Care Home: The Sands Nursing & Retirement Home

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What the care home does well The inspection was conducted in a very friendly and cooperative manner and all the residents were very happy to tell us about their home. They told us how happy they were living at The Sands. We observed a very relaxed atmosphere and noticed the staff and residents getting on well together. Several residents were cared for in bed on the nursing floors. They were well cared for and we observed the staff caring for them with respect and dignity. Progress charts were kept on them so that care provided could be monitored. These included fluid chart and a chart to record when a resident has been turned to prevent pressure sores. The residents who responded to the written survey and those consulted during the inspection were very complimentary about the quality and variety of meals provided at the home. Great satisfaction was expressed about the standard of meals and choices on offer during each mealtime. A written pre admission assessment (Indicator of Dependency Form) is done to ensure that residents admitted to the home are provided with care to meet all their needs. This form covers all areas of needs such as personal care, communication, mobility, personal and medical history and other areas to meet the needs of the residents We found that the manager and the staff have a good awareness of equality and diversity in that that they treat everyone as equals and respect people`s different ways and habits. Although the manager has overall responsibility for the home, each of the nursing floors is managed by a qualified nurse. This enables residents to have direct access to someone in charge on each floor. A receptionist is employed during peak times to answer the telephone and welcome visitors at the home.The staff benefit from a good standard of training. It was also pleasing to note that the home continue to meet the national target in NVQ training, with 70% of carers holding the qualification at level 2 or above. What has improved since the last inspection? All the beds on the nursing floors have been replaced with `nursing` beds. The garden area at the back of the home has been paved and revamped. One resident, whose window faces the garden, told us that she was very pleased with the view. Refurbishments continue with new carpets, decorating and some furniture replacements. Full bodied hoists have been purchased to help lift residents with dignity. What the care home could do better: We would strongly recommend that consideration be given to ensuring that the staff on the ground floor are given some assistance to help with answering the door, greeting visitors and answering the telephone when the receptionist is off duty. CARE HOMES FOR OLDER PEOPLE The Sands Nursing & Retirement Home 390 Marine Road East Morecambe Lancashire LA4 5AU Lead Inspector Mr Ajam Auckburally Unannounced Inspection 19th October 2007 10:00 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 The Sands Nursing & Retirement Home DS0000006159.V348226.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. The Sands Nursing & Retirement Home DS0000006159.V348226.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Sands Nursing & Retirement Home Address 390 Marine Road East Morecambe Lancashire LA4 5AU 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) 01524 400300 01524 410284 Victoria & Thornton Court Limited Mrs Lisann Christine Smith Care Home 80 Category(ies) of Old age, not falling within any other category registration, with number (80) of places The Sands Nursing & Retirement Home DS0000006159.V348226.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home shall at all times employ a suitably qualified and experienced manager who is registered with the National Care Standards Commission. 4th September 2006 Date of last inspection Brief Description of the Service: The Sands is a purpose built care home which also provides nursing care and is known as a Care Home with Nursing. The home is situated on Marine Road in Morecambe and faces the sea front. The building has five floors and residents are accommodated on the ground, first, second and third floors. A passenger lift is available for access to all the floors. The central kitchen, the laundry, the manager’s office and the administrative section of the home are situated on the fourth floor. A total of 80 residents can be accommodated at any one time. The ground floor is for people who do not require nursing care (residential). Each floor has its own lounge, dining room and kitchenette. All the bedrooms are single rooms and all except four have an ensuite facility. A new paved patio garden has been built in the recent weeks at the rear of the home. The home is staffed around the clock to meet the needs of all the residents. Nursing staff are employed to meet the needs of residents who need nursing care. There were 75 residents staying at the home at the time of the inspection. Current weekly fees are between £386 and £650 depending whether residential or nursing care is provided. The residents pay for additional extras like hairdressing, private chiropody and newspapers. The Sands Nursing & Retirement Home DS0000006159.V348226.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Under IBL (Inspecting for Better Lives) The Sands was assessed as requiring a statutory key visit (inspection) between April 2007 and June 2007. An unannounced key site visit was carried out on 19th October 2007 followed by another visit on 22nd October 2007 to complete the inspection. The inspection lasted a total of 10 hours. The inspection was carried out against the National Minimum Standards for Older People. The inspection despite being an unannounced one was carried out in a friendly atmosphere and with the full cooperation of the manager, the staff and the residents. During the inspection, we looked at some records and spoke to several residents and staff. The residents we spoke to were very positive about the care they receive and the way the staff treat them. Every year we asked the registered person to supply us with written information about the quality of the service they provide