Care Home: Walshaw Hall

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What the care home does well This is a care home where residents are well looked after. We found the management and staff teams work well together so that resident`s needs are met in all areas of care, including their social, medical and cultural needs. We spoke to a number of residents who commented on how well they are cared for, they included, "Its really nice hear, they treat us really well, nothing is too much trouble", " I know it`s a big home but it really is homely" "the staff can`t do enough for you". We talked to a number of staff and it was found they have a good knowledge of the individual care needs, social and cultural needs of residents living at the home so that they are not disadvantaged in any way. Staff comments included, " I`ve worked here for a while now and find everybody really supportive", "Its like a home from home here", "I always treat people as I would expect to be treated", " Residents can more or less do what they want, some like to stay in their rooms and they have their own bits and pieces in them" Observation of care practices throughout the day confirmed residents are treated with dignity and respect, as well as making sure their right to privacy is respected, by knocking on doors before entering for example, and talking with respect to people at all times. We saw the home is very well maintained and comfortable so that people can move around without restrictions. Rooms are personalised with evidence of personal items in place so that it is familiar to them. One resident said, "I`ve got my own things in my room, and its such a lovely view from here". We found some residents have their own telephone in their rooms so that they are able to communicate with family or friends in the privacy of their own rooms. "Its great being able to ring my son whenever I want and he can ring me". What has improved since the last inspection? We found the way risk assessments are carried out have been improved, so that risk to residents in moving and handling and nutrition are being identified and staff spoken to are aware of this so that nobody is disadvantaged. Residents have a lockable facility in their rooms, so that they can store things privately. We spoke to some residents who said they like to keep things safe and private. We spoke to residents who said they go to regular meetings and they feel they can give their views about the way they live. The manager told us there are annual surveys for all stakeholders of the service and this information is used to identify and make changes in the annual business plan for the benefit of people who use the service. We saw the care plans being used and the participation of others to be involved in the production of the plan. The manager told us not all residents have the ability to participate but where this is applicable it is used. CARE HOMES FOR OLDER PEOPLE Capstone Care Limited Walshaw Hall Bradshaw Road Tottington Bury Lancs BL8 3PJ Lead Inspector Mrs Jackie Riley Unannounced Inspection 09:15 18 March 2008 th 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 Capstone Care Limited DS0000008410.V337488.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. Capstone Care Limited DS0000008410.V337488.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Capstone Care Limited Address Walshaw Hall Bradshaw Road Tottington Bury Lancs BL8 3PJ 01204 884005 01204 883710 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) None Capstone Care Limited Mrs Marilyn Bates Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (50) of places Capstone Care Limited DS0000008410.V337488.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st June 2006 Brief Description of the Service: Walshaw Hall is situated in a semi rural setting in extensive gardens overlooking fields and farmland. It is a large detached and extended property set in its own grounds close to the village of Tottington. It is approximately 10 minutes drive away from the town centre of Bury. There is ramped access to the back of the home to allow access for wheelchair users and people who have problems climbing steps. There is adequate parking to the front of the home with extensive additional parking within the grounds. The home is registered to provide 50 places for the personal (residential) care of elderly people. There are 42 single and 4 double bedrooms. 35 single and 2 double bedrooms have en-suite facilities. This accommodation is provided on three levels with a passenger lift to the first floor and a stair lift to the second floor. There is plenty of lounge and dining space and the decoration and furnishings are of a very good standard. The toilets and bathrooms have aids to assist any resident with a disability or mobility problem Capstone Care Limited DS0000008410.V337488.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 3 Star. This means the people who use the service experience excellent outcomes. This key inspection which included a site visit, that the home did not know was going to happen, took place on the 18/03/08. We spoke to the manager, staff members, ten residents, and a number of visitors to the home. As part of the inspection process we talked to people using the service and asked staff about those peoples needs. We also looked at their rooms, care plans, records and daily notes, this is called case tracking. Other residents are invited to pass their opinions to us if they wish. We had responses from surveys/questionnaires sent to relatives and residents for their views on how the home is run. All comments gathered were positive and some are included in this report. Every year the person in charge or manager is asked to provide us with written information about the quality of the service they provide, and to make an assessment of the quality of their service. We use this information, in part, to focus our inspection activity. We looked at recruitment and training records of three staff members. We also spent time in the lounge areas, walked around the building and watched people living and working to see how everyone was supported and talked to each other. What the service does well: This is a care home where residents are well looked after. We found the management and staff teams work well together so that resident’s needs are met in all areas of care, including their social, medical and cultural needs. We spoke to a number