Care Home: Southport Rest Home Ltd

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What the care home does well A statement of purpose is available to provide prospective residents with the information they need to make a choice if they wish to live in the home. All prospective residents are admitted following a pre assessment to determine if the home can meet their needs. A further assessment is completed with the involvement of the resident, during their one month trail period. Prospective residents are invited to visit prior to admission to view the home and meet the staff and other residents. Each resident has an individual care profile, which provides clear information on their personal details. This enables the staff to provide the care the residents need in a way in which they prefer. A dependency assessment is made on each residents` mobility, communication, hearing, sight and sleep patterns. This ensures that the staff are able to assist in the correct care needed to provide positive outcomes for the residents. Residents are able to make choices, which include if they wish to be checked by staff during night. If they wish to keep their valuables in the safe and if they wish to have a key to their door. During the visit the staff on duty were seen to treat the residents in a polite and dignified manner and a pleasant atmosphere was in place throughout the day.The staff were observed to be attentive to residents` needs at all times. There were sufficient staff on duty to ensure the residents are cared for and their needs are met. The residents have access to health care professionals, such as GP or district nurses when needed. Thus ensuring the residents are kept well. All medication is administered safely by staff who are trained. This ensures the safety of the residents. All residents seen during the day were clean and well presented in their appearance. The ladies all wore makeup and lipstick and took pride in their appearance. Residents wear their own clothes at all times and have a weekly hairdresser available to them in a hairdressing room. The laundry is very well organised. All meals provided are following the Kosher code to meet the Jewish religious needs of the residents. Four weekly menus are reviewed regularly to ensure the residents have a variety to meet their individual tastes and choices. Alternatives are provided daily and tea and coffee is served throughout the day. All Jewish festivals are celebrated and respite visitors are encouraged at this time if vacancies allow. An activity programme ensures the residents have stimulation and can join in activities of their choice. Relatives and friends are encouraged to visit and this was observed to take place thoughout the day. There is a complaints policy and procedure, which all residents and visitors have access to should they wish to complain. Training in abuse is provided to ensure staff are aware of what to do should this take place. This helps to protect the residents from harm. Sufficient communal areas are available for the residents to enable them to relax, meet their visitors and take part in activities of their choice. All private rooms are comfortable and contain personal items. An ongoing maintenance programme ensures that repairs are responded to. There are sufficient toilet and bathing facilities with equipment to aid mobility, thus providing a pleasant place for the residents to live. Fire alarm tests are conducted weekly and all electrics and emergency lighting checks are recorded. Certificates for services are up to date as recorded in the AQAA. Thus ensuring residents` safety. National Vocational Qualifications (NVQ) are encouraged to ensure staff are equipped with the skills to carry out their roles. What has improved since the last inspection? New service. Not assessed. What the care home could do better: The risk assessment for one resident identified at the visit should be brought up to date to identify the daily risks to the resident. Written entries on the medication administration record (MAR) charts should be countersigned to ensure the records are correct for the safety of the residents. Training records should be updated to clearly show the staff who have received training in abuse. Improvements are needed to replace cracked kitchen floor tiles. Window tiles are falling off and need replacing. An up to date Criminal record bureau check (CRB) must be obtained for all new staff prior to employment. Existing CRB`s are not transportable from their previous employer. A recommendation is made for more regular supervision to take place for staff to ensure they are monitored in their roles.It is recommended that the training plan matrix should include records of medication training that staff have received to demonstrate this is given. Additional training is recommended in areas such as diabetes and dementia care to enable the staff to be aware of the conditions of the people they care for. Key inspection report Care homes for older people Name: Address: Southport Rest Home Ltd 81 Albert Road Southport Merseyside PR9 9LN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Elaine Stoddart     Date: 3 0 0 6 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 32 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 32 Information about the care home Name of care home: Address: Southport Rest Home Ltd 81 Albert Road Southport Merseyside PR9 9LN 01704531975 01704546966 office@sjah.freeserve.