Care Home: Winash Rest Home

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What the care home does well Outcomes for the residents are positive. For example five residents spoken with said, “The home is nice, the staff are kind and caring, and the food is good.” A good rapport between staff and residents was observed. The home has a warm and pleasant environment with a good standard of fixtures and fittings. The staff work well as a team and ensure the well-being and comfort of the residents’ and treat them with great respect and kindness. People living at the home feel valued and cared for. Staff feel well supported and enabled to provide a high standard of care. Staff are dedicated to meeting the needs of people living in the home in a personal "person centred" way providing the little extras that make this an excellent service. This was evident in the way the care needs of people living in the home were recorded, and also how staff could identify the individual needs of the person when asked. Staff had a clear understanding of the importance of individuality and allowing people to maintain control over their everyday lives. Meals are varied, healthy and nicely presented offering choice and variety. Residents’ health and personal care needs are well met by knowledgeable staff in an understanding way. Residents feel that if they had something to complain about they would speak to a member of staff. All residents spoken with said they had nothing to complain about. One resident said ‘the home is excellent; I would recommend it to anyone”.’ What has improved since the last inspection? The home continues to provide a good service and seeks to increase the standard of the environment, and the skills and knowledge of the staff team for the benefit of people living in the home. What the care home could do better: Residents would be better protected if all staff consistently followed a clear system to ensure medicines entering and leaving the home can be audited to ensure safe management. Attention to detail in record-keeping would ensure the smooth running of the home for the residents’ benefit and their protection.Winash Rest HomeDS0000069260.V377485.R01.S.doc Version 5.2 Ensure that all transactions relating to resident monies are undertaken by two members of staff and verified through signatures for the safety of residents. Key inspection report CARE HOMES FOR OLDER PEOPLE Winash Rest Home 9 Albert Road Clevedon North Somerset BS21 7RP Lead Inspector Patricia Hellier Key Unannounced Inspection 14th December 2009 10:00 DS0000069260.V377485.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Winash Rest Home DS0000069260.V377485.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Winash Rest Home DS0000069260.V377485.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Winash Rest Home Address 9 Albert Road Clevedon North Somerset BS21 7RP 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) 01275 873129 01275 879362 heatherhouse87@hotmail.co.uk Winash Limited Mrs Heather Jane House Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places Winash Rest Home DS0000069260.V377485.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd January 2007 Brief Description of the Service: Winash is a privately owned residential care home in Clevedon for older people. It is a well established home and is situated close to local shops and amenities in the older part of Clevedon. There is access to the town centre, shops and amenities from the local bus along the road. The home is formed by two joined Victorian houses that have been extended and upgraded over the years. All bedrooms are well appointed and some have en suite facilities. There is a passenger lift accessing both upper floors of the home. The home has a well maintained garden that is accessible for residents with comfortable garden furniture. The provider makes information available through an information pack. The information pack contains the Statement of Purpose and Service User Guide and all relevant information about the home. The range of fees is available from the manager. Additional charges are made for hairdressing, chiropody, newspapers, and toiletries. Winash Rest Home DS0000069260.V377485.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 this service experience excellent quality outcomes. This key inspection took place over 6 hours on one day. The Registered Manager, Mrs House, was on holiday but her deputy was present throughout the inspection. Before the inspection the information about the home was received from the file held in the office, surveys received from ten people who use the service, five members of staff and four Health Care professionals. The last two inspection reports were reviewed, as there had been two Annual Service reviews since the last inspection. The completed Annual Quality Assurance Assessment (AQAA) form, from the provider was also reviewed. