Care Home: Shockerwick House

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What the care home does well Each resident spoken with, and those who wrote to us, said they liked living in the home and `always` receive the care and support they need. Each relative who wrote to us said the home does provide the care and support they expect and supports people to live the life they choose. Staff members we spoke with, or who wrote to us, said they are well supported and given appropriate training to enable them to do their jobs well. A high standard of personal and nursing care continues to be provided and staff work hard to meet the needs and wishes of the residents. Staff are respectful and sensitive towards the residents at Shockerwick House. A structured and stimulating activities programme continues to be provided, which includes time on a 1:1 basis with those residents who are unable to or who choose not to take part in communal activities. Meals are well presented and menus show a healthy well balanced diet for all residents who benefit from a wide variety of choice. The home`s environment and its surroundings meet the needs of residents and continues to provide great pleasure and enjoyment to them. The home is peaceful, comfortable, tastefully decorated and furnished and very well-maintained. The home is managed by an effective team who have a good rapport with residents, are knowledgeable about their care needs and ensure their views and interests are promoted. There is an effective Quality Assurance system in use. This helps to accurately measure the quality of the services provided and ensures the home remains committed to improvement wherever possible. The quality of record keeping within the home is excellent. This helps to ensure a competent and accountable service for each person with an interest in the service. Mrs. Holbutt and the team are therefore commended for continuing to provide residents with a service which is very well regarded and which has high standards of care. What has improved since the last inspection? The residents` dignity is now better upheld as the taking of their photos is now sensitive about their clothing. (This was the only improvement we asked for followingthe last Key Inspection). However, a number of other improvements have been made by the home, described below, and these are commended. A resident library has been created on the first floor of the home. This is well stocked and available for each person who lives in the home to use. A new brochure has been produced and the Service Users guide has been re-written. The size of text on some written information has been increased as this may make it easier for some people to read. New care planning documentation is now being used, which promotes a person centred approach to each resident`s care and support. A new Nite Bite` system has been introduced to ensure that hot and cold food and snacks are available to residents 24 hours a day. New staff have been recruited to cover vacancies within the staff team. This helps to ensure consistent care and support is provided to each person who lives in the home. What the care home could do better: The home should consider increasing the frequency of supervision for members of the night staff team. This would improve the support they receive which enables them to continue to provide a high quality of care and support to residents. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Shockerwick House Shockerwick House Lower Shockerwick Bath Bath & N E Somerset BA1 7LL     The quality rating for this care home is:   three star excellent 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: David Smith     Date: 1 2 0 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 30 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Shockerwick House Shockerwick House Lower Shockerwick Bath Bath & N E Somerset BA1 7LL 01225743636 01225744335 holbuttc@bupa.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : BUPA Care Homes (CFC Homes) Ltd care home 38 Number of places (if applicable): Under 65 Over 65 38 0 old age, not falling within any other category physical disability Additional conditions: 0 5 Manager must be a RN on parts 1 or 12 of the NMC register May accommodate up to 38 persons aged 50 years and over May accommodate up to 5 Persons aged 18 years or over with Physical Disabilities Staffing Notice dated 30/08/2001 applies Date of last inspection Brief description of the care home Shockerwick House Nursing Home is registered for 38 residents requiring nursing and personal care. It is a Georgian stately home originally built in 1712, grade 2 listed and tastefully converted in the 1980s. It is set within 12 acres of landscaped gardens, with areas immediately adjacent to the house easily accessible to residents and staff. There are pathways around the home and two summerhouses where residents can sit. There is a large car park, with a small number of additional car parking spaces immediately Care Homes for Older People Page 4 of 30 Brief description of the care home in front of the home. The home can be accessed by car or bus. Transport is needed for access to local shops and other venues. 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: three star excellent 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 of this service was completed on 15/01/07. This was an unannounced visit to the home, to enable us to complete a Key Inspection of this service. The pre-inspection planning involved reviewing the report of the last Key Inspection carried out in January 2007, the Annual Service Review carried out in May 2008 and the report of the Random Inspection carried out in July 2008. We also looked at the service history, which details all other contact with the service. We (the CSCI) provided the home with their Annual Quality Assurance Assessment Care Homes for Older People Page 6 of 30 (known as an AQAA). This is a self-assessment, which focuses on how well outcomes are being met for the people who live at Shockerwick House. The home sent us their AQAA when we asked for it. It was clear and gave us all the information we asked for. We provided a number of surveys for residents, their