Care Home: Sidegate Lane Nursing Home

What the care home does well What has improved since the last inspection? Since the last inspection we received an improvement plan that set out how the home was to address the requirements we had set. We have seen progress made in relation to medication training of staff and using the appropriate coding when recording medication usage. This ensured further the protection of residents who relied on staff for their medication. Residents were involved in the reviewing of their care and were treated with respect and dignity. We observed good practice and people told us they were respected. People had recently had an opportunity to input changes to the menus and residents told us they were very satisfied with the food at the home. Completed staff training records and attendance at several courses recently ensured that the residents were in safe hands. Residents safety was further enhanced as the fire systems were regularly maintained, portable electrical appliances were tested and chemicals were securely locked away. CARE HOMES FOR OLDER PEOPLE Sidegate Lane Nursing Home 248 Sidegate Lane Ipswich Suffolk IP4 3DH Lead Inspector Claire Hutton Unannounced Inspection 12th August 2008 10:30 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 Sidegate Lane Nursing Home DS0000024487.V370257.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. Sidegate Lane Nursing Home DS0000024487.V370257.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sidegate Lane Nursing Home Address 248 Sidegate Lane Ipswich Suffolk IP4 3DH 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) 01473 274141 01473 715245 michelle.webster@orbit.org.uk Orbit Housing Association Mrs Michelle Webster Care Home 24 Category(ies) of Dementia (24), Mental disorder, excluding registration, with number learning disability or dementia (24) of places Sidegate Lane Nursing Home DS0000024487.V370257.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th August 2007 Brief Description of the Service: 248 Sidegate Lane is a purpose built care home, providing accommodation and nursing care for up to 24 people over the age of 55 with dementia or mental health needs. The home is owned by the Orbit Housing Association and is situated in a residential area of Ipswich, close to local amenities and a short bus or car journey from Ipswich town centre. Orbit Housing Association is a non-profit making organisation run by voluntary committees and provides a cross section of housing throughout the country. The home is operated in conjunction with Social Care Services and as such admission can only be accessed via this agency. Accommodation is divided into three living units, two on the ground floor and one on the first. These are separated into zones. Each zone has eight bedrooms and its own open plan dining and kitchen area and communal bathrooms. All bedrooms are for single occupancy and have the benefit of ensuite shower and toilet facilities. Access between floors is via a passenger lift. A statement of purpose and a service user guide provides detailed information about the home, the services provided and access to local services. This is available at the home. Information obtained from the statement of purpose/service user guide reflects that the range of fees charged by the home is £791.65 to £855.00 per week. These charges cover all care, accommodation, heat, lighting, meals, and laundry and continence products. They do not cover additional services such as the dentist, optician, hairdresser, personal items such as toiletries, clothing, or daily newspapers. Sidegate Lane Nursing Home DS0000024487.V370257.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 quality outcomes. This was a key inspection, which focused on the core standards relating to care homes for older people. The inspection was unannounced on a weekday, which lasted eight hours. This report has been written using accumulated evidence gathered before and during the inspection, including information obtained from 1 relative, and 2 staff ‘Have Your Say’ surveys. The Annual Quality Assurance Assessment (AQAA), issued by the Commission for Social Care Inspection (CSCI) was returned completed by the new manager. This self-assessment gives providers the opportunity to inform the CSCI about their service and how well they are performing. We (CSCI) also assessed the outcomes for the people living at the home against the Key Lines of Regulatory Assessment (KLORA). A tour of the premises was made and a number of records were inspected, relating to people using the service, staff, training, the duty roster, medication and health and safety. Time was spent talking with people who live in the home and 4 members of staff. The manager of the home was available during this inspection and fully contributed to the inspection process. What the service does well: People thinking of using Sidegate Lane Nursing Home can expect to have their needs assessed before they move in and be given a chance to visit. This home tended to take people who had previously not settled or had their needs met in other care homes. The home was very proud that they have never terminated a residents contract due to the fact that their needs cannot be appropriately met. People who use this service were treated with respect and their privacy was upheld. Systems in place around medication were generally safe and staff had a sensitive approach. Carers were very attentive and responded to residents needs immediately in a calm and respectful manner. One resident said ‘The staff are lovely. We’ve just had another cook and they are pretty good’. Sidegate Lane was well designed for smaller group living and had good accessibility throughout for disabled people. Sidegate Lane Nursing Home DS0000024487.V370257.R01.S.doc Version 5.2 Page 6 The facilities on offer (hoists, assisted bathing, shaft lift, wide door ways, safe accessible garden, all en-suite bedrooms) enable older people to be cared for in an appropriate environment that does not disable them further. Residents told us the home was always fresh and clean. We visited most areas of the home and found everywhere to be very clean and fresh. Residents health and care needs were met by the staffing