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. We (The Commission) also reviewed all correspondence and regulatory activity since the last Key inspection. The accumulated evidence for this report comes from the above and also fieldwork that included discussions with 10 residents, two relatives, and five staff. Practices were observed and documents relating to care, recruitment and health and safety were reviewed. Resident survey responses indicated they felt their care needs are met by responsive staff, and they are provided with what they need. Comments from residents were “Winash is a very good home with a high standard of care on all levels”; “a happy carefree place to be.” No areas of concern were raised. Staff survey responses told us “Winash is a great home – efficiently run and everyone is important”; “training is excellent and all staff are very professional”. No areas of concern were raised. The Health Care Professionals responses told us “the home works well with other professionals for the well being of residents”; “it provides a warm and family like atmosphere for residents backed by good management and judgement”. All residents and relatives spoken with told us that the home was good and the staff very kind. Comments received were “it is very homely and comfortable”; “it’s a good staff team”. Winash Rest Home DS0000069260.V377485.R01.S.doc Version 5.2 Page 6 What the service does well: Outcomes for the residents are positive. For example five residents spoken with said, “The home is nice, the staff are kind and caring, and the food is good.” A good rapport between staff and residents was observed. The home has a warm and pleasant environment with a good standard of fixtures and fittings. The staff work well as a team and ensure the well-being and comfort of the residents’ and treat them with great respect and kindness. People living at the home feel valued and cared for. Staff feel well supported and enabled to provide a high standard of care. Staff are dedicated to meeting the needs of people living in the home in a personal person centred way providing the little extras that make this an excellent service. This was evident in the way the care needs of people living in the home were recorded, and also how staff could identify the individual needs of the person when asked. Staff had a clear understanding of the importance of individuality and allowing people to maintain control over their everyday lives. Meals are varied, healthy and nicely presented offering choice and variety. Residents’ health and personal care needs are well met by knowledgeable staff in an understanding way. Residents feel that if they had something to complain about they would speak to a member of staff. All residents spoken with said they had nothing to complain about. One resident said ‘the home is excellent; I would recommend it to anyone”.’ What has improved since the last inspection? What they could do better: Residents would be better protected if all staff consistently followed a clear system to ensure medicines entering and leaving the home can be audited to ensure safe management. Attention to detail in record-keeping would ensure the smooth running of the home for the residents’ benefit and their protection. Winash Rest Home DS0000069260.V377485.R01.S.doc Version 5.2 Page 7 Ensure that all transactions relating to resident monies are undertaken by two members of staff and verified through signatures for the safety of residents. 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 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. Winash Rest Home DS0000069260.V377485.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 Winash Rest Home DS0000069260.V377485.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 Statement of Purpose and Service User Guide is comprehensive and provides prospective residents with information to make an informed choice. The home’s assessment process is thorough and ensures that it is able to meet residents’ needs EVIDENCE: Residents are provided with a comprehensive Residents’ booklet containing the Statement of Purpose, Service User Guide and all the information required to ensure they, or their relatives, have access to the relevant information at all times. The Statement of Purpose includes information regarding equality and diversity issues and the homes philosophy of care that includes meeting cultural and diversity needs. All residents spoken with had a copy of this. Winash Rest Home DS0000069260.V377485.R01.S.doc Version 5.2 Page 10 Other information leaflets on care home life and advocacy were on display in the home and on the notice board in the dining room The registered manager, or her deputy, carries out a needs based preadmission assessment on all prospective residents. Admissions to the home take place once the registered manager is confident the residents care needs can be met. The registered manager does not always write to new residents, or their relatives, to confirm the home can meet their individual needs. This is recommended. Two residents assessment documentation were read to find out how well the needs are assessed. The assessments were informative, and showed the residents had been consulted about their range of physical, mental and social care needs. Residents were able to recall having been visited by the manager prior to admission, and also being invited to visit the home. Thus enabling the prospective residents to meet other residents, see the facilities offered and look around the accommodation available. The residents’ when spoken to said ‘I am well looked after; they know what I need”. “they always ensure I am happy and are always pleased to help with anything – however minor” All 10 survey responses told us residents felt they had received enough information about the service, and that they had a contract of residency for their security. Social services care plans had been obtained where relevant. Care practices observed showed that staff were fully aware of the residents needs as stated in their assessments. The home does not provide intermediate care Winash Rest Home DS0000069260.V377485.