Care Home: The Croft

Similar services:

• Flint House
• St Vincents
• The Cotswold Home
• Fairways
• Winton House
• Treloar College
• Rush Court

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Croft Chestnut Lane Amersham Bucks HP6 6EJ     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: Mike Murphy     Date: 3 0 0 4 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 29 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 29 Information about the care home Name of care home: Address: The Croft Chestnut Lane Amersham Bucks HP6 6EJ 01494 732500 01494 732 510 lorraine.coe@heritagecare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): Type of registration: Number of places registered: Heritage Care Mrs Lorraine Coe care home 60 Conditions of registration: Category(ies) : People with Dementia Number of places (if applicable): 0 Older People (over 65 years old) who are 0 not covered by any of the other categories People with a physical disablity Additional conditions: 60 older people- some of whom may have dementia and/or physical disabilities 2 3 0 5 2 0 0 7 0 Date of last inspection Brief description of the care home The Croft is a residential home providing accommodation for sixty elderly residents in the categories of old age and dementia. The accommodation is over two floors and access to the first floor is via a passenge lift or stairs. The home has sixty single bedrooms all having en-suite facilities. The communal areas are well situated on the ground and first floor. There are pleasant gardens to the rear of the home. The layout of the home is conducive to meeting the needs of residents. The home is divided into four residential units. The home is situated in Amersham.The town is well served by public transport: buses, rail and London Underground. Information regarding the service offered is available from the home on request. Care Homes for Older People Page 4 of 29 Care Homes for Older People Page 5 of 29 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: This unannounced inspection was carried out by one inspector in April 2007. The inspection process included consideration of information supplied by the manager in advance of the inspection, a visit to the home, examination of records (including care plans), discussions with staff, residents, and relatives, discussion with the manager, a walk around the home and garden, observation of practice, and consideration of the results of a CSCI survey in which questionnaires were sent to residents, health and social care professionals and staff. Fees at the time of this inspection ranged between £480 - £512 per week. Care Homes for Older People Page 6 of 29 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk.You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line – 0870 240 7535. 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 home Page 8 of 29 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. The needs of prospective residents are assessed by experienced staff before an offer of a place in the home is made. The assessment process aims to ensure that the home can meet the person’s care needs. Evidence: The home only accepts referrals from Buckinghamshire Social Services, in particular from the team for services to older people based in Amersham. The referral to the home includes a copy of the community care plan for the person. On receipt of a referral the Registered Manager, Deputy Manager or a Care Team Leader make arrangements to visit the person at their current place of residence to carry out an assessment. The assessment is structured by completion of a Heritage Care dependency scale. The pre-admission assessments examined during the Care Homes for Older People Page 9 of 29 inspection visit were comprehensive and of a very good standard. The prospective resident and their family or representative are provided with a copy of the homes brochure and service users guide which provide comprehensive information on the facilities and services available at the home. The guide was being updated around the time of this inspection. The outcome of the assessment is discussed with the manager and other senior staff. A decision on whether the home can meet the persons needs is made. Where an offer of a place is made the prospective resident and their close relatives are invited to view the home and its facilities. The home liaises with the referring care manager. A room is prepared and an initial care plan drawn up. A key worker is assigned to the person. There is an initial three month settling-in period. A review meeting involving the person, their relatives, key members of staff, a social worker, and, in some cases a health professional, is held at the end of this period. If all parties are satisfied then a permanent place is offered. The review meeting may take place earlier than three months if necessary. care home Page 10 of 29 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. A comprehensive care plan is in place for each resident. Care plans are based on an assessment of needs, risk assessments and liaison with health and social care agencies in the community. Care plans ensure that peoples’ needs are met, that risk is minimized, and that the independence of individual residents is supported. Evidence: A care plan is in place for each resident. The care of four residents was examined in detail. The care plans examined were comprehensive. All had a photograph of the resident - although the quality of the picture varied. Care plans include basic information (key contacts etc.), an assessment of support needs in relation to personal