Care Home: The Conifers Care Home

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What the care home does well The care plans are person centred and give staff clear guidance about how to support people with their need. They are agreed with the person themselves so they are clear about how staff intend to help them. Health care needs are properly assessed, provided for and referrals for treatment are made to maintain the health and wellbeing of people living at the home. People are treated with respect for their dignity and privacy and the people living at the home think the staff are "wonderful." A good range of activities are on offer both in the home and the community, and people are encouraged to maintain their daily living skills by helping with household chores if they wish to. People are given choices in all areas of daily life and these are respected by the staff at the home. Relatives and friends are welcomed into the home, and are encouraged to ask questions, give feedback and make themselves at home. The food is of good quality, with lots of choice and plenty to eat. The people who live at the home like the food. The environment is clean, safe, homely, comfortable and well maintained, people like living there. There are enough staff to support the people living at the service with all of their needs and help is provided when they need it. The staff are well trained and they know how to do their jobs and what help the people living at the home need. The people we spoke with praised them very highly. The people living at the service and their relatives tell us the home is very well run and managed. They are asked for their views on care and action is taken to address any issues of concern to make sure the service is responsive to the people living there. People`s money is well managed, recorded and handled, their financial interests are protected. People told us, "It`s lovely, you can`t fault it, and it`s my home. The staff are wonderful, superb, I love living here. I have a close friend I sit with and I share a room but I don`t mind at all." What has improved since the last inspection? People are properly assessed before being admitted to the home to make sure their needs can be met there. They are given good information on which to base their decision about whether to move into the home. The arrangements for recording what medication has been administered have improved significantly and there were no gaps on the Medication Administration Record sheets. It is now clear what medication people have taken and if it has not been given there is a clear reason identified.All complaints are properly recorded, investigated and responded to so that people can be assured their concerns have been heard and responded to. All of the staff have now had training on safeguarding adults and they know that they must report any inappropriate behaviour to make sure people living at the service are safe from harm and abuse. All of the staff that work at the service have either got, or applied for a Criminal Records Bureau check to make sure they are suitable to work with vulnerable people. The staff have done a lot of training in the past year to make sure that they have understand how to do their jobs well and how to make sure the people living at the service are safe. The records are now kept safe and people can be assured that their confidentiality is maintained. What the care home could do better: The staff rota could be completed more accurately so it is clear what hours staff are working and in what capacity. The pre employment checks could be improved to make sure the service is following guidance which is in place to protect vulnerable people from those who may be unsuitable to work with them. Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Conifers Care Home 15 Bakerdale Road Bakersfield Nottingham NG3 7GJ     The quality rating for this care home is:   two star good 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: Linda Hirst     Date: 0 8 0 9 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 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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 30 Information about the care home Name of care home: Address: The Conifers Care Home 15 Bakerdale Road Bakersfield Nottingham NG3 7GJ 01159110024 F/P01159110024 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Debra Frances Buxton care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 16 The registered person may provide the following categories of service only: Care Home only - Code PC 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 Dementia - Code DE Date of last inspection Brief description of the care home The Conifers in an adapted and extended property situated in the heart of a residential area of Bakersfield, about two miles from Nottingham City Centre. The home provides care for up to 16 older people or for people with Dementia. It does not provide nursing care. Ten bedrooms have en suite facilities. The bedrooms are on the ground and first floor and there is a stair lift to provide access to the upper floor. Two of the first-floor bedrooms can only be accessed via a stairway that does not have a chair lift therefore these bedrooms are only suitable for more mobile residents. There is a shared bedroom on the ground floor. Local shops, public houses and public transport are easily accessible from the home, although the road has a slope so people with mobility Care Homes for Older People Page 4 of 30 16 0 Over 65 0 16 Brief description of the care home difficulties may need assistance to go out. The fee for care and accommodation at this home is £385 per week. This is regardless of room size and whether or not fees are paid by Social Services or paid privately. All of the people who live at the service have a copy of the service user guide and the most recent inspection report in their bedroom. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The Quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for people who live at the home and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. We have introduced a new way of working with owners and managers. We ask them to fill in a questionnaire about how well their service provides for the needs of the people Care Homes for Older People Page 6 of 30 who live there and how they can and intend to improve their service. We received this back from the manager in good time and the form was well completed and helped us to plan our visit and to decide what areas to look at. We also reviewed all of the information we have received about the home since we last visited and we considered this in planning the visit and deciding what areas to look at. We sent out 8 surveys to people living at the home, and 4 to staff to get their views on the service being provided. We received six back from people who use the service, and three from staff. These were overwhelmingly positive, comments included, My (relative) has not been resident at the Conifers for long. Although it was a decision made in some haste we were absolutely convinced after a visit that this was the right home for our (relative). A staff member commented, The service provides good well being, a nice, clean friendly place to be in excellent person centred care and much more. I think an excellent service is provided. The main method of inspection we use is called case tracking which involves us choosing three people who live at the service and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. English is the first language of all of the service users living at the home at the moment. The staff team come from a variety of backgrounds and experiences. We spoke with two members of staff, a relative and a person living at the service to form an opinion about the quality of the service being provided. We read documents as part of this visit and medication was inspected to form an opinion about the health and safety of people who live at the service. What the care home does well: What has improved since the last inspection? People are properly assessed before being admitted to the home to make sure their needs can be met there. They are given good information on which to base their decision about whether to move into the home. The arrangements for recording what medication has been administered have improved significantly and there were no gaps on the Medication Administration Record sheets. It is now clear what medication people have taken and if it has not been given there is a clear reason identified. Care Homes for Older People Page 8 of 30 All complaints are properly recorded, investigated and responded to so that people can be assured their concerns have been heard and responded to. All of the staff have now had training on safeguarding adults and they know that they must report any inappropriate behaviour to make sure people living at the service are safe from harm and abuse. All of the staff that work at the service have either got, or applied for a Criminal Records Bureau check to make sure they are suitable to work with vulnerable people. The staff have done a lot of training in the past year to make sure that they have understand how to do their jobs well and how to make sure the people living at the service are safe. The records are now kept safe and people can be assured that their confidentiality is maintained. 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 30 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 30 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. People who want to live at the service have their needs assessed and they are given the information they need to help them make informed choices about living at the service. Evidence: The provider told us in her Annual Quality Assurance Assessment that prospective service users are assessed in their current setting, and that the statement of purpose and service user guide are updated annually. We looked at the care plan of the person who was most recently admitted to the service and found that there was a comprehensive assessment of their needs in place and a full care plan. The person had been admitted in an emergency. We received a complaint before our visit about the service admitting people outside of Care Homes for Older People Page 11 of 30 Evidence: their category of registration and we issued an immediate requirement which has been complied with. The provider applied to add Dementia care to her registration category and this has been approved so the situation should not reoccur. People we spoke with told us that they either already knew of the service or that they looked around and chose to live at the home. One person told us, I was given full information about the service, and another said, I would not have come anywhere else. We have a lovely home, and its all very easy. The staff we spoke with have a clear understanding of the admissions process, they told us, I read the care plans and the managers give a verbal update, this helps us settle people in. I talk to people about their life and preferences, sometimes I take them for a walk, show them the home and the garden. Intermediate care is not provided at the service and this standard is not applicable. Care Homes for Older People Page 12 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal and healthcare needs are assessed and provided for in a way which shows respect for the privacy and dignity of people who live at the service. Evidence: The provider told us in her Annual Quality Assurance Assessment that there is a comprehensive care planning system in place with regular reviews built in. The care plans we saw were person centred and covered issues to do with mental capacity, and they give clear guidance to staff about how to involve people in the delivery of care to them. There is a clear record of peoples likes, dislikes and preferences. We saw evidence of regular reviews taking place and people have