Care Home: Woodside Hall

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What the care home does well The home has a comprehensive pre-admission procedure, which ensures that the home only admits people whose needs it can meet. All evidence indicates that the home ensures that people`s health and care needs are met. People living at the home stated the food is always/usually good with choice available. special diets are catered for. Activities are provided four afternoons per week by the homes activities organiser. The home employs appropriate numbers of nursing and care staff that ensure that peoples needs are met. Staff receive the necessary training and good recruitment procedures are in place. The home has above fifty percent of care staff with an NVQ in Care of at least level 2. The provider continues to invest in the premises and equipment provided at the home. What has improved since the last inspection? Following the previous inspection two requirements were made. The home has complied with the first of these and the controlled drugs cupboard is now secured to a solid wall and complies with the Misuse of Drugs (safe custody) Regulations 1973. A requirement was also made that the company must undertake regulation 26 visits and keep copies of the visit reports at the home for inspection. One of the directors is permanently based at the home and undertakes all the homes administration and supports the manager on a daily basis. The director stated that she has therefore not been undertaking regulation 26 visits or writing reports as she is constantly in the home and working with the manager. The director agreed to ensure that a representative of the provider commenced Regulation 26 visits and compile reports. The home has continued its routine maintenance and redecoration programme and has also provided improved facilities for people who live there. These have included a new level access shower room on the first floor and all beds are of a modern profiling design. What the care home could do better: Although no requirements are made following this inspection there are areas the home can improve upon and these are identified in the evidence section of the relevant outcome group. The home needs to update the statement of purpose to ensure the previous registered manager is no longer stated and that the correct address for the Commission is provided. The home must ensure that the medications fridge is defrosted on a regular basis and that maximum and minimum temperatures are recorded on a daily basis to ensure thatmedications are stored at the correct temperature. The home must also ensure that people are weighed regularly. This will enable the monitoring of some medications and to assess and reassess nutritional and pressure injuries risks. The flooring in the laundry has worn in parts and no longer provides an impermeable surface. The home must ensure that the laundry floor is impermeable and can be kept hygienically clean. The home must register a manager with the commission. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Woodside Hall Woodside Wootton Bridge Isle Of Wight PO33 4JR     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: Janet Ktomi     Date: 2 1 0 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. the things that people have said are important to them: They reflect 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 32 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 32 Information about the care home Name of care home: Address: Woodside Hall Woodside Wootton Bridge Isle Of Wight PO33 4JR 01983882415 01983884578 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Colville Care Limited care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 20 The registered person may provide the following category of service: Care home with nursing (N) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category : Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Woodside Hall is located at the far end of New Road and is approximately 1.5 miles from the amenities of the local town. The premises is a large period property set within its own substantial grounds, the front of which has been given over to parking and the rear which has been laid mainly to lawn with views to the sea. Service user accommodation is provided in mainly single bedrooms, some with ensuite facilities and others with washbasins. Communal rooms (lounges and dining areas) and suitable bathing facilities are provided. The accommodation is divided between two main floors accessible via the passenger lift, although the first floor is split-level with the latter half of the floor accessible via a chairlift or stairs. The home is owned by Colville Care Limited and at the time of the unannounced inspection did not have a registered Care Homes for Older People Page 4 of 32 Over 65 20 0 Brief description of the care home manager. At the time of the inspection visit weekly fees start from 620 pounds with addional fees dependant on assessed need and room occupied. Up to date information about fees and room availablilty should be sought from the home. Care Homes for Older People Page 5 of 32 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: This report contains information gained prior to and during an unannounced visit to the home undertaken on the 21st January 2009. All core standards and a number of additional standards were assessed. The home was previously inspected in February 2007 and had an Annual Service Review in January 2008. The visit to the home was undertaken by one inspector and lasted approximately seven hours commencing at 09.30 am and being completed at 4.30 p.m. The inspector was able to spend time with the person in charge, one of the directors of Care Homes for Older People Page 6 of 32 the provider company, staff on duty and was provided with free access to all areas of the home, documentation requested, visitors and people who live at the home. Prior to the visit the director completed an Annual Quality Assurance Questionnaire (AQAA), information from which is included in this report. Information was also gained from the notifications of incidents in the home. During the visit to the home the inspector was able to meet with and talk to people who live at the home and several visitors. What the care