care, information on the persons environment and on social aspects of the persons life, daily living activities, a section which rather oddly combined Financial and Spiritual aspects of the persons life, risk assessments, and other relevant information (such as a description of the person or a summary of their life written by members of their family). Care Homes for Older People Page 11 of 29 Individual care plans included information on any problems with memory, emotion, mobility, continence, eating, help required on getting up and going to bed, washing and dressing. They also included dietary preferences, interests, information on contacts with family and friends, and references to end of life care. Risk assessments covered manual handling, Waterlow pressure sore risk assessment (though not as a matter of routine for all residents), and a general risk assessment. The manager said that no resident had a pressure sore at the time of this inspection. Care plans are reviewed quarterly in the home and annually with care managers. Entries are made on a persons Personal Care Chart at the end of each staff shift. These include sections on personal care, diet/fluid intake, skin condition, and activities. All residents are registered with a GP. The home is in touch with five GP practices in Amersham and Chesham. Referrals to district nurses may be made directly and the home has frequent contact with district nurses. A podiatrist visits fortnightly. A dentist visits when required. An optician will also visit when required. Specialist mental health professionals, such as psychiatrists and community psychiatric nurses (CPNs), and other health professionals are accessed through the persons GP. Medicines are prescribed by the persons GP and are dispensed by Boots Chemists. Tablets are mainly dispensed in the Boots monitored dosage system (MDS). Medicines are stored in cupboards in each unit. Medicines requiring cool storage are stored in a locked box in the fridge. Staff are trained by Boots Chemists. Competence is assessed in the home through supervised practice and a test. Care staff are not permitted to administer medicines until the they have been assessed as competent. Some reference texts for staff could be updated (CSCI and The Royal Pharmaceutical Society of Great Britain have both published guidance since October 2007 and a new edition of useful general textbook was published by the BMA in 2007). The home had a 2008 edition of a British National Formularly (BNF). The Medicines Administration Records (Mar charts) folder includes a photograph of the person, the MAR chart, and risk assessments for as required (also known as PRN) medicines. MAR charts examined during the course of this inspection visit were in order although it was noted that in one case Senna 1 or 2 tablets to be given when necessary appeared to be administered on a regular basis. More precise indications for administration, combined with other approaches to the treatment of constipation, and periodic review would be advisable. care home Page 12 of 29 Arrangements for maintaining the privacy and dignity of residents are good. Residents expressed satisfaction in living in the home. Staff were noted to treat residents with courtesy. Personal care is provided in bedrooms or bathrooms . care home Page 13 of 29 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents lead a varied lifestyle according to individual needs, abilities and interests. This ensures that people experience a variety of social and leisure activities and are supported in maintaining involvement with their families and the local community. Evidence: All residents were said to be in touch with their families. Care plans include a section on Family History. The extent to which this was completed varied in the care plans examined. Many residents had members of their families visit over the course of the inspection visit to the home. Relatives seen expressed a high level of satisfaction with the care provided provided. One relative said that she and her husband had celebrated their golden wedding anniversary in the home. She said It was a complete surprise, they were marvellous. Residents interests are recorded in care plans. The home employs two part-time Care Homes for Older People Page 14 of 29 activity organisers. The activity organisers and care staff organise a range of individual and group activities for residents. These include music and movement, board games, walks out around the local area, birthday celebrations, outings to the theatre (a group had recently been to a musical show at the local theatre in Chesham), a trip to the seaside, outings for pub lunches, and arranging for performers, musicians and singers, to visit the home. They also ensure that one to one activities such as chatting, reading and discussing newspapers and magazines, and board games are provided to residents who are unable or who do not wish to share in a group session at a point in time. The home has an annual fete. The lounges on the ground floor open out on to the garden which facilitates outdoor activities in good weather. An album of photographs of activities which have taken place is available to view and a programme of forthcoming activities is on display in the home. Residents may see visitors in the privacy of their own room or in the lounge. The home has a spare room for use by visitors if required. The service users guide includes the statement The Croft prides itself on assisting and encouraging residents in maintaining contact with their family and friends. The home seems to be achieving this, based the evidence