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Southport Rest Home Ltd Name of registered manager (if applicable) Mrs Gillian Cliffe Type of registration: Number of places registered: care home 25 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category/ies of service only: Care home only - Code PC to people of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category- Code OP The maximum number of people who can be accommodated is: 25 Date of last inspection Brief description of the care home Southport Rest Home is a newly registered service, which was registered with the Commission in January 2009. The home was previously known as Southport and Jewish Care Home. The home is a Registered Charity and Mrs June Bennett is the Director/Trustee who has the support of an Executive Committee. The home is managed by Mrs Gill Cliffe who is qualified and experienced in the care of older people. The home provides personal care and support for up to 25 older people. Nursing care is provided by the local district nursing care services when needed. The home is Care Homes for Older People Page 4 of 32 Over 65 25 0 Brief description of the care home located in Southport and is close to the ammenities provided by the town. These include parks, shopping centre, promenade, theatres and pubs. The home caters for mainly elderly Jewish people over the age of 65. Non Jewish people are welcome to the home. The home has an in-house Synagogue used by the residents and available to the local community. All Jewish festivals are celebrated. Respite care is provided, when vacancies allow, for those people who wish to attend the Jewish festivals. There is a patio area and car park at the front. Parking and an additional garden area is available at the rear. Both are available for visitors and residents to use. There are sufficient communal areas for the residents and these include a conservatory, dining rooms and a lounge. The home has disabled access facilities, handrails throughout, passenger lift and equipment to assist those people with limited mobilty. A call system is available to allow residents to call for assistance when needed. The cost for the service ranges from 349.00 pounds to 459.00 pounds per week. Care Homes for Older People Page 5 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: A site visit took part as part of the inspection and this was conducted by one inspector over one day for approximately eight hours. Information for this inspection was gathered in a number of different ways. This included the unannounced site visit where time was spent reading service records, looking at areas of the building and speaking with residents, visitors, staff and management. All of the key standards and other standards were looked at. The manager and a number of staff were present for the inspection. Feedback was provided to the manager at the end of the visit. Case tracking was used as part of the site visit. This involves looking at the support residents receive from the manager and staff. This also includes looking at the residents care plans to obtain information on how their care needs, medication and finances are managed. Three residents were case tracked, however this was not carried out to the detriment of other residents who also took part in the inspection process. Care Homes for Older People Page 6 of 32 Time was spent meeting with residents, visitors, relatives and staff to gain their views on the overall service. Surveys were sent out to staff and residents to ask them for their comments. Comments from surveys received and people spoken with are contained within this report. An AQAA (annual quality assurance assessment) was completed by the manager in good detail prior to the visit. The AQAA comprises of two self-questionnaires that focus on the outcomes for people. The self-assessment provides information as to how the staff and manager are meeting the needs of the people who live there. The data set gives basic facts and figures about the service, including staffing numbers and training. Some information provided by the AQAA is included in this report. The people accommodated at the home wished to be called service users and this term is used in the report. Care Homes for Older People Page 7 of 32 What the care home does well: A statement of purpose is available to provide prospective residents with the information they need to make a choice if they wish to live in the home. All prospective residents are admitted following a pre assessment to determine if the home can meet their needs. A further assessment is completed with the involvement of the resident, during their one month trail period. Prospective residents are invited to visit prior to admission to view the home and meet the staff and other residents. Each resident has an individual care profile, which provides clear information on their personal details. This enables the staff to provide the care the residents need in a way in which they prefer. A dependency assessment is made on each residents mobility, communication, hearing, sight and sleep patterns. This ensures that the staff are able to assist in the correct care needed to provide positive outcomes for the residents. Residents are able to make choices, which include if they wish to be checked by staff during night. If they wish to keep their valuables in the safe and if they wish to have a key to their door. During the visit the staff on duty were seen to treat the residents in a polite and dignified manner and a pleasant atmosphere was in place throughout the day.The staff were observed to be attentive to residents needs at all times. There were sufficient staff on duty to ensure the residents are cared for and their needs are met. The residents have access to health care professionals, such as GP or district nurses when needed. Thus ensuring the residents are kept well. All medication is administered safely by staff who are trained. This ensures the safety of the residents. All residents seen during the