home does well: What has improved since the last inspection? What they could do better: Although no requirements are made following this inspection there are areas the home can improve upon and these are identified in the evidence section of the relevant outcome group. The home needs to update the statement of purpose to ensure the previous registered manager is no longer stated and that the correct address for the Commission is provided. The home must ensure that the medications fridge is defrosted on a regular basis and that maximum and minimum temperatures are recorded on a daily basis to ensure that Care Homes for Older People Page 8 of 32 medications are stored at the correct temperature. The home must also ensure that people are weighed regularly. This will enable the monitoring of some medications and to assess and reassess nutritional and pressure injuries risks. The flooring in the laundry has worn in parts and no longer provides an impermeable surface. The home must ensure that the laundry floor is impermeable and can be kept hygienically clean. The home must register a manager with the commission. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 32 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 32 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. All people are assessed prior to moving into the home to determine that their individual needs can be fully met. People, or their representatives, are able to visit the home prior to admission to assess the quality, facilities and suitability of the home. Standard 6 is not applicable, as the home does not provide intermediate care. Evidence: The person in charge explained the homes admission procedure and the pre admission assessments for one person admitted shortly before the inspection visit and one person due to be admitted the day after the inspection visit were viewed. The inspector discussed admissions with care staff and with some people who live at the home. The person in charge explained the homes admission procedure. If an initial inquiry Care Homes for Older People Page 11 of 32 Evidence: from either social services, health continuing care or from a person or their family indicates that the home would be able to meet the persons needs the person in charge will arrange to visit the person, either at their home or in hospital. A comprehensive pre admission assessment is completed including where appropriate members of the persons family and professionals involved in their care. The person is provided with information about the home and where practicable is invited to visit the home before making the decision as to whether to move in on an initial trial basis. When the person is unable to visit the home a relative is invited to view the available room and facilities at the home. The home has one shared bedroom and discussions with the person in charge indicated that consideration is given as to compatibility with the existing person who is using the bedroom when assessing a person for a twin room. Some bedrooms on the first floor are accessible only via a short rise of stairs and chair lift. The person in charge stated that consideration is given to access when assess people for these rooms. The home has an assessment tool that covers all the relevant areas necessary for the home to decide if it is able to meet a prospective persons needs. The person in charge was clear about the level of care needs the home can accommodate. Also viewed in peoples files were copies of assessments completed by care managers. The home records as part of the pre service planning when relatives have visited to view available rooms, discussions about fees and provision of information brochures. Discussions with people who live at the home confirmed that people or their relatives have visited the home prior to a person moving in. Discussions with a person who had moved into the home shortly before the inspection visit confirmed that the person in charge had visited him in hospital and given him information about the home, room available and answered any questions he had as well as asking a number of questions of him. Discussions with care staff confirmed that they felt they had enough information about new people admitted to the home and that they had the training and time to meet peoples needs. People living at Woodside Hall tend to be long term, however the home could provide respite or short stay accommodation if a suitable room were available. The same admission procedures would be used for respite or short stay admissions as for longterm admissions. The home needs to update the statement of purpose to reflect the change in the management of the home following the departure of the previous registered manager. Care Homes for Older People Page 12 of 32 Evidence: The home does not provide dedicated accommodation for, intermediate care or specialised facilities for rehabilitation. Care Homes for Older People Page 13 of 32 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. The health and personal care, which a person receives, is based on their individual needs. Medication is correctly stored, administered and full records are maintained, however the home the medications fridge has not been defrosted on a regular basis and daily maximum and minimum fridge temperatures have not been recorded to ensure medications are stored at the correct temperature at all times. People are treated with respect and their dignity and privacy is maintained. Evidence: Three care plans were viewed, one for a person recently admitted to the home and the the others for people who have been living at the home for a longer time. Additional information on health needs for these people was also viewed. The inspector discussed with staff, visitors and people who live at the home how care needs are met. The arrangements for the storage, administration and records relating to medication were viewed. Care Homes for Older People Page 14 of 32 Evidence: People have a detailed plan of care that related to the persons assessment. The care plans follow a comprehensive format and are individualised and person centred being written in plain language providing detailed information as to how needs should be met. An example being one care plan which clearly identified how a person liked their room