and to make an assessment of the quality of their service. A pre inspection questionnaire called the AQAA (Annual Quality Assurance Assessment) is sent for the manager of the home to complete and return. We use this information, in part, to focus our inspection activity. The completed questionnaire gave information about several areas such as staffing, checks that the home has made about the safety and maintenance of the building, equipments, information about residents and other useful information. The AQAA also requests information about good practices and developments. We also sent questionnaires to the residents, the families, staff and other professionals such as district nurses and doctors. Six relatives, one GP and 7 staff returned their completed forms. When we analysed them, they showed that everybody was happy with the quality of care provided and the facilities at the home. The staff were very positive about the management of the home. There were 75 residents living at the home at the time of the inspection and there were an adequate number of qualified nurses, care staff, and other ancillary staff on duty. The manager and the catering staff were also on duty. We observed the staff being polite and attentive when talking and dealing with the residents. The Sands Nursing & Retirement Home DS0000006159.V348226.R01.S.doc Version 5.2 Page 6 What the service does well: The inspection was conducted in a very friendly and cooperative manner and all the residents were very happy to tell us about their home. They told us how happy they were living at The Sands. We observed a very relaxed atmosphere and noticed the staff and residents getting on well together. Several residents were cared for in bed on the nursing floors. They were well cared for and we observed the staff caring for them with respect and dignity. Progress charts were kept on them so that care provided could be monitored. These included fluid chart and a chart to record when a resident has been turned to prevent pressure sores. The residents who responded to the written survey and those consulted during the inspection were very complimentary about the quality and variety of meals provided at the home. Great satisfaction was expressed about the standard of meals and choices on offer during each mealtime. A written pre admission assessment (Indicator of Dependency Form) is done to ensure that residents admitted to the home are provided with care to meet all their needs. This form covers all areas of needs such as personal care, communication, mobility, personal and medical history and other areas to meet the needs of the residents We found that the manager and the staff have a good awareness of equality and diversity in that that they treat everyone as equals and respect people’s different ways and habits. Although the manager has overall responsibility for the home, each of the nursing floors is managed by a qualified nurse. This enables residents to have direct access to someone in charge on each floor. A receptionist is employed during peak times to answer the telephone and welcome visitors at the home. The Sands Nursing & Retirement Home DS0000006159.V348226.R01.S.doc Version 5.2 Page 7 The staff benefit from a good standard of training. It was also pleasing to note that the home continue to meet the national target in NVQ training, with 70 of carers holding the qualification at level 2 or above. What has improved since the last inspection? What they could do better: 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. The Sands Nursing & Retirement Home DS0000006159.V348226.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 The Sands Nursing & Retirement Home DS0000006159.V348226.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): 3 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There are very good practices and written information to help new residents in deciding whether to choose the home. EVIDENCE: We examined the records of admission of the last resident admitted to the home. They showed that adequate information was obtained to ensure that appropriate care is provided. The manager told us that in this instance, information was obtained from the relatives who visited the home on behalf of the resident. The Sands Nursing & Retirement Home DS0000006159.V348226.R01.S.doc Version 5.2 Page 10 A member of the management team always visits prospective residents who are unable to visit the Sands, either in their own home or in hospital before admission. The manager told us that this helps with introduction as well giving and gaining information. The brochure contains information about the care, the facilities, the staffing, the complaint procedure and other useful information. A copy of the last inspection report is given to all new residents. Prospective residents or their families are encouraged to visit the home and spend as much time as they need before making a decision. A written pre admission assessment is done at this stage to ensure that the staff of the home can meet the assessed needs. A form (Indicator Of Dependency) is used to record information under the heading of: personal care, nursing needs, mobility, eating, communication and several more areas relevant to the care of the resident. Bedrooms are allocated according to vacant rooms and often there is only one to choose from. However, room can be changed when there is a vacancy. The staff told us that they are given as much information about the new residents as possible so that they can provide tailor-made care. Several residents told us that their families have chosen well for them and that they liked living at the Sands. They said that they can do what they want and that the staff provide assistance and help when required. The manager informed us that referrals from residents of an ethnic background would be welcomed. She said that research would be carried out, for example if the home was unsure how to meet cultural, religious and dietary needs of people from a different country or culture. The residents told us that the staff are very good and that nothing is too much trouble for them. The home does not provide intermediate care. The Sands Nursing & Retirement Home DS0000006159.V348226.