Care Home: West View

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What the care home does well People with knowledge of the home speak highly of it. Comments include: "Staff are very nice and kind. They`re always there to help you" and "Excellent caring staff. Dignity is upheld". The ethos of West View is excellent, with the emphasis on quality of life for people. People are encouraged to express their views and those views are acted upon. There are residents meetings, chaired by a resident, regular reviews of care planning and surveys of opinion, collated to see where the home could improve. People`s personal and health care needs are met by a knowledgeable and skilled staff. Staff are fully engaged in providing a service which gives people dignity and respect. The home promotes people`s independence. Staff receive a training which equips them to do this. There is an excellent programme of activities and events, with frequent outings. People`s individuality is supported. Food is enjoyed. Any concern or complaint will be acted upon and people are protected from abuse. The home environment is comfortable and pleasant; good use has been made of the space so as to provide variety and choice. The provider/manager demonstrates a commitment to respect and dignity for people who use the service and staff, who are supported and encouraged. What has improved since the last inspection? There is continual investment in the home. This has included new windows to the front of the building providing better heat retention, security and ventilation and a new patio with raised planting beds providing home grown produce. There is a new computerized system to help improve administration at the home. There is a new method in use for the handling of medicines, which helps staff better monitor their use. There is now only one set of medicine keys in use at the home and they are handed over between senior staff. This reduced the possibility of mishandling or confusion. The medicines trolley is now kept locked when unsupervised. There is now clarity in recording whether a medicine has been administered or left for the person to take at a later period. The home`s policy on hand washing has been reviewed and updated and so hygiene practices are improved. People who require a soft diet now have the portions served separately. This provides variety of taste and looks more attractive.The policy on how to respond to concerns which might be abuse is clearer. What the care home could do better: The home should ensure that people have the written information they need to tell them about the service. Following the last key inspection a formalized risk assessment, relating to self handling of medicines by people who use the service, was instigated. However, this remains an area with risk. The system in use when we visited was not sufficient to prevent mistakes. Where it has been necessary to hand record a new medicines coming into the home staff have not always recorded the amount or signed, which provides a record of who is accountable. All medicines brought into the home must be checked in so that a full audit is always possible. Care homes that do not provide nursing must now store medicines, known as Controlled Drugs, in accordance with the specific regulations on their storage. When people are newly admitted to the home, whether for short or long term care, there must be a plan of how their care will be delivered. The home`s complaints procedure should state that the Commission may be contacted `at any stage` of a complaint and the whistle blowing procedure should include the contact details for the Local Authority safeguarding team. Both these measures will further improve people`s safety. The home must comply with the regulations which ensure safe recruitment of staff. Inspecting for better lives Key inspection report Care homes for older people Name: Address: West View 72 Broad Park Road Bere Alston Yelverton Devon PL20 7DU     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Anita Sutcliffe     Date: 3 0 1 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: West View 72 Broad Park Road Bere Alston Yelverton Devon PL20 7DU 01822840674 01822840684 west.view@tiscali.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Peninsula Care Limited care home 28 Number of places (if applicable): Under 65 Over 65 10 28 10 5 dementia old age, not falling within any other category physical disability sensory impairment Additional conditions: 0 0 0 0 Service users to include up to 10 adults aged over 65 years with a physical disability (PD(E)). Service users to include up to 10 adults aged over 65 years with dementia (DE(E)). Service users to include up to 28 adults of old age (OP) Service users to include up to 5 adults aged over 65 years with a sensory impairment (SI(E)). Total number of service users not to exceed a maximum of 28. Date of last inspection Brief description of the care home West View is a privately owned care home that provides care and accommodation for older people who may also have a physical disability, dementia or a visual or hearing Care Homes for Older People Page 4 of 30 Brief description of the care home impairment. Any nursing need is met through the district nursing service. The home is situated in the village of Bere Alston, six miles from the town of Tavistock. Accommodation is available on three floors with access between floors being provided by stairs and stair lifts. A small percentage of the accommodation is reached only via shallow steps. Rooms are well presented and the registered provider has an on going programme to upgrade the accommodation and fit en suite facilities wherever possible. There is a good choice of communal space, which includes a conservatory and outdoor patio for use in fine weather. There is a garden and greenhouse at the rear. Car parking is available in front of the home. The current scale of charges is between £430 and £480 a week An additional charge is made for personal items, chiropody, massage therapy, manicure and a percentage of the cost of outings. The last inspection report is available on request by potential service users, but is always sent to existing service users and family. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The Commission has collected information about West View since the previous key inspection November 2006. The home provided us with information about the service. This includes data, such as how many staff work there and when policies were last reviewed. It also gives the home the opportunity to tell us what they do well, any barriers to improvement and what improvements are planned. We did two unannounced visits to the home. We looked closely at the care of three people who use the service. This included meeting them, speaking with staff about their needs and examining records pertaining to their care. We also spoke with several Care Homes for Older People Page 6 of 30 other people who use the service, a visitor and observed staff going about their work. We saw most of the building at and several bedrooms. We examined some policies, procedures and records. We asked questions of staff and the manager, who was present throughout. People who use the service may be described within this report as residents, clients, service users or patients. What the care home does well: What has improved since the last inspection? There is continual investment in the home. This has included new windows to the front of the building providing better heat retention, security and ventilation and a new patio with raised planting beds providing home grown produce. There is a new computerized system to help improve administration at the home. There is a new method in use for the handling of medicines, which helps staff better monitor their use. There is now only one set of medicine keys in use at the home and they are handed over between senior staff. This reduced the possibility of mishandling or confusion. The medicines trolley is now kept locked when unsupervised. There is now clarity in recording whether a medicine has been administered or left for the person to take at a later period. The homes policy on hand washing has been reviewed and updated and so hygiene practices are improved. People who require a soft diet now have the portions served separately. This provides variety of taste and looks more attractive. Care Homes for Older People Page 8 of 30 The policy on how to respond to concerns which might be abuse is clearer. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home works hard to ensure peoples individual needs and requirements are fully understood prior to admission. Evidence: We looked at how the admission of the last two people to move to West View had been managed. This involved meeting them, looking at records and discussion with staff. Assessment questions at West View provide the opportunity for people to say what really matters to them. They include: How do you like to present yourself and What causes you concern, unhappiness, anxiety or low mood? We saw that health needs, information about activities of daily living and that pertaining to personal history are all recorded. This is especially important where a person may have reduced memory. From this information the person and staff should be able to plan the care to be provided. Care Homes for Older People Page 11 of 30 Evidence: We found that certain important information was missing from the assessment. The Mental Capacity Act now provides a legal framework which protects people who are unable to make decisions regarding their own welfare. This includes: Lasting Power of Attorney and Advanced Decisions to refuse treatment. This information has to be known by the home but was not recorded. However, it has been included in the contract (terms and conditions) which people will soon receive at admission. We visited the two people newly admitted. They told us: I love the place and the way it is run and Very nice, kind. Always here to help you. However, one did not have the information guide about the home, believing her family had taken it. We were told: I dont know the routines, the finer things, such as laundry and bathing. This information should be available to the person who needs it. We were given a copy of the homes brochure which clearly describes what the service can offer and the home reports: We continue to respond to challenges to improve the way we enable residents to make an informed choice of home. This includes suggesting other homes in the area that may provide a comparison. We are open to suggestions for further improvement. The home reports: Prospective clients are invited to come for the day and have a meal with their relatives to get a flavour of the home and to see how we accommodate residents with differing needs. We confirmed that people are first visited in their own home wherever possible. Care Homes for Older People Page 12 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that their personal and health care needs will be well met and they will be treated with the utmost of respect but the management of medicines in the home needs further attention. Evidence: We looked at how health and personal care are delivered at West View. The home reports: West Views overarching policy recognises the self determination of individuals and the right to independence, choice, privacy and dignity applies to medication administration. We found this to be the case. Each person living in the home must have a plan of care that accurately reflects his or her care needs and identifies the action required by staff to meet those needs. The plan should be reviewed a minimum of monthly in consultation with the person or their representative and updated when the persons needs change. This is to ensure that a persons changing needs are assessed and met. Care Homes for Older People Page 13 of 30 Evidence: We looked closely at the care of three people who use the service, one who had been resident for five days. Two of the people had a plan of care but the new resident did not. Whilst it is understandable that a care plan will be an ever evolving document each person must have a plan from the point at which they become resident otherwise care is not planned. This is particularly important where there might be a risk, for example, of falls or relating to assistance with moving safely. Records indicate that people, and/or their family, are involved in planning their care and there is monthly care plan monitoring which includes peoples weight, skin condition, mood and the amount of time provided for one to one attention and group activity. We were told there is also a