levels at this home. Residents were in safe hands because staff were trained to do their job. A new staff member said ‘I’m doing my formal induction now – I have it with me. I will then do my NVQ’. One relative said ‘the staff are very friendly. The music days are a great hit with my relative’. We also observed staff caring for residents and found they took time with each individual as they needed and every resident was well presented and appeared comfortable, with any request quickly responded to. What has improved since the last inspection? What they could do better: The Statement of Purpose and Service Users Guide had incorrect information and needs updating to reflect the actual situation to avoid confusion and misunderstandings. We found that there were 3 occasions when the medication administration record had not been signed by staff that had administered medication. Records around medication administration must be accurate and in line with the prescription. This will ensure the protection of the resident and staff. This was a repeat requirement. Sidegate Lane Nursing Home DS0000024487.V370257.R01.S.doc Version 5.2 Page 7 The home did have some measures in place to monitor quality of the service but quality assurance systems must take into account the views of family, friends and other professionals associated with the home. This will confirm how the home is meeting the aims and objectives set out in the statement of purpose. This was a repeat requirement. 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. Sidegate Lane Nursing Home DS0000024487.V370257.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 Sidegate Lane Nursing Home DS0000024487.V370257.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can expect to have their needs assessed before they move in and be given a chance to visit. However information about this service may not be current and could be misleading. EVIDENCE: We were provided with a copy of the Statement of Purpose and Service Users Guide. This contained a lot of information about how to access the home, fees and the type of care provided. The manager explained that this document was in the process of being updated. The document does contain out of date information and could be misleading, but also a lot of information that may not be readily needed or indeed accessible to people of all abilities. The self-assessment told us: ‘All residents receive a comprehensive needs assessment prior to admission, which includes social services assessments, nursing assessments or written reports available. The applicant would be Sidegate Lane Nursing Home DS0000024487.V370257.R01.S.doc Version 5.2 Page 10 visited in their current accommodation and interviewed along with their family or carers as appropriate. Once admitted the resident is allocated a named nurse and key worker. We would encourage full participation in writing their care plan. After 6 weeks we meet with the resident, family and social worker to ensure everyone is happy with the placement. At this point a contract of care would be signed’. We looked at the records relating to 3 people at the home and found that an assessment had been completed before an individual moved in. In one case information was gathered from hospital. We saw copies of completed assessments that were very detailed. This had followed the process described by the home and the 6 week review had taken place. One relative told us that the home had given them enough information about the home. The home was very proud that they have never terminated a residents contract due to the fact that their needs cannot be appropriately met. Sidegate Lane Nursing Home DS0000024487.V370257.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service were treated with respect and their privacy was upheld. Plans of care were informative and up to date. Therefore consistently good care was assured to everyone. Systems in place around medication were generally good and staff had a sensitive approach, but better records would minimise risk. EVIDENCE: The self-assessment told us: ‘The quality of our personal and health care support is high. We offer individualised care packages that are agreed with service users and their relatives as appropriate. Staff also review these care plans regularly and are quick to notice were changes in individual needs require review of care provided. We work closely with a multidisciplinary team which includes GP’s, psychology, speech and language therapy and hospice at home’. Majority of our time was spent in the various units within the home observing Sidegate Lane Nursing Home DS0000024487.V370257.R01.S.doc Version 5.2 Page 12 care and support given. We observed some very good care practice. Carers were very attentive and responded to residents needs immediately in a calm and respectful manner. Personal care was carried out in the privacy of bedrooms. We spoke to 3 staff about how they promoted privacy and dignity. All gave slightly different answers, but all were quite clear about ensuring that when giving personal care this would be done in private and that they would ensure that an individuals independence was maintained along with giving them choices at every stage. We saw good manual handling practices with good use of equipment. When a staff member noticed a resident was distressed they immediately responded to them. We looked at 3 care plans and spoke with 2 residents and 3 staff. In talking to residents they all said they were well looked after by very good staff. One resident said ‘the staff are lovely. I like to dance on occasion and have with one of the girls’. There was relaxed conversation between residents and staff that was full of smiles and occasional laughter. Care plans were informative. One plan contained a specific plan around behaviour and how staff could best support the individual. Staff spoken with had a good understanding of this plan and were confident that they had the knowledge to support the individual well. One staff member said ‘the care plans contain a lot of detailed information. The 24hour support plan is very good guidance for staff’. The daily notes made by staff were consistently good quality of the support and care given. One resident said ‘I like