of residents who commented on how well they are cared for, they included, “Its really nice hear, they treat us really well, nothing is too much trouble”, “ I know it’s a big home but it really is homely” “the staff can’t do enough for you”. We talked to a number of staff and it was found they have a good knowledge of the individual care needs, social and cultural needs of residents living at the Capstone Care Limited DS0000008410.V337488.R01.S.doc Version 5.2 Page 6 home so that they are not disadvantaged in any way. Staff comments included, “ I’ve worked here for a while now and find everybody really supportive”, “Its like a home from home here”, “I always treat people as I would expect to be treated”, “ Residents can more or less do what they want, some like to stay in their rooms and they have their own bits and pieces in them” Observation of care practices throughout the day confirmed residents are treated with dignity and respect, as well as making sure their right to privacy is respected, by knocking on doors before entering for example, and talking with respect to people at all times. We saw the home is very well maintained and comfortable so that people can move around without restrictions. Rooms are personalised with evidence of personal items in place so that it is familiar to them. One resident said, “I’ve got my own things in my room, and its such a lovely view from here”. We found some residents have their own telephone in their rooms so that they are able to communicate with family or friends in the privacy of their own rooms. “Its great being able to ring my son whenever I want and he can ring me”. What has improved since the last inspection? We found the way risk assessments are carried out have been improved, so that risk to residents in moving and handling and nutrition are being identified and staff spoken to are aware of this so that nobody is disadvantaged. Residents have a lockable facility in their rooms, so that they can store things privately. We spoke to some residents who said they like to keep things safe and private. We spoke to residents who said they go to regular meetings and they feel they can give their views about the way they live. The manager told us there are annual surveys for all stakeholders of the service and this information is used to identify and make changes in the annual business plan for the benefit of people who use the service. We saw the care plans being used and the participation of others to be involved in the production of the plan. The manager told us not all residents have the ability to participate but where this is applicable it is used. Capstone Care Limited DS0000008410.V337488.R01.S.doc Version 5.2 Page 7 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. Capstone Care Limited DS0000008410.V337488.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 Capstone Care Limited DS0000008410.V337488.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. Standard 6 was not assessed as intermediate care is not provided Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission and assessment procedures were clear and precise to ensure the needs of the residents are met. EVIDENCE: We looked at the records of three residents. They had assessment information recorded in detail, so that the staff know what the individual needs of residents are. There has been a revised recording system put in place since the previous inspection which includes risk assessments for moving and handling and for nutrition, so that staff know the level of risk for individual residents. We talked to the registered manager who always visits prospective residents to carry out a preliminary assessment to make sure the home can meet the needs of the resident. Visitors we spoke to and surveys we received all said Capstone Care Limited DS0000008410.V337488.R01.S.doc Version 5.2 Page 10 they felt confident the home can meet their relative’s needs. Comments included, “the manager came to visit me in hospital to introduce herself and tell me all about Walshaw Hall”, “Staff are most attentive. Mum has had a difficult time for a few months and staff have phoned immediately to keep me up to date with how she is. They also help me with informal paperwork, e.g. social services. I feel the management and staff can help with any worries I have and lift them off me. I was most grateful of this first contact”. The files we saw had in place an assessment with information on file for the care staff at the home to develop a care plan to ensure all health, welfare and social and cultural needs are identified and recorded. A staff member spoken to said, “We make sure we know all about the resident when they come in and find out just what their needs are, sometimes we talk to social workers or district nurses who have taken care of them before they came into the home”. A resident spoken to confirmed they were involved in the assessment process and able to give their views of the support they required. Another resident spoken to said, “They went through all my health needs before I came, to make sure they knew just what I needed”. Staff members we spoke to said they use the assessment plans to guide them when providing care, and the assessment information is the basis of the care plan. The home does not provide intermediate care. Capstone Care Limited DS0000008410.V337488.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. Promotion of health is taken seriously. Resident’s welfare is closely monitored and health needs are identified and met. EVIDENCE: The records of three residents who were case tracked were complete, accurate and had good information relating to the health and welfare of the individual residents. The care plans were well structured and there was evidence reviews had taken place so that any necessary changes are being addressed. Care staff are involved in the care planning process and those spoken to said, “we know the importance of recording a residents needs, and how they are going to be met, it’s really important to make sure everything is recorded”. A resident said, “they talk to me about what I need so I know they are looking after me”. Capstone Care Limited DS0000008410.V337488.R01.S.doc Version 5.2 Page 12 Health care records showed there is a good link between the home and healthcare professionals including doctors, district nurses, chiropody, and optical services, so that residents are not disadvantaged in any