organised at night with table on the right side with drink, bell, tissues and clock. Other plans had similar individual information within them. Plans are reviewed on a monthly basis and when needs change, where possible with the person whose plan of care it is. People spoken with confirmed that they had been involved in their care plans and reviews. Care plans are kept in peoples bedrooms so are readily accessible to care staff. When returning care plans to bedrooms the inspector asked one service user where to put the care plan and they were obviously aware of the care plan and showed the inspector where it should be stored. Care plans contained relevant risk assessments and management plans including nutrition, manual handling, falls, bed rails, pressure areas and any individual risks. Risk assessments viewed appeared appropriate to the persons needs and had been reviewed monthly or when risks changed. The home undertakes nutritional risk assessments for people however there was no evidence seen in the three files viewed that people are being regularly weighed. In order to fully monitor the medication of one person regularly weighing would be considered good practice and necessary to determine if the person was receiving the correct level of the medication. Care staff spoken with said that communication about peoples needs was good. As stated care plans and risk assessments are kept in peoples bedrooms and care staff were observed completing daily records of care provided at the end of the morning. The home uses a key-worker system. Discussions with care staff indicated that the qualified nurses and care staff work as a team. This was also observed at lunch time when the qualified nurse assisted with the meal time routine to ensure all people received their lunch in a timely manner. The inspector was able to talk with people who live at the home who stated that they felt they received the care and support including medical care they need. The inspector telephoned local social services following the inspection and comments from care managers were positive about the home and care people received there. Records were available to demonstrate that people have access to a range of services such as GPs, Dentists and Chiropodists. Records and discussions with people who live at the home confirmed that health professionals are consulted when necessary. Care plans contained individual manual handling assessments and information as to how a person should be moved. One persons moving and handling plan was clear that Care Homes for Older People Page 15 of 32 Evidence: a standaid should be used as the person can weight bear but is tired after tea so is not safe and hoist to be used to go to bed. Equipment listed in other peoples moving and handling plans was seen in their rooms an example being a person whose plan stated they used a walking frame and this was seen with the person in their room. The home has the necessary moving and handling equipment and aids including hand rails in corridors to promote independence. Care staff confirmed that they had undertaken manual handling training. People stated that they felt that staff always treated everyone who lives at the home with dignity and respect. Observations of staff interactions indicated that people are treated with respect and their right to dignity maintained. The home has one twin bedroom which was seen to contain curtain screens to promote privacy during personal care. Care staff confirmed that they had sufficient time to meet peoples needs and discussions indicated that they had a good understanding of individual peoples needs and how these should be met. Observations of care staff indicated that they had sufficient time to meet peoples needs. Care staff explained that they are allocated a part of the home, usually ground or first floor, to work but will help each other out when necessary. At the time of the inspection visit nobody was self administering his or her medication. The person in charge stated that should people wish to self administer an assessment of their ability to do so would be undertaken and they would be provided with secure storage in their rooms for any medication. All medication is administered by qualified nurses. The home has an office where medications are stored. Following the previous inspection a requirement was made that the controlled medications storage must be secured to a solid wall. The person in charge showed the inspector the new location of the controlled medication storage which is now secured to a solid wall and therefore the requirement has been met. The home has the necessary recording books for controlled medications. Also seen were destruction kits for controlled medication no longer required by service users. The home has a fridge for the safe storage of medication that must be kept at cool temperatures. The home records the temperature of the fridge on a daily basis however this is only the temperature at the time it is checked as the fridge does not have a maximum/minimum thermometer. The medication fridge also needed defrosting. The person in charge must ensure that the medication fridge is defrosted on a regular basis and that maximum/minimum temperatures are available for the medications fridge to demonstrate that medication has been stored at the correct temperature. Care Homes for Older People Page 16 of 32 Evidence: Other medication is stored in the medications trolley which was seen to be secured to a wall when not in use. Additional supplies were stored in a locked cupboard. The inspector viewed medication administration records and checked medication available for the people whose care plans were viewed. All medication administration records were fully completed and there were stocks of all medication listed on the medication administration records. Care Homes for Older People Page 17 of 32 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The routines for daily living and activities made available are flexible and varied to suit peoples individual needs. Family and friends are able to visit. People receive a balanced diet in pleasing surroundings at times convenient to them. Evidence: The inspector spent time talking with people, observed part of the lunchtime meal and met the homes cook. The inspector also met several