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): 7,8,9 & 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The practices to meet the health and personal care needs of the residents are excellent. Residents benefit from having their needs assessed and met by a team of dedicated staff. EVIDENCE: Four residents, one of whom being the last one admitted to the home were case tracked. This means that we selected four residents and the care they receive examined closely. Their assessments and care plans were examined and they were spoken to. The Sands Nursing & Retirement Home DS0000006159.V348226.R01.S.doc Version 5.2 Page 12 Two of the residents being case tracked were able to tell us that they were well looked after and that all the staff are kind and helpful. The other two were not able to express verbally how they were treated but appeared to be well cared without any signs of neglect. The records show that detailed written information about the residents has been recorded. These include an assessment to identify the needs of the residents and also a care plan which shows how the needs were being met. The physical assessment covers; personal hygiene, mobility, hearing, vision and other areas. The care plans give details of how the assessed needs are met. For example, if someone needed help with personal hygiene, the record will show that this person needs staff to wash and dress her. On the nursing floors, the care plans are used more because treatments are provided on an ongoing basis. For instance, the care plans we examined show that fluid, feeding and personal hygiene charts are used to record and monitor residents’ progress. The care plans for people with nursing input are reviewed on a daily basis to meet their needs. The care plans for people who do not need nursing care are reviewed monthly or as required to meet their changing needs. The residents and their families are involved in this exercise. The residents told us that they were very well looked after by a team of very good staff. They were very positive about the staff and the management of the home. They described the home as being very good. We observed a very relaxed and friendly atmosphere in the home. There were good interactions between the staff and the residents. All of the toilets have been fitted with grab rails to help those residents with poor balance and mobility. All the beds on the nursing floors have been replaced with ‘nursing’ beds. A passenger lift is available to access all the floors. The lift is on the small side and is constant use. Some of the baths and showers have easy access and facilities to help residents who are disabled. Bath hoists are available to assist residents with getting in and out of the bath. Full bodied hoists have been purchased to lift residents with dignity. The Sands Nursing & Retirement Home DS0000006159.V348226.R01.S.doc Version 5.2 Page 13 All the residents are white British, but the manager informed us if a resident from a minority group was to be admitted to the home, she will obtain as much information as possible by researching this group to meet care, cultural and dietary needs. Resident’s health care needs are met by involving health care professionals. GP’s, district nurses and chiropodist visit when required. We examined the medications of two residents and we found that they were being administered and stored appropriately. Residents who are able and willing can keep and administer their own medications. The staff are sensitive to the needs of all the residents and do everything to help them remain as independent as possible. The staff told us that their job is to work with the residents and meet all their needs. They said that they have very good relationships with all the residents. We observed them talking and helping the residents with respect and dignity. The Sands Nursing & Retirement Home DS0000006159.V348226.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): 12,13,14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a good range of activities to help stimulate the residents. Residents are encouraged to participate in activities and are helped to remain independent and active. EVIDENCE: The manager told us that residents are encouraged to remain as independent as they want and able to. The residents informed us that they can do what they want and join in organised activities that they liked. Residents were observed doing their own things. Some were in the lounges and others were in their rooms. They told us that they are able to remain as independent as they want or able to. They said that staff are helpful and will provide assistance when required. The Sands Nursing & Retirement Home DS0000006159.V348226.R01.S.doc Version 5.2 Page 15 Several residents told us that they like to stay in their rooms for most of the day. Some of them would join the others in the dining room at meal times, whilst some would eat in their rooms. An activity organiser is employed to do a variety of activities to suit the different needs of the residents. She said that she tries and do activities which the residents like. Activities include bingo, soft ball games, art and craft. A notice advising residents when activities are taking place is displayed on each floor. Residents’ birthdays are celebrated by the chef providing a cake. On the day of the inspection, a special birthday party was held to celebrate the 100th birthday of a resident. Families and friends of residents are encouraged to visit when they want. Some of the residents said that their relatives take them out regularly. The manager told us that when there is a social event, residents from all floors are encouraged to join in. The staff said that they assist the residents to do what they like. The staff said that they try and meet residents’ individual needs. They said that if residents wanted to go for a walk or do something, they would try to oblige. The residents told us that they can do what they want and that the staff are very helpful and would assist them when required. The residents said that the food is very good and that they are offered choices at all mealtimes. On the day of the inspection, the choices for lunch