Care Home: Woolston Mead

Similar services:

• Chirnside House
• Keer Sands Residential Home
• Ruskin Lodge
• Bushell House
• Langrigg House
• Parkside
• Dystlegh Grange
• Thornton Lodge

What the care home does well Residents are assessed prior to admission and are invited with their relatives to view the accommodation on offer. One relative interviewed stated, ".....first came here for a break and decided to stay on, she is so happy here". Residents are supported by staff to live their lives within their abilities. Residents who live at Woolston Mead were happy with how they live their lives. Residents are encouraged to retain their independence as much as they are individually able with staff support and adaptations and equipment fitted to enable easier access around the service. Residents interviewed stated, "I like it very much". Residents and staff were complimentary about the care provided. A health professional visiting the service was complimentary also. The health professional stated, "There is good communication with all staff, they follow instructions and communicate quite good and work well together, I would put my mother in here". The service provides a pleasant and homely environment for the residents. Dining tables have fresh flowers, matching crockery, cutlery and napkins for residents use. Pretty gardens are to the front of the service with secluded seating areas to the rear accessed by a ramp for residents who have may have mobility problems. Relatives were complimentary about the service. One relative interviewed stated, "We think it`s wonderful". Residents are regularly canvassed for their views through the surveys and monthly meetings. Pre employment procedures for new staff ensure residents are protected. What has improved since the last inspection? Improvements have been made to residents bedrooms to provide a more pleasant environment. One of the bathrooms is also being replaced with a walk in shower, which will offer the residents more choice. The training programme has improved with regard to manual handling, infection control and induction for new staff. The service user guide has been updated therefore prospective residents and visitors to the service can be better informed. Medication training has been implemented and audits are taking place. A record of activities attended by residents is recorded in the daily diary. A complaints log evidences any complaints made. 97% of care staff have achieved the NVQ qualification. This exceeds the standard. What the care home could do better: The pre admission assessment needs to provide more detailed information to ensure that the service is suited to the prospective residents specific needs. Care plans need to evidence the individual needs of the resident in more detail. The care plans need to be discussed with the resident and have evidence of their agreement to the agreed care planned. Medication audits need to be improved to ensure they pick up on any discrepancies. Medication received into the service needs to be recorded on the medication administration sheet so that it is easier to audit medication. The menu needs to evidence a choice of main courses for lunch. Residents can then see what the alternative is. All staff need to attend adult protection training so that they are familiar with local procedures and therefore promote residents welfare. The windows in one or two of the bedrooms need to be repainted therefore making it a more pleasant environment for residents. All references for new staff should be dated to ensure authenticity. The register provider visits need to be recorded and kept up to date and available for inspection. Residents financial records should evidence residents signatures at each financial transaction and regular audits need to be carried out to protect staff and residents. Service records need to be more organised therefore making it easier to access information. The service need to ensure that all staff have fire training on a regular basis to ensure residents safety is promoted. This has been raised as a requirement in the report. A copy of the lift servicing agreement needs to be sent into the Commission to ensure it is up to date. Accident records need to be fully completed to ensure all information is recorded. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Woolston Mead 4 Beach Lawn Waterloo Liverpool Merseyside L22 8QA     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: Margaret VanSchaick     Date: 1 1 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 31 Information about the care home Name of care home: Address: Woolston Mead 4 Beach Lawn Waterloo Liverpool Merseyside L22 8QA 01519283796 01519283796 anneorme@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Tulip Care Limited care home 28 Number of places (if applicable): Under 65 Over 65 28 old age, not falling within any other category Additional conditions: 0 The registered person may provide the following category of service only: Care home only: Code PC, to people of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category: Code OP. The maximum number of people who can be accommodated is: 28. Date of last inspection Brief description of the care home Woolston Mead is registered to provide care to twenty eight older people. The home is privately owned by Tulip Care Limited and the responsible individual is Dr Jaydeep Kantilal Patel. The Commission for Social Care Inspection appointed Mrs Anne Orme as the Registered Manager in May 2007. The home is located in a quiet residential area in Waterloo. From the front of the premises there are lovely views across Liverpool Bay and over to North Wales. The home is also near a number of shops and there is access to local transport. Accommodation is provided over four floors with two lounges on the ground floor and a Care Homes for Older People Page 4 of 31 Brief description of the care home dining room in the basement. The home is fitted with stair lifts and a passenger lift for residents to access all areas. Residents have the use of a call