoy listening to music, sings a longs and dancing. Music for Health visits the home on a regular basis and according to staff this is very well received. Care plans detail record if people wish to attend a church service or not. The three plans sampled stated that the person had no particular religious beliefs. One staff member told us that the vicar would visit at Christmas time and Easter. Within their report, the expert by experience stated I left a notebook behind accidentally and when I went back to collect it this afternoon the two girls on duty were Care Homes for Older People Page 16 of 30 Evidence: in the lounge talking and entertaining the residents. As with previous visits I have made where the degrees of confusion were high, I feel that more effort should be made to get the local church involved and that perhaps a painting class or similar could be started by some outside group. At the time of our site visit, the hairdresser was at the home. Two people had their hair shampooed and set. The registered provider told us that when the new building has been completed they would have a room as a nursing station, which the hairdresser can work from. One person living at the home told us, they have all sorts going on here but I often have a taxi and go to visit my son. Another person commented, I enjoy the singsongs. I dont watch television, Im on my own, its a lonely life. Within the AQAA it states, we plan to ask societies like the WI and church for volunteers to assist us. People using the service are able to participate in small household tasks, if they wish to do so. Mr Coleman said, some people like to do some dusting around the house. During our inspection, one person had a friend visiting them. We took the opportunity to ask them their views on the service provision. They confirmed, that they are always made welcome and offered a drink. They added, that on one occasion they were invited to join their friend for tea, which they enjoyed. They said that they felt the meals were wholesome and well balanced. They told us, that they feel the home, do their best. Some people told us, that they prefer to eat their meals in their rooms and this is respected. Staff members told us, that people are given keys to their bedrooms but generally they become lost very quickly.One person living at the home took us to her bedroom so we could speak in private.They had their own key on them. Generally, bedrooms are locked during the day, when the person is in the communal areas to prevent, people getting confused and entering rooms that are not theirs. Within their report, the expert by experience stated I spoke to several of the residents who as stated earlier, are in varying degrees of confusion. They had no complaints Care Homes for Older People Page 17 of 30 Evidence: about the food. Breakfast is served in the dining area quite early in the day and those residents who find it more difficult to get moving in the morning have their meal slightly later when the day staff arrive. There are always two staff on duty all night and during the day four staff are available in the mornings and two for the remainder of the day. Lunch is the main meal and in the evenings snack meals are served i.e. Beans on toast, boiled egg etc. Drinks are available all day and I observed them being served at least twice while I was there. The staff on duty while I was there consisted of a lady who was preparing lunch with plenty of fresh vegetables. The kitchen was clean and at one time she was called away to answer the telephone but on her return I noted she went straight away and washed her hands before doing any further preparation. One person living at the home commented, I am most impressed with the food here, the cook is wonderful. Care Homes for Older People Page 18 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is ensuring that people using the service have their complaints listened to and there are procedures are in place to protect them. Evidence: Within the AQAA it states, the home have not received any complaints in the last twelve months. The registered provider confirmed this during the inspection. The home now keep a log to record any complaints, which may be recieved. People we spoke to, told us that they knew who to speak to if they had any concerns or complaints that they wished to raise. One person using the service, told us I have no complaints or worries, I have the highest regard for them here. Another person commented theres nothing wrong with it here. One member of staff reported that if she was concerned about the service, she would discuss it with the manager or contact CSCI for advice. Discussion with staff members demonstrated an awareness of what constitutes abusive practice. Staff confirmed that they had attended safeguarding training. One recently appointed member of staff reported, they had yet to attend this training. The home has a whistleblowing policy in place and staff understood the procedures for raising any concerns, relating to suspected abuse and the protocols, within the No Secrets guidelines. There have been no safeguarding referrrals made or safeguarding investigations, Care Homes for Older People Page 19 of 30 Evidence: within the last twelve months. Care Homes for Older People Page 20 of 30 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 home provides a homely and safe environment, which is well maintained and comfortably furnished. Evidence: As mentioned earlier in this report, the home are currently