Care Home: Trent House

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What the care home does well From talking with residents and from the comments received it was clear that residents were happy living at the home and that staff and residents got on well together. Comments received from residents included "I am very happy here", "I have lived here for 4 years and am very happy", "its very nice" and "I can come and go whenever I want and the staff help me out when I need them to" The home provides care and support to enable residents to live fulfilling and meaningful lives. Residents are given choice in their day-to-day lives with appropriate support provided by staff at the home.There is a flexible staff team who support residents in their day-to-day lives and they are treated as individuals and with dignity and respect. Meals in the home are good and offer a choice at meal times and there is a varied diet. Residents told us that the food was good. What has improved since the last inspection? What the care home could do better: There was 1 requirement and 1 recommendation made as a result of this visit and other points, which need to be addressed to help improve the service provided for residents are contained within the main body of the report, general observations were: Each care plan had information on the support needed and each resident had a "personal hygiene and task schedule" where staff were required to record when care had been delivered. However on some of the schedules seen there was a lack of recording and after discussions with staff it was suggested that it would make recording for staff easier, if these schedules were kept in each resident`s room, as this is where the support was given.The general fabric of the home is satisfactory, however the providers have acknowledged that there are certain areas of the home that would benefit from upgrading and decoration. There are no hand washing facilities in the laundry and there is a need for clear signs to be in place to direct staff to the nearest hand washing facilities The main concerns raised by resident and staff were staffing levels. At present the home has 3 vacancies and if these numbers increased then it is not clear if the current staffing levels would be sufficient. The manager of the home needs to be registered with the Commission for Social Care Inspection also the home has a quality assurance system in place, which needs to be further developed to seek the views of residents, relatives and other professionals to measure the effectiveness of the service provided at the home. CARE HOMES FOR OLDER PEOPLE Trent House 42 Newport Road Cowes Isle Of Wight PO31 7PW Lead Inspector Mick Gough Unannounced Inspection 21st October 2008 09:30 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 Trent House DS0000069870.V372839.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. Trent House DS0000069870.V372839.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Trent House Address 42 Newport Road Cowes Isle Of Wight PO31 7PW 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) 01983 290596 01983 281 616 ymmccourt@yahoo.co.uk McCourt Care Limited Manager post vacant Care Home 19 Category(ies) of Dementia (0), Old age, not falling within any registration, with number other category (0), Physical disability (0) of places Trent House DS0000069870.V372839.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (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 (OP) Physical disability over 65 years of age (PD) 2. Dementia (DE) The maximum number of service users to be accommodated is 19. Date of last inspection 20th November 2007 Brief Description of the Service: Trent House is an extended older detached property in Cowes. The home is registered to provide accommodation and care for up to 19 people over the age of 65 years who may or may not have dementia or a physical disability. The accommodation is on three levels. The home has a passenger lift in order to access all levels. The home has appropriate communal and bathing facilities with a garden accessible via a chair lift or short flight of steps from the lounge. Most bedrooms are for single occupancy some with ensuite facilities. The home is sited close to all local amenities and on a main bus route to/from Cowes. The home is owned by McCourt Care Limited. At the time of the visit fees at the home ranged from £376.67 to 511 per week, depending on the type and level of support required. An up to date scale of fees can be obtained by contacting the home. Trent House DS0000069870.V372839.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience Good quality outcomes. This report details the evaluation of the quality of the service provided at Trent House and takes into account the accumulated evidence of the activity at the home since the last inspection key inspection, which was carried out in November 2007. The inspection took into account the homes Annual Quality Assurance Assessment (AQAA); and comment cards received from 4 users of the service and 2 members of staff. Included in the inspection was an unannounced site visit to the home, which took place on the 21 October 2008. For this visit the inspector was assisted for part of the inspection by an “Expert by Experience” (this is a person who, because of their shared experience of using service’s, and/or ways of communicating, visits a service with an inspector to help them get a picture of what it is like to live in or use the service). Evidence for this report was obtained from reading and inspecting records, touring the home and from observing the interaction between staff and users of the service. The expert by experience spent time talking to residents, staff and visitors to obtain their views on how the service was meeting the needs and expectations of residents. It was also possible to speak with 3 members of staff the homes manager and the registered provider. The home is registered to provide support for 19 residents and at the time of the inspection there were 16 people living at the home. What the service does well: From talking with residents and from the comments received it was clear that residents were happy living at the home and that staff and residents got on well together. Comments received from residents included “I am very happy here”, “I