bell with an alarm facility and there are mobility aids in place to assist those who are less able. There are attractively laid gardens to the front and rear of the property with wheelchair access at the rear. The current fee rate for accommodation is £400-£440 a week. Care Homes for Older People Page 5 of 31 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: A site visit took place as part of the unannounced key inspection. It was conducted over one day by one inspector and lasted 7.5 hours. Twenty five residents were accommodated at this time. As part of the inspection process most areas of the service were viewed including some of the residents bedrooms. Care records and other documentation was also viewed. Discussion took place with the residents, their relatives, a health professional and staff. The inspection was conducted with the registered manager Ann Orme. During the inspection three of the residents were case tracked (their care files were looked at and their views of the service were obtained). All of the key standards for older people were inspected. Previous requirements were met and recommendations Care Homes for Older People Page 6 of 31 still to be carried out were discussed. Satisfaction forms Have your say about... were distributed to residents, their relatives and staff. A number of comments included in this report are taken from surveys and interviews. An AQAA (Annual Quality Assurance Assessment) has been conducted. The AQAA comprises of two self assessment questionnaires that focus on the outcomes for people. The self assessment provides information as to how the manager and staff are meeting the needs of the current residents and a data set that gives basic facts and figures about the service including numbers and training. What the care home does well: What has improved since the last inspection? What they could do better: Care Homes for Older People Page 8 of 31 The pre admission assessment needs to provide more detailed information to ensure that the service is suited to the prospective residents specific needs. Care plans need to evidence the individual needs of the resident in more detail. The care plans need to be discussed with the resident and have evidence of their agreement to the agreed care planned. Medication audits need to be improved to ensure they pick up on any discrepancies. Medication received into the service needs to be recorded on the medication administration sheet so that it is easier to audit medication. The menu needs to evidence a choice of main courses for lunch. Residents can then see what the alternative is. All staff need to attend adult protection training so that they are familiar with local procedures and therefore promote residents welfare. The windows in one or two of the bedrooms need to be repainted therefore making it a more pleasant environment for residents. All references for new staff should be dated to ensure authenticity. The register provider visits need to be recorded and kept up to date and available for inspection. Residents financial records should evidence residents signatures at each financial transaction and regular audits need to be carried out to protect staff and residents. Service records need to be more organised therefore making it easier to access information. The service need to ensure that all staff have fire training on a regular basis to ensure residents safety is promoted. This has been raised as a requirement in the report. A copy of the lift servicing agreement needs to be sent into the Commission to ensure it is up to date. Accident records need to be fully completed to ensure all information is recorded. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 31 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 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The pre admission assessment needs to provide more detailed information to ensure that the service is suited to the prospective residents specific needs. Evidence: Prospective residents and their relatives are invited to the service prior to admission to see if they like it. One resident interviewed stated, My son came here first, he went round two or three, he chose this one, its very nice. Residents are assessed by the manager prior to admission. One of the residents interviewed confirmed this and stated, A....came to see me in hospital. The assessment documentation of three of the residents was looked at. Two of the residents pre admission documentation showed a very brief summary of their basic needs. A newer assessment document that has been introduced shows more information has been gained and looks at activities of daily living. The information collated is still not detailed enough to evidence fully the individual needs of the prospective resident. Further detailed information needs to be Care Homes for Older People Page 11 of 31 Evidence: collated to ensure the service is suitable for the resident. This information will clarify residents specific needs. The admission details with regard to date of admission, family and health professional contacts was in place. Personal details such as nok, religion and marital status are recorded. Care Homes for Older People Page 12 of 31 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. Care plans need to evidence the individual needs of the resident in more detail. The care plans need to be discussed with the resident and have evidence of their agreement to the agreed care planned. Evidence: All residents are assessed prior to admission as evidenced in care files and this information is used to commence care plans for each resident. We looked at the old system of care plan and the new one the manager has recently introduced. Both care plans evidence that the basic care needs for each resident is recorded, however there was insufficient detail provided in the care plans. The new system does not allow enough space for a detailed care plan. The information is too brief and needs further detail to ensure all residents needs are clearly identified and addressed. None of the