Care Home: St Anne`s Nursing Home

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What the care home does well People who live in the care home continue to say that they are satisfied with the quality of the service they receive. The staff at St Anne`s offer a welcoming atmosphere and the environment is homely and pleasant. Some of the comments we received during the inspection were as follows: "The staff are always attentive." "They know how I like things done". "My mother is always treated with respect". "They are always checking out if I am getting what I want." "The meals are fine". "I can choose what meals I want on the day. Sometimes O don`t fancy any of the choices available so I can pick something else to eat." "The food is excellent." "My room is pleasant and always kept clean." The staff team have shown a commitment to making improvements in the service and continue to have an enthusiastic approach to training. The home has achieved "The Dignity Challenge". In order to achieve this, the staff team had to evidence that it has a zero tolerance to all forms of abuse and to ensure that people feel able to complain without fear of retribution. What has improved since the last inspection? Prior to this visit, the information about the home, told us that the quality of the service provided was adequate. This visit has clearly identified that the home is being managed more effectively and where the best interests of the people living there were at the heart of the service. A new manager is in post and is in the process of consolidating the work already done previously by the interim manager and the deputy. The new manager will be applying for registration. The staff team are piloting a new service user plan system and are able to give sound feedback about its` effectiveness and where amendments are necessary. There is a more consistent to looking after people and taking account of their individuality. Dignity, respect and personal choice are given a much higher priority than previously. Nursing staff are more confident about being responsive to the changing health care needs of the people who live in the home. There is a good rapport between the home and other health care professionals, which means staff have access to specialist knowledge. There is ongoing development and training for both nursing staff and care workers. The methods for preventing cross infection have improved and safe practices are more likely to be in place. Improvements have been made to the building in that the unit kitchens have been upgraded and 15 bedrooms have been decorated. The decoration will be ongoing so that all bedrooms will be fresh, clean and tidy. There is a greater commitment to seeking the views of people who live at the home and making improvements based on this. What the care home could do better: Where we found areas for improvement, plans are already in place to address the issues. We have not made any recommendations but have set a recommendation regarding the programme of social activities. Currently the main activities still remain as group activities and most of those we spoke to said that they enjoyed taking part. It is important that the activities organiserand the care staff share information about what people used to do and a programme can be built around this. There needs to be a number of different things going on such as painting, drawing, rummage boxes, knitting, sewing, newspapers depending on and relating to individual choices. CARE HOMES FOR OLDER PEOPLE St Anne`s Nursing Home 60 Durham Road London N7 7DL Lead Inspector Pippa Canter Unannounced Inspection 17th April 2008 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address St Anne`s Nursing Home DS0000010329.V362059.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. St Anne`s Nursing Home DS0000010329.V362059.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Anne`s Nursing Home Address 60 Durham Road London N7 7DL 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) 020 7272 4141 020 7263 0952 nelia.nabeebaccus@anchor.org.uk Anchor.org.uk Anchor Trust Fiona Ndanga is in post Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (50) of places St Anne`s Nursing Home DS0000010329.V362059.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. For the Provision of General Nursing care for up to 40 Frail Elderly People aged 60 years and over. The Staffing Notice For the provision of personal care for up to 20 frail elderly people Date of last inspection 30th November 2007 Brief Description of the Service: St Anne’s is a residential care home with nursing. The home provides longterm care for up to 50 frail people over the age of 60. There are currently 37 places for people who require nursing care and 13 for people who require personal care only. The residential beds include two for respite care. The home can use up to ten beds flexibly for either personal or nursing care and still operate within their registered categories. This is particularly useful as it means that people in the residential beds can stay at the home when their needs increase. The home is situated in Islington and is accessible by both bus and tube networks. The home was purpose built in 1997 and is accessible to wheelchair users. The property is over three floors, with service user accommodation being on the first and second floor. All bedrooms are en-suite and meet statutory requirements for space and size. Residents have their own letterbox and doorbell. The home provides 24 hour staffing covered by registered nursing staff and trained support workers. The home is owned by Anchor Homes an established national, not for profit, provider of housing and support for older people. Islington Primary Care Trust (PCT) and the London Borough of Islington jointly commission the service. The range of fees is from £620.26 (personal care only) to £656.41 (nursing care). Staff from the Primary Care Trust assess each person for eligibility to receive a NHS contribution to their nursing care. St Anne`s Nursing Home DS0000010329.V362059.