of discussions with residents and visitors and observation over the course of the unannounced visit carried out in connection with this inspection. Meals are prepared and served in accordance with Heritage Care Catering Standards. The home was awarded a Silver Food Safety Award following a visit by an Environmental Health Officer in June 2007. Breakfast consists of fruit juice, a choice of cereals or porridge, fruit, toast and preservaties and tea or coffee. A cooked breakfast is offered on alternate days. Dinner, which is served around 12:45 pm is the main meal of the day. It is a two course meal. Residents may have an alcoholic drink of their choice if specified in their care plan. Lunch was taken with residents during the inspection visit. The choice consisted of Chicken Casserole or a Meat Pie accompanied by Carrots, Sprouts and Mashed Potatoes. Vegetable Lasagne was available for residents who did not eat meat. Dessert was Creme Caramel. The meal was a pleasant affair. Portions were good. Water or fruit squash was available to drink. Staff offered support to residents as required. Staff providing assistance sat beside the resident and allowed the person to eat at their own pace. In keeping with tradition a fish dish is always on the menu on Fridays. Friday menus examined during this inspection included: Deep Fried Battered Fish and Tartare Sauce with Chips and Peas, Homemade Fish Pie with Potatoes, Tomatoes and Peas, and, care home Page 15 of 29 Cod in Parsley Sauce with Potatoes, Carrots and Peas. An non-fish alternative is always offered. A roast meat based dish is always on the menu on Sundays. Tea is served around 5:30 pm and is a lighter meal consisting of a savoury main course and followed by homemade cake. Choices may include such dishes as Fish Fingers and Tomatoes, Cold Meats and Salad, and, Home Made Savoury Flan or Finger Buffet. Coffee and Biscuits are served mid-morning and Tea and Cakes mid afternoon. The cook prepares a selection of sandwiches each afternoon to be served in the evening or during the course of the night if desired. Soft or liquidised meals or special diets can be prepared if required. Meals which take account of cultural or religious requirements can also be arranged. On occasions themed meals are served e.g. Chinese or food to accompany a jazz performer. Menus are planned on a four week rotating seasonal basis. Menus and residents views on the food are discussed at the monthly meetings with residents. A sample of residents view are recorded daily. Residents nutrition is monitored through observation, expressed dietary preferences and monthly weighing of each resident. The advice of a dietitian is sought on occasions. care home Page 16 of 29 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. The home has good procedures for investigating complaints. It has a framework of policy and staff training with regard to safeguarding vulnerable adults. These aim to protect residents from abuse and to ensure that complaints are properly investigated. Evidence: The complaints procedure is outlined in a leaflet ‘Comments & Complaints’. This is also available in Braille, audio cassette, large print and other languages on request. The leaflet advises that a person may talk to someone in the home about their complaint or complete a post paid postcard and send it to the company’s head office in Loughton, Essex. It says that a person may ask a friend, relative or advocate to make a complaint for them. It says that a person may make their complaint to someone employed by Heritage Care (member of staff, manager od director) or to the local social services department. The leaflet outlines what the organisation will do on receiving a complaint and timescales for responding. It does not mention CSCI or a persons right to make a complaint to CSCI at any stage (standard 16.4). This omission lies outside of the direct control of the home and needs to be addressed by a senior manager at the head office. The home’s service users guide also includes reference to complaints and does include references to CSCI. However, some amendments are required in order to inform Care Homes for Older People Page 17 of 29 residents of their right to refer to CSCI at any stage, to clarify the role of CSCI in complaints, to ensure that the correct title is used in all references to CSCI in the document, and to add the national CSCI customer helpline telephone number. The home had received ten complaints over the twelve months prior to this inspection. All were resolved within 28 days. Residents are registered to vote. The organisation has a number of policies governing staff with regard to safeguarding vulnerable adults. These consist of ‘Adult Protection’, ‘Confidential Reporting (Whistleblowing), ‘Comments and Complaints’, ‘Code of Conduct & Confidentiality’, and ‘Disclosure of Criminal records & Vulnerable Adults Register (POVA)’. The home has guidance (including leaflets to take away) on the subject of reporting suspected abuse for staff and others on display in the foyer. Information is available on Age Concern Advocacy. The home has a copy of the current Buckinghamshire joint agency policy on safeguarding adults. Staff training is provided in-house by a specialist trainer, through training events offered by Buckinghamshire County Council, during the course of the induction of new staff, and through a local network of care homes in Buckinghamshire. Procedures for the recruitment of new staff are thorough and include POVA and Enhanced CRB checks prior to taking up employment. care home Page 18 of 29 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 