to go to bed early and to make notes on things I want to remember – and I’m able to do that ’. We saw that there was regular review of care plans. A new style had been introduced and staff said they preferred this new model. Care plans also contained other specific plans that promoted good health such as pressure prevention (the home had more that 50 of specialist beds in place) nutrition assessments that included recording of weight and oral heath. Care plans did detail any medical intervention such as visits by GP, district nurses and specialist services from health. We saw the pharmacist delivering medication on the day we were there. In relation to medication management within the home practices observed were generally good for most residents. Medication storage was good and was kept secure. There was also a medication fridge with temperature record. The system in operation was a monitored dosage system. The ordering systems in place ensured that the home did not run out of medication. Checking in of medication was completed by 2 people this ensured its safekeeping. Medication records were generally completed and showed that residents Sidegate Lane Nursing Home DS0000024487.V370257.R01.S.doc Version 5.2 Page 13 received medication prescribed for them. However we did find that there were 3 occasions when the medication administration record had not been signed by staff that had administered medication. Where residents were on medication that controlled behaviours we would expect there to be written guidance from doctors as to how much and in what circumstances medication was to be given. This had recently changed for one resident as the GP and home was trying to reduce the medication a resident was taking. Nursing staff spoken with had a good sensitive approach to this, but the prescription and records were not up to date to support this new medication regime. This was needed to protect the resident and staff. We audited one residents controlled drugs and found that the records matched the medication stored. Storage of these controlled drugs was appropriate. On the records for controlled drugs, which were on the whole well kept, there was one occasion when a second person had not signed. Sidegate Lane Nursing Home DS0000024487.V370257.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service can expect to have many of their expectations and preferences met however cannot be assured that their social needs will be fully catered for. People can expect to receive a good range of food as part of a balanced and varied diet. EVIDENCE: Each of the units within Sidegate Lane had their own lounge, dinner/kitchen area. This was the focus of the social gathering area, but there are smaller areas for seating that individual people can and did go to if they chose to be on their own or see their visitors in private. There was a larger lounge area near the entrance and a smaller craft room. This was full of craft work that had been produced by the residents. One person was seen walking in the garden. This was a safe and secure area and staff were aware of where the resident was. Another resident was returning from a trip to town having made purchases for a Pimms event that the residents had planned later in the week. Sidegate Lane Nursing Home DS0000024487.V370257.R01.S.doc Version 5.2 Page 15 The previous week they had had a strawberries and cream tea. Each area had a television and a selection of books and activities such as board games. One resident spoken with said ‘I do not think there are enough activities. We used to go out more in a coach’. A staff member wrote that it would be good to have a minibus so that they could get the residents out more and not just rely on taxis. Other staff felt ‘we try to give them activities as much as possible and we have communion once a month for those who wish to attend’. A relative told us ‘I feel a few more trips out would be of benefit. Music days are a hit with my relative’. The home does not employ a specific person to develop and deliver activities within the home. This was discussed with the manager who said she had been considering this and agreed to look into it. This would go a long way to changing the experience that some people appear to have in relation to activities and daytime occupation. The self-assessment told us ‘We offer activities on several levels e.g. group activities, 1:1 activities, snozelen activity, group games etc. We try to keep ‘homely’ activities going which promotes independence’. We observed a resident request a hot drink and the carer was immediately able to fulfil the request. Lunchtime was observed within a unit at Sidegate Lane. The food was delivered to each unit in a hot trolley and there was a choice of main meal available. Feedback from residents spoken with was very positive about the choices of food available and the quality of food on offer. One resident spoken with and they said ‘We’ve just had another cook – he’s pretty good. Today we had beef stew and you can have extras of whatever you like. It would be good to have the menu displayed’. The self-assessment told us ‘We offer nutritious home cooked meals to our residents with a full range of fruit and snacks available around the clock.’ A relatives told us that they can visit any time and that the care home always helps their relative keep in touch. The home has developed links with the local school and children visit the home. Here were photographs on the wall of a harvest festival. The children from the local school have been involved in a competition to choose a new name for the home. Sidegate Lane Nursing Home DS0000024487.V370257.R01.S.doc Version 5.2 Page 16 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service can be confident that their complaints are taken seriously and acted upon. Residents are protected from abuse. EVIDENCE: Residents at Sidegate Lane say they have access to people who will listen to them if they have any concerns. A resident told us ‘If I had any concerns I’d talk them over with the manager – she has resolved matters for me in the past’. A relative told us that they were of how to complain if they needed to and ‘I would write to the manager initially’. Surveys from staff say they would know