extending the premises to provide a conservatory/dining room and further ensuite accomodation. This will enable them to accomodate five more people. Hot water regulators have been fitted to all hot water outlets on the first floor of the building. Downstairs outlets are regulated by the boiler. All radiators are guarded. The first floor is in better decorative order than the ground floor. The registered provider confirmed, that he is planning to address these areas and is also intending to replace the hall carpet and redecorate. He agreed that some areas on the ground floor are in need of brightening up. Certains parts of the hall way were seen to have plaster flaking off the walls. Furniture in the communal areas is of good quality and arm chairs are clean and comfortable. Within their report, the expert by experience stated, There has been a recent death Care Homes for Older People Page 21 of 30 Evidence: and some changes are in the process of taking place to enable the owner to have a downstairs bedroom renovated and redecorated. Also there is a brand new Conservatory in the process of being built. When it is complete all meals will be served there and the present living space will be given over in its entirety to a lounge for the residents.I get the impression that the owner has several plans for the future redecoration of the ground floor, which is in need of some up grading. The upstairs rooms are all in reasonable shape and have obviously had some work undertaken in the recent past. There is a lift suitable for a wheelchair. One person using the service told us, it is very clean here. Another person commented, I am most impressed with the cleanliness here. People are able to bring in personal belongings, if they wish to do so, when they are admitted to the home. One person had brought in various mirrors and a cabinet for their ornaments. The laundry has a commericial washing machine, with a sluice facility and a commercial drier. All soiled laundry is transport to the washing machine using red alginate bags to avoid cross infection. People using the service told us, that they are satisfied with the laundry arrangements. We found that one toilet and the bathroom downstairs did not have any paper towels for people to dry their hands. There was also only a small piece of soap available and no antibacterial hand wash. Staff are provided with protective clothing such as gloves and aprons. Care Homes for Older People Page 22 of 30 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 home is ensuring staff recuitment is being safely managed. Training is provided to ensure staff have the necessary skills to meet the needs of people living at the home. Evidence: Examination of the rota and discussion with staff, showed that there are normally four staff on duty in the morning, two on duty in the afternoon, with one extra staff coming in between six oclock and eight oclock. Two waking staff, support people throughout the night. Staff members confirmed, that they feel the staffing levels are sufficent to meet the needs of the people they support. The managers hours are in addition to the rota. The home currently employ fifteen staff. Twelve staff have a National Vocational Qualification (NVQ) level 2 in social care. Senior staff are working towards NVQ level 3. Following a recommendation made at the last inspection, the manager now has a training matrix in place. We were unable to see the completed copy as the Registered provider could not locate it. We did see a copy of the template on the computer. The manager did confirm during feedback on the telephone, the following day, that she has this in place. She also confirmed that staff had received training in manual handling, first aid, abuse awareness, basic food hygiene, health and safety and fire training. Care Homes for Older People Page 23 of 30 Evidence: The registered provider confirmed that all staff attend training in dementia awareness. One member of staff told us that they are going on an intensive food hyeine course, following a recommendation made at the last Environmental Health Officers visit. One recently appointed member of staff told us they have completed an induction, where they shadowed a more experienced member of staff. They confirmed that as part of their induction they had completed training in all the mandatory subjects, such as first aid, health and safety, fire, basic food hygeine and manual handling. As part of the inspection process, we sampled the recruitment records for two recently employed staff. Both members of staff were from overseas. Files contained a current, satisfactory certificate from the Criminal Records Bureau (CRB) together with a Protection of Vulnerable Adults (POVA) check. The registered provider could not locate the references received for the two staff and reported that the manager had them. We asked the manager the next day to ensure copies of these are forwarded to CSCI for examination. The manager confirmed that they had been posted to CSCI, however we have not received them to date. Staff members we spoke to confirmed that they are happy working at Seahorses. Within their report, the expert by experience stated, all the other staff that I met were from abroad and two were definitely from the Phillipines. The abilty of one to make herself understood I felt was a bit difficult for people who already have problems in communicating with everyone else. There was no question that they are very caring and interested in helping, in whatever way