day were clean and well presented in their appearance. The ladies all wore makeup and lipstick and took pride in their appearance. Residents wear their own clothes at all times and have a weekly hairdresser available to them in a hairdressing room. The laundry is very well organised. All meals provided are following the Kosher code to meet the Jewish religious needs of the residents. Four weekly menus are reviewed regularly to ensure the residents have a variety to meet their individual tastes and choices. Alternatives are provided daily and tea and coffee is served throughout the day. All Jewish festivals are celebrated and respite visitors are encouraged at this time if vacancies allow. An activity programme ensures the residents have stimulation and can join in activities of their choice. Relatives and friends are encouraged to visit and this was observed to take place Care Homes for Older People Page 8 of 32 thoughout the day. There is a complaints policy and procedure, which all residents and visitors have access to should they wish to complain. Training in abuse is provided to ensure staff are aware of what to do should this take place. This helps to protect the residents from harm. Sufficient communal areas are available for the residents to enable them to relax, meet their visitors and take part in activities of their choice. All private rooms are comfortable and contain personal items. An ongoing maintenance programme ensures that repairs are responded to. There are sufficient toilet and bathing facilities with equipment to aid mobility, thus providing a pleasant place for the residents to live. Fire alarm tests are conducted weekly and all electrics and emergency lighting checks are recorded. Certificates for services are up to date as recorded in the AQAA. Thus ensuring residents safety. National Vocational Qualifications (NVQ) are encouraged to ensure staff are equipped with the skills to carry out their roles. What has improved since the last inspection? What they could do better: The risk assessment for one resident identified at the visit should be brought up to date to identify the daily risks to the resident. Written entries on the medication administration record (MAR) charts should be countersigned to ensure the records are correct for the safety of the residents. Training records should be updated to clearly show the staff who have received training in abuse. Improvements are needed to replace cracked kitchen floor tiles. Window tiles are falling off and need replacing. An up to date Criminal record bureau check (CRB) must be obtained for all new staff prior to employment. Existing CRBs are not transportable from their previous employer. A recommendation is made for more regular supervision to take place for staff to ensure they are monitored in their roles. Care Homes for Older People Page 9 of 32 It is recommended that the training plan matrix should include records of medication training that staff have received to demonstrate this is given. Additional training is recommended in areas such as diabetes and dementia care to enable the staff to be aware of the conditions of the people they care for. 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 10 of 32 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 11 of 32 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. Assessments of need take place prior to admission to ensure the home can meet the needs of the people who live there. Evidence: Southport Rest Home was registered in January 2009. The home was previously called Southport and Jewish Care Home. The home is a Registered Charity and Mrs June Bennett is the Director/Trustee and is supported by the Executive Committee. The home provides personal care and support to 25 residents who are mainly of the Jewish faith. Non Jewish people are also welcome. The home provides respite care for residents who wish attend the religious festivals. Nursing care is not provided as visiting district nurses provide this service when required. The home is managed by Gill Cliffe, who is the Registered Manager approved by the Commission. The AQAA reported that prospective residents are invited to visit prior to admission to view the home and meet the staff and other residents. A statement of Care Homes for Older People Page 12 of 32 Evidence: purpose is available to provide prospective residents with the information they need to make a choice if they wish to live in the home. All prospective residents are admitted following a pre assessment to determine if the home can meet their needs. A further assessment is completed with the involvement of the resident, during their one month trial period. Three residents files were looked at to view their assessments in place. The Manager completes an admission check list to ensure all the residents details are obtained prior to admission. The assessments seen were found to be detailed and clearly outlined the assessed needs of the residents. These areas include information on personal care, medication, mobility, communication and health care. Each resident has an individual care profile, which provides clear information on their personal details. These include their place of birth, personal care needs, how they like to spend their time, past employment, hobbies and interests. This enables the staff to have the information available to them to provide the care required. A dependency assessment is made on each residents mobility, communication, hearing, sight and sleep patterns. This ensures that the staff are able to assist in the correct care needed to provide positive outcomes for the residents. Diet sheets for each resident are completed to show individual likes/dislikes, allergies and how they like