residents had signed to agree their care. None of the residents interviewed knew about their care plans. Care plans evidence monthly review dates. Residents interviewed told us that they were happy with the care provided. One resident interviewed stated, I like it very much. Relatives interviewed were complimentary about the care provided. Care Homes for Older People Page 13 of 31 Evidence: One relative interviewed stated, We are happy with the care, she always looks so nice, Spock and span and she is so happy here. Additional treatment or advice from other health professionals including Gaps chiropodists, district nurses and opticians is recorded on care documentation. Residents interviewed about the care and support provided were satisfied. One resident stated, Staff help me with my medication and I have seen the Dr since I came in. Staff also support residents to access other health professionals such as hospitals for tests or treatments. Risk assessments are in place for many areas including manual handling, nutrition and pressure area care. These are reviewed monthly. A health professional interviewed was complimentary about the service and stated, I would put my own mother in here. The health professional confirmed that all care documentation is always in place and made available for them. The health professional also confirmed that they were happy with the care provided and had no concerns. The health professional stated, Staff follow instructions, the communication is quite good and we work together quite well. Medication is stored in lockable cupboards in the managers office and the use of a medication trolley was observed. The storage is tidy and there was no evidence of old stock being used or stored. Medication records were viewed and showed clear instructions are printed or in one or two cases hand written. Most of the medication received into the service was signed in with amounts, date and signature of person checking them in. A few of the medication records show that not all medication is signed on receipt, which makes it difficult to audit the medication. Prescribed medication courses that have been completed or discontinued have this recorded clearly on medication records. Medication has not been carried forward to the new monthly medication record therefore it is not known what amount is available at the beginning of the month. Controlled medications are audited regularly throughout the month by two staff as seen on medication records. The Commission picked up a discrepancy with regard to one of the controlled medications during the inspection therefore it shows that the audit being carried out for this particular medication was not a true audit. Records were viewed of medication returns and all entries evidenced a signature and dates. Some of the residents share bedrooms and screens were noted to be in place for all three double bedrooms. Care Homes for Older People Page 14 of 31 Evidence: Residents were observed to be treated well by all staff who interacted in a respectful and friendly manner. Residents looked well groomed and cared for. Residents whose condition deteriorates are supported to stay in the service unless medical treatment is needed. The manager told us they have a very supportive district nurse team who provide the care and support for residents who need it. The Commission have received a letter from a family whose relative was cared for in the service. The letter was very complimentary about the care and support the service and the district nurse team provided for their relative before they passed away. Care Homes for Older People Page 15 of 31 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. Residents are supported by staff to live their lives within their abilities. Evidence: Care documentation shows that residents individual preferences are taken into account. Residents interviewed confirmed that they can make choices about how they live their lives within their individual abilities. Residents interviewed stated, You can do what you want, bring what you want and visitors can come anytime they want, staff bring them a nice tray, a pot of tea and biscuits, You can do what you like, go to bed and get up when you want and It varies when I get up, I ring for staff, I prefer to go to bed at 10.15 same as at home. The AQAA stated that some of the residents preferred to have a bath in the evening therefore staffing levels were adjusted to suit this request. One resident interviewed stated, I have a bath, J does my bath, its nice to have the same person. Activities arranged for residents include, quizzes, manicures, massage, sing a longs, gentle exercises, talks, DVDs and the tuck shop trolley. The tuck trolley was commenced at the residents request so they could purchase small items they need. Outside entertainment is also brought into the service occasionally. On occasions in the warmer weather Age Concern provide bus outings to garden centres and pub lunches. Occasional prize bingo is played, to which, families Care Homes for Older People Page 16 of 31 Evidence: are invited. Residents interviewed stated, I join in with whatever is going on, afternoon tea, the quiz after Thursday lunch, a talk, reminisce or sing a longs. Its open visiting too and visitors are made welcome and I like the television, I like the news and football. I also do the keep fit, Im pretty good at that. Religious needs of residents are met through the weekly service held. One resident interviewed stated, Every Sunday we have a little service and Communion, the minister is very nice. Residents have been able to personalise their bedrooms with their own items as seen during the visit. Residents have the choice of a large dining room and a smaller dining area for mealtimes. The tables were laid with matching crockery, cutlery and linen napkins. Fresh flowers were present on each table. Many of the residents prefer to have breakfast in their own rooms and this is accommodated. The AQAA stated that breakfast time was delayed until 8.30 at the request of the residents