have lived here for 4 years and am very happy”, “its very nice” and “I can come and go whenever I want and the staff help me out when I need them to” The home provides care and support to enable residents to live fulfilling and meaningful lives. Residents are given choice in their day-to-day lives with appropriate support provided by staff at the home. Trent House DS0000069870.V372839.R01.S.doc Version 5.2 Page 6 There is a flexible staff team who support residents in their day-to-day lives and they are treated as individuals and with dignity and respect. Meals in the home are good and offer a choice at meal times and there is a varied diet. Residents told us that the food was good. What has improved since the last inspection? Since the last inspection the home has worked hard to improve the service provided at the home and the following improvements have been made: • • There is an effective care planning system in place and these give good information for staff on the support needed. Medication procedures have been improved and there is a clear medication policy and procedure, which gives guidance to staff who administer medication. The homes statement of purpose and service user guide have been updated and all residents now have a contract/ terms and conditions and these have been signed by residents. Recruitment procedures have been improved and all staff are subject to a thorough process before they start work at the home. Staff at the home treat residents with dignity and respect and residents’ have access to a full range of healthcare support. Meals in the home are good and offer a choice at meal times and there is a varied diet. Residents told us that the food was good. A new large disabled toilet has been installed and new carpeting has been laid on the ground floor of the home. • • • • • What they could do better: There was 1 requirement and 1 recommendation made as a result of this visit and other points, which need to be addressed to help improve the service provided for residents are contained within the main body of the report, general observations were: Each care plan had information on the support needed and each resident had a “personal hygiene and task schedule” where staff were required to record when care had been delivered. However on some of the schedules seen there was a lack of recording and after discussions with staff it was suggested that it would make recording for staff easier, if these schedules were kept in each resident’s room, as this is where the support was given. Trent House DS0000069870.V372839.R01.S.doc Version 5.2 Page 7 The general fabric of the home is satisfactory, however the providers have acknowledged that there are certain areas of the home that would benefit from upgrading and decoration. There are no hand washing facilities in the laundry and there is a need for clear signs to be in place to direct staff to the nearest hand washing facilities The main concerns raised by resident and staff were staffing levels. At present the home has 3 vacancies and if these numbers increased then it is not clear if the current staffing levels would be sufficient. The manager of the home needs to be registered with the Commission for Social Care Inspection also the home has a quality assurance system in place, which needs to be further developed to seek the views of residents, relatives and other professionals to measure the effectiveness of the service provided at the home. 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. Trent House DS0000069870.V372839.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 Trent House DS0000069870.V372839.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has clear statement of purpose and service user guide and each resident has a written contract/statement of terms and conditions with the home. Potential new residents have a needs assessment undertaken prior to moving into the home and this allows the home, the resident and their relatives to see if the home can meet the resident’s needs. The home does not provide intermediate care. EVIDENCE: We looked at the homes Statement of Purpose and service user guide and this gave potential new residents information to be able to make an informed decisions before deciding whether to move into the home. All residents had a contract/terms and conditions and these had been signed by residents or their representative. None of the residents spoken to by the expert by experience could remember anything about a contract with the home, apart from one lady who vaguely thought that she had one. One resident’s daughter said she was Trent House DS0000069870.V372839.R01.S.doc Version 5.2 Page 10 waiting for the contract to be drawn up, as her father had moved in only 6 days before. The homes completed AQAA told us that new service users are admitted only after an assessment has been carried out. At this visit the manager confirmed that a senior carer or the manager carries out an individual needs assessment prior to residents moving into the home and there is a clear admission process. Assessments were on file at the home and were looked at for the 3 residents. The needs assessments seen had information on medical history, mobility, medication, personal care need, communication, daily routines, sleep routines, religious needs, financial arrangement & leisure and interests. Assessments were made using a number of different needs assessment forms and therefore covered the same issues for everyone. The manager told us that potential new residents are able to visit the home before they moved in to the home and residents spoken with on the day of the visit confirmed this. Two of the residents had chosen the home because of prior connections with it including one new resident whose wife had lived there until her death. Intermediate care is not provided at the home. Trent House DS0000069870.V372839.