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 using this service experience good quality outcomes. This unannounced key inspection took place on a weekday. The length of visit was from mid-morning to early evening, a total of seven and a half hours. The inspection focused on the key national minimum standards paying particular attention to the deficiencies recorded at the last inspection. A similar method was used to plan and carry out this inspection as had been followed for other visits. Prior to the inspection we reviewed the information that the Commission for Social Care Inspection had about the home. This included an improvement plan. We reviewed and summarised the incident reports and monthly reports supplied by the home. Postal questionnaire were circulated for people living in the home; relatives as well as health and social care professionals and home care staff. To date only one survey from a person using the service and a staff survey has been returned. Where comments have been made on surveys or received during the visit, these are reflected throughout the main body of the report. During the visit we looked at a large sample of rooms throughout the premises. People living in the service and staff were spoken to and serving of lunch was observed; and there were other periods of observation throughout the day. Staff were indirectly observed going about going about their duties and interacting with residents. The inspector observed a handover in the ground floor meeting room. Four care plans were looked at and compared with the care being provided. Service users were asked for their views about living in the home and there was discussion with staff and the management team about aspects of care, staffing levels, supervision, complaints and adult protection. What the service does well: People who live in the care home continue to say that they are satisfied with the quality of the service they receive. The staff at St Anne’s offer a welcoming atmosphere and the environment is homely and pleasant. Some of the comments we received during the inspection were as follows: “The staff are always attentive.” “They know how I like things done”. “My mother is always treated with respect”. “They are always checking out if I am getting what I want.” “The meals are fine”. St Anne`s Nursing Home DS0000010329.V362059.R01.S.doc Version 5.2 Page 6 “I can choose what meals I want on the day. Sometimes O don’t fancy any of the choices available so I can pick something else to eat.” “The food is excellent.” “My room is pleasant and always kept clean.” The staff team have shown a commitment to making improvements in the service and continue to have an enthusiastic approach to training. The home has achieved “The Dignity Challenge”. In order to achieve this, the staff team had to evidence that it has a zero tolerance to all forms of abuse and to ensure that people feel able to complain without fear of retribution. What has improved since the last inspection? What they could do better: Where we found areas for improvement, plans are already in place to address the issues. We have not made any recommendations but have set a recommendation regarding the programme of social activities. Currently the main activities still remain as group activities and most of those we spoke to said that they enjoyed taking part. It is important that the activities organiser St Anne`s Nursing Home DS0000010329.V362059.R01.S.doc Version 5.2 Page 7 and the care staff share information about what people used to do and a programme can be built around this. There needs to be a number of different things going on such as painting, drawing, rummage boxes, knitting, sewing, newspapers depending on and relating to individual choices. 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. St Anne`s Nursing Home DS0000010329.V362059.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 St Anne`s Nursing Home DS0000010329.V362059.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People moving into St Anne’s’ can be assured that their care needs and aspirations will be met. EVIDENCE: The care records of the last four admissions were checked. In one instance we were able to talk to the new admission and their close friend about their experiences since being referred to the home. From a look at the care records and discussion with people using the service, it is clear that the service is recognising the importance of having sufficient information available for all referrals, so that they can make an informed choice about the service. The care home has a statement of purpose and service user guide. Discussion with a new admission and feedback from surveys highlighted that people had sufficient information about the service prior to admission. St Anne`s Nursing Home DS0000010329.V362059.R01.S.doc Version 5.2 Page 10 Admission to the care home are not being made until a full needs assessment has been carried out. All admissions are via the care programme approach therefore assessments are available from care managers. Copies of these are available on the care records. However the home also visits the prospective admission and carries out their own assessment. According to people who we spoke to, this is also when they were given information about the care home and could ask their own questions. Each care record looked at also contained a pre-admission proforma, which had been completed prior to admission. This makes sure that all information obtained prior to admission is assessed therefore a process is in place to meet identified needs from the time of admission. St Anne`s Nursing Home DS0000010329.V362059.