relatives and staff members to enable us to carry out the last Annual Service Review. Sixteen surveys were completed and returned and the views of the people who wrote to us have also been included in this Key Inspection report. We gathered additional information during our visit through informal discussions with some of the people who live in the home, the Manager and staff members who were working in the home. We also observed lunch being served in both dining rooms, sat in on a do you remember when discussion which a number of residents attended and joined staff for the afternoon handover meeting. We looked at a selection of records in the home including: Care plans and associated records, Risk Assessments, complaints and compliments, medication administration, menu plans, staff recruitment, supervision and training records and health and safety records. We also viewed all communal areas of the home and some of the residents own rooms. What the care home does well: What has improved since the last inspection? The residents dignity is now better upheld as the taking of their photos is now sensitive about their clothing. (This was the only improvement we asked for following Care Homes for Older People Page 8 of 30 the last Key Inspection). However, a number of other improvements have been made by the home, described below, and these are commended. A resident library has been created on the first floor of the home. This is well stocked and available for each person who lives in the home to use. A new brochure has been produced and the Service Users guide has been re-written. The size of text on some written information has been increased as this may make it easier for some people to read. New care planning documentation is now being used, which promotes a person centred approach to each residents care and support. A new Nite Bite system has been introduced to ensure that hot and cold food and snacks are available to residents 24 hours a day. New staff have been recruited to cover vacancies within the staff team. This helps to ensure consistent care and support is provided to each person who lives in the home. What they could do better: 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. Prospective residents have the information they need to enable them to decide if they wish to move to Shockerwick House. Each person has their needs thoroughly assessed before they are given the opportunity to move to the home. Evidence: The homes Statement of Purpose and Service Users Guide contains comprehensive information about the services the home is able to offer, with the Service Users guide being recently re-written. We were provided with a copy of the homes new brochure which was printed in November 2008. This provides lots of information about the home and contains many photographs. The homes AQAA says that the size of written text has also been increased in some Care Homes for Older People Page 11 of 30 Evidence: written documents for prospective residents as this may make them easier for people to read. It is hoped that information about the home can also be produced in other formats, such as on tape or in braille, in the future. The care records for one resident who has recently moved into the home were examined. These show that there were comprehensive assessments carried out to determine whether the home could meet their needs. These include medical details, how they communicate, how to keep them safe, their hobbies and interests and family involvement. Any potential risks to this person were also identified. Other information was also present such as the Funding Authoritys care plan and other historical information which helped the home to ensure they have assessed all aspects of the care and support this individual requires. Some residents we spoke with said they have a copy of homes new brochure. When asked if it accurately described the services available they said yes. One person said I think this is a very nice home. Each resident who wrote to us said they did have enough information before they moved in to decide if it was the right place for them to live. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each individuals health care need are fully met and details of these needs are set out in an individual plan of care. Residents are protected by the homes medication policies and procedures. Each resident is treated with respect and their right to privacy promoted. They can be assured that at the time of their death, staff will treat them, and their relatives, with care, sensitivity and respect. Evidence: We examined four care plans during this visit. The care planning within the home has been developed and improved since the last Key inspection, with new, person centred, documents now being used. Personal plans contain clear guidance for staff in relation to the care and support each person needs with their health and personal care. Files contain health care risk Care Homes for Older People Page 13 of 30 Evidence: assessments such as assessments for the likelihood of a pressure sore developing, for the prevention of falls, how to move and transfer safely, nutritional assessments and the use of bed rails. Each is regularly updated and takes into account the daily records for each person, for example if an individual has a fall this information is used in the review process. Care plans are developed with residents, and their relatives, involvement where this is appropriate. Most personal plans are kept by the residents, in their own rooms and the contents shared with them. This is good practice. Each care plan is regularly reviewed. Residents and their relatives are encouraged and supported to take part in the review process. Each person who lives in the home has both a named nurse and keyworker who play a key role in ensuring each persons care and support needs are well met. Each resident who wrote to us said they receive the medical support they need: one person said I am very happy and comfortable. Each relative who wrote said the home meets residents needs and provides the care they expect. One said I like the way staff talk to my husband and treat him with respect. Each care pan is supplemented by the daily