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 living at Winash benefit from personal and specialist healthcare support, that is provided in a person centred way, respecting their privacy and dignity. EVIDENCE: The residents and visitors with whom we spoke said that they were very satisfied with the standards of care and felt the staff were good. One relative told us that the staff are “always understanding about the residents needs and wishes. The resident told us “I can do what I like and they support me. They are very good”. Survey responses told us “staff are pleasant, bells are answered promptly and help is given quickly and efficiently in cases of falls or other need”. Individual records are kept for each of the residents, which include all key personal information. Three care plans were inspected and all reflected clearly current identified health and social care needs. Clear actions to met identified Winash Rest Home DS0000069260.V377485.R01.S.doc Version 5.2 Page 12 needs were recorded and regular evaluation noted. All of the three care plans showed residents, or relative, involvement. In discussion with residents although they were not always aware of their care plans they talked of their Key Worker and the discussions with them about their needs. Staff when interviewed were clearly able to describe the needs of the residents being case tracked and demonstrated a person centred approach to care. This is good practice. Health care professionals such as GP’s and district nurses visit the home as required to carry out health care checks and offer advice to staff. Evidence was seen of residents being taken to other appointments as needed. Resident’s comments supported this. Feedback from 4 Health care professionals told us “it is an excellent home” and “the service work well with other professionals fro the benefit of residents”. While residents comment supported this there was not always supporting documentation to evidence the good practice. This is recommended. Records showed clear information and understanding of psychosocial needs and how they are to be met. In the activities records there was clear evidence of spiritual and emotional needs being recognised and met. Comments from three residents support this. One told us “they help me to get to the local church” and another told us “they help me go to the local club when they can”. All care plans contained well-formulated risk assessments for Manual Handling and falls. Other personal and environmental risk assessments were present to ensure the safety of the resident while promoting independence as able. One resident said, “It is just nice to have the reassurance of someone there to help”. Daily records were up to date and written in a respectful manner. Care practices observed showed caring interactions and good communication skills from staff. Choices and preferences were observed being discussed and offered. Detailed conversations with eight of the residents confirmed a satisfactory standard of personal care. Two residents said, “it’s homely” another resident said, “people are very kind, we are well looked after” and a third said “they are very respectful and helpful”. Another resident told us “I would recommend the home to anyone”. Medication storage, receipt and disposal are managed in a satisfactory manner for the safety of residents. A full audit trail of medicines entering and leaving the home is not always correct giving rise to concern that medication is not always managed in the best interests of, or for the safety of residents. A system to ensure this is possible is recommended. The Medication Administration Record (MAR) sheets had been well completed with no gaps. The staff who administer medication have received appropriate accredited training and a list of specimen signatures were recorded in the medicine administration record. Hand written prescriptions had been Winash Rest Home DS0000069260.V377485.R01.S.doc Version 5.2 Page 13 appropriately signed by two staff for accountability purposes. practice. This is good The interactions of the care staff observed demonstrated respect for individuals and their right to privacy. Residents spoken to say, “the staff are very thoughtful and kind and treat you very well”. All residents spoken with felt that kind and caring staff respected their dignity and privacy. The home has an Equality and Diversity policy that recognises the cultural and social needs and differences that are present in society. Both management and staff demonstrated clear knowledge and desire to meet cultural and diversity needs as and when they should arise. Staff interviewed said, “We are all one happy family here”. Clear information about race, age, gender and religion is given in the Statement of Purpose and staff have undertaken training to enable them to discuss diversity issues with residents and their relatives. Winash Rest Home DS0000069260.V377485.