Care Home: St Leonards Rest Home

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• St Vincents
• The Cotswold Home
• Winton House
• Rush Court
• Hillyfield Rest Home
• The Maypole Nursing Centre
• The Briars

What the care home does well Information is provided for people interested in using the service and the home carries out thorough assessments of individuals` needs before a placement is offered. Staff members we spoke with demonstrated a good understanding of the needs of the individuals whose records we saw, which reflected the guidance in the care plans. People who live in the home are treated with respect and have access to a range of health care services. The home has introduced new dinner and supper menus and expanded activities that are provided. People who use the service told us that they like the meals provided and a visiting relative said that the home cooked food "looks and smells fantastic". A person who uses the service told us "staff are very pleasant and we have a laugh." They also told us that if they need anything "just tell the staff and they`ll see to it." The home provides a clean and comfortable environment to live in, which one person`s relative described as "homely, not institutional." The service carries out thorough checks on new staff members before they are allowed to work in the home and there is a training schedule. The home has conducted an annual quality assurance survey and we saw that the comments received from people involved with the service were positive.St Leonards Rest HomeDS0000011859.V375024.R02.S.docVersion 5.2 What has improved since the last inspection? The home`s medication policy and procedures have improved, including the facility to store controlled medication, written guidance for staff to follow and the system of dispensing medication. Areas of the home, including residents` bedrooms and a bathroom have been redecorated. What the care home could do better: There were no requirements or recommendations identified as a result of this inspection. The service has plans for further development, for example updating the fire safety system in line with the fire safety officer`s recommendations. Key inspection report CARE HOMES FOR OLDER PEOPLE St Leonards Rest Home 38 St Leonards Avenue Hayling Island Portsmouth Hampshire PO11 9BW Lead Inspector Laurie Stride Key Unannounced Inspection 27th May 2009 10:45 DS0000011859.V375024.R02.S.do c Version 5.2 Page 1 This report is a review of the 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. 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. St Leonards Rest Home DS0000011859.V375024.R02.S.doc Version 5.2 Page 2 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 St Leonards Rest Home DS0000011859.V375024.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Leonards Rest Home Address 38 St Leonards Avenue Hayling Island Portsmouth Hampshire PO11 9BW 023 9246 3077 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) Mr F W Bartlett Mrs M Bartlett Mrs M Bartlett Care Home 15 Category(ies) of Dementia (15), Dementia - over 65 years of age registration, with number (15), Mental disorder, excluding learning of places disability or dementia (15), Mental Disorder, excluding learning disability or dementia - over 65 years of age (15), Old age, not falling within any other category (15) St Leonards Rest Home DS0000011859.V375024.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. All service users must be at least 60 years of age. Date of last inspection 6th June 2008 Brief Description of the Service: The home provides a service for up to fifteen older people (over the age of 60) who may also have dementia or a mental disorder. There are 11 single bedrooms and 2 shared bedrooms (located on the ground and first floors). Communal areas comprise of the lounge, conservatory and dining room. There is a garden at the side/rear. Car parking is available at the front. There are nearby local amenities including shops and the Hayling Island seafront. Staff are on duty 24 hours a day. The home’s weekly fees range from £445.00 to £480.00 per week. This information was obtained at the time of the inspection visit. Members of the public may wish to contact the care home for up to date information about fees. St Leonards Rest Home DS0000011859.V375024.R02.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 stars. This means the people who use this service experience good quality outcomes. We (the commission), carried out an unannounced visit to the home on 27/05/09, which lasted seven hours. This visit was part of a key inspection of the service, which takes into account all the information we have received about the service since the last key inspection on 06/06/08. The information includes the homes Annual Quality Assurance Assessment (AQAA), which the registered person sent to us prior to this visit. We had sent survey questionnaires to the home for the manager to distribute to three of the people who use the service and two healthcare professionals. At the time of writing this report we had received completed questionnaires from three of the people who use the service. During this key inspection visit we also spoke with one of the people who live in the home, two relatives of people who use the service, two staff members, the assistant manager and the owners. We observed the interaction between staff and people who use the service and looked at samples of the records held in the home. What the service does well: Information is provided for people interested in using the service and the home carries out thorough assessments of individuals’ needs before a placement is offered. Staff members we spoke with demonstrated a good understanding of the needs of the individuals whose records we saw, which reflected the guidance in the care plans. People who live in the home are treated with respect and have access to a range of health care services. The home has introduced new dinner and supper menus and expanded activities that are provided. People who use the service told us that they like the meals provided and a visiting relative said that the home cooked food “looks and smells fantastic”. A person who uses the service told us “staff are very pleasant and we have a