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, & 10 -Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is now a clear and consistent care planning system in place, which provides staff with the information they need to respond to the changing needs of people who live in the home. Medications practices are sound therefore safety is ensured. Personal support is being offered in a way so as to promote and protect peoples’ privacy and dignity. EVIDENCE: At the last inspection on 30th November 2007, the management team were implementing and progressing an action plan to improve the quality of the nursing care provided in the home. This included staff attending training on person centred care, enrolling on a 10 week Dignity Challenge Audit, assessing the competency of the nursing staff and developing a training programme. This inspection showed that the care home has successfully achieved “The Dignity Challenge”. This was awarded in January 2008. The benefits were seen when inspecting the care records as well as observing the interaction between staff and the people living in the care home. A key worker system St Anne`s Nursing Home DS0000010329.V362059.R01.S.doc Version 5.2 Page 12 makes sure that staff are able to work on a one-to-one basis. Levels of interaction between staff and people living in the home are much higher than previously seen; incidents of well-being were observed to be more evident; and discussion with people living in the home showed that there is a higher level of satisfaction. Comments received were: “The staff are always attentive.” “They know how I like things done.” “My mother is always treated with respect.” A similar methodology was used for this inspection as at the last inspection. Four care plans were looked at together with the previous four weeks daily records. On this occasion the care records involved the latest four admissions. However these still included needs specific to gender, religious backgrounds and complex health needs. In each case we met the person concerned, but in some instances were not able to discuss their care with them. We did, however, compare the care as detailed in the care plan with the care being received on a day-to-day basis. The care plans are person centred and wherever possible these have been agreed with the individual concerned. The plans are mainly written in plain English, are easy to understand and address all areas that are important to the individual person. Past life history was recorded, likes and dislikes included and end of life decisions were clear and reflected the person’s religious beliefs. Risk assessments were in place and manual handling instructions had been reviewed and updated. Staff have a greater understanding of the importance of residents being supported to make their own decision sand choices. People said that they had been involved in planning their care and their lifestyle since admission to the care home. Examples were seen in the care plans and confirmed by people living in the home of gender specific care as a personal preference and based on cultural background. One person said, “They are always checking out if I am getting what I want.” Another person confirmed that because of the philosophy of the care home that they feel comfortable in challenging pre-conceptions by the staff. “This is an open environment in which to live.” Care plans are now viewed as working documents and are being reviewed according to changes in the person’s condition. The care home is benefiting from liaising with other health care professionals such as the Community Matron who had been visiting on a weekly basis. There are clear indications that the nursing staff are seeking the intervention of specialists in wound management, continence and the sensory impairment team. The practice of formal handovers has been continued. The format makes sure that staff are addressing changes in health, particularly signs of deterioration. Handovers are attended by both nurses and care staff in the large meeting room on the ground floor. Care staff take the lead by feeding back all the care that has been given to individuals and all pertinent issues are discussed. The St Anne`s Nursing Home DS0000010329.V362059.R01.S.doc Version 5.2 Page 13 manager attends the handovers and ask questions to ascertain what interventions have been made and how this has been recorded. This format has had a developmental approach for both nurses and care staff and there is a proactive approach to care rather than a reactive one. An audit of the ordering, storage, administration and disposal of medication was done. This was a sample of the medication administration records of the four people being case tracked. There are robust medication policies and procedures n place. The service continues to have robust audit processes in place. No gaps were noted for receipts, administration or disposal. The service continues with the practice of disposal being witnessed by two nurses. Dosage changes were signed and dated by the GP and were case tracked to records of doctors notes in the care plan. There were records of training and competency assessments. The manager confirms that training needs have been identified but there are training programmes for all levels of administration. St Anne`s Nursing Home DS0000010329.V362059.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Links with the community are good and further developments will support and enrich peoples’ social opportunities. The meals in this home are good offering both choice and variety as well as catering for special dietary needs. EVIDENCE: Care plans were inspected and people living in the service were asked about how they organised their day. The activity organiser was not interviewed on this occasion and feedback was also received through surveys. Both people living in the care home and their relatives confirmed that the home has a strong commitment to fostering important personal and family relationships. There is open visiting, rooms where relatives can stay and the use of private lounges. Family and friends joining relatives for meals is also encouraged. The training on person centred planning and “The Dignity Challenge” have supported staff to feel more confident in promoting individual rights and choices. Consideration is given to the protection of people using the service so that they make informed choices about their level of independence. Risk assessments are clearly documented and reviewed regularly. St Anne`s Nursing Home DS0000010329.V362059.R01.S.doc Version 5.2 Page 15 Observation within the lounges again highlighted that there is good interaction between staff and people living in the care home. Likes, dislikes and social histories are being recorded in care plans. This is highlighting interests that are personal to individuals, which the key workers are addressing. Group activities are still available and most of those spoken to said that they enjoyed taking part. The garden has been improved to provide a sensory environment and