Care Home: Sutton Valence Nursing & Care Centre

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What the care home does well The home provides good information for prospective residents. Care plans are detailed, and are kept up to date. The staff work hard to maintain these to a good standard. This ensures that the home is able to meet the health and social needs of each individual resident. The home provides a good choice of activities and outings; and visitors are made welcome in the home. Residents said that the quality, presentation, and variety of the food is of a consistently high standard. Residents said that they find the staff to be caring and friendly. Residents are involved in the life of the home, and know that their viewpoints will be taken into account. What has improved since the last inspection? The home has responded well to previous requirements and recommendations, providing an overall higher standard of care. This is reflected in the rating, which is now "good". The company have carried out a refurbishment of the premises. This includes redecoration, new carpeting or flooring, furniture and soft furnishings for all communal rooms and corridors, and thirty bedrooms. Two bathrooms have been altered into "wet rooms" so that residents now benefit from the choice of a bath or shower. A new activities organiser has been employed. She has brought an enthusiasm into the home for ensuring that activities are available to meet individual preferences. What the care home could do better: The complaints procedure on display in the entrance hall is unclear, as it does not include timescales or specific names and addresses. The procedure is included in a better format in the service users` guide, so there is a recommendation to ensure that the copy on display contains all relevant details. The company must keep working to improve the percentage of care staff who have completed NVQ 2 training.Staffing recruitment files must include a recent photograph of the staff member. The company must ensure that staff members are appropriately supervised i.e. they should have the opportunity for one to one supervision on a regular basis. CARE HOMES FOR OLDER PEOPLE Sutton Valence Nursing & Care Centre North Street Sutton Valence Maidstone Kent ME17 3LW Lead Inspector Mrs Susan Hall Unannounced Inspection 20th January 2009 08:45 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 Sutton Valence Nursing & Care Centre DS0000026208.V373620.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. Sutton Valence Nursing & Care Centre DS0000026208.V373620.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sutton Valence Nursing & Care Centre Address North Street Sutton Valence Maidstone Kent ME17 3LW 01622 843999 01622 844364 sutton.valence@fshc.co.uk 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) Tamhealth Limited (wholly owned subsidiary of Four Seasons Health Care Limited) Mrs Carla Jayne Wilson Care Home 73 Category(ies) of Old age, not falling within any other category registration, with number (73) of places Sutton Valence Nursing & Care Centre DS0000026208.V373620.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home can provide care for up to 8 persons with a physical disability 40 years and over. Date of last inspection 7th April 2008 Brief Description of the Service: Sutton Valence Nursing and Care Centre provides nursing care for seventythree older people. It is owned by Tamhealth Ltd., which is a wholly owned subsidiary of Four Seasons Health Care. Four Seasons operate care homes throughout the UK, and currently have over three hundred homes. Sutton Valence Nursing and Care Centre is located at the outskirts of Sutton Valence village. There is car parking at the front, and local public transport is available nearby. The home is purpose built, and is set in its own grounds, which overlook public playing fields. Accommodation is on two floors, with access to the first floor via two passenger lifts. Some of the rooms on the first floor have balconies that overlook the garden and car park areas; and some of the ground floor rooms look on to an inner landscaped courtyard. Most bedrooms are for single use, and shared rooms are only let for two people to use if this is their specific request. All the residents’ rooms are equipped with a nurse call system, television and telephone points. The current fees range from £437.02 to £850.00 per week. These are determined according to individually assessed needs. Extra payments are required for items such as chiropody, hairdressing and newspapers. Sutton Valence Nursing & Care Centre DS0000026208.V373620.