laugh.” They also told us that if they need anything “just tell the staff and they’ll see to it.” The home provides a clean and comfortable environment to live in, which one person’s relative described as “homely, not institutional.” The service carries out thorough checks on new staff members before they are allowed to work in the home and there is a training schedule. The home has conducted an annual quality assurance survey and we saw that the comments received from people involved with the service were positive. St Leonards Rest Home DS0000011859.V375024.R02.S.doc Version 5.2 Page 6 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 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. St Leonards Rest Home DS0000011859.V375024.R02.S.doc Version 5.2 Page 7 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 Leonards Rest Home DS0000011859.V375024.R02.S.doc Version 5.2 Page 8 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 3, 5 & 6. People using the 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 continues to carry out thorough assessments of the needs of those people referred for possible admission, which ensures the home accommodates only those individuals whose needs it can meet. People who are interested in using the service are given information about the home and are able to visit so that they can make an informed choice about whether or not to move in. EVIDENCE: The previous inspection report identified that the home carried out thorough assessments of need of those people referred for possible admission, which ensured the home accommodated only those whose needs it could meet. Potential residents were given information about the home and were able to visit so that they could make an informed choice about whether or not to move in. For this inspection, the AQAA stated that four people had been admitted in the last 12 months. St Leonards Rest Home DS0000011859.V375024.R02.S.doc Version 5.2 Page 9 During this visit, we saw the assessment and admission records in relation to one recently admitted person. The manager told us that she and the assistant manager who completed the assessment had visited the person on two occasions and that admission had been delayed while further clarification had been sought about the individuals’ needs. The records included the hospital discharge notes and a letter from the manager to the General Practitioner requesting further information about medication and the individual’s personal routines. The home’s own assessment form had been completed and there had also been liaison with the Community Psychiatric Nurse. We saw that an initial care plan had been developed from the combined assessment information, including risk assessment, and that daily observations were recorded from the time the person was admitted. We spoke with a relative of the person whose record we had seen. The relative told us that they had visited the home more than once and had also spoken with the service providers over the phone before a decision was made. The relative also confirmed that they had received copies of the terms and conditions of residence and the home’s brochure or service user guide. They said that the care environment is “homely, not institutional.” We spoke with another resident’s relative who also told us they had come to view the home first and had been made to feel welcome. This relative said that they were pleased with the care provided and that the home is “like a little hotel.” For this inspection we received comments through survey questionnaires from three people who use the service, one of whom was assisted in completing the form by a relative or carer. All three indicated that they had received enough information to help them decide if the home was the right place for them, before they moved in. They also confirmed that they had been given written information about the homes terms and conditions. The home does not provide intermediate care, therefore this standard is not applicable. St Leonards Rest Home DS0000011859.V375024.R02.S.doc Version 5.2 Page 10 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 & 10. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person has a care plan detailing how their care needs are to be met and people who live in the home are treated with respect. People who use the service are now better protected by improvements in the home’s medication procedures. EVIDENCE: The previous inspection report showed that each person had a care plan detailing how care needs were to be met and that reflected the individual’s preferences and wishes. People using the service were treated with dignity and their privacy was promoted. During this visit we looked at a sample of two individual’s care plans and risk assessments, which provided clear guidance for staff about how to meet the person’s assessed needs and minimise any risk. Each plan had been updated on a monthly basis and contained sections where evaluations of the person’s health and social care needs were recorded. Were individuals lacked the capacity to state how they wished to be cared for, we St Leonards Rest Home DS0000011859.V375024.R02.S.doc Version 5.2 Page 11 saw that the home involves people’s relatives as well as external health professionals in agreeing the best way to meet the individual’s needs. For example, the use of bed rails for one individual had been discussed and agreed by the person’s doctor and a relative along with the home’s manager. We spoke with two of the care staff who both demonstrated a good understanding of the needs of the individuals whose records we saw, which reflected the guidance in the care plans. For example, both staff talked about using a nonconfrontational approach when working with one individual’s occasionally challenging behaviour and needs in order to help reduce the person’s anxiety. The records we saw included sections on monitoring weight, fluid intake and nutrition. Health checks including appointments with external professionals were recorded in the care plans with the outcomes. We observed that people who use the service had drinks such as orange squash in their rooms, as well as being offered hot drinks during the day. We spent some time talking with a person who uses the