signed their care plans to show that they agree with them. A relative told us, they tell my relative about what they will do for him. They ask my relative too so hes involved. You can ask them anything. A person living at the service told us, I received a lot of care plans which I am very pleased about, it helps me to know what is happening and it is very helpful to me. Care Homes for Older People Page 13 of 30 Evidence: The staff we spoke with told us, the managers write the care plans and they tell us when they are ready. We make time to read the care plans and the plan tells us what people can do themselves and what they need help with. We also talk to residents about their personal history. The provider told us in her Annual Quality Assurance Assessment that people can stay with their own Doctor if possible, and that all staff have had training on promoting continence in the past year as well as training on supporting people who have Dementia. People living at the service told us, I have my own Doctor and although I am well, if I have any problems the staff call him straight away. Another said, I receive excellent support on medical needs. Relatives commented, Health is looked after well, they walk (my relative) down to the surgery for tests and call a Doctor if (my relative) is unwell, It is a relief to know that my (relative) is so well cared for. The staff we spoke with knew the people who are at risk of pressure areas developing, and they told us that mattresses and cushions are provided as a preventative measure. They also told us that some people have a District Nurse visiting and one person has been referred to a dietician. They said the managers refer any medical needs to the Doctor and, the Doctors respond very quickly. We found the healthcare needs of people living at the service are being assessed and there is clear evidence in the records that they are referred for specialist advice and treatment as needed. The provider told us in her Annual Quality Assurance Assessment that, staff are only allowed to administer medication when they have had training and are competent. The staff we spoke with confirmed that they have received training both from Boots and they have done a more intensive five week course at a local college. We saw evidence of this in training files. We found that medication is securely and appropriately stored. We observed medication being administered safely and the records are clear and fully completed. The manager has a photograph of each person on their Medication Administration Record sheet, and there are also person centred directions for staff as to how people prefer to take their tablets. (E. g. likes to chew all tablets.) Staff told us, sometimes people refuse their tablets but medication is given out safely. One relative told us, (my relatives) Warfarin dose changes regularly, and although I Care Homes for Older People Page 14 of 30 Evidence: have never seen them give out tablets he is well and healthy. People told us that the staff treat them with respect, the staff are lovely. If I want to be alone I can, if I want privacy they respect that. The staff are nice to me, if they werent Id tell the boss. A relative we spoke with told us they have never seen any of the staff be impatient or unkind, the staff are nice with the residents, they talk to them a lot. A person said in their survey, the care and support is wonderful and very much appreciated. The staff showed a good understanding of the principles of respect and dignity and they told us, I have never seen anyone behave in a negative way towards residents. (The managers) would expect us to report this. Care Homes for Older People Page 15 of 30 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. People have a flexible lifestyle which is in accordance with their needs, ability and preferences. Evidence: The provider told us in her Annual Quality Assurance Assessment that activities are provided in line with the ability and preferences of people living at the service. They do a quarterly newsletter to keep all of the people living at the service abreast of news about staffing, events and activities which have been held. Themed days have been arranged, such as Royal Ascot Day and St Patricks Day and a garden party is planned. Relatives are encouraged to attend. They have made improvements to the service by creating sensory area in the garden and specific and identifiable activity areas around the home. They have improved signage to help orientate people who have Dementia, and they plan to introduce raised beds so that people can tend their own plants. The staff we spoke with told us they take people for walks to the local shops and cafes, they play board games, cards, look at reminiscence photographs, watch DVDs, play music and read newspapers with people who live at the home. They also arrange meals out for people. Care Homes for Older People Page 16 of 30 Evidence: One person who lives at the service commented, they have games, a computer, exercises, sometimes we go for a pub lunch or go out for a little walk or go to the cafe for a coffee and we can listen to music. Another said she likes to paint, enjoys listening to music, reading and watching television. the gardens lovely, weve been out a lot, we go for pub lunches I also like to help in the kitchen, I dry the pots up. Relatives commented positively on the activities and said, they do all sorts of things; games, music, reminiscence. They take them out as well, to Stoke Bardolph for lunch, they go out for Christmas, they sit out in the garden and they take (my relative) to get a paper from the shop every morning. Another said, My (relative) is stimulated and encouraged to take part in activities on a daily basis. The provider told us in her Annual Quality Assurance Assessment that visitors are encouraged and welcomed. Relatives who completed comment cards and who we spoke with were very positive about the service. They all said they are welcomed