way and their individual health needs are met. Records examined confirmed risk assessments have been completed and are reviewed when required and updated reflecting any changes that may have occurred individually and in the environment ensuring the resident’s needs are being monitored. Medication practices we observed at lunchtime were safe and good records had been kept ensuring residents health is maintained. Individual members of staff are identified to be responsible for administering medication. Staff training in this area is ongoing and links in with the supplying pharmacist and the training provider to the home so that staff are competent in this area and the system is safe for the protection of users of the service. Comments included, “I’ve been on training courses for medication and the manager is always checking up on meds”, “We’ve just changed the meds system and the pharmacist is giving us advice, but it’s a better system than the last one”. We found the way meds are stored should be improved in that the storage areas are limited. However after discussion with the manager and a senior member of staff we were made aware that a new larger secure drug storage cabinet suitable is on order and awaiting delivery, so that medication storage will be more suitable than the system used at present. We looked at how residents dignity and privacy are protected during the visit and we found staff treated people with respect at all times. This was confirmed by observing staff members knocking on doors before entering rooms, and the way staff talked and responded to residents. Comments we received said, “they’ve always got time for you”, “they always knock and give a shout before they come in”. Staff said, “We know some people want to be in their own room and be private and we respect that”. Capstone Care Limited DS0000008410.V337488.R01.S.doc Version 5.2 Page 13 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 excellent. This judgement has been made using available evidence including a visit to this service. Social activities and meals are both well managed, creative and provide daily variation and interest for people living in the home EVIDENCE: We spoke to a number of residents who said routines in the home are flexible and they were able to make their own decisions about how they live their lives. Comments we received said, “Its great being able to ring my son whenever I want and he can ring me”, “We have a nice lady who does activities every day, I like that because it keeps me busy”, “There’s always something going on, and if you don’t want to watch telly you don’t have to, the rooms are really big, so that you can bring some of your own things and its really homely”, “We have an excellent lady who is here Mon to Fri and she arranges all kinds of activities for residents. I spend some of my time making cards for special occasions”, “Mum has her own phone in her room”, “Mum enjoys the singing and entertainers that come on Friday afternoons. She sometimes joins in with the other activity”. Capstone Care Limited DS0000008410.V337488.R01.S.doc Version 5.2 Page 14 We observed that televisions on in both lounges were not too loud, so that it did not hinder conversation. A staff member spoken to said the televisions have a system whereby people with hearing aids can pick up audible sound so they can enjoy television without the need for additional volume. Staff comments included, “Many of the residents have some really interesting stories about their lives and they like to talk about things like that”, “There’s always something going on here, but if you don’t want to be involved you don’t have to, I like my own space”. We saw a well designed activity programme on the entrance notice board so that people know what is happening and when. It is flexible and some residents spoken to said, “I prefer to be in my own room, but sometimes I like to join in”. As well as entertainers, there are trips out, garden parties in the summer months, regular birthday celebrations which include families. There are therapeutic sessions, as well as having a designated member of staff to undertake activities. We found all activities are varied and meet the needs of the residents living at the home. We received many comments including “Walshaw Hall offers a range of activities, outings and choice. There is an excellent choice of places to visit. The hall and grounds are extremely well kept and there is plenty of choices of seating for residents and visitors to enjoy”, “We have a lovely hairdresser in the salon, so we don’t have to go out and get our hair done”. We looked at diet and nutrition and found the home provides a varied and balanced diet for residents. There is a designated cook, who was spoken to and confirmed the home provides a varied menu, which is designed around resident’s choices and preferences. The dining experience is designed to be a positive one with meals being taken in the large ornate dining room. We spoke to a number of residents who said they enjoy spending time together and having a good natter over a meal. Other residents we spoke to said they prefer to eat in their own rooms and this was not seen to be a problem. Special dietary needs are taken into account and advice is sought in some instances for specialist diets. Care planning makes sure the home is promoting equality by treating residents as individuals. Discussion with a resident confirmed the home is taking into account personal hobbies and interests. “I like to do my own thing and the staff understand that”. Capstone Care Limited DS0000008410.V337488.R01.S.doc Version 5.2 Page 15 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. Arrangements for complaints are handled well and taken seriously ensuring people are listened to. Procedures for reporting abuse were satisfactory ensuring people are adequately protected. EVIDENCE: The home has a detailed complaints procedure, which is made available to all residents on admission and is contained in the Statement of Purpose and Service User Guide to ensure they feel protected. We spoke to a number of residents and visitors who said they were aware of how to make complaints and felt they would be listened to and acted upon. Comments included, “Mum will say straight away if she is not happy”, “The staff are very prompt in letting me know of any problems that may occur”, “Usually the manager or senior care will deal with any complaint we may have”. We looked at a number of records and saw there have been no formal complaints made to the home or the Commission since the previous inspection. Capstone Care Limited DS0000008410.V337488.R01.S.doc Version 5.2 Page 16 We saw the home has a procedure in place for dealing with allegations of abuse. The manager and staff spoken to had a good understanding of the procedures to be followed in the event of any allegations or suspicion of abuse or neglect. We spoke to the manager and some staff about training in safeguarding adults and were informed this area is addressed by the home and through the external training programme in place. This gives staff the knowledge and skills to address any concerns raised in an appropriate manner in accordance with local and national guidance. Capstone Care Limited DS0000008410.V337488.