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents’ benefit from flexible routines and menus. A variety of activities is offered, and residents’ right to choice and control over their lives is well respected, and encouraged. Friendly staff always welcome relatives and visitors. EVIDENCE: Many residents commented on the atmosphere of the home. One person described it as nicely informal, and residents’ felt that their visitors are also helped to feel relaxed and at home. When asked about activities and their daily routine two residents said, “there is always something going on, although not so much at weekends”. While another said “there is a lot to do if we want to, and I have just come from doing exercises”. Four residents spoken with told us “there is not always something to do at weekends. Especially if you don’t have family around and cannot get out” In discussion with five staff we were told they “we take time to talk to residents and play games with them. In the summer we take them out on Winash Rest Home DS0000069260.V377485.R01.S.doc Version 5.2 Page 15 walks to the park”. Another comment was “there is a weekend box, as the activities people don’t work then, and this has games and DVD’s and other puzzles”. A range of activities is provided with a diary of events displayed in the lift as a reminder of what is happening. This included hair and nails, arts and craft and music and movement sessions. Four residents told us they like to “sit and read the paper”. There is a quiet lounge and a lounge with a television. In the dining room we saw a large bookcase with library boos which we were told are changed every six weeks. A number of the books on the shelves were large print thus enabling more of the residents to access the library facilities. This is good practice. During the inspection some people who use the service were seen exercising choice of activity, and being encouraged to undertake the activity they chose. All people who use the service enjoy meeting in the lounge and said they have “many stimulating and enjoyable conversations”. Social care is valued and supported as an important part of life at Winash. The home has three part time staff dedicated to maintaining an activities programme throughout the week. People who use the service told us they can see their visitors at any time, helping them to feel this is their home. Relatives spoken with told us they feel “welcomed” when they come, and that “there is a warm, caring feel to the place”. The dining room is homely and tables well presented providing an atmosphere that is conducive to an enjoyable meal. All residents said they liked the meals, and felt a good and balanced diet is provided. While no choice of main course is offered the kitchen staff are aware of residents’ likes and dislikes and an alternative is offered when this is the case. Resident spoken with told us they were happy with the current arrangement for the main meal, but would like a better choice in the evening. One person told us “it is always pastry and bread which I find indigestible”. All staff have received Food Handling and Hygiene training to ensure they have the skills and knowledge to protect residents from poor practices and potential infection. Environmental Health (Food) have visited recently and were satisfied with the provision. Winash Rest Home DS0000069260.V377485.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents’ are protected from abuse, and they can be confident that complaints are taken very seriously. EVIDENCE: The home has a comprehensive complaints procedure and all residents receive a copy on admission. There have been no complaints since the last inspection. Residents stated that if they were not happy about anything they would speak to the manager. Residents said that the manager and staff are “very approachable”. Survey responses told us that seven out of the ten who replied knew how to make a complaint. During the inspection we saw that all residents have a copy of the complaints process in their rooms. Staff and residents spoken to, say the manager is very approachable and understanding. One resident said ‘I’ve nothing to complain about, it’s just like home – we are one family”. A system for keeping clear records of complaints received, with actions taken, and outcomes are available should any complaints be received. The registered manager promotes the resident’s individual rights in the home. Information leaflets were available on how to contact advocacy agencies, and Winash Rest Home DS0000069260.V377485.R01.S.doc Version 5.2 Page 17 resident’s can vote at political elections if they chose, with staff enabling them to go to the polling station or obtaining a postal vote for them. The home has a copy of the ‘No Secrets’ in North Somerset guide and a comprehensive local policy and procedure for responding to allegations of abuse for the protection of residents. Staff interviewed were conversant with the home’s Safeguarding policy and demonstrated good knowledge of the adult protection procedure that should be followed, if abuse is suspected for the protection of residents. The home also has a Whislteblowing policy and staff are aware of this and their duty of care in relation to whistle blowing for the safety of the residents. Staff have received formal training regarding Safeguarding Adults and how to whistle blow should the need arise. Staff when interviewed were aware of the policy, had an understanding of what constitutes abuse and how best to respond to any allegations or incidents, should they occur for the protection of residents. All residents said, “The staff are very kind and take time”. In the AQAA we are told there is a suggestions box in the reception area of the home, which was seen during the inspection for any one to put comments in. We are also told to staff have commenced training on the implementation of the Mental Capacity Act 2005 to ensure they have the skills and knowledge to ensure the safety and protection of residents. Winash Rest Home DS0000069260.V377485.R01.S.doc Version 5.2 Page 18 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are provided with homely, safe and comfortable surroundings to meet their needs. EVIDENCE: The home is nicely decorated and maintained with a welcoming atmosphere, and made comfortable with homely communal spaces. Accommodation is provided over