into the home, as visitors we are also made very welcome, they are always welcoming to visitors and listen and act on any concerns of the residents family. If I have any questions they will always answer them, they always give you a chance to ask questions. The staff also confirmed that relatives are welcome to come to the home when they like and to ask any questions. The provider told us in her Annual Quality Assurance Assessment that there is flexibility and choice in all routines and areas of daily life. One person we spoke with told us, I get up when I feel like it. I could lie in. I like to go to bed late as I have a lot of things to do. I get a choice for every meal. Staff we interviewed demonstrated a good knowledge of the individual routines of people living at the service. They commented in surveys, we always give choices to residents and we do lots of activities with residents of their choice. We observed lunch which is served in two dining areas. There were two choices and people asked what they would prefer. The food looked and smelled appetising, people were asked if they would like an apron on and the purpose of this was explained to them. People who need assistance to eat are supported by staff in a discreet, caring and supportive manner. The meal time was quiet and relaxed. People living at the service commented to us, we get a choice in what we would like Care Homes for Older People Page 17 of 30 Evidence: at mealtimes which I find nice, we get lots to eat, good, hot food. The staff we spoke with demonstrated a good understanding of the importance of choice and a good healthy intake of food and drink. They know who is losing weight and monitor them. Care Homes for Older People Page 18 of 30 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 know how to complain and have confidence that concerns would be acted upon and responded to. The people who live at the service are safeguarded from harm and abuse. Evidence: The provider told us in her Annual Quality Assurance Assessment that there is a comprehensive complaints procedure, that all complaints are recorded and responded to within a 28 day timescale and a copy of the investigation and outcome are sent to the complainant. A complaint was made directly to us about people being admitted outside of the category of registration. This has been recorded at the service and appropriate action has been taken to prevent a reoccurrence of this, (See OP3). We saw the complaints procedure on display in the home, and the people we spoke with all knew they could complain and how to do this, I have never had to complain, but I would and I know they would deal with it properly. I have never had to complain, I have nothing to complain about, but if I did, I would and the boss would deal with it. Staff we spoke with said they had never dealt with a complaint but they talked us Care Homes for Older People Page 19 of 30 Evidence: through the procedure and the action they would take if complaints were made. I think it would definitely be sorted out and dealt with. The provider has told us in her Annual Quality Assurance Assessment that all staff have received safeguarding training since our last visit. There have been no safeguarding allegations in the past year. We looked at the training file and found evidence of the safeguarding training. People who we spoke with told us they feel safe at the home, I have never seen staff respond in a bad way towards residents, I feel completely happy that (my relative) is safe, the staff are lovely and I have never seen anything that worried me. The staff we spoke with told us they have received safeguarding training, they told us, I have never seen anyone behave in an abusive way. I would report them to the managers and I know they would deal with it straight away. Care Homes for Older People Page 20 of 30 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. People live in a clean, safe, comfortable and well maintained home which meets their needs. Evidence: The provider told us in her Annual Quality Assurance Assessment that the environment is maintained to a high standard of comfort and hygiene. There have been improvements to the decor and carpeting in various parts of the home since our last visit and they plan to fit radiator covers to exposed heaters. We did a partial tour of the accommodation and found it to be clean, comfortable and furnished to a high standard. The home was clean, fresh and odour free. As the service now offers a service to people with Dementia there are signs around to orientate people and the garden has a sensory area to stimulate the senses of people with Dementia. There are two lounges, and a designated pamper area for people to have their hair and nails done. People commented in surveys, It is the only home I have ever been in that doesnt have an unpleasant smell of urine. It is spotlessly clean and always fresh. Those we spoke with said, We have quiet areas to sit if we wish to have some alone time. We have landscaped gardens and can sit outside for coffee etc (weather permitting), and, Care Homes for Older People Page 21 of 30 Evidence: the home is clean, homely and warm. Staff we spoke with told us, repairs are done quickly. The home is well maintained and safe, it is always clean and free from odour. If the weather is nice we have tea outside. Care Homes for Older People Page 22 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by well trained staff in sufficient numbers to meet their holistic needs. However, the way in which staff are recruited is not robust enough to ensure that people are protected from those who may not be suitable to work with vulnerable people. Evidence: The provider told us in her Annual Quality Assurance Assessment that the staff are well trained and loyal and all have either achieved National Vocational Qualification level 2 or are doing this; agency staff are not used. We looked at the staff rota and found that there are usually three care staff