records for each resident. These are divided between the care and support provided by the homes staff and a separate record of other health care professionals, such as GPs, District Nurses and Chiropody. We observed staff interacting with and supporting residents at various times during our visit. Through these observations it is clear that each resident is treated with dignity and respect. Staff members were seen to address each person individually and knock on doors prior to entering rooms. One member of staff said we know this is the residents home and we come to work to support them. Residents sign to say if they are happy with their picture being taken. Some residents were also asked if they wished to be featured in the homes new brochure, to which some people happily agreed. All of the photographs of residents we saw are respectful of each persons appearance. The promotion of privacy and dignity has a very high profile in BUPAS customer service programme, known as personal best. Most of the homes staff team have completed this programme and this also enables residents to nominate staff if they feel they are performing particularly well in their role. The home has recently updated its medication administration policy in line with Care Homes for Older People Page 14 of 30 Evidence: guidance from professional bodies. They use a monitored dosage system of medication administration, with all medicines being administered by trained nurses. The medication records contain details of each resident, a recent photograph, details of their medication and times of administration. A thorough check is kept of all medicines kept in the home. All medicines are stored securely in one room of the home. A medicine fridge is available. Some medicines require additional secure storage and this is provided together with a register to record their use. The home uses a trolley when medicines are dispensed. This ensures that all medicines are dispensed and then given to the person immediately to reduce the risk of errors or people not taking their medicines at the right time. This trolley is stored securely when not in use. The home has a very clear policy and procedure for the care and comfort of the dying. The care plans we looked at contain clear guidance in this area, including residents personal preferences. Hospitality would be offered to relatives if need be where residents are being nursed in the terminal stages of illness. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents lifestyles match their expectations, and satisfy their social, cultural and recreational interests. Residents are supported to maintain personal relationships, exercise choice and control over their lives and are part of the local community. Healthy and appealing meals are provided within the home, served in pleasant very surroundings, at times convenient to residents. Evidence: Residents continue to have access to a wide range of activities and recreational pursuits, organised by staff and the activity co-ordinators. Time is spent with residents gathering information on their interests and suggestions for activities and events. Activities include visitors or entertainers coming into the home as well as organised trips to local places of interest. There are planned events each day which are prominently displayed in the home; the events described on this weeks calendar include sing-a-long, bingo, book club, do you remember when and a pianist coming in to entertain residents. We sat in on part Care Homes for Older People Page 16 of 30 Evidence: of the do you remember when discussion, which was attended by a number of residents. This session was relaxed, informal and appeared to be enjoyed by each person who attended. If residents do not wish to take part in the communal activities, this is respected. They are offered one to one sessions at different times during the day. This is good practice. A regular Church of England service and communion is held in the home. Staff provide support for residents who have other faiths or cultural beliefs. A resident library has been created on the first floor of the home. This is well stocked and available for each person who lives in the home to use, either individually or with the help of the activities co-ordinators. There are plans to improve the library further, by adding internet access. Each resident who wrote to us said there are activities planned which they can take part in. Each resident is supported to maintain contact with their families and friends. The life story section of care plans describes these relationships in more detail. Relatives who wrote to us said the home helped them to keep in touch and always kept them up to date about important issues. One said there is a lovely ambiance, activities are well run and the grounds are lovely. The home has a relaxed and open visiting policy. During our visit, there were a number of friends or family members visiting residents. They are welcome to dine with residents if they wish and meet with them in the privacy of peoples own rooms or in one of the homes lounges. It is clear that each person is supported to exercise choice and control over their lives. We observed interaction between staff and residents at various times during our visit. Staff informed the residents but allowed them to make decisions, with appropriate levels of support. Each member of staff allowed sufficient time to effectively communicate with each of the residents and never appeared to be hurried or rushed in any way. We observed lunch being served in both of the dining rooms. The meals looked very appealing and staff were seen to treat each resident with sensitivity and respect. There was a relaxed and unhurried atmosphere during lunch and each resident was offered appropriate support to enjoy their meal. Some residents choose to eat their meals in their own rooms and this is always respected. Care Homes for Older People Page 17 of 30 Evidence: There is always a choice of meals; residents generally decide on their meal choices one day in advance. The home has improved catering by introducing a new Nite Bite system to ensure that hot and cold food and snacks are available to residents 24 hours a day. The dining rooms are both very pleasant, well furnished and look out over the extensive grounds. 