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home is assessed as having a rating of good, 2 stars. This was a key inspection, which involves assessing all of the key national minimum standards; and takes into account the information obtained about the home since the previous inspection. This includes the Annual Quality Assurance Assessment, which was completed by the manager to a good standard, and submitted to CSCI within the required time frame. The visit was carried out by one inspector, and lasted for seven hours. During this time, we (i.e. CSCI) viewed all areas of the building, chatted with residents and staff, reviewed documentation such as care plans, medication charts, recruitment files, and staff training; and observed staff carrying out their duties. The inspector was accompanied for three hours by an expert by experience from Help the Aged. This is an arranged process by which a person with previous knowledge and experience of the care of older people, assists the inspector by chatting with residents and staff about specific aspects of the homes life. On this occasion we requested that she spend time with people discussing activities in the home, and the quality of the food. Her input was most helpful, and comments from her records have been included in this report. The home has had a Safeguarding Adults issue investigated during the past year by the Kent County Council Safeguarding Adults team. The manager and staff co-operated throughout the investigations, and the matters have now been resolved. Complaints in the home are well recorded, and are dealt with appropriately. The home has had a refurbishment in most areas during the past year. This has made a big difference to the quality of the accommodation, and residents and staff said how much better it is now. There has also been an increase in the numbers of staff on duty, and this has contributed to an overall improvement in care. The expert by experience included the following comments from residents in her report: The staff are wonderful; there is always something going on here; and “I am so happy here, I wouldn’t want to be anywhere else, and certainly not at home on my own”. Sutton Valence Nursing & Care Centre DS0000026208.V373620.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: The complaints procedure on display in the entrance hall is unclear, as it does not include timescales or specific names and addresses. The procedure is included in a better format in the service users guide, so there is a recommendation to ensure that the copy on display contains all relevant details. The company must keep working to improve the percentage of care staff who have completed NVQ 2 training. Sutton Valence Nursing & Care Centre DS0000026208.V373620.R01.S.doc Version 5.2 Page 7 Staffing recruitment files must include a recent photograph of the staff member. The company must ensure that staff members are appropriately supervised i.e. they should have the opportunity for one to one supervision on a regular basis. 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. Sutton Valence Nursing & Care Centre DS0000026208.V373620.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 Sutton Valence Nursing & Care Centre DS0000026208.V373620.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): 1-5 (standard 6 is not applicable in this home). Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides good information for prospective residents, enabling them to make a clear decision about staying in the home. EVIDENCE: The statement of purpose and the service users guide have been recently updated to indicate some changes in staffing. The statement of purpose is clearly set out, and includes all the required information, such as the admission criteria for the home, and the schedule of accommodation. The service users guide is provided in a folder with an attractive colour brochure, which has photographs of the home. The guide includes the aims and objectives of the home; and specific arrangements such as meal times, visiting, and health care management such as doctors visits. Clear terms and Sutton Valence Nursing & Care Centre DS0000026208.V373620.R01.S.doc Version 5.2 Page 10 conditions of residency are included; and the complaints procedure, and a copy of the current menu plan. All residents have a pre-admission assessment carried out, either by the manager, or by the clinical specialist for the home. Some residents are admitted for short-term respite care, and the same pre-admission assessments are carried out for each visit. We viewed four pre-admission assessments. These are documented using a new and very detailed process, called the Care and Health Assessment Profile. The same forms are used to check the condition of the resident at admission. These forms include data for every aspect of a persons life, such as past and present medical history, social and family background, psychological and mental health well being, medication needs and personal preferences. The four viewed had been very well completed. Some files were currently being updated so that all residents files have the same format for pre-admission data. Residents are admitted for a trial period of four weeks, after which a review is carried out to ensure that the placement is suitable. All residents are provided with a contract, and these state clearly if the contract is a private arrangement, or is via Local Authority funding. Sutton Valence Nursing & Care Centre DS0000026208.V373620.