who preferred it. The menu offers choice for breakfast, lunch time puddings and evening meals. The menu does not offer a choice for the main course at lunch time but residents are able to choose an alternative suitable for them. Residents interviewed confirmed they were able to choose alternative meals and were complimentary about the food served. Residents stated, The food is beautiful, we have a very good chef, the foods not bad, there is a choice and The food is okay, we have a choice, Im faddy, they always try to get something to suit. Care Homes for Older People Page 17 of 31 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. All staff need to attend adult protection training so that they are familiar with local procedures and therefore promote residents welfare. Evidence: The service has a complaints procedure, which is easy to follow. The complaints book was viewed. There have been no complaints logged since the last inspection. The manager told us there have been none. No concerns or complaints have been raised through the Commission. The entrance hall table had information such as the complaints procedure, service user guide, statement of purpose and survey forms for anyone to complete if they wished. Advocacy details were available for residents also. Minutes of residents monthly meetings evidence that the manager asks residents if they have any concerns to raise. Therefore they are given an opportunity to discuss any concerns or complaints. Residents were confident that had they any concerns or complaints they would raise them with the manager or her deputy. Residents interviewed stated, I would go the A (manager) or F (deputy) if I had any complaints. The manager told us that she sees and speaks to residents daily and they have been able to discuss any concerns with her and she resolves any issues at the time. The service has commenced a record in 2007 of any minor concerns raised by residents and one entry is in evidence. Care Homes for Older People Page 18 of 31 Evidence: A copy of the older version of the Sefton Adults Protection procedure was in evidence and the manager was given the contact details to get the newer version. Some of the staff have attended adult protection training as evidenced in interviews with staff. All of the staff need to attend this training including the manager to ensure everyone is familiar with the process and therefore be able to protect residents. Care Homes for Older People Page 19 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service provides a pleasant and homely environment for the residents. Evidence: The service provides a pleasant environment for the residents. There are wonderful views of Crosby Bay and the Welsh mountains from one of the public rooms and some of the residents bedrooms. Pretty gardens are situated at the front of the service and more secluded seating areas are in place to the rear garden. A lift is available for residents to access all floors including the lower ground floor dining room. Chair lifts on the four main staircases provided residents who are more independent with an alternative choice to access the main sitting room and bedroom floors. Although there are many hallways and stairs to negotiate they are easily accessed by the residents who live there. The front garden grounds are accessed by a short flight of steps and the rear gardens through french windows and ramp access. There are three double bedrooms for those who wish to share and all of the bedrooms have an en-suite facility. Bedrooms viewed were decorated in a pleasant domestic style. When bedrooms become vacant residents are offered the choice to change rooms if they want to. One relative interviewed confirmed this and stated, She likes her room, she was asked would she like a bigger room and she said no that this one was fine. Some of the older windows need to be repainted. The public rooms were Care Homes for Older People Page 20 of 31 Evidence: pleasantly decorated and comfortable looking armchairs were in use for residents. Sufficient bathroom and toileting facilities were in place. One of the bathrooms on the lower ground floor is being refurbished to accommodate a walk in shower facility, which will give residents further choice. Adaptations and equipment is in place to suit the varied needs of the residents. Where needed specialist equipment such as beds and chairs were provided for the specific needs of residents. The AQAA states that a hairdressing salon is in place and this was viewed and showed a spacious clean and pleasant environment for residents use. A call bell system is fitted throughout the service and was tested and found to be working during the visit. The kitchen is situated in the lower ground floor and was found to be clean, organised and well managed. The laundry facility was clean and well organised. Residents interviewed told us they were happy with the laundry service. One resident stated, The laundry is first class. Care Homes for Older People Page 21 of 31 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. Pre employment procedures for new staff ensure residents are protected. Evidence: The AQAA states that sufficient staff are on duty to provide care and support for the residents. The off duty rota was viewed and evidenced sufficient staff were on duty to care for residents. Staff interviewed stated, We have enough time to do our work. The AQAA states that 97 of staff have the NVQ Level 2 and 3 qualification. This was confirmed following discussion with staff and examination of some staff training records. The service has exceeded the standard in this area. One staff interviewed stated, Im halfway through a Level 3 NVQ Leadership and Management course. I get enough training, if there is something that I am really interested in, I tell A (manager) that Im keen and she looks into it for me. Three staff files were viewed at random to look at pre employment procedures and training records. Brief employment history, previous experience and qualifications are on record. All pre employment checks