food to be served. Residents are able to make choices, which include if they wish to be checked by staff during night. If they wish to keep their valuables in the safe and if they wish to have key to their door. Residents spoken with provided the following positive comments on the service they received. I am very happy here and the staff are marvellous. Everybody is lovely here, so very kind and caring. Its a lovely place to live. Comments from surveys received from residents include I am satisfied with the service Care Homes for Older People Page 13 of 32 Evidence: Very happy with the service.Everything is OK I am well cared for and dont have anything to worry about I am happy with everything Standard 6 was not assessed as this is not provided. Care Homes for Older People Page 14 of 32 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans clearly outline the care and support required to meet the residents needs. Residents are involved in developing their plans of care. Residents are treated with dignity and respect at all times. Evidence: The AQAA reported the residents are treated with dignity and respect at all times. Prospective residents are assessed prior to admission and this forms the basis of their plan of care. During the visit the staff on duty were seen to treat the residents in a polite and dignified manner and a pleasant atmosphere was in place throughout the day. The staff were observed to be attentive to residents needs at all times. There were sufficient staff on duty to ensure the residents are cared for and their needs are met. A selection of care files were viewed and identified all health and personal care needs. This ensures the staff have the information required to provide the care. The care plans contained detailed assessments and these provide the information to outline the plan of care needed. Staff maintain daily records to ensure information on residents Care Homes for Older People Page 15 of 32 Evidence: are up to date. Staff spoken with confirmed the information available is good and enables them to provide the care required. The care plans viewed were detailed, easy to read and outlined the needs and actions to be taken by staff to meet those needs. Staff spoken with confirmed their understanding of the residents care needs. The home has a key worker system (a key worker is a designated member of staff who works closely with the resident). Staff spoken with confirmed it is their role to keep the care plans up to date to ensure ongoing needs of the residents are met. Records showed that care plans are updated monthly or before if needs change. Daily records show the residents daily care given and record their well being or needs of that day. Care plans showed the residents dependency levels, risks, communication, health and medication needs. All residents sign their agreement to their care plan. Residents wishes are taken into account and residents sign to agree if they wish staff to monitor them during the night, if they wish to have a key to their room or they wish the manager to hold their finances. Care records showed information on how the residents wish to receive their personal care and support. This enables the residents to have a choice and provide positive outcomes for them. All personal care given in relation to bathing is recorded. Records seen and residents spoken with confirmed they can have a bath or shower whenever they wish too. Personal care is provided in a sensitive caring manner. One resident commented, The staff always treat me with dignity and are sensitive to my needs. The residents have access to health care professionals, such as GP or district nurses when needed. All care provided by health care professionals is recorded. Clear records show if residents require assistance to health care visits and staff are made available to provide this support. All care by visiting health care professionals are recorded and clear records show if residents require assistance to health care visits and staff are made available to provide this support. Hospital transfer forms are completed in detail should the resident be admitted to hospital. This ensures information is available to the health care staff to enable an easy transfer for the residents. All treatment by health care visitors is provided privately in residents own rooms and the visiting district nurse spoken with confirmed this. The visiting district nurse spoken with provided the following comments. Care Homes for Older People Page 16 of 32 Evidence: Lovely home. Lovely feeing about it when you come in. The staff are really caring and kind Risk assessments are in place to show those residents who maybe at risk of falls or need assistance with their mobility. These are reviewed monthly or before if needs change. It was brought to the attention of the manager that a risk assessment for one resident required updating as discussion with staff during the visit highlighted that the residents needs had changed. The manager agreed to update the information at the time of the visit. This ensures that clear and up to date information is available to staff on residents care needs. All medication is administered safely by staff who are trained. Risk assessments are recorded to ensure residents who wish to self medicated are safe to do so. Residents sign their consent for medication to be administered by the staff. Senior care staff administer medication and staff and records seen confirmed they are trained to administer safely. The senior on duty signs for medication store keys at each shift handover. This ensures a good audit trail for medication administered. Countersignatures for written entries on the medication administration record (MAR) was not obtained