what to do if anyone had a concern about the home. Staff spoken with said they would encourage residents to speak up for themselves but if they couldn’t then they would ‘be the eyes and ears and speak up for the residents’. We saw the complaints procedures displayed at the home and given to people in the Service Users Guide. The home had a log of all concerns and complaints made. This showed that concerns were recorded and dealt with. There had been a complaint received and logged since our last inspection to the home. This had been looked at by the home and responded to. Sidegate Lane Nursing Home DS0000024487.V370257.R01.S.doc Version 5.2 Page 17 The individual was not satisfied and chose to raise the matter with us and with social services. Both organisations looked into the matter and responded to the individual. In relation to being protected from abuse we found that all staff records showed that staff are recruited appropriately and that the Protection of Vulnerable Adults national listing was checked along with a criminal records bureau check before staff started work at the home. The home had the local procedure on safeguarding adults from abuse and were aware of the local website where up to date information was available. The home had not needed to use the procedure or referral system since our last visit to the home, but was aware of what to do if and when needed. Staff spoken with were aware of reporting any signs of abuse, and were clear about what whistle blowing meant in this context. All 3 staff spoken with said they had received training in abuse awareness. The self-assessment also told us that ‘senior staff have attended Mental Capacity Act training and Deprivation of Liberty Safeguard Training’. Sidegate Lane Nursing Home DS0000024487.V370257.R01.S.doc Version 5.2 Page 18 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can be assured that Sidegate Lane was comfortable, safe, well designed to meet needs and very clean. EVIDENCE: Sidegate Lane had a foyer with comfortable seating and relevant information greeted people on entering the home. Sidegate Lane was well designed for smaller group living and had good accessibility throughout for disabled people. Sidegate Lane was a purpose built home, which spanned two floors. Accommodation was divided into three living units, two on the ground floor and one on the first. These were separated into zones. Each zone had eight bedrooms and its own open plan dining and kitchen area and communal bathrooms. All bedrooms were for single occupancy and had the benefit of ensuite facilities, incorporating a toilet and wash hand basin. Access between floors was via a passenger lift. Additional communal areas included a large reception area, lounge and a conservatory. Sidegate Lane Nursing Home DS0000024487.V370257.R01.S.doc Version 5.2 Page 19 There were plans to upgrade the environment and have a re-launch of the home to boost moral. A new name has been chosen and each of the zones will have a name. The idea comes at the end of a period of time when the ownership of the home was uncertain. The home was surrounded by beautifully landscaped and enclosed gardens with a range of shrubs, trees, flowers and vegetables. An individual with a keen interest in gardening had an area of the garden that they had helped to plant and maintain. The home was nicely decorated, warm and comfortable offering a good standard of accommodation. Evidence was seen that people are provided with aids and equipment for the prevention of pressure areas, where required. All corridors, bathrooms and toilets were provided with grab rails for people’s safety and to promote independence. A selection of people’s rooms seen, were nicely decorated with personal items, including small items of their own furniture, photographs, ornaments and paintings. Many of the rooms were equipped with people’s own televisions and music centres. All bedrooms were fitted with a call bell, door lock and lockable cabinet for personal items, on request. The laundry facilities seen were clean and tidy with appropriate equipment to launder clothing and bedding. The washing machine had a sluice facility for dealing with soiled linen. Appropriate hand-washing facilities of liquid soap and paper towels were situated in all bathrooms and toilets where staff may be required to provide assistance with personal care. Random testing of water temperatures reflected that the water supply was within the recommended 43 degrees centigrade, which minimises the risk of people living in the home scalding themselves when taking a bath or shower. Residents told us the home was always fresh and clean. We visited most areas of the home and found everywhere to be very clean and fresh. Sidegate Lane Nursing Home DS0000024487.V370257.R01.S.doc Version 5.2 Page 20 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can be assured that staffing levels met residents health and care needs and that staff were trained to do their job. Residents were protected by the homes recruitment practices. EVIDENCE: The staffing levels at this home were examined and discussed with the manager. The home had a nurse on duty at all times. There were 2 staff per unit at all times of the day and additional laundry, kitchen, administration and management staff to support them. At night there was waking night staff and a nurse on duty. Feedback from residents and staff about staffing levels were positive about meeting the care needs. One resident said ‘All the staff are lovely, and yes there are enough of them’. A relative said ‘the staff are very friendly’. We also observed staff caring for residents and found they took time with each individual as they needed and every resident was well presented and appeared comfortable, with any request quickly responded to. We saw a committed team of staff meeting peoples needs. They were able to give in-depth accounts of the health and personal care needs of people and new exactly how to look after them. Sidegate Lane Nursing Home DS0000024487.V370257.R01.S.doc Version 5.2 Page 21 Staff were very positive about the team approach they have especially strong between nurses and carers as the nurses were keen to share their knowledge. The self-assessment told us ‘We