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 good. This judgement has been made using available evidence including a visit to this service. The environment is safe and clean maintained to a high standard providing comfortable surroundings for the residents, however lack of a monitoring system at the front entrance has the potential to put people at risk. EVIDENCE: We looked around the building both externally and internally and found it to be maintained to a very high standard. We received many positive comments about this and they included, “The domestic staff are excellent keeping everywhere clean and fresh”, Cleanliness is really excellent and it is carpeted, Walshaw Hall is always spotless”, “The hall and grounds are extremely well kept and there is plenty of choices of seating for residents and visitors to enjoy”, “Just look at these grounds, where else can you get a view like that” Capstone Care Limited DS0000008410.V337488.R01.S.doc Version 5.2 Page 18 “I love sitting here just watching out of the window, just to see how the weather can change form one minute to the next”. We saw evidence through general observation and records that the home is well maintained and decorated for the comfort of the users of the service. There is a maintenance employee designated to provide regular maintenance cover to areas of the home both internally and externally so that it is maintained to a good standard and in accordance with health and safety practices. As the home is so large there are other external contractors overseeing maintenance as and when necessary. We found the entrance system should be looked at in that, due to the large layout of the entrance area, visitors can enter without staff knowing who is in the home at any one time. This could have implications for health and safety issues. We spoke to the manager about this who said this is being discussed with the registered owners and a solution is being looked at. We looked around the home and found it to be clean and tidy with no evidence of offensive odours. A resident said, “they’re always cleaning and tidying up”. We saw the home has designated staff for domestic and laundry procedures. We saw the homes laundry system is effective so that resident’s clothes are generally managed well and returned to the residents on a daily basis. There are policies and guidance for laundry processes and for the control of infection ensuring the home is kept clean, pleasant and hygienic. The home benefits from a continuous programme of decoration for the comfort of the people using the service. One resident commented on how nice it was to be able to have their own things in the room, as it was a ‘home from home’. “We’ve got our own things in here, so it’s just like home”. We looked a number of resident’s rooms and those spoken to were very happy with heir own environment and all had personal items from home, so that they felt very comfortable. Residents and visitors we spoke to said they can use their rooms whenever they chose to and this was seen throughout the time we spent at the home. Many of the residents we spoke to especially liked the position of the home and the views from the large windows, both in the lounge areas and from many of the residents own rooms. Other resident’s spoke of how they enjoy using the large grounds during the summer months as they are pleasant and well maintained so that they bring pleasure to the residents and visitors using them. A new patio area around the home is almost complete so that residents can use this area in the warmer weather. The grounds are also suitable for people with limited mobility or those who require walking aids so that nobody is disadvantaged in any way. Capstone Care Limited DS0000008410.V337488.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 good. This judgement has been made using available evidence including a visit to this service. The procedures for the recruitment of staff are good ensuring the safety and protection of the residents. Training for staff is good and enables staff to have the skills and competencies for their roles. EVIDENCE: We looked at the recruitment system for staff, which is robust in that the management team have in place a system where staff have to follow a thorough system of recruitment before they are accepted to undertake a role in providing care to residents. This was confirmed through observation of three staff files. Staff spoken to said, “I had my references and everything else checked before I started so they know you are safe to work with older people”. We spoke to a number of residents and visitors who are happy with the staff team, they commented on how helpful and cheerful they always are. Other comments we received included, “Staff are most attentive”, “Mum has looked so much better for being a resident at Walshaw Hall. Her recovery rate has been far more rapid than when she lived at home and this is due to the excellent care she receives”. Staff are very aware of the needs of the residents. Capstone Care Limited DS0000008410.V337488.R01.S.doc Version 5.2 Page 20 We looked at the homes staffing rota and found the home is staffed in numbers to meet the current needs of residents living there. As the home is very large and spacious and divided between three floors, some people don’t always feel there are enough staff on duty, comments included, “Staff listen to what I say but sometimes they appear over busy”, “Sometimes the staff are not available due to inconsistent staffing levels”, “it would be nice if there were a few more staff around sometimes, I know it’s a big place