relatives who were visiting the home. The inspector discussed activities with people who live at the home, staff, activities organiser and viewed information about activities undertaken in daily logs and related information in care plans and pre service assessments. People living in the home are able to spend their time in the home where they wish, people were seen sitting in both of the homes lounges and others chose to spend time in their bedrooms. The home has extensive gardens to the rear with views to the sea. The home has encouraged wildlife including red squirrels to visit the garden and area outside the lounges by providing feeding stations and rope bridges. Care plans viewed contained information about peoples likes and dislikes and Care Homes for Older People Page 18 of 32 Evidence: individual preferences about how their care needs should be met. People confirmed to the inspector that they are given choice over what time they get up and go to bed, as well as choice as to how and where they spend their time and what they have for their meals. Bedrooms seen contained personal items brought into the home. Care plans and assessments include information about leisure activities, hobbies, interests, catering and religious needs. The home has an activities organiser who works four afternoons per week providing a range of group and individual activities. Information about planned activities was provided on the hall wall with the activities coordinator stating that she organises different activities depending on what people want to do. On the afternoon of the inspection some people were watching a film and the activities organiser was playing a game of scrabble with another person. Care plans contained information about peoples social and leisure activities and interests. The home can arrange for newspapers to be delivered on a daily basis and people confirmed that they receive these. The activities orgnaiser stated that although she does not have a specific budget she is able to purchase equipment and items and this is reimbursed or ordered by the home. The activities organiser has not undertaken specific training and this was discussed with the person in charge and one of the directors who stated that should training be available they would ensure the activities organiser were able to attend but that they have not yet identified suitable specific training. The inspector was able to meet several visitors. Visitors are able to visit at any time and complete a visitors book on entering the home. The home does not have a private room for visitors. This did not appear to be an issue for people visiting the home who visited their relatives in either the lounges or the persons bedroom. Care plans contained nutritional assessments and information about specific nutritional needs and likes and dislikes of the people living at the home. The home has a dining table in one of the lounges and people were seen to have their meals in both of the lounges or their bedroom. People living at the home informed the inspector that they enjoyed the food at the home. At the start of the inspection visit the nurse in charge was completing a menus choice list for the lunch time meal with the people who live at the home. People stated that if they did not like what was available they would say and stated instances when alternatives had been provided. People confirmed that they are provided with fresh fruit and vegetables, supplies of both being seen in the homes kitchen. The inspector was present for the main lunchtime meal. Meals including those for people requiring a soft diet were well presented and people appeared to enjoy their meal clearing their plates. Drinks and snacks are also available throughout the day with people confirming this as Care Homes for Older People Page 19 of 32 Evidence: well as the inspector observing people being given morning and afternoon hot drinks and biscuits.The need for special diets or supplements is recorded pre admission. The pre admission form included information about peoples food likes and dislikes. Discussions with the cook confirmed that she was aware of the dietary needs of people and showed the inspectors forms completed on admission with information about peoples dietary needs and wishes. Care staff were observed taking a tea trolley round the home for the afternoon drinks. This contained two types of cakes, biscuits and also some soft snacks (yogurts) for people on soft diets. Also seen was a plate with bread, butter and marmite which care staff stated was for a particular person who likes that as his afternoon snack. The home has been awarded five stars (the maximum) for food hygiene by the local environmental health department. Care Homes for Older People Page 20 of 32 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. People and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. People are protected from abuse. Evidence: Discussions with people who live at the home, visitors, people in charge and staff as well as information in the homes AQAA and records viewed are considered. The homes AQAA stated that the complaints policy was on display in the homes hallway. On arriving at the home the inspector looked for this but could not see it. The inspector later asked the person in charge and the director who was at the home and had completed the AQAA. The Director stated that she had thought the complaints procedure was on display but on checking agreed that it was not. The Director stated that she thought the complaints procedure had probably been removed when the hall was redecorated and not put back on display, she would however locate it and ensure that it was displayed with other information in the hall. There was a copy of the homes statement of purpose in the hall and this did have information within it about the homes complaints procedure. Visitors and people the inspector spoke with stated that they did not have any concerns or complaints, however they stated they would raise any concerns if they had any and were confident that the home would sort out any issues. Discussions with staff Care Homes for Older People Page 21 of 32 Evidence: confirmed they were aware of what to do if a person or their relative complained or raised an issue. The inspector telephoned social care professionals