on all entries seen. A recommendation made in the report for this to be provided to ensure that records are correct. Staff confirmed that regular audits on medication practices are completed. This ensures the staff are competent in administering medication safely to the residents. We recommended that a record of the audit is completed to show staff competency in this and to highlight any training issues. All medication is securely stored in a medication trolley and staff were observed to transport this during medication administration and signed for all medication given. Medication policy and procedures are available to staff and are kept in the staff room for access. Information is available to all staff on drug side effects, which may affect the residents well being. All residents are of the Jewish faith and their death wishes are recorded and their Jewish rights respected to to ensure their death is treated with dignity. All residents seen during the day were clean and well presented in their appearance. The ladies all wore makeup and lipstick and took pride in their appearance. Residents wear their own clothes at all times and have a weekly hairdresser available to them in a hairdressing room. Care Homes for Older People Page 17 of 32 Evidence: The laundry is very well organised by the house keeper and the residents complemented the system and commented that no losses are made of clothing. Care Homes for Older People Page 18 of 32 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. Residents are provided with a wholesome, varied menu and can choose how to spend their day. Evidence: The AQAA reported that all meals provided are following the Kosher code to meet the Jewish religious needs of the residents. Four weekly menus are reviewed regularly to ensure the residents have a variety to meet their individual tastes and choices. Alternatives are provided daily and tea and coffee is served throughout the day. All Jewish festivals are celebrated and respite visitors are encouraged at this time if vacancies allow. A pleasant atmosphere was in place during the visit and residents were observed having their breakfast in comfortable, clean and pleasant surroundings. Breakfast included fresh fruit, cereal and toast. Residents are able to eat their meals in the two dining rooms or within the comfort of their own room. The main meal is served at lunch. There a two cooks who are assisted by kitchen assistants. Thus ensuring meals are delivered promptly and in an unhurried manner. The kitchen procedures follow the Kosher code. A diet plan is recorded for all residents Care Homes for Older People Page 19 of 32 Evidence: and any allergies and dietary needs are noted. Choices of likes and dislikes and how and where they wish their food to be delivered are recorded in their plan of care. Thus ensuring their meals are delivered as they like them and choices are catered for. Meals are served at set times, however the home is flexible to the residents needs and it was observed that several residents had their breakfast in their rooms as they wished to have a lie in, relax or watch TV. Visitors are encouraged to stay for meals if they wish. Visitors are able to meet with the residents in the privacy of their own rooms or within a number of the communal areas available. Food stores were viewed and were found to be well stocked with fresh vegetables and fruit. Residents opinions on the food are sought at residents meetings and questionnaires. Positive feedback was received from the residents spoken with on the food. Coffee, tea and biscuits were observed to be served throughout the day. An activity programme ensures the residents have stimulation and can join in activities of their choice. These include - quizzes, exercises, walks in the park, craft sessions and afternoon teas. The activities on the day of the visit included What the papers say. Recent activities included - a visit to a farm for afternoon tea, birthday celebrations, a violinist and a cheese and wine afternoon. Garden parties are held in the rear garden when the weather allows. A record is made of daily activities taken part in by the residents. The residents have the use of the homes in house Synagogue for their Jewish worship. This is also used by the Jewish community in Southport. Relatives and friends are encouraged to visit and this was observed to take place thoughout the day. Positive comments were received from visitors spoken with on the politeness and caring attitude of the staff. The home employs a receptionist five days a week who provides a friendly and welcome approach to visitors. Residents are encouraged to handle their own financial affairs where possible. If they wish the manager to assist in this there are policies and procedures in place to ensure the residents financial interests are protected. Care Homes for Older People Page 20 of 32 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 are confident their complaints will be listened to and acted upon. People are kept safe from harm. Evidence: The AQAA reported that there is a complaints policy and procedure, which all residents and visitors have access to this should they wish to complain. The AQAA reported that all complaints are taken seriously and listened to by the staff. The AQAA reported that no complaints or safeguarding referrals have been received to date. Residents spoken with confirmed if they had any complaints they would not hesitate to discuss them with the manager who they are confident will sort them out. Training records viewed showed that training in abuse is provided to ensure staff are aware of what to do should this take place. Training records should be updated to clearly show the staff who have received training