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): 7-11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Health and personal care is well managed, and residents are confident that staff will meet their individual needs. EVIDENCE: Care plans are discussed with residents on admission, and at monthly reviews. We examined five care plans from each of the three work areas – the ground floor; the left side on the first floor; and the right side on the first floor. The care plans are well completed and extremely detailed. Each resident has assessments and associated care plans for all aspects of daily living, such as personal care needs, mobility, continence, nutrition, pain levels, mental state and social needs. The care plans clearly identify each residents needs, and how to meet these. Personal care plans include specific data such as if the resident prefers a bath or a shower; if they clean their own teeth or need assistance with oral hygiene Sutton Valence Nursing & Care Centre DS0000026208.V373620.R01.S.doc Version 5.2 Page 12 and dentures; if they see the chiropodist or hairdresser; and if they have any skin conditions such as dry skin, wounds or bruises. Moving and handling care plans show if they require assistance with mobility, and include data such as use of wheelchair, hoist (and the type of sling), bath hoist, and sliding sheets for moving in bed. Wound care is well documented with separate documentation for each wound, and a record kept of each dressing change, showing the state and progress of the wound healing. These records are accompanied by dated photographs and body maps. Residents are assessed for the risk of falls, and care plans show the actions taken to prevent these. Any equipment used is clearly itemised, such as if the resident has a profiling bed, air mattress, or bed rails. Consent if obtained for the use of bed rails, after discussion with the resident or next of kin about the risk involved in using these. Consent is also obtained for taking photographs of wounds, and photographs for use on internal documents – such as Medication Administration Records, or for recording of social activities. There is a good liaison with local GPs, and referral to other health professionals as needed. This includes speech and language therapist, dietician, dentist and physiotherapy. Medication is stored in one large clinical room, and each work area has a separate medication trolley. Storage cupboards and two trolleys were inspected, and these were found to be in good order, with no overstocking of medication, or out of date items. Storage trays in the trolleys are colour coded according to which of the 3 GPs it is. Homely remedies such as paracetamol or senokot may be given, and each GP has signed agreement to this. Good records are maintained for auditing purposes. Controlled drugs are stored correctly, and the controlled drugs register is neatly and clearly maintained. Residents who wish to self medicate have a detailed assessment carried out, to ensure that they are able to administer their own medication effectively. There is a lockable storage facility in each bedroom. Good records are maintained for the receipt and disposal of medication. In response to a previous requirement, there are now sites on each floor where medication trolleys can be safely tethered in the event of an emergency during a medication round. Oxygen is stored in the clinical room, and there was a notice on the door in regards to this. There were also notices on bedroom doors showing where oxygen is in use. This is good management, but it would be clearer for authorised people coming into the home (such as fire officers) to use statutory warning notices, and there is a recommendation to provide these. Residents said that they are well cared for, and this was evidenced by observing that residents were well groomed, and appropriately dressed for the time of year. One resident said that they could not praise the staff highly enough; and another said that they are always willing to do anything to help. Staff were seen to show a caring and gentle attitude to residents. Residents who chatted with the expert by experience stated that they are very happy in the home, and staff are affectionate and friendly. Sutton Valence Nursing & Care Centre DS0000026208.V373620.R01.S.doc Version 5.2 Page 13 End of life care is discussed during the admission process as much as possible, depending on the different attitudes of residents and relatives. Care planning processes showed that there is a concern by the home to obtain sufficient information to enable them to carry out any specific wishes. There is also evidence that staff understand the implications of the mental capacity Act, and how this may relate to making decisions on behalf of residents who not longer have full mental capacity. When this involves decisions about end of life care, discussions are carried out between the GP, resident, next of kin and nursing staff. The doctor signs to confirm decisions which have been reached. This would be better evidenced if all parties were able to sign their agreement, and there is a recommendation to review the documentation for this process. Sutton Valence Nursing & Care Centre DS0000026208.V373620.