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 good. This judgement has been made using available evidence including a visit to this service. The health, personal and social care needs of residents are set out in an individual plan of care and residents and have access to all relevant health care professionals and their health care needs are met, however the recording in care plans could be improved to provide better evidence of care delivery. The administration of medication is satisfactory and residents at the home are treated with dignity and respect and their personal care is given in private. EVIDENCE: Care plans were inspected for 3 residents and these plans were broken down into sections and were easy to follow. Each care plan had information on the support needed and each resident had a “personal hygiene and task schedule” where staff were required to record when care had been delivered. However on some of the schedules seen there was a lack of recording. Staff members spoken with said that they were very busy and did not have time or forgot to record after support was given as the care plans were kept on the ground floor, we discussed this with the senior member of staff and it was suggested that it may be easier for staff if these schedules were kept in each residents room as this is where the support was given. Also on care plans there were Trent House DS0000069870.V372839.R01.S.doc Version 5.2 Page 12 sections for each residents key worker to review care plans and to note that individual tasks had been completed for residents such as checking toiletries, we were told that this was a new system and that staff had not yet become familiar with the key worker system and as such recording of this was not always carried out. It was suggested that it might be easier for staff if they worked in key teams so that these tasks could be divided amongst the team and this would utilise each staff member’s skills. All care plans contained risk assessment forms these detailed in what if any areas risks had been identified, where a risk had been noted a detailed risk assessment was in place which gave information on the risk and also provided information on how the risk could be minimised. Residents said that staff were always very helpful and comments received by the expert by experience included: • • • ‘ I couldn’t be better looked after, not only the care but also the loving nature that goes with it.’ ‘We can please ourselves going to bed when we want-we’re all happy’, I am well looked after here” and another said “they help me whenever I ask”. ‘We’re in safe hands’ We spoke to 1 visitor who said that they felt that their relatives care needs were met by the home. Residents are registered with a local health centre and have a number of different GP’s. District nurse visits are arranged though the health centre and the home keeps a record of any appointments or visits by any health care professionals. The home uses a continence nurse who advises all residents at the home who need support. Dental care is provided by the health centre although residents may keep their own dentist if they wish. There is a visiting optician and a chiropodist call every 4 – 6 weeks. Any other relevant health care professionals are arranged through GP referral. The home has a policy for the receipt; storage, return and administration of medication and all staff at the home who are authorised to administer medication have undertaken training with regard to medication. The home uses a monitored dose system from a local pharmacy and the medication administration records sheets (MARS) were inspected and found to be up to date. The homes medication storage was looked at and this was suitable for its purpose and this included the storage arrangements for any controlled drugs. During the visit staff were seen to behave appropriately with residents and we and the expert by experience observed staff interacting well with residents and using their preferred form of address. The carers had a quiet friendly way with the residents and the manager also had a very good rapport with some of the Trent House DS0000069870.V372839.R01.S.doc Version 5.2 Page 13 residents. Staff were seen to knock on residents doors before entering and residents spoken to confirmed that staff treat them with dignity and respect. A member of staff spoken with knew that one resident preferred to get up in the mornings later. One resident who preferred to stay in bed had her door open opposite the kitchen, as she wants to hear what’s going on, and the home had put up a privacy curtain for her so she wasn’t in everyone’s view. Trent House DS0000069870.V372839.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. The home provides a range of activities for residents, which generally meet their expectations, however the availability of transport would enhance the recreational activities that are provided for residents. Residents are able to maintain contact with family and friends and visitors are welcome at any time. Residents are supported to exercise choice and control over their lives as much as possible and they are provided with a balanced diet in pleasant surroundings at time convenient to them. EVIDENCE: Activities at the home are arranged by one of the senior carers and she is backed up by other staff and by activities provided by people outside the home and these includes visiting entertainers and remembrance sessions. Other activities include games, Bingo on Fridays’ (led by the cook), facial and hand massages’, music, and films. On the day of the visit there was a clothing party where residents had the opportunity to view clothes in the comfort of their own home and purchase items if they wanted. Several residents mentioned that they liked two different sets of musicians who came in once a month or so and a ‘quick-change artist’ who has come in the past. One resident said that she wasn’t interested in the activities but chose to read, do puzzles or paint in her room, another liked all the activities, but also did her Trent House DS0000069870.V372839.R01.S.doc Version 5.2 Page 15 tapestries, one of which we saw and the manager said she’d have framed for her. The home also has its own shopping trolley going around once a week for residents. One member of staff explained to the expert by experience that she hadn’t had any time to put on some music for the residents in the lounge after lunch, instead of the TV which none of the 3 residents watching wanted on Currently the home does not have any transport available and a Mini Bus Committee has been set up to raise funds to enable a vehicle to be purchased so that residents can get out more, the manager, some relatives and staff are on the committee and it is hoped residents will also