have a well trained stable staff team, who despite the uncertainty of the past three years have maintained a commitment to the high quality service that our residents and their relatives have come to expect’. In speaking with staff they told us they were well trained in manual handling, medication, 1st aid, dementia, infection control and food hygiene. Staff surveys told us that the induction they were given covered everything they needed to know to do the job. One staff member said ‘I’m doing my formal induction now – I have it with me. I will then do my NVQ’. The same staff said they were given training that is relevant to the job, that helps them understand individual needs and diversity issues and that they were kept up to date with new ways of working. When observing staff we saw they completed tasks such as personal care, manual handling and drug administration in line with current training. Recent training completed by staff at the home had included dealing with challenging behaviour, a lecture on osteoporosis, nutrition and the Liverpool pathway (this was around death and dying with dignity) and syringe driver updates for nurses. The self-assessment told us that 62 of the carers have achieved their NVQ 2 in care. We also looked at the recruitment records for 3 relatively new staff. These were satisfactory and had information such as a full application form with job history, proof of identity, the national register for the protection of vulnerable adults and a criminal records bureau check (CRB) was checked before potential staff started work at the home. Two references were available for inspection. From the surveys completed by staff all said ‘yes’ the employer did carry out checks such as a CRB and references before they started work. Sidegate Lane Nursing Home DS0000024487.V370257.R01.S.doc Version 5.2 Page 22 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can be assured that residents health, safety and welfare was safeguarded by the home’s processes and assured that the owners have been undertaking the necessary monitoring and evaluation of the service. EVIDENCE: The manager was appropriately trained and has had 4 years experience as the manager of this care home. The manager was helpful and knowledgeable throughout the inspection process. A Senior Manager within Orbit who now has direct responsibility for this and a second nursing home owned by Orbit joined us at the end of the inspection for feedback. It was clarified that this home was not to be sold, but will remain within Orbit for the time being. Staff and relatives said that the manager ensured that the home ran smoothly and that she was approachable. One staff member said ‘The manager is very Sidegate Lane Nursing Home DS0000024487.V370257.R01.S.doc Version 5.2 Page 23 supportive and I speak to her and matters are dealt with’. Three staff members confirmed they received regular formal supervision. One said they didn’t receive this, but another said they were confident that regular supervision was set to improve. Staff said they had regular staff meetings and that a recent meeting had been very productive and decisions made. In relation to health and safety the self-assessment told us, ‘we utilise risk assessment and risk management systems to enable and facilitate our residents living as independent lives as possible’. We sampled servicing records of equipment and found these up to date. We looked at all fire records and found that records relating to fire extinguishers, door closures and fire testing were up to date and recorded appropriately. Chemicals were safely stored. Portable appliance testing was up to date. We sampled hot water in baths and showers and found these to be within safe limits. In relation to quality assurance and seeking the residents views the home holds regular residents meetings. Decisions that were made by residents included new suggestions for a recent menu change and selecting artwork for display around the home. The owners of the service had been monitoring and evaluating the service in the form of regulation 26 visits. The new Senior Manager mentioned above will take on this responsibility from now on. In addition we discussed other quality assurance systems that should be in place. This was a requirement from the last inspection and the manager and Senior Manager were keen to develop this. The AQAA (annual quality assurance assessment) the self-assessment we have commented upon through out this document was completed by the manager and the information gave a reasonable picture of the current situation within the service. Whilst we were at the home a chiropodist was visiting and treating several residents feet. We observed the chiropodist being paid from individual residents money. The process in place ensured sound procedures with an audit trail and safe storage. Sidegate Lane Nursing Home DS0000024487.V370257.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 2 2 2 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 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X 3 3 X 3 Sidegate Lane Nursing Home DS0000024487.V370257.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes 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 OP1 Regulation 4,5 and 6 Requirement The Statement of Purpose and Service Users Guide must provide up to date correct information. This will avoid confusion and misunderstandings. Records around medication administration must be accurate and in line with the prescription. This will ensure the protection of the resident and staff. This is a repeat requirement. The quality assurance systems must take into account the views of family, friends and other professionals associated with the home. This will confirm how the home is meeting the aims and objectives set out in the statement of purpose. This is a repeat requirement. Timescale for action 13/10/08 2. OP9 13 (2) 13/10/08 3. OP33 24 13/10/08 Sidegate Lane Nursing Home DS0000024487.V370257.R01.S.doc Version 5.2 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Sidegate Lane Nursing Home DS0000024487.V370257.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Sidegate Lane Nursing Home DS0000024487.V370257.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!