service, who told us that they had regular contact with their doctor and if they had any other health or support needs “just tell the staff and they’ll see to it.” The person confirmed that they are treated with respect and their privacy and dignity is upheld. Prior to our visit we received comments through survey questionnaires from three people who use the service. All three indicated that they always receive the care and support they need. Two said that the staff are always available when needed, the other person said they usually are. Two said that the staff always listen and act on what they say; the other person said they usually do. All three said that the home always make sure they get the medical care they need. The previous key inspection report had identified four requirements in relation to the management and administration of medication within the home. A subsequent visit to the service by one of the commission’s pharmacist inspectors took place on 08/09/08. The pharmacist visit identified that the home had made improvements since the key inspection by obtaining a controlled drug cabinet and improving care plan information around prescribed medicine. Following the pharmacy report there were two remaining requirements, which we looked at during this inspection. We observed the assistant manager giving out medication at lunchtime. Medication was taken from pharmacy blister packs at the prescribed time and given to the person using the service, after which the person completing this signed the record. This meets one of the previous requirements. Staff members we spoke to during this visit were aware that the procedures had changed and confirmed that they receive training in the administration of medication. We saw that the home’s written medication policy now included a section on what to do in the event of a medication error, which meets the other previous requirement. There were no controlled drugs being held on the premises at the time of this inspection. St Leonards Rest Home DS0000011859.V375024.R02.S.doc Version 5.2 Page 12 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 & 15. People using the 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 who use the service benefit from opportunities to make choices from a varied food menu and programme of activities. The home supports people to maintain their independence and social contacts. EVIDENCE: The previous inspection report identified that people using the service were able to exercise choice in their daily lives and benefited from a range of activities and stimulation, including contact with the local community. The AQAA stated that the home has introduced new dinner and supper menus and expanded activities that are provided. We saw the home keeps a record book of daily activities provided for stimulation and relaxation. Entries included bingo games, reading the newspaper, walks on the beach and hairdressing. Some people who use the service attend a lunch club run by Age Concern. One individual was continuing to go to another club on 3 days a week as they had done before they came to live at the home. There were also records of weekly entertainment and St Leonards Rest Home DS0000011859.V375024.R02.S.doc Version 5.2 Page 13 activities by external facilitators and we observed one of these sessions in progress during our visit. The home has an appointed activities co-ordinator who was on leave at the time of our visit so we were not able to talk with her. The manager showed us a book the home has been giving to people’s relatives, called ‘A grandparents’ book – our story, our life’, through which further information from relatives to support care planning can be gathered. A visiting relative we spoke with told us they had received a copy of the book, which they were working through. We spoke with a member of staff who told us that all staff take part in providing activities on a daily basis. The staff member said that she sometimes read to small groups of people who live in the home, which had opened up discussions. We spoke with a person who uses the service and they told us that visitors are welcome at any time, though they are asked to respect mealtimes. This person said that they are also able to keep in telephone contact with their relatives. The individual said that they can access the house at will and choose what time they went to bed. Breakfast is served at 08:15 followed by tea/coffee at 11:00 and lunch at 12:15. Tea and supper with hot drinks are also provided. The person told us that there is plenty of food and variety of choices. They said that they choose to do some of their own washing and also buy their own fruit although the home does provide for these things. Staff will go to the shops for them if requested. We received comments through survey questionnaires from three people who use the service. Two said that the home always arranges activities that they can take part in if they want; the other person said the home usually does. All three indicated that they always like the meals in the home. We saw a sample of the menus, which were varied and offered alternatives. We also saw that the home keeps a record of the food that people who use the service have eaten. A visiting relative told us that they are always made to feel welcome and that staff members offer them refreshments. They said that the home cooked food “looks and smells fantastic”. Another visitor who had taken their relative out during the morning told us that they had been offered a meal on their return and that it “was very nice”. We observed people sitting down to eat at lunch and tea-time and that staff were available to give individual support. Both relatives confirmed that the home keeps them informed about any changes. One told us that staff members support their relative receiving care to help out in the home and “do little bits and pieces, to feel useful”. They said that their relative is “always well turned out” after they have phoned the home to say they are coming to take them out. St Leonards Rest Home DS0000011859.V375024.R02.S.doc Version 5.2 Page 14 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 & 18. People using the 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 who use the