people living in the home can sit outside to enjoy fine weather. Integration with the local community is being fostered. There is a weekly visit from the local school children, the library visit and Islington Drama Therapy Workshop holds sessions in the home. The service is also accessing day centres and events hosted by the local Church. The manager has identified this as an area for further development. This will include the programme to include more cultural events and celebrations from around the world. A “Cultural Heritage Day” has been organised. Pictures are available of staff dressed in ethnic costumes and cooking traditional dishes from around the world to celebrate different cultures. Feedback from staff and people living in the home was that it was a very worthwhile event When care plans were examined, they contained individual nutritional assesments. This information is fed into the menu planning by the Chef Manager. There has been a change to the pre ordering of menu choices. People are no longer asked to make a choice the day before but rather at the meal time. This make sthe choice more spontaneous and has real meaning for the people living in the care home. There is clear evidence that cultural needs are incorporated into the care plan and meals are provided accordingly. People using the service said that “The meals are fine”. “I can choose what I want on the day. Sometimes I don’t fancy any of the choices available so I can pick something else.” “The food is exellent.” Staff have participated in “the dining with dignity” training. The lunchtime meal was observed and it was found to be a calm but social occasion for people. The catering team have attended Catercraft training. St Anne`s Nursing Home DS0000010329.V362059.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): 16 & 18 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints’ system with clear evidence that people using the service feel that their views are listened to and acted upon. EVIDENCE: As previously stated the staff team has achieved “The Dignity Challenge” award. In order to achieve the home had to evidence that it has a zero tolerance to all forms of abuse; and to ensure that people fee able to complain without fear of retribution. The annual quality assurance assessment (AQAA) completed by the manager prior to the inspection recorded that “complaints and feedback are actively welcomed, as a mechanism to improve service provision.” Discussions with one of the recent admissions highlighted that they felt comfortable about openly raising issues with staff. They said that they had found the staff to be “receptive and accommodating”. There are robust complaints procedures in place, which are documented and on display throughout the home. Both staff and people using the service confirmed that they knew the process. All complaints are recorded and an inspection of the entries showed that timescales were adhered to and resolutions found. The service has a robust policy and procedure for the safeguarding of adults. This is underpinned by staff training, which is on a rolling programme, and records show that all staff have attended. Feedback during discussion with St Anne`s Nursing Home DS0000010329.V362059.R01.S.doc Version 5.2 Page 17 staff and from surveys confirms that staff understand what constitutes abuse and the reporting mechanisms. They demonstrated an immediate concern for the safety of the alleged victim and a need to “blow the whistle on poor practice”. The service has a robust recruitment procedure, a training plan appropriate to the needs of people using the service, access to Care Specialist Advice and sound policies and procedures. Consent forms and risk assessments are completed when equipment that may be used to restrain individuals. This includes bed rails, recliner chairs and wheelchair belts. People are involved in the decision making process about any limitations to their choice in this area. All this contributes to maintaining a safe and secure environment for older people living in the care home. St Anne`s Nursing Home DS0000010329.V362059.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): 19 & 26 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment within this home is good providing people who live there with a homely and attractive place to live. There has been considerable strides made in implementing the guidance relating to the prevention of cross infection. People living in the care home are less likely to be at risk EVIDENCE: The home is providing a physical environment that is appropriate to the specific needs of the people who live there. The environment is well maintained. Since the last inspection there has been a refurbishment of the kitchens in each of the four living units and fifteen of the bedrooms have been decorated. There has also been the installation of the unit bathrooms. Where required specialist aids and adaptations have been incorporated. A tour of the home highlighted that health and safety is attended to as the home is pleasant and a safe place to live. Bedrooms and communal rooms afford sufficient St Anne`s Nursing Home DS0000010329.V362059.R01.S.doc Version 5.2 Page 19 space and ensuite facilities are provided. The home has been designed so that the layout allows for small clusters of people to live together. People living in the home have the personal choice of mixing with others in the communal lounges or staying in their rooms. The staff team recognise that needs to be a greater move towards encouraging people to personalise their personal space. However overall staff are using the environment to promote privacy, dignity and autonomy for the people who reside there. The previous inspection identified this outcome area as poor. This related specifically to the prevention of cross infection procedures and the outcome of a health and safety inspection. This inspection had highlighted that staff practices were potentially placing people living in the home at risk by not following correct cross infection procedures. The staff in the home were about to implement the guidance at the last unannounced key visit in November 2007. A considerable improvement was noted in particular the hand washing routine was in line with acceptable practice and gloves were being used appropriately. Feedback from the people living in the care home is that it is always fresh and clean. The house keeping staff are described as being “highly motivated.” On the day of the inspection all areas of the home were noted to be clean, hygienic and free from odours. St Anne`s Nursing Home DS0000010329.V362059.