following the inspection visit and no concerns were raised about the home. No complaints have been received about the home at the Commission. The homes AQAA stated that no complaints have been received at the home and this was confirmed by the person in charge at the time of the inspection visit. The home has a policy and procedure relating to safeguarding adults and ensuring that people are not at risk of abuse. Care staff have safeguarding adults training as part of their induction. The person in charge stated and the training plan for 2009 confirmed that all staff will be undertaking updates in safeguarding during the first three months of 2009. The person in charge and staff also stated that they have undertaken safeguarding training during induction. People stated to the inspector that they felt safe at the home. The home correctly notified the commission of an incident at the home however it was not clear if this had also been reported under local safeguarding procedures and to other government and regulatory bodies. This was discussed with the director during the inspection. The home does not become directly involved in peoples personal finances and appropriate recruitment procedures are in place. Care Homes for Older People Page 22 of 32 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. People live in a clean, safe, well-maintained home. The home laundry room floor does not provided an impermeable floor surface. Evidence: The inspector had not previously visited the home so requested that the person in charge show her the home towards the start of the unannounced inspection. All areas of the home viewed were found to be clean and the layout and atmosphere provides a homely and comfortable environment. The home has two cleaners most days and they stated that they have sufficient time to complete the cleaning and have all the necessary products and equipment. Nursing, care and ancillary staff confirmed that they have all the equipment required to meet peoples needs. The AQAA stated that all equipment is regularly serviced. The home has a shaft lift to the first floor. The AQAA stated and the Director confirmed the improvements that have been made to the home in the past year. These have included redecorated of the entrance hall and new carpets in first lounge, lower hallway and stairwell, new lighting in corridor and complete refurbishment of first floor bathroom to provide an level entry shower. Bedrooms are redecorated as they become vacant and if they need redecoration. A Care Homes for Older People Page 23 of 32 Evidence: new computer has also been provided in the nurses office. Exterior woodwork has been repainted and flower beds replanted. The home employs a maintenance man. The home has two lounge/dining rooms both with views out to the sea over the rear garden. One lounge has had a new carpet since the previous inspection. The home provides mainly single bedrooms with one twin room on the ground floor. Some having en suite facilities other bedrooms have a washbasin. People confirmed that they were able to bring in personal items when they moved into the home and bedrooms viewed contained personal items. Most bedroom doors did not have locks. Some bedrooms on first floor are only accessible by a chair lift down a short flight of about four steps. The person in charge stated that consideration is given to this when deciding if the home can accommodate a person in these bedrooms. The Director and person in charge stated all bedrooms now have electric profiling beds. All bedrooms seen had profiling beds. Many rooms at back of home have extensive sea views and those to the front have pleasant woodland views. Externally the home has parking to the front of the home and extensive rear gardens providing views to the sea from the rear of the home. There is level access to the home via a ramp to the front door from the car park. Some bedrooms on the ground floor have patio doors providing access to a patio area. The home has a laundry that was viewed. The flooring in the laundry has worn in parts and no longer provides an impermeable surface. The home must ensure that the laundry floor is impermeable and can be kept hygienically clean. Care Homes for Older People Page 24 of 32 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. The home employs appropriate numbers of staff that ensure that peoples needs are met. Staff receive the necessary training and good recruitment procedures are in place. Above fifty per cent of care staff have an NVQ of at least level two in care. Evidence: All comments from people who live at the home, visitors and professionals were positive about the homes nursing and care staff. A person who lives at the home stated the staff are very nice, very helpful and everyone is very kind. Service users and visitors stated that they felt there were enough staff to meet peoples needs. Professionals stated that staff appear to have the necessary skills and experience to meet peoples needs. Duty rotas were seen during the visit to the home. Duty rotas stated that one qualified and four care staff are provided in the morning, one qualified and three care in the afternoon/evening and one qualified and one care at night. Cleaners, activities worker, maintenance and kitchen staff are also employed. During the inspectors visit staff on duty corresponded to those on the duty rota. Care staff stated that they generally have sufficient time to meet peoples needs and throughout the inspection care staff appeared to have time to meet peoples needs. The person in charge provided training and qualification information during the inspection and on the AQAA. The home has Care Homes for Older People Page 25 of 32 Evidence: approximately sixty-five per cent of care staff with at least NVQ level 2 in care. With eight of the thirteen staff having a qualification and another has recently commenced NVQ training. The person in charge showed the inspector the training matrix for 2009 which showed that all mandatory and some additional training courses are planned throughout the year. The nurses office has a new computer with Internet access and the person in charge stated that they are planning on accessing a range of training via the Internet from the department of health website. Nursing and care staff stated