in this and those yet to receive it. Thus safeguarding the residents. Two care staff have enhanced knowledge of safeguarding people as the have completed an advanced course in Vulnerable Adults. The home has policies and procedures in place for handling residents monies. Residents sign a consent form if they wish the manager to handle their monies. Personal allowances are recorded in individual record books for all monies held and all Care Homes for Older People Page 21 of 32 Evidence: transactions are signed for and receipts obtained. Only monies such as payments for hairdressing and newspapers are held by the manager. The home employs an administrative assistant to deal with residents fee payments and donations. Care Homes for Older People Page 22 of 32 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. Residents live in comfortable, clean and safe accommodation. Evidence: AQAA reported the home provides a clean, comfortable place for the residents to live. Sufficient communal areas are available for the residents to enable them to relax, meet their visitors and take part in activities of their choice. There is an indoor synagogue for Jewish worship. All private rooms are comfortable and contain personal items. An ongoing maintenance programme ensues that repairs are responded to by two maintenance persons. Outside contractors are employed for major works. A tour of all communal areas, kitchen, hairdressing room and some residents rooms took place. The home was found to be spotlessly clean, very comfortably furnished to a good standard. There are plenty of communal areas for the residents, which include a conservatory, dining rooms, front patio and a garden. Residents were observed to use all the communal areas to chat, watch TV or meet with visitors. Some residents spent time in their own room as it was their wish to. A selection of private rooms were viewed and were found to be clean and comfortable with personal possessions. Residents spoken with were happy with their rooms and commented on the cleanliness of the home. Regular room checks are conducted by the head of house to check the standard of the rooms and report any repairs or breakages. Care Homes for Older People Page 23 of 32 Evidence: There are sufficient toilet and bathing facilities with equipment to aid mobility. There is a luxury hairdressing/nail treatment with soft lighting where residents can go to sit and relax. A synagogue for Jewish worship is available and services are conducted daily to meet the needs of the residents. Handrails are in place throughout to aid residents mobility and a lift provides access to the upper floors. The laundry is very well organised and laundry and domestic staff employed to keep the home to a high standard of cleanliness. The domestic work and laundry is overseen by the house keeper. There is sufficient equipment in place to launder residents clothing. No losses have been reported and residents commented on the organised system in place. Sheets and bedding are in plentiful supply. All rooms have en suite with the exception of two rooms, which have a hand basin and a nearby toilet and bathroom. The kitchen is run in the Kosher code and is very well organised and clean. Improvements are needed to replace cracked kitchen floor tiles. Window tiles are falling off and need replacing. These are recommended within this report. Plenty of gloves and aprons and hand washing equipment is in place to avoid cross infection. All rooms have low heat surface radiators with temperature controlled valves. To ensure the safety and comfort of the residents. Water temp checks are recorded by the maintenance man to ensure water is delivered at a safe temperature. Fire alarm tests are conducted weekly and all electrics and emergency lighting checks are recorded. Certificates for services are up to date as recorded in the AQAA. Thus ensuring residents safety. CCTV is located on the exits and entrances for security purposes and does not intrude with the residents privacy. Care Homes for Older People Page 24 of 32 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. Staff are trained to carry out their roles safely. Recruitment practices must be more robust to protect the residents. Evidence: Sufficient staff were found to be on duty to meet residents needs. These included the manager, administrative person, receptionist, two domestics, maintenance person, laundry asistant, housekeeper, a senior carer , three carers, two cooks and two kitchen assistants. Night cover is provided by two waking nights carers. 21 residents were accommodated at the time of the visit. Staff were observed to very polite and caring. Staff responding to the residents needs and treated them with dignity and respect at all times, The morning period was very busy as staff assisted residents to get up and helped them with their personal care needs. A key worker system is in place and staff and residents are aware of who their key worker is. The key worker works closely with the resident and is responsible for up dating their plan of care. The receptionist provides a pleasant welcome to the home for visitors. The receptionist commented: This is a very nice home. The staff are very pleasant. I have only worked here since February 2009. Care Homes for Older People Page 25 of 32 Evidence: A number of staff were spoken with and their comments include I love it here. We all get on very well. Residents spoken with and surveys received provided positive feedback on the staff and the care provided. National Vocational Qualifications (NVQ) are encouraged to ensure staff are equipped with the skills to carry out their roles. The AQAA reported that of the 16 permanent care workers 11 have completed an induction