three floors with a shaft lift to access these. The décor, fixtures and fittings are in good order. The lounges are furnished with a variety of suitable and comfortable chairs to suit residents’ needs. The home has a well maintained garden for residents to enjoy. Some areas of the home have been redecorated for the benefit of residents. There was no ongoing maintenance and refurbishment plan available at the Winash Rest Home DS0000069260.V377485.R01.S.doc Version 5.2 Page 19 inspection to demonstrate the timeframe for the redecoration of areas of the home, or when maintenance requests would be undertaken for the benefit and safety of residents. Following the inspection we were contacted by the registered manager, who was not present during the inspection, and shown an ongoing maintenance plan which demonstrates how issues are addressed in a timely way for the benefit of residents. During the inspection we saw a bathroom needing redecorating following the replacement of the toilet and we saw some loose wires in a wall and a loose lamp fitting in one of the corridors. The registered manager showed was able to explain to use the reasons for this and showed us evidence that she is planning and discussing arrangements for changes to this area of the home in the interests of the residents. Some fire doors were not fitting flush to frame for the safety and protection of residents. Following the inspection the registered manager spoke to us and sent written confirmation that the Fire Service had reviewed the fire arrangements at the home in early November and had made a recommendation for all doors to be fitted with intumescent strips with smoke excluders. Evidence was submitted that this work is in progress and has affected the door closures and the carpenter is now working to ensure all doors close appropriately. There are appropriately closing fire doors at the top and bottom of all flights of stairs, for the protection of residents in the event of a fire. The home has grab rails situated at relevant points and a shaft lift to all floors that is easily used to assist resident mobility, and aid independence within the home. The home has sufficient bathroom facilities with aids for the benefit of residents. Equipment was clean and well maintained to ensure protection for residents from cross infection. The home was clean and free from offensive odours throughout. The laundry facilities were well organised to minimise potential cross infection in the main. On the day of inspection we saw commode pots soaking in a sink next to where clean laundry was being ironed. This potentially enables the spread of infection. Staff interviewed and observed demonstrated good understanding of Infection Control procedures and practices and maintained a clean and hygienic environment. Dispenser soap and paper towels are provided in communal areas, thus providing good facilities for ensuring that staff can maintain good hand washing practices, between caring for residents. Four residents, when asked if the home is fresh and clean, said yes spotless, while another person said a lovely home that is always kept neat and tidy. Winash Rest Home DS0000069260.V377485.R01.S.doc Version 5.2 Page 20 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 living at home are supported by a properly recruited and trained staff in sufficient numbers to meet their needs. EVIDENCE: Staff at the home work hard to deliver a professional and caring service. Staff know the residents well and care is delivered to meet their needs as individuals. We found that the numbers of staff employed were sufficient to meet the needs of the people at home. People, asked if staff are available when needed, told us they were with one visitor saying “I have noticed that staff are always busy about their duties while continually interacting with the residents”. Another comment was I feel secure as I can always ring the bell and someone will come. When additional staff are required this is arranged to ensure residents needs are met at busy times. Key workers are appointed for service users and one person was asked about this, they knew who had been allocated to them and was pleased with this system. People spoken with were very complimentary about the staff with Winash Rest Home DS0000069260.V377485.R01.S.doc Version 5.2 Page 21 comments including the staff have all been very kind and helpful and they are all wonderful, caring, cheerful, efficient, welcoming people. Staff recruitment files for two recently employed staff were examined and found that all checks necessary to ensure they are safe to work with vulnerable adults had been completed before they began work at the home. Criminal Record Bureau checks were seen for all staff employed at the home. However we noted that gaps in employment had not always been recorded and this is recommended as good practice for the protection of residents. Induction records, records of supervision and training opportunities were reviewed for these two staff and all were well completed and included evidence showing aspects of safety and protection of residents had been covered. Supervision was recorded and included an annual appraisal. Training opportunities for staff as seen through the training plan included leadership skills, dementia care training and NVQ placement. As mentioned in previous sections of this report attention to detail in record keeping would evidence, the good practice we are told by both the management and staff about recruitment. For example clear evidence of individuals employment history, and information about