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): 12-15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents enjoy the range of activities provided by the home. Food is well managed, and residents benefit from a nutritious and varied menu. EVIDENCE: There is a good variety of activities taking place in the home, and this includes one to one care as well as group activities. In order to assess this area more fully, we (i.e. CSCI) requested an expert by experience to accompany the inspector for part of the visit. This is a person who has prior experience and understanding of the care and social needs of older people, and we were grateful for the provision of a representative from Help the Aged. We asked her to spend time talking with residents about the range and variety of activities, and the quality of the food in the home. Her report confirmed that residents enjoy the activities and outings provided. Residents who are confined to their own rooms are visited by the activities coSutton Valence Nursing & Care Centre DS0000026208.V373620.R01.S.doc Version 5.2 Page 15 ordinator or care staff to help them read their newspapers or to play word games, puzzles etc. with them. Each resident has a social activities calendar included in their care plans, which is a weekly overview showing their preferences for different weekdays. The activities co-ordinator also maintains separate records showing each residents involvement. Activities include items such as coffee mornings, videos, quiz games, arts and crafts, musical entertainment and bingo. The home has a mobile shop available on certain days, so that residents can make their own small purchases. A church service is held in the home each month, and residents are supported with visiting churches or other places of worship as they wish. The home provides trips out several times per year. The expert by experience recorded that residents are taken on country tours as well as to the seaside and nearby towns. There is a photo album in the reception area which shows how much residents enjoy special occasions. Attention is given to meeting different needs and ideas, such as providing a garden area for one resident to grow his own flowers and vegetables. There is also a variety of clubs, such as a flower arranging club, a movie club (complete with popcorn sometimes!), a poetry club and a nature club. Residents from the nature club have enjoyed going out bird watching, making bird feeders, and watching the rabbits, squirrels and other wild life in the grounds. The expert by experience visited the kitchens and talked with the chef and other kitchen staff. The kitchens were seen to be well organised, and there is a varied menu. This takes residents individual preferences and personal choices into account. There are choices available at lunch and tea times. Cooked breakfasts are available every day, and some residents take advantage of this. The chef spends time talking with residents on a regular basis, so that he is fully aware of how they regard the quality of the food; and of additional items they would like on the menu. Chocolate bars, drinks, and fresh fruit are available any time. There is a large bowl of attractively presented fresh fruit kept in the reception area, and residents help themselves to this. Lunch was seen to be well presented, and looked appetising. All residents spoken with were very complimentary about the food, and had no complaints. Sutton Valence Nursing & Care Centre DS0000026208.V373620.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. Complaints are taken seriously and are dealt with appropriately by the management. Staff are trained in the recognition and prevention of adult abuse, so that residents are protected from abuse. EVIDENCE: The complaints policy and procedure is included in the service users guide, and this contains relevant information about applying to the manager, or regional manager. It also includes the details for CSCI, and states timescales for responding to complainants. The complaints procedure is also on display in the front entrance hall. It is helpful to have this displayed in an area which is easily accessible, but unfortunately this copy did not include all of the relevant data, such as timescales, and names and addresses. It may be helpful to include the details for the local Social Services office, as a reminder to complainants that this is a good pathway to follow, as well as speaking with the manager. The complaints log is well maintained, and records the details of each complaint, and the action taken to address these matters. It shows that the management takes complaints seriously, and deals with them appropriately. Sutton Valence Nursing & Care Centre DS0000026208.V373620.R01.S.doc Version 5.2 Page 17 The manager has a good understanding of the processes for managing any issues related to safeguarding vulnerable adults. Some safeguarding issues were raised during the past year, and the Kent Social Services Safeguarding team has addressed these. The home co-operated fully with the processes of investigation. These matters have now been resolved, and there are no outstanding issues. The home has a copy of the Kent and Medway protocols available, and all staff are trained in the recognition and prevention of different types of abuse. Sutton Valence Nursing & Care Centre DS0000026208.V373620.