Care Home: St Joseph`s Nursing Home

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What the care home does well The atmosphere throughout the home felt relaxed and happy. Residents spoken to appeared content and stimulated. Residents and visitors spoken to were complimentary about the staff. Comments included "this is truly a wonderful place and the staff are lovely", "the staff give fantastic care to my mother, I never worry about her when I am not here", "the staff are very kind and care for me very well" and "I couldn`t ask for anything for more". The decor, furnishings,cleanliness and facilities provided at the home continue to be of an excellent standard. There are numerous lounge, dinning areas, a library, a craft room, a shop a tea bar, with 2 seating areas and a hairdressing room. In addition there is a large concert hall, a treatment room and a Chapel that provides a daily service or for those residents who are unable to attend it can be televised to their own bedroom. All bedrooms are single with en suite facilities. There are large, attractive, well maintained grounds with a variety of garden areas which are safe and accessible to residents. Before a prospective resident is admitted to the home a pre-assessment of their needs is undertaken to make sure that the person`s needs can be met. Visitors are made welcome in the home at any time and can visit in the resident`s own room or in any of the communal areas of the home. This was confirmed by residents and visitors spoken to during the visit. From observations made, looking at care plans and talking to residents and visitors it was evident that privacy and dignity is respected and choice is encouraged. There are systems in place to support people to raise any concerns or complaints they have and all of the returned comment cards from staff indicated that they knew what to do if somebody had a concern. The residents spoken to and the information received in the comment cards indicated that residents knew how to make a complaint. One lady said she knew how to make a complaint "but in the four years I have lived here I have never wanted to make a complaint, why would I". There is a choice of meals and a daily menu is on display. The meals are varied and nutritionally balanced. The feedback received via people spoken to and information received in the returned comment cards was positive with regard to the food provided. One resident said "the food is excellent, I like it very much". All residents spoken to confirmed that choices are always available and drinks and snacks are available on request. There is a wide variety of activities available for people to participate in. One resident said "there are activities every day as well as, parties, fairs, concerts and loads of trips out of the home". One lady said her faith was very important to her so it was wonderful that she could attend daily mass and the staff always supported her to attend. Staff are encouraged and supported to attend relevant training to ensure that theyhave the necessary skills to meet the needs of the residents living at the home. There is a thorough recruitment process to ensure that the staff employed are safe to work with the resident`s living at the home. What has improved since the last inspection? Since the last inspection visit the home has employed the services of an activity coordinator and a social and spiritual care plan have been implemented. On the day of this visit several residents were seen in the concert enjoying the afternoons activity. One resident said the activity coordinator was "brilliant" and she "loved doing all the activities". Maintenance and renewal of decor and furnishings is ongoing at St Joseph`s. Since the last inspection visit new carpets have been laid on the first floor corridor and two of the unit`s kitchenettes have been refurbished. In addition bedrooms are redecorated and refurnished on a continual as need basis. Lighting and ventilation in all of the en-suites have been updated and new lighting has been installed in the main corridor. All doors have had intrumescent strips and seals fitted to ensure fire safety and a new hot water system has been installed. On the day of this visit the decorators had started to re-decorate the ground floor corridor. What the care home could do better: No requirements were made at this inspection visit, all the standards assessed met or exceeded the minimum standard. However some good practice recommendations were made. For example, it is recommended that a regular audit of medication is undertaken. In is also recommended that the policies and procedures relating to resident finances are reviewed and updated to accurately reflect the procedures the homes follows. Inspecting for better lives Key inspection report Care homes for older people Name: Address: St Joseph`s Nursing Home 52 Plymouth Grove West Longsight Manchester M13 0AR     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Geraldine Blow     Date: 1 0 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: St Joseph`s Nursing Home 52 Plymouth Grove West Longsight Manchester M13 0AR 01612734147 01612732162 lspmanc@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Sister Caroline Mary Kissane Type of registration: Number of places registered: Little Sisters of the poor care home 53 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 with nursing - Code N to service users 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 service users who can be accommodated is: 53 Date of last inspection Brief description of the care home St Josephs Nursing Home is registered to accommodate a maximum of 53 older people. The home is owned and run by The Little Sisters of the Poor. The home is located in