training programme and 11 have NVQ Level 2 or above. The housekeeper has also competed NVQ Level 2. Staff spoken with confirmed that NVQ is encouraged and some staff are moving onto to do higher levels. The training plan includes all mandatory training such as moving and handling and food hygiene. The plan showed some training gaps for staff, which is in the process of being updated. It is recommended that the training plan be updated to show the recent training undertaken by staff. It is also recommended that the training matrix should include records of medication training that staff have received. Additional training is recommended in areas such as diabetes, dementia care to enable the staff to be aware of the conditions of the people they care for. Staff spoken with said, The training is good New staff complete an induction programme, Pathway to Care. The manager assesses their competence in the job over a period of time. The induction includes the manager going through a checklist on their introduction to the home and involves a video on Role of the care worker. A selection of staff files were viewed to ensure correct recruitment and selection process is in place. Those viewed showed that they are recruited following the receipt of two written references and a criminal record bureau check. One staff file viewed showed that a CRB had been obtained for a staff member, which was in date at the time of her appointment and had been obtained by her previous employer. The manager was informed that CRBs are not transportable and a new CRB must be made for the member of staff under the organisations name. Thus ensuring the people they care for are protected from harm by up to date information. This was agreed and actioned by the manager at the time of the visit. Other staff records viewed confirmed up to date CRBs are in place for staff. Care Homes for Older People Page 26 of 32 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 well run by an experienced, qualified manager. Evidence: The home is registered as a limited company. It is a charity organisation. The manager Gill Cliffe is registered with the Commission, is qualified in NVQ Level 4 and has years of experience of working with older people. The responsible individual monitors progress monthly and provides reports to show this. There is an office manager who assists the manager with all administrative functions, such as residents finances and wages. The AQAA reported that all certificates for services are up to date to ensure the people live in a safe place. All accidents and injuries are recorded to monitor residents care needs. Regular fire, water temperatures and emergency lighting checks take place to keep residents safe. All staff are trained to care for the residents in a safe manner through an ongoing Care Homes for Older People Page 27 of 32 Evidence: training plan. There was a very relaxed, pleasant atmosphere present. Staff and residents were seen to communicate well to discuss daily affairs. Regular surveys take place to ask residents for their views on the home. As well as surveys sent out by the provider many thank you letters were seen to provide positive comments on the home. Both staff and residents meetings are held to obtain their views. Some staff and the manager were spoken with and records were seen to show supervision takes place. To enable staff to obtain support and direction in their roles. The manager agreed that supervision should take place more often to monitor staff progress. A recommendation is made for more regular supervision to take place for staff. Residents monies are recorded by the manager who deals only with personal allowances to pay hairdresser and newspapers. All accounts for fees are dealt with by the administrative officer. Receipts are obtained for all transactions made and records kept. Regular fire checks are conducted by the maintenance and regular fire drills are undertaken. This ensures the safety of the residents and staff. All policies for safe working practices are up to date as from and are reviewed annually by the manager to ensure staff have up to date information on safe working practices. Care Homes for Older People Page 28 of 32 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 29 of 32 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 29 19 An up to date criminal record bureau (CRB) check must be obtained by the manager for all new staff prior to employment. Existing CRBs are not transportable. To ensure recruitment is robust to protect the people they care for. 31/07/2009 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 7 The risk assessment for one resident identified at the visit should be brought up to date to identify the daily risks to the resident. Written entries on MAR charts should be countersigned to ensure the records are correct for the safety of the residents. Training records should be updated to clearly show the staff who have received training in abuse. Improvements are needed to replace cracked kitchen floor Page 30 of 32 2 9 3 4 18 19 Care Homes for Older People Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations tiles. Window tiles are falling off and need replacing. 5 30 It is recommended that the training plan matrix should include records of medication training that staff have received to demonstrate this is given. Additional training is recommended in areas such as diabetes, dementia care to enable the staff to be aware of the conditions of the people they care for. A recommendation is made for more regular supervision to take place for staff. 6 36 Care Homes for Older People Page 31 of 32 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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