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 an accessible, pleasant, clean and well-maintained environment. It provides residents with a comfortable and safe place to live. Evidence: The home is located in a quiet residential area in Amersham on the Hill. There is car parking to the front of the building and in nearby streets. The nearest rail station is Amersham (Chiltern Line and London Underground Metropolitan Line). The home is owned by English Churches Housing Group. The home is a medium sized modern building. Access is controlled by staff. The home is divided into four residential units (Windsor, Balmoral, Buckingham and Sandringham), two units on the ground floor and two on the first floor. The ground floor also includes administrative offices, staff room, kitchen and laundry. There are enclosed gardens. Each residential unit has 15 places. All bedrooms are single and have en-suite facilities(shower, wc and hand basin) . Bedrooms have telephone, internet and television points. In addition to bedrooms each unit has a lounge, kitchen, dining area, assisted bathroom and wc. While access to the home and to some areas of the ground floor (kitchen, laundry, administrative office, and staff room for example) is controlled Care Homes for Older People Page 19 of 29 by staff, each of the residential units is open and residents are free to visit most areas. Bedrooms are comfortably furnished and those seen during the visit had been personalised by the residents. Lounges are comfortable and well furnished. The main corridors appeared rather bare but this may be a matter of opinion. New carpets have been fitted in some units since the last inspection. The laundry has two washing machine machines and two tumble dryers. There are facilities for storage and ironing. Flooring is non-slip. It is a bright and spacious. Laundry is carried out by housekeepers. The arrangement is reported to meet current needs. The kitchen is suitably equipped for current needs. It was in good order, clean and tidy on the afternoon of the inspection visit. The kitchen was inspected by an Environmental Health Officer from Chiltern District Council in June 2007. A copy of the report was made available for this inspection. The inspecting officer made a number of requirements. The manager said that all have been addressed. It is noted that the inspecting officer also awarded a Silver Food Safety Award. All areas of tho home were clean and tidy on the day of the inspection visit. No untoward odours in general were noted but it was felt that an odour lingered towards the top of an internal staircase in the morning. This may be due to a ventilation problem. The manager also suggested that it may have been attributable to some of the materials used in hairdressing which was taking place that day. The gardens are safe and enclosed and provide a pleasant area for residents and for home events in good weather. They comprise areas of lawn, flower beds, and mature shrubs. care home Page 20 of 29 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels, procedures for the recruitment of new staff, and for staff training and development are good. These aim to ensure that there are sufficient numbers of appropriately trained staff to meet the needs of people living in the home. Evidence: The present staff establishment provides for ten care staff plus one team leader in the morning, ten care staff plus one team leader in the afternoon and evening, and four care staff plus one team leader at night. These figures exclude the registered manager. In addition the home employs an administrator, housekeeping staff, catering staff, and two part-time activity organisers. A gardener and handyman were engaged on a contract basis. The manager said that the staffing levels met current needs. The home has recruited a number of staff since the last inspection in May 2007. The files of five staff were examined on this inspection. All had a completed application form. All had a recent photograph of the person. References had been received in all cases. An Enhanced CRB certificate had been received prior to staff taking up post. Evidence of a health check was present in all five files. It is noted that personnel files include an equal opportunities monitoring form - a good practice. All five files were Care Homes for Older People Page 21 of 29 considered to be in order and to fully meet the standard and conform to the relevant Regulation. Newly appointed staff follow a three month induction programme which meets the Skills for Care Common Induction Standards. The home was scheduled to meet with staff from Skills for Care the week after this inspection visit. The home is accredited with Investors In People. Accreditation was recently renewed to 2010. The manager is an accredited trainer with the Alzheimers Society. Ten staff had recently attended an Alzheimers Society training course on the care of people with dementia. A further group are due to attend the course in June 2008. It is anticipated that all staff working with people with dementia will have completed the course by the end of 2008. The manager said that over 75 of care staff were qualified to NVQ2 or above. A copy of the staff training programme (Training Calendar 2008 For Elders and of the staff training spreadsheet) were provided for this inspection. Staff have access to a wide range of training opportunities. Managers have records of training attended by staff. Records show that staff have attended training in Manual Handling, Fire Safety, Advanced POVA, POVA (Protection of Vulnerable