that they felt they had the necessary skills to meet peoples needs and were not expected to undertake activities for which they had not been trained. The activities orgnaiser stated that they had not undertaken specific training in activities. This was discussed with the director and person in charge who stated that they had attempted to identify suitable training and should some be found then the activities person would undertake it. The recruitment records for three people recruited since the previous inspection were viewed. These contained all the required information and confirmed that all staff are fully checked including references, CRB and POVA checks prior to commencing employment at the home. The homes recruitment procedures should ensure that unsuitable people are not employed at the home. The person in charge explained the homes induction procedure that includes the Skills for Care induction. Induction workbooks were seen along with certificates for courses staff had attended. New staff also complete an early and late shift as supernumerary as part of their induction. Care staff confirmed that new staff work additional to numbers for their first shifts. Care Homes for Older People Page 26 of 32 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 appropriately managed and run in the best interests of the people who live there. Peoples financial interests are safeguarded. At the time of the inspection the home did not have a registered manager however the person in charge stated that she intends to register with the commission. Staff are supervised. Records are well maintianed. The health, safety and welfare of people and staff are promoted. Evidence: The person currently managing the home was not on duty at the start of the unannounced inspection visit but was contacted by the nurse in charge and came into the home. The person in charge is a registered nurse who also has the Registered Managers Award and stated that it is her intention to apply to become the registered manager for the home. The person in charge also confirmed that she has undertaken all mandatory and specific training relevant to the needs of the people who live at the home. The person in charge has been managing the home since the departure of the previous registered manager three months prior to the inspection visit. Throughout the Care Homes for Older People Page 27 of 32 Evidence: inspection visit the person in charge demonstrated knowledge of the people who live at the home and the mechanisms by which support can be obtained when necessary. The providers are in frequent contact with the home with one of the directors being at the home most days having an office at the home and undertaking the homes administration. The director assisted with part of the inspection. The provider was previously required to complete regulation 26 visits and reports. This was discussed with the director who stated that as she is currently in the home on a daily basis and part of the homes management that she has not been completing specific regulation 26 visits and reports. Following the inspection visit the director agreed to ensure that a representative of the provider complete regulation 26 visit and compile reports that would be avaialable to view at future inspections. Compliance will be assessed during the next inspection visit of the home. People who live at the home, visitors and staff stated that they felt they could approach the director or person in charge and that the home was effectively managed. The director completed the AQAA to a good standard providing relevant information about the service and returned this to the commission within the required timescales. The providers undertake a range of quality assurance activity. The person in charge showed the inspector specific work undertaken in connection with meals and stated that as a result the homes menus had been changed. The cook confirmed this to the inspector. The director stated that questionnaires are provided to people who live at the home and their relatives and that once completed the providers complete a report identifying any areas that require further improvement. The inspector was shown completed questionnaires. At present other stakeholders (staff or external professionals) are not consulted as part of quality assurance work and this is recommended for the future. The maintenance person stated that the person in charge and he undertake a monthly audit of the homes environment to identify areas that may require attention. The home does not does not act as appointee or hold valuables for people living at the home. Peoples personal finances are dealt with by the resident themselves or their families or solicitors. All bedrooms have a lockable facility to ensure the safekeeping of money or valuables. Should people require services that are not covered by the fees, for example hairdressing or chiropody these are invoiced to the representative responsible for the persons money. An example of an extras invoice was seen during the inspection visit and clearly identifies what additional charges are for. Staff confirmed that they felt appropriately supervised. The new person in charge has commenced supervisions and records were shown to the inspector confirming this. Care Homes for Older People Page 28 of 32 Evidence: Various records were viewed during the inspectors visit. All records were appropriately stored with access only available to people who should have access. Records were seen to be well maintained. The home is generally well maintained and clean, with its own maintenance person who is able to respond immediately to minor repairs. The laundry floor requires attention to ensure an impermeable surface. The home undertakes weekly checks of the fire detection equipment and the records for these were seen. The inspector viewed records of servicing of equipment. Care Homes for Older People Page 29 of 32 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 30 of 32 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 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 Care Homes for Older People Page 31 of 32 Helpline: 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 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. 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