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. Residents, their relatives and friends can be confident that all complaints will be listened to, taken seriously and acted upon. Each individual is protected from abuse. Evidence: The home has a formal Complaints Policy, an Adult Protection Policy and a Whistle Blowing Policy, which staff can use in confidence to raise any issue or concern they have regarding the service. We looked at the complaints made to the home since the last Key Inspection. These records show that each has been investigated in accordance with the homes policy, within the specified time scale and a clear record kept. The outcome of the investigation is explained to the complainant. Each resident who wrote to us said they knew who to speak to if they are unhappy and how to make a complaint. Staff always listen to them and acted on what they say. Relatives who wrote said they are aware of how to make a complaint if they are unhappy with the service provided by the home and they felt the home always responds appropriately to any concerns. Care Homes for Older People Page 19 of 30 Evidence: The home now keeps records of compliments they receive. We did view several compliments from residents, their friends or family members about the high quality of care and support provided at Shockerwick House. Comments include: many thanks for all your kindness and care, it is a very special place and thank you for your care and kindness throughout the year. Staff remain clear on their responsibility in providing a safe home for residents to live in. They have been provided with training in the Protection of Vulnerable Adults, the Mental Capacity Act and are subject to an enhanced Criminal Record Bureau disclosure, before they start work in the home. Some residents can become anxious or present aggressive behaviour. Residents have strategies and risk assessments within their care plan which give clear guidance for staff to follow. Clear records are maintained of any accidents or incidents which occur in the home. We continue to be kept informed of significant events which occur. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a safe, comfortable, clean and extremely well-maintained environment. Residents rooms suit their needs and they are encouraged to personalise them as they wish to. Evidence: Shockerwick House is a Georgian stately home originally built in 1712. It is a grade 2 listed building which was tastefully converted in the 1980s. It is set within 12 acres of landscaped gardens, with areas immediately adjacent to the house easily accessible to residents and staff. There are pathways around the home and two summerhouses where residents can sit. There is a large car park, with a small number of additional car parking spaces immediately in front of the home. The home can be accessed by car or bus. Transport is needed for access to local shops and other venues. People enter the home through the large reception area. A member of staff is now on reception duties 7 days a week, to welcome visitors to the home. Care Homes for Older People Page 21 of 30 Evidence: There are three lounge areas, all decorated to a very high standard, with far reaching views of the grounds. The dining rooms are described earlier within this report. Due to the home being very large there are a number of peaceful places for residents to sit and relax. There are 28 single and six double bedrooms. Each bedroom room has a telephone point, remote controlled tv and 24 hour nurse call system. Each resident is encouraged to personalise their room with their own belongings, pictures, photographs and small items of furniture. Some also have their own computers and internet access is arranged if people wish. There is an appropriate choice and adequate provision of bathroom facilities. There is a hairdressing room, which is enjoyed by residents. A hairdresser regularly visits the home, but some residents continue to use a hairdresser of their choice. The home is arranged over three separate floors and there is a lift to enable people with mobility problems or those who use a wheelchair to access all parts of the home. Smoking is not permitted in any areas of the home. There is a designated smoking area outside, which is a safe distance from the home. The home is very clean, as noted on our previous visits. A specialist cleaning system and effective regime keeps the home clean and odour free. There are clear policies and procedures regarding infection control and handling clinical waste and staff are provided with appropriate training. 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. Residents are in safe hands and their support needs are well met by the numbers of well-trained and competent staff. The homes recruitment policy and practice supports and protects each person who lives in the home. Evidence: There is a clear staffing structure within the home, with each level of staffing having their own roles and responsibilities as part of the team. There are both Registered Nurses and care staff working in the home, who are supported by housekeeping staff, who were seen working in the home during our visit. Each staff members role is clearly defined and staff spoken with are keen to provide a caring and responsive service to each resident. We did visit the home in July 2008 as some surveys returned to us for the Annual Service Review identified possible shortages of staff. It was noted in the report of this visit that a number of staff who work at night had left the home and this had caused some staffing issues. We did note however that the home continues to offer a good quality of service to residents, despite the vacancies within the staff team at that time. Care Homes for Older People Page 23 of 30 Evidence: The home has worked hard to recruit new staff and has been very successful: new, experienced staff have joined the staff team. They have also carried out a study of response times to call bells to identify particularly busy periods, however this proved inconclusive. Staffing levels are kept under constant review to ensure residents