Adults), Infection Control, Health and Safety, Food Hygiene, First Aid (Four day course), First aid (One Day), Mental Capacity Act, Customer Care, Record Keeping, Listening and Counselling, Oral Care, Understanding Sight Loss, and others. Some update training is now being carried out through a computer based E-learning programme. care home Page 22 of 29 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. This is a well managed home where a positive approach to the quality of the service is providing good care outcomes for residents. Arrangements for health and safety are thorough and aim to maintain a safe environment for residents, staff and visitors. Evidence: The registered manager (the manager) has worked at the home for a number of years and has been manager since July 2005. The manager has acquired the Registered Managers Award (RMA), NVQ3 in Care and is an accredited trainer with the Alzheimers Society. The manager reports to the Area Manager. Within the home, Care Homes for Older People Page 23 of 29 there is a deputy manager, four team leaders and six senior care assistants in addition to care assistants and other staff. The home participated in a Heritage Care Care Pathways audit in 2007. A copy of the report was made available to this inspection. The audit covered a number of aspects of life in the home including (among others); information, healthcare, privacy, participation in some aspects of running the home (such as staff appointments or attending meetings), choice, and meals. The manager is required to compile a quarterly summary report of complaints and compliments. Policies are regularly reviewed by managers at Heritage Care head office. Feedback from residents and relatives to this inspection was positive. Residents generally expressed satisfaction with the home. Comments included: I am very happy with the care and help I am given; Staff look after me well and I am very happy with them; Im very happy here, Ive made lots of friends; I enjoy knitting and have the choice to join in other activities if I want to; I am happy with help and care I am given - also the meals could be improved and I would like to see more variety. Comments from relatives includedCouldnt improve on the care; Staff are good but have limited time (for individual residents); Mum treated as an individual there are lots of activities for residents. Comments from health professionals included:(The home) cares for residents in a sympathetic way with respect; I am particularly impressed with the way individuals are treated and spoken to with dignity. Arrangements are in place for managing some monies on behalf of residents. These are governed by Heritage Care policies and financial procedures and are mainly administered by the homes administrator. Records are maintained of all transaction. A safe is available for secure storage if required. All care staff have access to one to one supervision. The frequency of supervison is currently every two months. Staff training is in place and notes of supervision sessions are maintained. Arrangements for health and safety are satisfactory. The staff induction and training programme includes training on health & safety matters. Managerial and staff practice is governed by a number of health & safety policies. Policies were last reviewed in April 2006 and all are scheduled for review again in 2008. care home Page 24 of 29 Contracts are in place for the maintenance of electrical, gas, fire safety, lifts and moving and handling. However according to information supplied by the manager the emergency call equipment was last checked by an engineer in 2002 - six years ago. Contracts are in place for the disposal of clinical waste. A fire risk assessment was carried out by the manager in June 2007. Staff fire safety training in carried out twice a year - it was next due in May 2008. Fire safety checks are carried out weekly. The home was visisted by representative of Buckinghamshire Fire Authority in November 2007. The manager said that all was found to be in order and that no requirements were made. Risk assessments are on included in individual care plans.Procedures are in place for recording accidents to residents and staff. Records were seen during the inspection visit. Copies are sent to the organisations head office for analysis. Copies of the homes business plans for 07/08 and 08/09 and associated quarterly reviews were made available to this inspection. care home Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 29 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 38 13 The Registered Manager must ensure that satisfactory arrangements are in place for the maintenance and periodic testing of the staff call system. To ensure that residents can recive help from staff when needed. 30/06/2008 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 12 7 It is recommended that the home review the document headed Financial and Spiritual with a view to a more appropriate separation of those matters in care plan documentation. It is recommended that the home consider drawing up a protocol or guidelines for staff on the management of constipation which includes guidance on the use of laxatives. It is recommended that the home obtain up to date reference texts for staff on the administration of medicines. It is recommended that the registered manager, together Page 27 of 29 13 9 14 15 9 16 Care Homes for Older People with senior managers, review complaints documentation to ensure full conformance to standard 16. 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. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!