on in the morning (excluding the managers) and two on in an afternoon (excluding the managers.) The night shift is staffed by two people. Cleaning staff are also employed. However, we found that the staff rota is not an accurate reflection of the hours worked by staff and in what capacity. The people living at the service told us that there are enough staff on duty to help them with their needs, I dont have to wait for help. You ask them for something and its done. A relative commented, there are enough staff on duty, (my relative) does not have to wait for long. The staff are very good. Care Homes for Older People Page 23 of 30 Evidence: The staff we spoke with confirmed that there are enough staff on duty to meet the needs of the people living there. When we looked at the training records we found evidence that the service has already achieved the target of 50 of care staff trained to National Vocational Qualification Level 2. They have also attended a number of other courses in the past year, including; Health and Safety, Basic Food Hygiene, Infection Control, Basic First Aid, Moving and Handling, Dementia Care training, Mental Capacity Act training and Medication training. The relatives and people living at the service commented that the staff are good and are competent in their role, the staff are nice and cheerful. It was the best choice I made, the staff are wonderful, I get on well with all of them, they are very good. The staff we spoke with confirmed they have attended a number of courses and said they get good access to training, support and supervision. The provider told us in her Annual Quality Assurance Assessment that all staff have had satisfactory pre employment checks in the past 12 months. We looked at three staff files but found some staff have started work before the Protection of Vulnerable Adults First check has been returned. When this was discussed with the provider she stated this was because of confusion about the rules. We confirmed with staff that they work under direct supervision until their Criminal Records Bureau check comes through so the person would not have been alone with vulnerable people, but the correct procedure has not been followed. We also found that although there is a Criminal Records Bureau check in place for each person, where there are previous convictions there is no evidence that these have been discussed with the person or their continued employment risk assessed. The provider said this was done verbally but there is no proof of this. Staff we spoke with confirmed that they all had pre employment checks before starting work. Care Homes for Older People Page 24 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is well managed and being run in the best interests of the people who live there. Evidence: The provider told us in her Annual Quality Assurance Assessment that the service is well managed; that there is an annual review of the quality of service and that finances are safe and records are well maintained. It states that the Data Protection Act is complied with. People we spoke with commented that the home is, very well run. I dont think it needs improvement, it is brilliant as it is. Its lovely, you cant fault it, its my home. I love living here. A relative commented, I am very happy that (my relative) is here, they look after people very well, how the carers are with the residents is fantastic. The staff told us that, the manager is very nice, she is fair, if she is unhappy with us she will tell us. The management and staff are friendly. Care Homes for Older People Page 25 of 30 Evidence: Quality Assurance surveys were sent out and the responses collated. There was a very good response rate and the results are contained in the newsletter sent to all of the people living at the service and their relatives. Only two issues were raised; about the removal of a hot and cold water drinks dispenser, which has been replaced by alternatives, and about activities, which has been addressed by being proactive at publicising activities in the home. The people we spoke with all confirmed that they have been asked for their views on the care provided. The provider has, in addition undertaken a full audit of all of the standards during the course of the year with the Deputy Manager to ensure the service is operating as it should. We looked at the arrangements for peoples finances and found the records to be well maintained, with receipts for any expenditure. The staff had no comments to make in this area as they do not have any dealings with peoples finances. The people we spoke with manage their own money. We found that the Health and Safety testing and servicing has been undertaken as required and staff told us that their Health and Safety is well protected and they are up to date with all statutory courses. This was confirmed by training records. Care Homes for Older People Page 26 of 30 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 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 27 17 The rota must specify the hours people work and in what capacity To show that there are enough staff on duty to meet the needs of people living at the service. 22/10/2008 2 29 19 People must not start working at the service until you have received their Protection of Vulnerable Adults First check To make sure that people are protected from those who may be unsuitable to work with them. 22/10/2008 3 29 19 If people have cautions, 22/10/2008 reprimands or convictions on their Criminal Records Bureau check, there must be evidence that these have been discussed with them and their continued employment risk assessed Care Homes for Older People Page 28 of 30 To protect the people in your care. 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 Care Homes for Older People Page 29 of 30 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 © (2008) 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. 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