care and support needs are well met. The organisation is currently piloting a staffing level tool, linked to the specific needs of residents. If this pilot proves successful or valuable, this tool will be used at Shockerwick House to help determine staffing levels. Residents spoken with and those who wrote to us said the staff are available when they need them. During our visit residents were well supported by staff. There was a very relaxed atmosphere in the home and at no time did staff appear to be rushed or unable to spend time with residents. One member of staff said this is a lovely place to work. Relatives who wrote to us said the staff team have the right skills and experience to support each individuals needs. We looked at personnel files of some staff who have recently started working in the home. These contained copies of their application forms, at least two satisfactory references, interview questions and answers, Criminal Record Bureau enhanced disclosures, documents confirming their identity, nursing status and eligibility to work in the UK. New staff are provided with a thorough induction to the home. Staff receive both mandatory and more specialist training to enable them to support residents including: infection control, diabetes, dementia awareness, wound care, catheterisation, medication, how to move and handle people safely, food hygiene, health and safety and the safe use of hazardous substances used in the home. Two staff recently attended training on cultural differences and relayed this session to other members of the team. Care Staff are encouraged to work towards a National Vocational Qualification (known as an NVQ). The homes AQAA confirms that nine staff have attained their award, with two members of staff currently working towards theirs. This represents 50 of the care team. BUPA care homes also have an Investors In People (IIP) accreditation. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a home which is very well run, in their best interests, and they benefit from the ethos and management approaches. The homes record keeping, policies and procedures safeguard residents rights and best interests. Staff are generally well supervised. The health, safety and welfare of residents and staff is promoted and protected. Evidence: The manager, Mrs.Holbutt, has worked at Shockerwick House for a number of years and has been the manager for four and a half. She is suitably qualified and has significant levels of experience, which enable her to lead the service and promote good Care Homes for Older People Page 25 of 30 Evidence: practice within the home. She attends training to ensure she remains up to date on new legislation, guidance and ways of working. Discussions with the Manager show they a have good rapport with residents, are knowledgeable about their care needs and ensure their views and interests are promoted. There is a commitment to develop and improve the service; many improvements have been made since the last Key Inspection, which have been described within this report, with further improvements planned. The home is run in the best interests of residents and their views are sought in a number of ways. Regular, informal meetings are held with residents and their relatives, there is a suggestions mailbox which people are free to use and more formal residents meetings are also held, the most recent taking place earlier this month. BUPA have comprehensive policies and procedures to support the home, which are designed to ensure it complies with the law and remains aware of good practice guidelines. Full details of each policy were provided by the Manager as part of the AQAA she completed for us as part of this Key Inspection process. The home conducts their own annual quality review, usually in November or December. Questionnaires are completed by residents, relatives and other people with an interest in the home. These cover all aspects of the service, with the results of these surveys collated and an action plan is devised where areas for improvement are identified. The home is well supported by the organisation who have a number of regional and national staff available for guidance or advice including: health and safety, finance and the recently developed team who review quality and compliance. The management systems and structures are very efficient. The record keeping is of an excellent standard. Files and documentation are well-organised and easy to access, with some records being improved since the last Key Inspection, such as the format of care plans. Staff are provided with formal supervision, which includes observation of their work practice. The records we looked at show that most staff are supervised at least six times per year. However, some members of the night staff team have not received this level of supervision, mainly due to vacancies in the night staff team earlier this year. Each time supervision is carried out, a clear record of the session is kept. There are recording systems in place to support Health and Safety within the home, Care Homes for Older People Page 26 of 30 Evidence: which are being used consistently. There are a number of general risk assessments in place to support safe working practices within the home. These are all reviewed regularly. We looked at the homes fire log, which contains the Fire Risk Assessment. Regular checks are made on the alarm system, fire fighting equipment, fire doors, evacuation aids and emergency lighting. There are also regular fire drills during the day and in the evening, the most recent taking place in September 2008. Care Homes for Older People Page 27 of 30 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 28 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 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 36 The home should consider increasing the frequency of supervision for members of the night staff team. This would improve the support they receive which enables them to continue to provide a high quality of care and support to residents. 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. 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). 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