were scampi and chips or sandwiches. A choice of potatoes and vegetables were also offered. Meals are cooked in the main kitchen and transported in heated trolleys to the different floors. Meals are served in the dining rooms on each floor. Tea making facilities is available in the small kitchen in the dining rooms. Residents are encouraged to eat with others in the dining rooms, but may eat in their rooms if they prefer. The staff told us that several residents, mainly on the nursing floors need assistance with feeding. They said that there is an adequate number of staff on duty to ensure that this task is done properly. The Sands Nursing & Retirement Home DS0000006159.V348226.R01.S.doc Version 5.2 Page 16 There is a good choice of hot and cold food to choose from at breakfast and teatime. Hot drinks are served at regular times in the day, but residents can ask for one when they want. Fruit bowls are available in each lounge and residents can help themselves to the fruit freely. Records of meals served we examined show that a good variety of meals are offered to the residents. The chef told us that within reasons, he would cater for every taste. He said that he is able to cook food to suit ethnic needs and if he did not know how, he will try and find out. The chef informed us that he attends monthly residents’ meetings and listens to what they have to say about food and would provide any reasonable food requested. Special diets such as diabetic, gastric, pureed and other foods can be catered for. The Sands Nursing & Retirement Home DS0000006159.V348226.R01.S.doc Version 5.2 Page 17 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 & 19 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There are stringent policies and procedures to safeguard and keep residents safe. EVIDENCE: The home has a robust procedure for dealing with complaints. All complaints and incidents are recorded on a form. The last complaint recorded was dealt with promptly and to the satisfaction of the complainant. Written information about how and who to complain to is given to residents or their families. The residents told us that if they had any complaints, they would speak to the manager and have every confidence that their concerns would be dealt with. The manager told us that the management team is always available to speak to the residents or their families. The Sands Nursing & Retirement Home DS0000006159.V348226.R01.S.doc Version 5.2 Page 18 The person in charge visits all the floors to speak to residents and staff on a daily basis. The manager said that this allows for problems and concerns to be sorted out as they appear. There are systems in place for staff to report any incident of abuse either by staff themselves or by families. There have been instances when the management of the home have been proactive in dealing with incidents of alleged abuse and theft in order to protect the residents. All the residents appeared to be safe and free from harm, neglect and abuse. We observed the staff treating the residents with respect and dignity. The staff we spoke to said that they were aware of different types of abuse and said that they have attended a course on the subject. The Sands Nursing & Retirement Home DS0000006159.V348226.R01.S.doc Version 5.2 Page 19 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 provides a good environment for the residents to live in. Residents’ accommodation is clean and comfortable. EVIDENCE: We carried out a tour of the building and found that all the communal areas were clean and tidy. We visited several bedrooms and they were found to be clean. The residents who were occupying some of these bedrooms told us that the domestic staff comes in everyday to tidy and clean their rooms. They said that they do not have to leave their rooms if they don’t want whilst cleaning is being done. The Sands Nursing & Retirement Home DS0000006159.V348226.R01.S.doc Version 5.2 Page 20 The domestic staff we spoke to said that she has had training on the use of cleaning materials and infection control. We saw her using a trolley to keep all her cleaning materials safe. The manager informed us that there is a rolling a programme of maintenance and carpets are changed when necessary. The policy of the home is to decorate and change carpets in empty rooms before new residents are admitted. All beds on the nursing floors have been replaced with new ‘nursing’ ones The residents told us that they feel safe living at the home and that their rooms are well maintained. There are policies and procedures regarding the handling of cleaning materials and infection control. Some staff have attended courses on the control of infections. The residents’ general comments were that the home is beautiful, clean and homely. The management of the home has made great effort in providing aids and adaptations to help residents with physical disabilities. There are grab rails fitted to some of the toilets to help residents who are disabled. There are a selection of different baths and showers to enable residents to have a choice which one they want to use. A passenger lift, albeit on the small side is available for the residents to use independently if they wish. A team of domestic staff is employed to do the cleaning and a handyman is also employed for maintenance. We found that the home was free from hazards and the residents said that they can get around the home safely. The Sands Nursing & Retirement Home DS0000006159.V348226.R01.S.doc Version 5.2 Page 21 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): 27,28,29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a robust recruiting and training procedures to ensure that staff employed are fit to care for the residents. A team of well-motivated staff care for the residents. EVIDENCE: The number of staff on duty has been maintained to a good level to meet the needs of the residents. At the time of the inspection, there were 2 managers, other staff including, nurses, care assistants, catering and other ancillary staff on duty. Staff rotas we examined show that the staffing is sufficient to meet the needs of the residents at the home. The same staff usually work on the same floor to ensure