they can. Knowing the difficulty of getting staff of a high calibre I cannot see what the answer to this problem is and in view of the comments, I mentioned earlier in this report from the more senior staff I am sure that they are well supervised. One other member of staff told me, she had been there for four and a half years and said I have never been happier than I am here she also said that the owner was very supportive and caring of the residents. A feature of the home is its muti cultural staff team. Staff confirmed that they receive regular supervision from their line manager. Supervision records were sampled. Staff members told us, that they ensure they have a good handover between shifts to make sure information is shared. Care Homes for Older People Page 24 of 30 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 run in the best interests of the people living there. The manager is experienced and qualified to manage the home and provide a safe environment for the people living there. Evidence: The manager has worked at the home for eight years. She has twenty years experience of working in various care homes for older people. She has obtained the Registered Managers Award Level 4, NVQ in care Levels 2 and 3 and is an NVQ assessor in Care. Both staff and the people using the service spoke highly of the management of the home. One person living at the home reported, they are always popping in my room to see if I am alright. One staff member told us, the management are very good, I could go to them with any problems. Care Homes for Older People Page 25 of 30 Evidence: As part of the homes quality assurance programme, an external person is brought in to carry out a comprehensive audit. This includes sending out questionnaires to relatives and representatives, for their comments. The responses are then collated and fedback to the provider and manager. We had the opportunity to sample the most recent report, which was carried out in August 2008. The report concluded that, Seahorses appears to be well run and managed. Relatives are pleased with the care provided. The home does not take responsibility for the management of individuals money. Regular health and safety checks are completed to ensure the safety of the people using the service. There is a health and safety policy in place dated 29/01/08. Within the health and safety file, is guideance on how to report incidents under R.I.D.D.O.R. Certificates evidence that staff have attended health and safety training. There is a current Gas Safety Certificate and a certificate showing that all small electrical appliances have been tested. Restrictors have been fitten to windows as required. The home had a visit from the Environmental Health Officer on 10/3/08. Some requirements and recommendations were made, as a result of the inspection. The registered provider confirmed that all work identified had been carried out to ensure compliance. Environmental risk assessments are in place, however they need to be dated and signed, as it is difficult to establish if they have been kept under review. Records showed that regular fire drills and staff training were taking place. There is a fire risk assessment in place, however this needs to be signed. Care Homes for Older People Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 10 14(a)(b) The registered manager must ensure that inappropriate judgements / terminology are not used in people?s daily records. 23/11/2007 2 16 17(2) Schedule 4(11) The registered manager 23/12/2007 must ensure that a complaints log is kept at the home to ensure any complaints raised are recorded with timescales and outcomes. The registered manager must ensure the fire risk assessment is updated to ensure the safety of the people living at the home. 23/12/2007 3 38 13(4)(a) 4 38 13(4)(a)(b)(c The registered manager ) must ensure all portable electrical appliances are checked annually. 23/12/2007 Care Homes for Older People Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 13 The practice of sharing prescribed creams must stop. This reduces the risk of cross infection 14/11/2008 2 7 15 The registered person must ensure that care plans include information on peoples specific mental health care needs and interventions. To ensure that peoples care needs are met. 14/12/2008 3 7 15 the registered person must 14/12/2008 ensure that care plans detail how people with specific conditions, such as diabetes will be supported to ensure their well being. To ensure that peoples care needs are met. Care Homes for Older People Page 28 of 30 4 9 13 All medicines must be administered from the original, labelled container. This reduces the risk of error in administration. 14/11/2008 5 9 13 A legal controlled drug cupboard must be available in the home. This will ensure that the home complies with the Misuse of Drugs and Misuse of Drugs (Safe Custody) (Amendment) Regulations 2007 30/01/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 3 4 5 7 19 26 38 38 It would be good practice to develop Life Books for people, if appropriate. Certain areas of the home are in need of re-decoration. Bathrooms and toilets should have antibacterial handwash and paper towels available. Fire risk assessments should be signed. Environmental risk assessments should be signed and dated. Care Homes for Older People Page 29 of 30 Helpline: 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 We want people to be able to access this information. 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