referees would enhance this process. All staff are encouraged and supported to achieve qualifications in care and some have National Vocational Qualifications (NVQ) levels two or three. People are very satisfied with the level of care they receive and staff told us the standard of training they undertake is good, one adding my induction was very informative and in-depth. Staff training is well planned and monitored and includes all aspects of health and safety that are relevant to the needs of older people. Competence of knowledge is assessed by the outside provider, and the manager regularly checks staff competence and practical application of learning. Staff spoken with told us they felt well supported in attending training relevant to the needs of the people in their care. Survey responses told us “everyone works well as a team to provide the best care”. “Training is excellent and all staff very professional”. “Care plans are always kept up to date” Winash Rest Home DS0000069260.V377485.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 well managed in the best interests of people who use the service. EVIDENCE: The manager is qualified and has a number of years experience in the area, she is supported by two deputy managers who were present during the course of the inspection. We observed, and were told of, a very open and approachable management style which people living in the home said they appreciated. The manager seeks to give leadership, guidance and direction to staff to ensure they are knowledgeable and competent to meet the needs of people who use the service. Winash Rest Home DS0000069260.V377485.R01.S.doc Version 5.2 Page 23 People who use the service and relatives feel the manager is approachable, available and seeks to ensure all their needs are met. One resident told us she cant do enough, and another told us “she is always there to help. Staff interviewed stated they felt supported by an approachable manager. Four staff told us they could not think of any way the home could improve. Comments received on surveys returned from staff told us the home provides a high standard of care in a friendly environment; and care plans are always up-todate and the home runs very well and we meet everybodys needs. Another person told us the home provides a safe caring environment with a good atmosphere. A formal quality assurance tool was available for inspection in order to demonstrate that the home consults with residents and relatives. People have their opinions of the service surveyed and where improvements have been identified these have been put into place. One resident told us we have chance to have our say at the regular meetings. A report of the findings of the regular audits that make up the quality assurance process in the home was seen together with evidence that it had been shared at the residents meeting. Pocket monies for the people who use the service held by the home were inspected and found to be accurate. Records maintained do not always clearly show the monies entering and leaving the account and are not always signed by two people for the safety and protection of residents. Clear records with two signatures are required for the safety and protection of residents. Records inspected show staff receive regular supervision to ensure they have the skills and knowledge to meet residents needs. Staff spoke of receiving these and their helpfulness in identifying areas of training they would like, and would benefit their care provision to residents. Records were available to show regular safety and fire checks are carried out, to maintain safe systems for the protection of residents. Staff spoken to said they had received fire instruction regularly and records supported this, demonstrating staff have the expertise to safeguard residents in the event of fire. The home stores records securely and uses them in accordance with the Data Protection Act 1998. As mentioned earlier in this report records are not always accurately maintained and attention to detail in completing records would ensure clear information for the provision of knowledgeable and consistent care to residents. Winash Rest Home DS0000069260.V377485.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 3 3 3 4 3 X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 3 3 3 3 3 3 3 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 4 4 3 X 2 3 3 3 Winash Rest Home DS0000069260.V377485.R01.S.doc Version 5.2 Page 25 NO 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 OP35 Regulation 13.6 Requirement The registered person to ensure that clear records of monies in and out of individual resident’s accounts are maintained and signed by two people, for the safety and protection of residents. Timescale for action 21/01/10 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 The registered person must ensure that a clear audit trail of medicines through the home is available for the safety and protection of residents. The registered person to ensure all maintenance issues are addressed in timely manner for the safety of residents. The registered person to ensure attention to detail in all record-keeping for the smooth running of the home and in the best interests of residents. DS0000069260.V377485.R01.S.doc Version 5.2 Page 26 2. 3. OP19 OP37 Winash Rest Home Winash Rest Home DS0000069260.V377485.R01.S.doc Version 5.2 Page 27 Care Quality Commission Care Quality Commission Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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. 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