join. A local organization helped the home raise £280 towards the Mini-Bus at a Beach-themed Garden Party in the grounds for the residents in June 2008. The home has a clear visitors policy and there are no set times, visitors sign in at the home and the visitors book is kept in the hallway, residents spoken to said that their visitors were always made welcome and we had the opportunity to speak with 1 visitor to the home who confirmed that visiting times were flexible and they had never experienced any restrictions. There is a 4-week rotating menu and these included recent suggestions from residents such as homemade fishcakes and beef stew and dumplings. The cook offers residents a choice and accommodates residents if they have any dietary needs. One resident told the expert by experience ‘they gave me a lovely piece of poached fish with a slice of lemon when I couldn’t eat the other choices available. Cold drinks were offered at the table and hot drinks were served afterwards. One resident said there was fruit and drinks available at any time. We looked at the storage arrangements and the freezer had containers of home-cooked chicken korma and these were labelled with dates and there was one fridge especially for fresh vegetables. Several residents told me that they had enjoyed their meals and one resident said, ‘It’s better than the Ritz here as the meals are served with a good heart.’ Some residents chose to eat in the dining room, some on trays in the lounge or in their bedrooms. Residents were happy with the times of meals. Trent House DS0000069870.V372839.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a simple, clear and accessible complaints procedure, which includes timescales for the process and any complaints are logged and responded to appropriately. The homes policies and procedures help protect users of the service from any form of abuse. EVIDENCE: The home has a clear complaints procedure, which contains all of the required information and a copy is issued to all residents and relatives when they move into the home. Residents spoken with had no real complaints apart from the odd murmuring about staffing (see later), but said they would talk to the new manager or a member of staff if they had cause to make any complaint. One resident said, ‘I was brought up not to complain and just get on with it.’ Staff members spoken to were aware of the complaints procedure and said that they would support any resident to make a complaint if they wished to do so. The homes AQAA told us that there had been 4 complaints received in the home in the past 12 months and the home keeps a record of all complaints and records confirmed that all complaints had been recorded and responded to appropriately. All staff have received training on adult protection and the home has a whistle blowing policy and manager and staff spoken to were aware of their responsibilities in this area and knew what to do should they suspect any form of abuse had taken place. Trent House DS0000069870.V372839.R01.S.doc Version 5.2 Page 17 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 adequate. This judgement has been made using available evidence including a visit to this service. Residents live in a safe and well-maintained environment and have access to reasonably comfortable indoor and outdoor facilities. Residents have the specialist equipment they require to maximise their independence and the home was generally clean, pleasant and hygienic, however an odour was noticed in one particular area of the home and the home would benefit from decoration in certain areas. EVIDENCE: We had a look around the home during the visit and all areas of the home were clean and tidy and furniture was in a reasonable state of repair, the providers have acknowledged that there are certain areas of the home that would benefit from upgrading and decoration and this is being carried out on a priority basis. The home has recently had a new disabled toilet fitted on the ground floor of the home and further improvements are planned. Trent House DS0000069870.V372839.R01.S.doc Version 5.2 Page 18 The home has a laundry, which is situated in the downstairs part of the home; this is equipped with industrial washing machines and tumble driers. There are no hand washing facilities in the laundry and we discussed the need for clear signs to be in place to direct staff to the nearest hand washing facilities. The home does no employ any dedicated staff to carry out laundry duties and care staff carry out these duties. All residents had named laundry baskets where clean clothes were placed so that staff could deliver to their rooms. Laundry is collected by staff and brought down to the laundry in bags with any soiled items clearly identified. All staff have received training with regard to infection control and the home was generally clean and tidy, however there was an odour in the corridor outside the dining-room and in a resident’s room above the dining-room. Trent House DS0000069870.V372839.R01.S.doc Version 5.2 Page 19 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 adequate. This judgement has been made using available evidence including a visit to this service. The home has a mix of staff that has a range of skills, however the home needs to review its numbers of staff on duty to ensure the needs of residents can be met at all times. The homes recruitment policy and practice supports and protects residents and they benefit from a staff team that has had sufficient training to meet their needs. EVIDENCE: The main concern of the residents and staff was staffing levels. There are currently 1 Senior carer plus 2 care staff on duty between 0745 & 2200 and 2 awake staff members on duty between 2200 and 0745, there is also 2 cooks and 1 cleaner who work at the home. We were informed that staffing numbers were down as the home was not full, but staff, who seemed somewhat subdued, said that residents coming in to the home had more needs than some years ago. On the day of the visit staff were seen to be working to capacity, but were seen to be hard-working in a calm way and were always busy and had a quiet pleasant manner with the residents. The expert by experience observed trays or dirty cups and plates on all floors, which were hanging around after lunch due to the staff’s more pressing