but you can sometimes have to wait a while for things”. By making observations throughout the inspection, we found that by sitting in different areas of the home residents may not see a staff member for a period of twenty minutes or more, this is not because they are not on duty but due to the geography of the building. It is recommended residents and visitors are made aware of how they can make contact with staff using the call bell system so that they feel more confident about receiving assistance. We received a number of positive comments about the staff team including, “Staff are considerate and listen to any problems I have”, “Its really nice hear, they treat us really well, nothing is too much trouble”, “the staff can’t do enough for you”. We looked at how the staff team are trained and found there is a lot of emphasis put on making sure all levels of staff receive training to support their personal and professional development so that they are equipped with the necessary skills and competences to carry out their individual roles for the benefit of all stakeholders of the service. There was evidence on the three staff files seen and through discussion with members of staff on duty that the home encourages all members of the staff team to attend training in areas associated with care practices and caring for older people. Comments included, “ We are encouraged to go on training courses, and I find it really good that we can learn new skills”, “When we start here, you get to know what to do from the manager and other senior staff, so you don’t feel out of it”, “I’ve been on training courses for medication and the manager is always checking up on meds”. The information the manager provided before we came to the home showed out of 34 staff members 29 have completed a national vocational qualification and at the time of the inspection 5 other staff were working towards completing this qualification. Other staff said they were now taking a higher level care qualification, and that staff attend external training in other areas of care associated with caring for older people. This means the home is committed to making sure the staff team are competent in their roles and that the home keeps up to date with changes in care practices for the benefit of all stakeholders of the service. The management team told us the staff team are supported through supervision and appraisal thereby making sure they are meeting the responsibilities associated with their individual roles, as well as promoting individual development in the area of care practice. Staff we spoke to were Capstone Care Limited DS0000008410.V337488.R01.S.doc Version 5.2 Page 21 motivated by this and felt it was important that they expanded their knowledge in care practices for the benefit of users of the service. Comments included, “ I feel really supported by the manager and the senior care staff, we all get on really well”. Capstone Care Limited DS0000008410.V337488.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed well and systems and policies in place for the protection and safety of staff and residents are good, however lack of reports from the registered owners mean there is no evidence of how they are monitoring the running of the home. EVIDENCE: We say the registered manager has the necessary skills and experience required to support the staff and residents and enable the home to meet its stated purpose and objectives. Capstone Care Limited DS0000008410.V337488.R01.S.doc Version 5.2 Page 23 Staff spoken to say they found the management team to be supportive and they felt provided a clear sense of leadership. Staff comments included “Its nice working here, we work well together”, another commented,“ Always approachable and helpful”. Comments from residents, surveys and visitors were positive about the management, comments included, “the manager is lovely, always got time for you”, Management and senior staff are attentive in dealing with requests and supporting me and mum through difficulties”. We saw there is a designated administrative employee who manages some of the residents financial and other administrative records. These records are independently audited ensuring residents interests are safeguarded. We found the home has improved its quality monitoring system so that it takes into account views from users of the service so that the home can use the information to measure their effectiveness in meeting their stated aims and objectives. We acknowledge the registered owners of the home are in regular contact with the manager and visit the home on a regular basis, however, there were no written reports as required by the Commission to show how the home is being monitored and changes being made, this is an area which requires development. Inspection of maintenance records confirmed equipment and facilities are being maintained as required by health and safety legislation so that the homes environment is safe for all users of the service. Capstone Care Limited DS0000008410.V337488.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Capstone Care Limited DS0000008410.V337488.R01.S.doc Version 5.2 Page 25 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. 1. Standard OP31 Regulation 26 Requirement The registered providers must produce a monthly report following the unannounced visits to the home, to ensure there is a record to inspect, which shows how the home is being monitored and evidence of any changes or actions, which are being taken. Timescale for action 30/04/08 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 OP9 Good Practice Recommendations Suitable medication storage should be in place to make sure all prescribed medication in the home is stored in one place for convenience and safety in administration. The Commission is aware a suitable storage facility is on order. The way staff are mobilized around the building should be looked at so that any resident requiring assistance at any one time can be assured there call will be responded to immediately. Consideration should be given to a more secure entrance DS0000008410.V337488.R01.S.doc Version 5.2 Page 26 2. OP27 3. OP19 Capstone Care Limited system so that staff know who is in the building at any one time. Capstone Care Limited DS0000008410.V337488.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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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