Longsight just south of Manchester City Centre. Local facilities and bus routes are within easy walking distance. The home provides ample secure parking facilities at the front of the building. The home is a three storey purpose-built building set in large, secure, well-maintained grounds. The home is divided into 3 units and a wide variety of communal areas are available for residents. Bedroom and communal accommodation for the residents is provided on the ground floor and the first floor. All Care Homes for Older People Page 4 of 28 Over 65 53 0 Brief description of the care home rooms are single and provide en-suite facilities. The second floor provides living accommodation for the Sisters. A daily mass is held in the chapel and for those residents who are unable to attend the chapel morning mass can be accessed via a special TV channel direct to their bedroom if they wish. The fees range from 400.00 to 420.00 pounds per week. There are additional charges for hairdressing, personal toiletries, newspapers and private telephones. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This report is based on information gathered by the Commission for Social Care Inspection (CSCI) since the last inspection on 14 November 2007 and supporting information received in the Annual Quality Assurance Assessment (AQAA) submitted by the manager prior to this visit. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. Prior to this visit residents and staff were sent comment cards. At the time of this visit 9 staff comment cards and 1 resident comment had been received by CSCI. Some of their comments are included in the body of the report. Care Homes for Older People Page 6 of 28 This visit was unannounced, which means that the manager and staff were not told that we would be visiting. The visit forms part of the overall inspection process and took place on Monday 10 November 2008. The opportunity was taken to look at all the core standards of the National Minimum Standards (NMS). This report is an overview of what the inspector found during the inspection. As part of the visit we (the commission) spent time examining relevant documents and files. We also spent time talking with the manager, several people living at the home, some visitors, members of staff and a tour of the building was undertaken. Feedback was given to the manager during the course of this visit. What the care home does well: The atmosphere throughout the home felt relaxed and happy. Residents spoken to appeared content and stimulated. Residents and visitors spoken to were complimentary about the staff. Comments included this is truly a wonderful place and the staff are lovely, the staff give fantastic care to my mother, I never worry about her when I am not here, the staff are very kind and care for me very well and I couldnt ask for anything for more. The decor, furnishings,cleanliness and facilities provided at the home continue to be of an excellent standard. There are numerous lounge, dinning areas, a library, a craft room, a shop a tea bar, with 2 seating areas and a hairdressing room. In addition there is a large concert hall, a treatment room and a Chapel that provides a daily service or for those residents who are unable to attend it can be televised to their own bedroom. All bedrooms are single with en suite facilities. There are large, attractive, well maintained grounds with a variety of garden areas which are safe and accessible to residents. Before a prospective resident is admitted to the home a pre-assessment of their needs is undertaken to make sure that the persons needs can be met. Visitors are made welcome in the home at any time and can visit in the residents own room or in any of the communal areas of the home. This was confirmed by residents and visitors spoken to during the visit. From observations made, looking at care plans and talking to residents and visitors it was evident that privacy and dignity is respected and choice is encouraged. There are systems in place to support people to raise any concerns or complaints they have and all of the returned comment cards from staff indicated that they knew what to do if somebody had a concern. The residents spoken to and the information received in the comment cards indicated that residents knew how to make a complaint. One lady said she knew how to make a complaint but in the four years I have lived here I have never wanted to make a complaint, why would I. There is a choice of meals and a daily menu is on display. The meals are varied and nutritionally balanced. The feedback received via people spoken to and information received in the returned comment cards was positive with regard to the food provided. One resident said the food is excellent, I like it very much. All residents spoken to confirmed that choices are always available and drinks and snacks are available on request. There is a wide variety of activities available for people to participate in. One resident said there are activities every day as well as, parties, fairs, concerts and loads of trips out of the home. One lady said her faith was very important to her so it was wonderful that she could attend daily mass and the staff always supported her to attend. Staff are encouraged and supported to attend relevant training to ensure that they Care Homes for Older People Page 8 of 28 have the necessary skills to meet the needs of the residents living at the home. There is a thorough recruitment process to ensure that the staff employed are safe to work with the residents living at the home. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 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. Systems are in place to make sure peoples needs are assessed prior to admission Evidence: Prospective residents and their families are encouraged to visit the home before making a decision to move in. The AQAA demonstrated that people are encouraged to visit the home and perhaps stay for lunch and join in activities so that they can get a feel for the home prior to making a decision about admission. The information received in the returned comment card from person living at the home indicated that they had received enough information before moving in. Before a person moves into the hme their needs are fully assessed to make sure theri needs can be met. A trial period of admission is always possible so that prospective residents gets to know the home and see if they think their needs can be met. Care Homes for Older People Page 11 of 28 Evidence: The files looked at during this visit all contained a care manager assessment or a funded nurse assessment and the homes own pre admission assessment. This means that all available information about a person moving into the home has been gathered so people can be confident that their needs will be met. An intermediate care service is not provided at St. Josephs. Care Homes for Older People Page 12 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care needs of people living at the home are being met. Evidence: Three people were case tracked during the course of this inspection visit. The care files were organised and easy to use. Each file contained a plan of care which had been generated from a needs assessment and the homes own care planning process. Each plan of care had been reviewed on a monthly basis and the manager stated that she does a random monthly audit of care plans. In addition evidence was also seen that the unit managers do formal audits of all care plans every month. This is seen as good practice. The care plans were detailed, informative and clearly set out the actions that needed to be taken by staff to ensure that all aspects of health, personal, cultural, religious and social needs of the residents are met. The plans contained good person centered information that clearly reflected the personal preferences and individual needs of residents. Care Homes for Older People Page 13 of 28 Evidence: Appropriate risk assessments had been included and had been regularly reviewed for example emergency evacuation procedure, bed rail risk assessments, pressue sore, nutrition, continence, pain and Moving and Handling. This ensures that any potentional risks are identified and the risk is kept to a minimum. Evidence from the returned resident comment card and from speaking to residents, visitors and staff indicated that people felt that they received the care and support needed. One visitor said that she was very happy with the care and felt very lucky that her mother was living at this home. Staff were observed assisting residents when needed with kindness and sensitivity. From the staff interactions observed it was obvious that staff knew the individual residents very well and understood their individual care needs. Independence and choice were seen to be encouraged in the plan of care and visitors spoken to confirmed that this as the case. All the residents spoken to confirmed that privacy and dignity was respected. This was also observed during staff interactions and was included in the plans of care examined. Residents are registered with a General Practitioner (GP) and evidence was seen of referrals to other health care professionals according to individual needs. The GP visits the home every week and have their own consulting room, or residents can be seen in the privacy of their own room if they prefer. The records regarding medication were examined. There were no gaps in the recording of medication and medication had been signed into the home. One medication administration record (MAR) examined identified that the resident had been prescribed a drink thickener, which is used to thicken drinks and soups for residents with a swallowing impairment. This had been signed for three times a day on the MAR. The manager confirmed that this was not an accurate record of the amount of thickened fluids given to the resident. To ensure that residents needs are being appropriately met it is recommended that the MAR should clearly cross reference to where there is a signed accurate recording of thickened fluids given to residents. Medication which had a limited life span, for example eye drops had a documented date of opening to help eliminate the risk of out of date medication being given to residents. A visual check of the blister packs indicated that medication had been given as Care Homes for Older People Page 14 of 28 Evidence: prescribed. However a tablet count for 2 boxed medications was inaccurate. One box contained 19 tablets too many and one box contained one less tablet. The manager confirmed that at the time of this visit there was no formal system of auditing medication. To ensure that residents are receiving medication as prescribed by the GP, medication should be accounted for at all times by means of an audit trail. Surplus, unwanted or expired medicines were documented in a returns book although it is recommended that 2 staff witness and sign for the disposal of waste medication. From observations and talking to residents, visitors and staff it appears that residents are encouraged to make choices around their daily lives and privacy and dignity is respected. Care Homes for Older People Page 15 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Activities are provided and people are encouraged to maintain contact with family and friends. Evidence: Residents are consulted about their social interests and personal preferences during the admission process and as already stated in this