tasks. During the morning staff were supporting residents to have a bath and those staff members spoken to said that they had little or no time to spare to chat to residents other than when they were actually supporting them and that an additional staff member in the mornings would benefit everyone. During our Trent House DS0000069870.V372839.R01.S.doc Version 5.2 Page 20 visit none of the carers had any breaks from 0750 till 1330. We spoke with one of the providers who told us that staffing levels were constantly under review to ensure that resident’s needs could be met and acknowledged that staff were working very hard to provide the level of support that residents require and expect. One member of staff mentioned that a new junior member of staff had not initially been trained on moving and handling equipment, so she could not be of much help ‘on the floor’ to begin with. She had now been trained. One resident said, ‘There should be 3 on duty at night, as they (2) can’t manage.’ One member of staff said that the carers had to do the laundry now as well and that night-staff did the ironing. Residents told us that “the staff are very good” One resident said of one of the staff, ‘She is so gentle and kind’. The Responsible Individual for the home informed us that additional staff have been put in place since the new provider purchased the home. The home employs a total of 18 care staff and the manager stated that 6 staff members already have NVQ level 2 and that there are 3 members of staff starting an NVQ in the near future. The manager and provider told us that the home would support staff to obtain National Vocational Qualifications. Recruitment records were seen for two members of staff and both files seen contained all of the required information including application form, 2 x references, photo, passport, birth certificate, health declaration, Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks and contract of employment. Staff training records were looked at and the manager showed us a training matrix, which showed that training is provided in; first aid, food hygiene, moving and handling, fire, infection control, adult protection, medication, health and safety, moving and handling, dementia care, depression in older people, communication, care skill and challenging behaviour. A suitable induction programme is in place and staff are expected to show that they are familiar with the homes procedures. Induction is based on skills for care induction standards and new staff complete an induction workbook and Staff spoken to confirmed that they received a thorough induction and that they are provided with appropriate training in order to carry out their care tasks. Trent House DS0000069870.V372839.R01.S.doc Version 5.2 Page 21 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 Good. This judgement has been made using available evidence including a visit to this service. The home has a manager in place to over see the day to day management of the home and there is a quality assurance system in place, however this needs to be further developed to seek the views of residents, relatives and other professionals to measure the effectiveness of the service. Systems are in place for the safekeeping of resident’s personal spending money and the health, safety and welfare of residents and staff are promoted and protected EVIDENCE: The manager has been in post since September and has worked in the care sector for over 3 years, she is not yet registered with the Commission for Social Care Inspection (CSCI) but told us that she is in the process of applying Trent House DS0000069870.V372839.R01.S.doc Version 5.2 Page 22 to be registered and intends to enrol on a suitable management course at the earliest opportunity. She told us that she undertakes regular training to update her skills. The managers office is in a separate building in the rear garden of the home and she will need to ensure that she spends time in the main part of the home to enable her to oversee the day to day running of the home and to provide support and guidance to residents and staff. The home has a quality assurance system and the home holds regular staff meetings every month and residents meeting are held every 4 - 6 weeks and minutes of these meetings provided evidence that any issues that are raised are taken seriously and are actioned by the home whenever possible. There is a comments book kept in the entrance lobby to the home and comments from visitors are welcomed. At present the provider is developing surveys and questionnaires for residents, relatives, staff and other interested parties on how the home is meeting residents needs. The home does not manage any residents’ money, however money is kept for residents personal items this is held on their behalf in the safe at the home. There is good recording with any transactions, balances, deposits and withdrawals detailed and this provides a clear audit trail. There is an in date fire risk assessment for the building and regular health and safety monitoring takes place. The fire logbook was inspected and all appropriate testing and checks have been recorded. Appropriate certificates were in date for gas safety, fire alarms systems and equipment, private electrical equipment, passenger lift and fixed hoists. Trent House DS0000069870.V372839.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x x x 2 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 2 x 3 x X 3 Trent House DS0000069870.V372839.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP27 Regulation 18 Requirement The registered persons must ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such number as are appropriate for the health and welfare of service users. This will help ensure that at all times service users have the help and support they need. Timescale for action 01/12/08 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 OP7 Good Practice Recommendations In order to improve evidence of care delivery and to improve the recording in care plans it is recommended that each residents “personal hygiene and task schedule” be kept in each residents room, where staff can record care delivery as it is given. Trent House DS0000069870.V372839.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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