yearly review and family are invited to attend this. The issue of peoples capacity to make decisions is not yet being addressed within the homes care planning. This was discussed with the acting manager who oversees all day to day care. We joined a hand over of information between staff. Good detail, including health, mood, diet and activities, was discussed. Daily records are informative and cover choices, activities, visitors and peoples health care needs. People looked well cared for. Attention is paid to the standard of personal care delivered and how people like to present. Staff receive training in aspects of health, such as continence care. Observation, discussion and records indicate that peoples health care needs are properly met at West View. There was a change in how medicines are managed at the home following some problems. Staff have received training in how to use the new, monitored dosage system. We looked to see if people are supported to manage their own medicines and whether the systems in place at the home are safe. The home reports: Toward improvement we plan to review policies and procedures to ensure that continuing risk assessments continue to be a tool for safeguarding our residents. We found that one person, who wants to manage their own medicines, was doing so but there had been an error. We would expect to see a record of how any risk from self medicating was assessed and records of how risk is managed, but were told there is no written record of this. There must be a risk assessment and it must be regularly reviewed. It must include the persons capacity to understand and handle their own medicines safely. Care Homes for Older People Page 14 of 30 Evidence: We looked at the medicines policy and found it had not yet been updated following the new system at the home. The storage of most medicines was safe and meets the requirements. However, the storage of the medicines known as controlled drugs does not. Although contained in a locked box within a locked cupboard the box was not secured in accordance with the Misuse of Drugs (Safe Custody) Regulations. We watched staff taking medicines to people and they did this in a safe manner, locking the trolley when it was left for any time. Most of the medicines had been checked into the home, as they must to ensure a full audit is possible, but where there had been a hand written entry this was not always the case. We checked the balance of controlled drugs against the record and it was correct. The home ensures that there are only one set of medicine keys now in use. We saw them formally handed over to the next shift leader. This helps to ensure safety. People are treated with great respect, kindness and consideration by staff. This was observed to be consistent throughout the two visits. People had told the home through survey: Excellent caring staff. Dignity is upheld and We always found the carers were wonderful and very easy to talk to. Care Homes for Older People Page 15 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are enabled to lead fulfilled lives because their individuality is respected and there is a wide variety of choice at the home. Evidence: We looked at whether the service supports people to live a fulfilled life. A monthly newsletter lets people know what activities are arranged at the home and the residents committee has meetings which give people the opportunity to make suggestions regarding, for example, trips, entertainment and the menu. People looked very relaxed at the home. People left the building to go out; one stayed in bed late because they wanted to. One person told us how much they liked that The staff dont interfere. There is an activities coordinator at the home. She ensures there is a variety of activity available. This has included: visits away from the home in the minibus, arts and crafts, cooking, reminiscence of how things used to be, weekly fellowship, manicure, donkey visit and firework display in November. We saw people reading the daily newspaper, Care Homes for Older People Page 16 of 30 Evidence: chatting with others and making Christmas decorations. The home reports: We pride ourselves in getting people out and about in our minibus to experience new activities like ten pin bowling as well as to attend local events, concerts and village days. We always enter a float at the village carnival and feel very much a part of the community. When people are new to the home, and following this, they have the opportunity to let the home know their individual needs. For example, people are asked what they like to do on their own and with others and what they consider acceptable presentation. However, although staff knew peoples preferences their care plan did not always reflect this. For example, we were told how much one person likes animals and trips to Dartmoor, but their care plan only said: Likes TV. The home reports: Menus have been reviewed by professional cooks and training on the preparation of more home cooked produce has been undertaken. The amount of choice has been improved at all meals. We asked people about the food and menu at the home. Food is discussed during residents meetings. Seven people told us they were very satisfied with the food provided, with comments: Good choice at tea time and good cooks. The menu listed home made soup, sandwiches or cauliflower cheese for tea the first day of our visit. Lunch was chicken pie. We saw that people had sherry and wine at lunchtime. Food is served already plated rather than served at table but people said they are perfectly happy with that arrangement. No person at the home is currently needing a soft diet, but we were told that, where this is necessary, portions are now separated so individual portions can be identified. Where people are unwell and need their diet monitored there are arrangements to record their diet. Care Homes for Older People Page 17 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Any concern or complaint will be acted upon and people are protected from abuse. Evidence: The home reports: We are open and transparent and actively encourage people who use our service, whether directly or indirectly, to voice any complaints, concerns or suggestions they may have. We see complaints as a way to improve our service and an important part of our quality assurance