report they have a related care plan. Since the last inspection an activity coordinator has been employed who organises a wide and varied range of activities. In addition she works closely with the physiotherapist and carries over some of the exercises with the residents. On the day of this visit photographs were on display of the homes Autumn fair that took place the Saturday before this visit. All residents and staff spoken to had enjoyed the fair and relatives, as always were invited to attend. Some of the many activities include card making, monthly birthday parties, outside entertainers, trips out in the homes mini bus, a monthly whist drive group, games and quizzes. Numerous activities, both in the home and trips out, were currently being organised for Christmas which the residents were very much looking forward to. Care Homes for Older People Page 16 of 28 Evidence: There is a library which also has large print books and a mobile library visits the home on a monthly basis. The AQAA confirmed that they have their own Chaplain who helps meet the spiritual needs of the residents. A daily mass in the chapel or prayer in the privacy our their own room is facilitated for residents if they so wish. For any residents unable to attend the daily mass there is a video link to all bedrooms. The home has good links with the local parish and recently a procession had taken place which residents were able to participate in and at the residents request they orgainsed and lead various devotions in the chapel. The manager stated that residents are encouraged to maintain contact with family and friends. Residents and visitors spoken to confirmed this and that there is open visiting and visitors are always made welcome. Feedback from residents spoken to and the response from the returned comment card was positive about the food. A copy of the menus was seen, which were varied and nutritionally balanced. The menus evidenced that a choice of meals is available and people spoken to during this visit confirmed this. The manager confirmed that the meals are constantly under review to accommodate residents likes and dislikes and are regularly discussed at the residents meetings. From observations made and from talking to residents it was evident that residents are encouraged to exercise choice and control over their day to day lives and residents are encouraged to bring personal possessions into the home. Care Homes for Older People Page 17 of 28 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. People are listened to, complaints are acted upon and people are protectd from abuse. Evidence: The complaint procedure is available in the residents library for people to access and each unit has a copy. In addition, on admission to the home each resident is given a Service User Guide which also contains the complaint procedure. The returned comment card indicated that the resident knew how to make a complaint and all the returned comment cards from staff indicated that they knew what to do if somebody had concerns about the home. Residents spoken to said they knew who to speak to if they had any worries or concerns. One resident said I have never wanted to make a complaint because I have always been very happy here. The completed AQAA demonstrated that one complaint had been received in the previous 12 months, which was not upheld. CSCI had not received any complaints about the service. The manager confirmed that a record is kept of complaints made which includes copies of staff statements, any correspondence and a conclusion to a complaint. The manager confirmed that she encourages people to raise any concerns they may have and she speaks to residents and visitors on a daily basis. Evidence was seen that Safeguarding Adults was covered during induction and that Care Homes for Older People Page 18 of 28 Evidence: staff had recently received updated Safeguarding training. The manager confirmed that they had a copy of the Manchester Multi Agency Policy on the Protection of Vulnerable Adults from Abuse No Secrets Guidance. Since the last inspection visit there has been one allegation of abuse. CSCI had been informed and the home had acted appropriately. Staff files showed that Criminal Record Bureau (CRB) checks and references were being undertaken before staff started work. This ensures that saff employed are sutitable to work with the people living at the home. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Excellent facilities and a clean, pleasant and comfortable environment is provided. Evidence: The home provides an exceptionally clean, comfortable environment, decorated and furnished to an excellent standard. As demonstrated in the summary of this report redecoration, renewal and maintenance is an ongoing process. The facilities, as detailed in the summary of this report, are numerous and accessible to all residents and their visitors. Bedrooms are all single with en-suite facilities and are decorated and furnished to an excellent standard. The bedrooms viewed on this visit were all personalised with items brought in from residents homes. Residents and visitors spoken to were all complimentary about the cleanliness and facilities provided. One resident said my room is beautiful and it is always kept lovely and clean. The manager confirmed that Infection Control policies and procedures are in place. They were not viewed on this visit as they have been viewed on previous visits and were currently under review. Care Homes for Older People Page 20 of 28 Evidence: The main laundry is situated on the ground floor and as detailed in previous inspection reports contains appropriate washing and drying facilities. Dirty linen is transferred to the laundry in coded bins and soiled linen