service can be confident that any concerns they have will be taken seriously and acted upon. The home’s policies and procedures, backed up by staff training, protect people who live in the home from abuse, neglect and self-harm. EVIDENCE: The previous inspection report identified that the home promotes the rights of the residents and takes steps to protect the people who live in the home from any possible abuse. The AQAA told us that since the last inspection the home had not received any complaints and there have been no safeguarding referrals/investigations. We have not received any complaints about the service in the time since the last inspection. During this visit we saw the home’s complaint policy and procedure and that there is a format for recording the details of any complaints that are received together with the home’s response and the outcomes. The home also keeps a compliments file. We spoke to a person using the service who told us that they had no complaints about the service and that “everything’s hunky-dory”. We received comments through survey questionnaires from three people who use the service, who all indicated that there is someone they can speak to informally if they are not happy and that they know how to make a formal complaint. Two visiting St Leonards Rest Home DS0000011859.V375024.R02.S.doc Version 5.2 Page 15 relatives we spoke with said they would feel comfortable approaching the owners if they had any concerns or complaints. The home supports peoples’ right to participate in the political process by enabling them to vote in elections, for example using the postal voting system. The home also provides information about an independent financial advocacy scheme and about elder abuse response services. We saw that the home has a whistle blowing policy that is signed by staff to show they have read the contents. Both members of staff who we spoke to demonstrated a clear understanding of their reporting and recording responsibilities under the safeguarding procedures. One of the staff members told us about a training video and questionnaire she had completed in the home in relation to dementia and abuse, which gave examples such as overmedication. The staff member said that the training exercise had helped her to understand some of the issues better. We saw further evidence of abuse awareness training in a sample of staff training records for March 2009. St Leonards Rest Home DS0000011859.V375024.R02.S.doc Version 5.2 Page 16 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 & 26. People using the 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 provides people who use the service with a clean and comfortable environment to live in, which meets their individual needs. EVIDENCE: At the time of our visit several of the people who live in the home were gathered in the lounge and appeared to be enjoying an activity initiated by an external facilitator. The lounge is equipped with a wide screen television and there are also a number of games and puzzles for people who use the service to use. There is a conservatory area where people can go if they wish. The AQAA told us that in the last 12 months two bedrooms and the main bathroom had been decorated and the carpet changed in both bedrooms, which the owners showed us during a tour of the premises. The AQAA also told St Leonards Rest Home DS0000011859.V375024.R02.S.doc Version 5.2 Page 17 us about plans for the next 12 months to redecorate two bedrooms and replace the sluice area and main kitchen sink with stainless steel units. Work on the sluice area commenced on the day of our visit. The home has a maintenance plan and encourages people who use the service or their relative or friend, to take part in choosing the colour scheme of their room. The home has 2 double shared bedrooms and 11 single and we saw that these had been personalised by the occupants. Four of the bedrooms have an en suite toilet. Privacy screens are provided in shared rooms and suitable locks are fitted on all bedroom doors. There is a stair lift to the first floor and the home has a mobile hoist for those with mobility needs. The home would benefit from more storage space for the hoist and wheelchairs, which are stored to one side in the hallway. The owner said these items are stored in this area so that they can be readily accessible. The home has a ground floor bathroom with an assisted bath and two bathrooms on the first floor. A toilet cistern had been replaced in the ground floor bathroom, which had damaged some of the surrounding tiles and the owners were aware that these would need replacing. The service was using another nearby home’s laundry facilities while awaiting the repair of the home’s washing machine. We saw that the home was clean and there is a monthly cleaning schedule that is maintained and signed by staff. We spoke with a person who uses the service, who told us they were happy with the accommodation and had everything they needed. They said that “the home is lovely and clean” and “the linen is changed regularly”. We received comments through survey questionnaires from three people who use the service, who indicated that the home is always fresh and clean. St Leonards Rest Home DS0000011859.V375024.R02.S.doc Version 5.2 Page 18 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 & 30. People using the 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 who use the service are supported by staff who are trained and in sufficient numbers to meet their needs. The procedures for recruiting new staff ensure that people who live in the home are protected. EVIDENCE: The previous inspection report identified that staff were well trained and deployed in sufficient numbers to meet the needs of people who used the service. Checks were carried out before staff started work at the home ensuring that people who lived there were protected. The manager said that there are 2 or 3 members of staff on duty in the morning, taking into account the needs of people using the service and work needing to be done. For example, if individuals like to have a bath in the morning. Otherwise there is a minimum of 2 morning staff plus a cook, so that the care staff can focus on supporting people. Between 2pm and 