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 home has benefited from a refurbishment during the last year, and the premises provide a pleasant and comfortable home for the residents. EVIDENCE: The home has undergone a thorough refurbishment of the premises during the past year. This has included the lounges, dining room, conservatory, reception area, corridors and thirty bedrooms. The refurbishment included new carpets or flooring, new furniture, and new curtains and other soft furnishings. Two bathrooms have been converted into wet shower rooms; and fire door guard fitments have been added to all bedroom and office doors. This means that residents can safely leave their bedroom door open if they prefer, as the fitments will close the doors in the event of fire. There are call bells in every Sutton Valence Nursing & Care Centre DS0000026208.V373620.R01.S.doc Version 5.2 Page 19 room, and residents are able to call for help wherever they are by the use of call buttons. We viewed all areas, and observed that the communal areas have good quality fittings and furniture, and are pleasant places to sit. There is a quiet sitting area on the first floor, and a separate quiet room, providing residents with a range of choices. The quiet room is often used for visits for families and friends. There is currently a designated smoking room on the ground floor. The home has well maintained gardens; and new outdoor garden furniture was purchased during the homes refurbishment. There are plans to alter an existing rose garden into a sensory garden, so that this will provide colourful plants throughout the year. This topic has been discussed and agreed at residents meetings. Bedrooms contain good quality furniture and soft furnishings, and can be personalised according to choice. Most beds are profiling beds or hospital beds. Some rooms have en-suite toilet facilities. As well as shower rooms, there is a bathroom on each floor with an adapted bath, so that residents can enjoy jacuzzi style baths. There are sufficient numbers of disabled toilet facilities available on both floors, and near to communal areas. The home has two passenger lifts, and sufficient equipment such as pressure relieving mattresses and bath hoists. There are currently six mobile hoists/standing hoists, but only one of these is designated for the first floor right unit. The manager said that another hoist is being purchased for this unit. Many residents use commodes for night time use, and there are sluice rooms on each floor. These were clean and tidy. All radiators are covered for safety, and routine checks are carried out by the maintenance man for items such as hot and cold water temperatures, bed rail checks, and fire safety checks. The home was noted to be very clean in all areas, and there were no offensive smells. There are usually three domestic staff on duty each day, which is important for such a large building. There is also a housekeeper, and a laundry assistant each day. The laundry is divided into separate areas for clean laundry and dirty laundry, and there are three washing machines and two tumble dryers. A red alginate bag system is used for the management of soiled items. The laundry room and other specific areas are protected with a keypad system on the doors. Sutton Valence Nursing & Care Centre DS0000026208.V373620.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): 27-30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has suitable numbers of well-trained and competent staff to deliver all aspects of care. EVIDENCE: The home is divided into three units, and there is a trained nurse for each unit for all day shifts – i.e. three nurses on duty in the day times. There is also a clinical nurse specialist on duty from Mondays to Fridays, who is supernumerary, and provides additional support and back up for trained staff. Night duties are covered with one nurse for the ground floor, and one nurse for the first floor. There are four care staff for each unit in the mornings, and three care staff for each unit in the afternoons and evenings. There are five carers at night. Residents said that care staff respond quickly to calls, and do not leave them waiting for long periods of time. The company pay for care staff to study for NVQ level two or three training, but there are currently only eight care staff that have completed this training, which is only twenty-two per cent. Four care staff are in the process of training and two others are waiting to commence the course. This will bring the Sutton Valence Nursing & Care Centre DS0000026208.V373620.R01.S.doc Version 5.2 Page 21 percentage up to a more acceptable level, but still below the target of fifty per cent. Recruitment procedures are well managed. Three staff files were inspected, and included required items such as an application form with full employment history; POVA first and Criminal Record Bureau (CRB) checks; two written references; health questionnaire; proof of identity; and confirmation of previous training. Some staff files did not contain photographs, and the manager said that these were in the process of being done. One file did not appear to contain a full employment history, and the manager said that she would ensure that this is full checked during interview procedures. Interviews are carried out by two senior staff, and a record of the interview is retained. Work permits are obtained and checked as needed, and nursing staff have their PIN number checked against the Nursing and Midwifery Council records. All staff go through a detailed induction programme, and a probationary period, during which all mandatory training is completed. The company have their own training department, and in