is transferred separately. To reduce the risk of cross infection the laundry has a clean and dirt entry and exit system and staff are employed to work specifically in the laundry. One resident said they do a really lovely job of washing my clothes. Care Homes for Older People Page 21 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples care needs are met by the numbers and skill mix of staff. Evidence: The number and deployment of staff available appeared sufficient to meet the needs of the residents. At the time of this visit 51 people were accommodated and from looking at the staff rota it showed that sufficient staff were provided to meet the needs of the residents. Information received in the resident and staff comment cards indicted that there was enough staff provided. The manager and the completed AQAA evidenced that 85 of care staff employed had successfully completed NVQ Level 2 or above and 10 of care staff were due to complete the training in the near future. As detailed in the previous inspection report the home employs an Induction Officer. There is Skills for Care structured induction and the manager confirmed that all new members of staff must complete induction. All of the comments included in the returned staff comment cards indicated that induction covered everything they needed to know about the job. Care Homes for Older People Page 22 of 28 Evidence: The Induction officer has a computorised matrix of all staff training, which evidenced that staff are receiving up to date, appropriate training. In addition to the matrix staff have an individual training and development record and plan. Comments received in the returned staff comment cards indicated that appropriate training was provided. A sample of staff files were looked at to see whether the required documentation was in place and if the necessary checks had been made. Three files were looked at for staff that had been recruited since the last inspection visit. All the files seen contained the required documentation. The files contained some photocopied documents but there was no evidence that the original documents had been seen. It is recommended that all photocopied documents are signed and dated to indicate that the original has been seen. Evidence was seen that a set interview format is used and notes are taken during the interview. This is seen as good practice. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed in the best interest of the people that live there and the staff working there. Evidence: The home is managed in the best interest of the people that live there. The registered manager has the qualifications and experience to effectively manage the home. She is supported and assisted by an assistant manager and a deputy manager in their absence. In addition there is an administration team which consists of a personnel officer, a training officer, an accounts assistant and a personal assistant. It is evident that the manager and staff are fully committed to continually improving the high standards of care provided and are fully committed to providing a homely, relaxed atmosphere. The manager confirmed that the polices and procedures were all under review. Care Homes for Older People Page 24 of 28 Evidence: In an attempt to gain residents views on the service provided there are bi monthly resident meetings that are minuted and the manager confirmed that she speaks to residents and relatives daily on an individual basis. In addition there is an annual quality monitoring form that is sent to residents, relatives and visiting professionals to gain their opinion of the service. The results of this were analysed in April 2008 and a report based on the results was produced and made available for people to view. This is seen as good practice. The systems in place for the recording of residents finances were in order with income an outgoings being recorded. Secure facilities are provided for the safekeeping of money and valuables and receipts retained for any purchase made on behalf of a resident. The manager confirmed that the policies and procedures regarding residents finances did not reflect the procedures followed in the home. It is recommended that they are reviewed and updated to reflect the procedures and processes used in the home and that agreements are made for staff to make purchases on residents behalf. The information provided in the completed AQAA demonstrated that the homes maintenance certificates and records are up to date. Care Homes for Older People Page 25 of 28 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 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 9 1. To ensure there that residents needs are being appropriately met it is recommended that the MAR should clearly cross reference to where there is a signed accurate recording of thickened fluids given to residents. 2. To ensure residents are receiving medication as prescribed by the GP medication should be accounted for at all times by means of an audit trail. 3. It is recommended that 2 staff witness and sign for the disposal of waste medication. 2 29 It is recommended that all photocopied documents are signed and dated to indicate that the original has been seen 1. It is recommended that the policies and procedures relating to finances are reviewed and updated to clearly set out the systems to be followed. 2. It is recommended that written agreements be developed between people and the home setting out permission for the staff to purchase personal items for that person and the receipt be signed by the person purchasing items. 3 35 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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. 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