9pm there is also a minimum of 2 care staff. Nights are covered by 1 awake and 1 sleep-in staff. These staffing levels were reflected in the numbers of staff on duty during our visit and in the samples of the staff rota that we saw. Comments received through survey questionnaires from three people who live in the home indicated that staff were always or usually available when they St Leonards Rest Home DS0000011859.V375024.R02.S.doc Version 5.2 Page 19 requested something. The AQAA told us that the home has altered the staffing rota to allow an extra member of staff on duty on Saturday mornings to allow residents to be taken out on an individual basis. A person who uses the service told us “staff are very pleasant and we have a laugh.” Two visiting relatives commented positively about the staff team. We looked at the recruitment records for two staff members who had commenced employment this year. These showed that the individuals had only commenced work after 2 written references had been obtained and the required Protection of Vulnerable Adults (POVA) check had been completed. The rota showed that one person had started work on a supervised basis until their Criminal Record Bureau (CRB) check was cleared. The records also showed us that the management had asked for more detailed employment histories as part of the recruitment process. Records were available in the home to show that 6 out of the 12 staff have National Vocational Qualification (NVQ) level 2 or above. Of these, one staff member had obtained the NVQ level 3 and 2 others were working to obtain the same level qualification. 2 others were working toward achieving the award at level 2. 2 new staff members are scheduled to commence NVQ level 2 in October 2009. A member of staff we spoke with told us they had completed NVQ 3. The home has a training schedule for 2009-2010, which included infection control, moving and handling, food hygiene, first aid, abuse awareness, dementia, medication and dealing with aggression. There is an induction procedure for newly appointed staff based on the nationally recognised common induction standards. We saw a copy of the induction workbook and a member of staff confirmed completion of the induction. Each staff member is also provided with a copy of the General Social Care Council standards of practice. We spoke with two members of staff who talked about the training and applying it in their work. Both told us that the staff and management work well as a team and there is good communication between staff and people who use the service and their families. They confirmed that they have regular formal supervision with the manager or assistant manager. St Leonards Rest Home DS0000011859.V375024.R02.S.doc Version 5.2 Page 20 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35 & 38. People using the 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 and management practices promote the wellbeing and best interests of the people who use the service. EVIDENCE: The manager is a registered nurse and holds the National Vocational Qualification (NVQ) level 4 in care management. She is supported by an assistant manager and two senior care assistants. Staff we spoke with told us that the management are supportive. One staff member said “Mary and Frank are great. They’re always there for you”. St Leonards Rest Home DS0000011859.V375024.R02.S.doc Version 5.2 Page 21 The AQAA was returned after the timescale. The owner sent us an email telling us they had not received the original request for the AQAA. The AQAA stated that the home was in the process of sending out a quality assurance questionnaire to all those involved or in contact with the home. The AQAA told us the results of this survey should be available by the end of May 2009. During our visit we saw that 19 survey forms had been completed and returned, including those from residents, relatives and carers, staff and healthcare professionals. The owners said that they will be responding with a letter informing people of the outcome of the survey. The results of the questionnaires that we saw were positive and indicated that people were very satisfied with the quality of service. A healthcare professional had commented “a very pleasant home”. Additional comments from the relatives of people who used the service included: “I couldn’t have wished for better care. My mind was totally at rest knowing she was well cared for.” “St. Leonards is a great home. Mary and Frank and all their staff are superb”. “Mother had a painting exhibited at the local library. She had never painted in her life before. This was thanks to St. Leonards and the trouble they take to stimulate residents”. We saw that the home has procedures for handling any resident’s finances. Records are maintained of any amounts being held for safekeeping alongside any amounts deposited or withdrawn. With the manager we did a sample check of one person’s record and cash balance and both matched. The AQAA told us the dates when the home’s equipment, such as fire detection and emergency call systems, gas and electrical appliances were serviced or tested. The home employs a private company to conduct annual health and safety checks, the most recent being carried out on 17/02/09. The owners said that they were receiving quotes for work to update the fire safety system in line with the fire safety officer’s recommendations from March 2009. The home has a shared fire evacuation procedure with another care home in the locality. The airing cupboard door was locked to prevent any risk to residents of burns. St Leonards Rest Home DS0000011859.V375024.R02.S.doc Version 5.2 Page 22 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 3 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 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 X X 3 St Leonards Rest Home DS0000011859.V375024.R02.S.doc Version 5.2 Page 23 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. Refer to Standard Good Practice Recommendations St Leonards Rest Home DS0000011859.V375024.R02.S.doc Version 5.2 Page 24 Care Quality Commission Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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. 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