mechanisms. We found this to be the case. People have told the home through survey: We have never found it difficult to talk to anyone or approach them and I do feel safe and secure and well looked after here. The Complaints policy is displayed by the entrance of the home. Currently it does not inform people that they can contact the Commission at any stage of a complaint but it does contain the Commission contact details. The homes brochure tells people to ask for the complaints policy if necessary. The home reports that it has received no recent complaints. The Commission has received no complaints about the service. Discussion with staff, and records, confirmed they receive training in how to safeguard people from abuse and they were able to describe what actions they should take Care Homes for Older People Page 18 of 30 Evidence: should they have concerns. We looked at the whistle blowing policy, which should tell staff how to alert concerns which might be abuse. The policy is easy for staff to access but does not include the contact details for the Local Authority safeguarding team; the people they should contact if they had concerns which might be abuse. Six staff surveyed say they are aware of how to protect residents from abuse. On discussion it was confused as to what training staff have received, but on questioning they understood the types of abuse, who to contact if they had concerns and where the homes abuse and whistle-blowing policies are kept. Care Homes for Older People Page 19 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home environment meets the needs of the people who live there. Evidence: The home reports: Environmental improvements have continued with further alterations to maximize the ease of movement through the home. New windows have been installed to the front of the building providing better heat retention, security and ventilation. A new patio with raised planting beds has enhanced the experience of home cooking with home grown produce. The home is well maintained. Rooms are personalised and appeared to be comfortable, some being like mini apartments. One person told us he was very pleased with his room. Another said they had all that they needed. Many have nice aspects, such as two views of the garden. Five staff told us that they have the equipment necessary to aid independence and protect both people who use the service and themselves. All at West View have the opportunity to lock their door should they wish; some do so. Some people have pendant alarms so can alert staff when out of their room. We were told that some have a bell mat, next to their bed so as to alert staff if the person is unable to use the call alarm. Not all bedrooms have level access but there is a chair lift and plans to Care Homes for Older People Page 20 of 30 Evidence: extend, include a vertical lift. The sitting and dining room space provide comfortable seating in warm and attractive surroundings. Much effort has gone into ensuring the home feels non- institutional. There is space for social or private leisure time. Bathrooms are very attractive and well equipped. The home was nice and warm. On the day of the inspection visit the home was very clean and mostly fresh throughout and very clean. The laundry is small, but the standard of laundry equipment is high. Staff were observed using protective clothing and understand how to maintain hygienic conditions; they have had training in hand washing and infection control. We were told that all bedrooms contain a liquid soap dispenser for staff use. Care Homes for Older People Page 21 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive a service from a staff which is well trained, skilled, knowledgeable and in sufficient numbers to meet their individual needs but recruitment is not always sufficiently robust. Evidence: People said of the staff: Theyre so happy and outgoing. They dont interfere. It was clear that staff are liked and respected at the home. We asked two people if they thought there are enough staff to meet their individual needs. Both felt that there were. People appeared to be well cared for and there were plenty of staff in the home the twice we visited. We looked at training records and spoke to staff about the training they receive. Records indicate that new staff receive a structured induction to the home and care work. People we asked said they felt staff were competent in their work. We were told that staff will work at least one of each shift as an extra to numbers when they are new and be supervised by the senior carer on duty. Records showed that one staff received training in fire safety, safeguarding adults, The Principles of Care, emergency 1st aid and health and safety when they were first employed. Care Homes for Older People Page 22 of 30 Evidence: Asked about training in the care of people with dementia we were told: Yes, lots over the years. Those we spoke with had a good understanding of how to meet peoples needs sensitively and this was also observed. Other training staff have received includes: Creative cooking, catheter care and continence, care of the dying and medicines. Health and safety training is also in place. The regulation relating to safe staff recruitment requires the home to make specific checks, including two written references and that of any possible criminal history. The Criminal Record Bureau (CRB) service enables organisations in the public, private and voluntary sectors to make safer recruitment decisions by identifying candidates who may be unsuitable for certain work, especially that involve children or vulnerable adults. We looked at the recruitment of four staff employed during 2009. Two of those four started work at the home before the required two references were received and prior to completion of both the CRB and list of people unsuitable to work with vulnerable adults, checks. It is also expected that the home will have a full employment history for each applicant but West View only makes a record of the last employer. The registered manager feels that the homes recruitment practice does protect people. For example, some new staff are known to other staff who work at the home. However, the required checks must still be complete toward the final judgment of their suitability. There is no record of the staff who would be supervising