house trainers are supported by a regional trainer. The home has two staff who are trained as trainers in moving and handling, and these staff ensure that procedures are being carried out correctly. Staff training records confirmed up to date training has been completed for moving and handling, fire safety, health and safety and protection of vulnerable adults. Kitchen staff are all trained in basic food hygiene, and all care staff are currently completing this training. The number of staff with first aid training is increasing each year, and there are designated first aid staff on each shift. There are additional training programmes for subjects such as customer care, communication skills and dementia care; and several staff are in the process of commencing a twelve week course in palliative care. Sutton Valence Nursing & Care Centre DS0000026208.V373620.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, and 35-38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good management processes ensure that the home is well maintained and runs smoothly. EVIDENCE: The manager is a trained nurse, who has been working in care home management for nearly seven years. She has completed the Registered Managers Award, and ensures that she keeps her own training up to date. The company have regional managers in place who provide support for the home managers; and carry out auditing programmes. Several residents spoke highly of the manager without any leading questions being asked. They said that she does a good job and makes sure everything keeps running smoothly. Sutton Valence Nursing & Care Centre DS0000026208.V373620.R01.S.doc Version 5.2 Page 23 The staff work well together as teams, and are able to discuss ideas and issues at staff meetings. Students from Christchurch College are seconded to the Home and confirmed that they are enjoying the experience and feel it is a good and happy home. All staff have an individual training and personal development file. Yearly appraisals are carried out, and were in the process of being completed for the last year. There is a staff supervision programme in place, but this is not working well. Some staff have not had formal one to one supervision for several months. Supervision has been delegated to different department heads. The recording process is very formal and may not take into account the daily discussions and training going on between members of staff. Staff are confident that they can go to senior staff or the manager for advice, and are aware that the manager has an open door policy. Residents have monthly meetings to discuss changes in the home, and ideas for the future. They know that they are able to put their ideas forward, and they will be listened to and taken seriously. There is also an annual customer survey carried out by an independent company. They produce the results in a clear format which is available for residents and visitors to read. Monthly (Regulation 26) visits are carried out by the companys regional managers. There are clear processes in place for managing residents monies. Small amounts are held in individual accounts, and these are all invoiced on computer. Two signatures are required for transactions, and the manager countersigns these. A monthly statement is provided to the resident or their representative on request. These accounts are audited by the regional support administrators. Records in the home are stored so as to maintain confidentiality, and are kept up to date. Routine health and safety checks such as fire drills and weekly fire checks are carried out by the maintenance man. He also carries out visual checks for electrical items coming into the home, until they are professionally PAT tested. A sample of maintenance and servicing records was viewed, and these were found to be good records, clearly recorded, and up to date. Sutton Valence Nursing & Care Centre DS0000026208.V373620.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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 X 3 3 3 STAFFING Standard No Score 27 3 28 1 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 2 3 3 Sutton Valence Nursing & Care Centre DS0000026208.V373620.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. 1 Standard OP29 Regulation 19 & Schedule 2 18 (2) Requirement Staffing recruitment files must include a recent photograph of the staff member. The company must ensure that staff members are appropriately supervised i.e. they should have the opportunity for one to one supervision on a regular basis. Timescale for action 28/02/09 2 OP36 28/02/09 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 2 3 Refer to Standard OP9 OP16 OP28 Good Practice Recommendations To provide statutory hazard signs for places where oxygen is stored or in use. To ensure that the complaints procedure contains all the relevant details, and is easily available to anyone entering the home. The company must keep working to improve the percentage of care staff who have completed NVQ 2 training. Sutton Valence Nursing & Care Centre DS0000026208.V373620.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Sutton Valence Nursing & Care Centre DS0000026208.V373620.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. 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