continuity. It was obvious that the staff knew the residents well and that there was a good rapport between them. We observed the staff and residents talking and laughing. The Sands Nursing & Retirement Home DS0000006159.V348226.R01.S.doc Version 5.2 Page 22 The 3 nursing floors have a good staffing level throughout the day, but the staffing level on the residential floor could be improved. There is normally 2 care staff on this floor to care for 19 residents whose needs are getting greater with every admission. The staff spoken to said that they manage to do everything they have to do but are always rushed. The ground floor which is the residential floor is also the reception floor for the home. From 9 am to 1 pm, a receptionist is employed to answer the door, greet visitors, answer the telephone and attend to other reception duties. However, when this person finished duty at 1 pm, all her tasks fall on the 2 care staff on duty on this floor. Visitors to all the floors enter the home via the ground floor and the door has to be opened by a member of staff for security reasons. One of the 2 carers has to leave what she is doing to answer the door. The staff we spoke to said that visitors have made remarks at the length of time they had to wait . This floor used to have a full time manager, but since her promotion to another home in the group, a replacement has not been made. We would strongly recommend that either the post of the manager on the residential floor is re-established or other arrangements made to help the staff on this floor. The manager informed us that when there is a shortage of staff in the home, agency staff are used. She said that she tries and use permanent staff to fill any gaps and only use agency staff as a last resort. The manager demonstrated a good understanding of the procedures to be followed when selecting and recruiting staff. The management team has produced a well written recruitment policy for its staff. A member of the management team is always involved in the recruitment of new staff. The staff files we examined show that appropriate checks had been carried out before offers of employment were made. Such checks included CRB (Criminal Records Bureau) checks and a POVA (Protection Of Vulnerable Adults) check. Once a new member of staff starts work at the home, she undertakes an induction training programme involving orientation of the home, meeting residents and staff. Training also include, Fire Procedures, Moving and Handling and many other relevant courses Training records we examined show that the staff at the home have attended several courses. These include: Abuse, Moving and Handling, First Aid, Dementia, Medications, etc. The Sands Nursing & Retirement Home DS0000006159.V348226.R01.S.doc Version 5.2 Page 23 Staff we spoke to said that they treat all the residents with respect and accept any difference people may have. There is a clear commitment to the training and development of all staff at the home and all non-nursing staff are expected to go on the NVQ training programme once they have completed their induction training. We recommend that at least 50 of care staff achieved NVQ (National Vocational Qualification) level 2. The percentage of care staff at the Sands with this qualification is 70 and is commendable. The staff we spoke to said that they enjoy working at the home very much. They said that the management is very supportive and listens to what they have to say. The residents told us that the staff are marvellous and will do anything for them. We observed good interactions between the residents and the staff. They all appeared to be happy and content. The Sands Nursing & Retirement Home DS0000006159.V348226.R01.S.doc Version 5.2 Page 24 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): 31,33,35 & 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has an efficient management team. The residents and staff benefit from living and working in a well managed home. EVIDENCE: The Sands is managed on a day-to-day basis by the registered manager Mrs Lisann Smith. She is a qualified nurse. She is supported by a deputy manager who is also a qualified nurse and other senior nurses and senior care staff. The Sands Nursing & Retirement Home DS0000006159.V348226.R01.S.doc Version 5.2 Page 25 The home is owned by a company called Victoria and Thornton Court Ltd. Mr Robert Wilson and Miss Maureen Mackay are the directors of the company. The manager told us that the home has an open door policy and that residents and staff are always welcome to come and have a chat. Residents and or their families are encouraged to deal with their own finances. Most of the fees due to the home are paid for by direct debit arrangements. Where the home, keeps money on behalf of residents, appropriate records are kept. We had had the full cooperation of the manager, the staff and the residents during the inspection. The manager informed us that she has daily contact with the residents and will deal with any concerns they may have straight away. The inspection was carried out in a friendly environment and residents and staff said that the Sands is a very good home. The managers from other homes within the company visit the Sands regularly and once a month completes a Regulation 26 form. This form is completed to ensure that owners who do not work at the home on a daily basis either himself or herself or a representative looks at all areas of the home and leaves a written report. A copy of the report is also sent to CSCI. The Sands Nursing & Retirement Home DS0000006159.V348226.R01.S.doc Version 5.2 Page 26 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 X X 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 The Sands Nursing & Retirement Home DS0000006159.V348226.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP27 Good Practice Recommendations The Sands Nursing & Retirement Home DS0000006159.V348226.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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 The Sands Nursing & Retirement Home DS0000006159.V348226.R01.S.doc Version 5.2 Page 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. 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