new staff. We were told it would be accepted as being the senior carer on duty but this must be recorded. We asked if people who use the service have a say in who is recruited to work at the home and we told it is normal practice for potential staff to look round the home and their interaction with people is noted. Care Homes for Older People Page 23 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run with the best interest of people who live there in mind but some aspects, which relate to safety, need to be better managed. Evidence: The registered manager is Mr. Trevor Atkinson but he delegates the day to day management of the home to an acting manager who has qualifications in nursing. Both have backgrounds in health and social care and have achieved awards in management. The acting manager has undertaken regular training to update her knowledge with regard to good good care practice. She is also trained to train staff, for example, in helping people with reduced mobility to move safely. The home reports: The responsibility/ accountability structure are clearly understood within the staff team. This assists good communication and understanding. Separate staff meetings are held monthly for management, team leaders, carers and domestics, and cooks. Care Homes for Older People Page 24 of 30 Evidence: We found that the home is organised using tiered responsibility: the manager delegates to the acting manager and she to shift leaders. We saw how information is passed on verbally between staff. This contained good detail; it related to peoples physical and emotional needs. During our visit staff were receiving training in a new computer system which it is anticipated will lead to further improved systems of administration. We were told that all senior staff had training in the Mental Capacity Act and the home has the Codes of Practice for use as reference. The culture and nature of the home fully supports the the rights and dignity of people who use the service. It is a caring and happy environment. People told us: Its very nice, kind. Theyre always there to help you and I love the place and the way it is run. Very supportive. I feel relaxed. Staff told us how good is is to work at the home. We saw banter between people and it is clearly a happy environment. The home reports: We have a holistic approach to care covering physical, emotional / psychological and social aspects of a persons life. We found that to be the case. We looked at how the quality of service is monitored at the home. There is a yearly survey of opinion and we were given a copy of the results, which includes positive comments, negative comments, peoples requests and the management response. People clearly felt able to speak their mind about the service. There is an annual review of each persons care and we were told that their family are invited. There are also residents meetings where people make suggestions and comments about the service. We discussed how people are supported regarding their financial matters and were told: No money belonging to people who use the service goes through the business account. A credit residents account is operated, from which money is taken to pay for newspapers etc. The home pays the bill and then invoices the service user. The bill is itemized and with receipts. Small amounts of money will be kept on peoples behalf if they insist. If people ask for lockable space they can have this and all have a key to their room if they wish. We saw that policies, procedures and codes of practice are reviewed. The information provided about the service indicates that all servicing and certification Care Homes for Older People Page 25 of 30 Evidence: is in place to ensure equipment and utilities (such as gas and electricity) are completed so as to maintain a safe environment. Staff receive the required health and safety training. However, we found one cupboard, which contained cleaning chemicals, was unlocked both times we visited. Safety had not been fully considered and there was no assessment from this risk in place. We found no maintenance or other environmental concerns. There are some risks relating to the management of medicines and recruitment of staff which need prompt attention. Care Homes for Older People Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 A care plan, which as a minimum includes assessment of risks, must be in place at the point at which a person moves into the home. So that there is a plan in place of how their needs will be managed. 31/12/2009 2 9 13 All medicines must be checked into the home. So that a full audit of their use is always possible. 31/12/2009 3 9 13 Controlled Drugs must be stored in compliance with the Misuse of Drugs (Safe Custody) Regulations 1973. To reduce the possibility of misuse or mishandling and to comply with the law. 31/01/2010 4 9 13 There must be an 31/12/2009 assessment of risk relating to peoples ability to manage their own medicines and this must include their capacity Page 28 of 30 Care Homes for Older People to do so. This must be regularly reviewed. So that risk can be removed or reduced. 5 29 19 No staff must start 31/12/2009 employment at West View until all the required checks have been completed, as listed in Schedule 2 of the Care Homes Regulations 2001. Those checks include: two written references, whether the person is on the list of people unsuitable to work with vulnerable adults, and whether they have a criminal record. to protect people from those who may be unsuitable or unsafe to work with vulnerable adults. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 1 16 The Service Users Guide should be available to each person who uses the service. The complaints procedure should make it clear that the Commission (CQC) can be contacted at any stage of a complaint. The whistle blowing policy should include the contact details of the Local Authority safeguarding team as it is they that should be contacted if a member of staff feels they need to take a concern outside the home. There should be a record of the full employment history or any person applying to work at the home. This is so any gaps in employment will be known and can be explored as part of the recruitment process. 3 18 4 29 Care Homes for Older People Page 29 of 30 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!