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): 27, 28, 29 & 30 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Significant progress has been made in establishing a stable and appropriately trained workforce. There is now a good match of well-qualified staff who are offering consistency of care within the care home. EVIDENCE: The care home has a full complement of staff. This has promoted stability and consistency, as there is no reliance on using agency staff to maintain staffing levels. The providers have a robust and thorough recruitment and selection process, which is underpinned by equal opportunities. People using the service said that they had confidence in the staff. They described them as “caring”, “reliable”, “approachable” and “attentive”. Since the last inspection the rota has been revised and is due again for review following a trial period. Changes to the rota were made by the management team in order to ensure that the home is staffed more efficiently particularly during busy periods. Induction training is planned and thorough for new starters. Feedback from staff is that they given training which updates their knowledge and skills and appropriate to meet the needs of the people in their care. Training records show that a variety of training programmes is available including generic courses from the provider, specific courses available through the Primary Care St Anne`s Nursing Home DS0000010329.V362059.R01.S.doc Version 5.2 Page 21 Trust or London Borough of Islington and external courses. The management team has systems in place to make sure that training as well as policies and procedures are underpinning practice in the home. Minutes and feedback from staff highlight that staff meetings are organised. Analysis takes place if complaints are received in order to identify areas for improvement. Documentary evidence and discussion with the members of the staff team show that supervision sessions are regular. Staff confirmed that they feel supported. St Anne`s Nursing Home DS0000010329.V362059.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): 31, 33, 35, 36 & 38 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is supported well by the senior staff in providing clear leadership throughout the home. The home has regularly reviewed aspects of its’ performance as a result of complaints’ investigations and has a clear plan in place to consolidate the improvements in the quality of the service. EVIDENCE: The provider informed the Commission for Social Care Inspection (CSCI) that new manager has been recruited since the last inspection. The manager has the required qualifications and experience and is competent to run the home. She is a registered nurse with the relevant experience with the client group and a background in management as well as appropriate post registration training. This is includes the Registered Managers Award. An application for St Anne`s Nursing Home DS0000010329.V362059.R01.S.doc Version 5.2 Page 23 registration will be submitted to the Regional Registration Team on receipt of an updated Criminal Records Bureau Check. The Annual Quality Assurance Assessment clearly recorded the areas where the home has improved and where future developments are required. The manager is supported by Corporate Services, which includes expertise in finance, human resources, care provision, training, health and safety, surveyors and catering. A business plan is available, which is linked to the financial and operational systems. There is an administrator on site. Where monies are in safekeeping, individual records are maintained. The records show credits and debits and there is a clear audit trail. People using the service felt that their views are listened to and they are consulted. Changes have been made to the service through various means of consultation including surveys, meetings and reviews. In order to facilitate this for residents meetings the loop system has been installed in the main lounges to enhance peoples’ participation. Some of the changes taking place have been the introduction of night check agreements; family members are encouraged to join their relatives at meal times; flexibility with the activities time table. installed the loop system in the main lounges to enhance service user participation. The new manager has been actively involved in implementing the action plan in order to improve the quality of the service following several past complaints. Together the management team have a focus on a person centred approach. This is as a result of establishing a stable staff team, staff training and development and the input from specialists advisers. Staff confirmed that there a strong ethos of open and transparent management and feedback is that the morale in the home has greatly improved. The service has a clear health and safety policy and staff are working continuously to implement the guidance relating to the prevention of cross infection. A sample of health and safety records were examined and these were found to be up-to-date. Staff receive health and safety training and observation showed that they were putting the theory into practice. St Anne`s Nursing Home DS0000010329.V362059.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 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 St Anne`s Nursing Home DS0000010329.V362059.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP12 Good Practice Recommendations It is strongly recommended that people living in the care home are able to engage in individual activities that are based on previous hobbies and interests. St Anne`s Nursing Home DS0000010329.V362059.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 St Anne`s Nursing Home DS0000010329.V362059.R01.S.doc Version 5.2 Page 27 - 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. 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