have been carried out including police checks. For one of the most recently employed carers the remaining police check has yet to be returned therefore they are working under supervision. One of the references for one of the staff is undated therefore this needs to be addressed to ensure authenticity. Care Homes for Older People Page 22 of 31 Evidence: The induction provided for staff has improved since the last inspection visit. One staff file evidenced the new induction schedule. The induction is planned to be carried out over several weeks and the staff file evidenced the first two weeks of induction which follows the Skills for Care programme. Staff interviewed confirmed they had an induction when they commenced employment. Staff surveyed also confirmed they had an induction. Carers commented, I had an induction, I worked alongside another carer to ensure I knew the job. Training is ongoing to keep staff up to date and I was very pleased as to how my induction was covered and we have regular courses during the year to update us. The service provides staff with a training programme including mandatory training. The training attended over the past year include NVQ, deprivation of liberty, POVA (Protection of Vulnerable Adults), medication, diabetes, first aid, continence, infection control, manual handling, care planning and food safety. Not all of the staff have attended adult protection training therefore this needs addressing. Residents living at Woolston Mead feel they are looked after by a very good team of staff. Residents interviewed stated, I couldnt praise the staff enough, All the staff are very good, they all work very hard and are quite attentive and All the staff are very nice, all helpful, staff are lovely. Relatives interviewed were complimentary about the staff employed and stated, I think she is very well looked after and staff keep us informed. One relative canvassed for their views commented, The girls are lovely and all very helpful. Care Homes for Older People Page 23 of 31 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 service need to ensure that all staff have fire training on a regular basis to ensure residents safety is promoted. Evidence: It is apparent through discussion with the registered manager that she is knowledgeable about the various care needs and conditions that can affect the older person. The manager has many years experience in her post and a City and Guilds Advanced Management in Care. The manager has been keeping herself up to date with most of the mandatory training except fire training. Residents, relatives, a health professional and staff were very complimentary about how the service was managed. A relative interviewed stated, We like it, its wonderful. Staff interviewed about how the service is managed were complimentary and one Care Homes for Older People Page 24 of 31 Evidence: carer stated, A is always available if you have a problem you can approach her for anything. I think we all work well as a team, its friendly and the care is good. Staff and residents told us that had they any concerns they would be confident to approach the manager or her deputy. One of the residents interviewed stated, I speak to A (manager) and F (deputy) they are very good. The manager holds monthly meetings with the residents, with the minutes published and these were viewed during the visit. Survey forms are also available for residents and visitors to completed when they wish. The results of some of these surveys were viewed and showed positive views. Staff meetings are held occasionally throughout the year and the minutes are published. The manager told us that the provider visits regularly and completes a record of his visits. The most recent provider visits could not be found but two earlier ones from this year were viewed. Some of the financial records of the residents were viewed. Individual records show that financial transactions are recorded for each one. Staff signatures evidence each transaction. The manager was advised to have residents sign each financial transaction with family/advocate help where the resident agrees. There are no audits of the financial transactions therefore it would benefit residents and staff to have the finances audited by two senior staff on a regular basis. Records kept in the service were at times difficult to find including the up to date lift servicing record. Staff files and care files were not very well organised. Old information needs to be archived and files need to be easy to access so that up to date information can be found quickly. Risk assessments with regard to safe working practices have not been addressed. One staff is booked to attend the fire warden course this month. The service have a fire drill on a monthly basis as records show. There is no evidence to show that all staff have attended fire training in the last year and this needs addressing now. The manager has arranged for a senior carer to attend a fire warden course this month. Further fire training needs to be arranged now to ensure all staff are familiar with the procedures and therefore promote residents safety. The fire log evidences that regular testing of equipment and fire points take place. Fire Care Homes for Older People Page 25 of 31 Evidence: equipment such as extinguishers are replaced when needed with the most recent dated this month. Some of the servicing certificates were looked at during the visit such as bath hoists, fire equipment, electrical equipment, gas boilers and chair lifts. All of these were up to date. The manager was unable to find the certificate to confirm that the lift had a full service this year. The last service information dated to March 2008. The manager told us the service has been carried out recently and therefore was asked to forward on the documentation to the Commission to verify the dates it was carried out. Accident records were viewed and most but not all were completed correctly. Care Homes for Older People Page 26 of 31 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 24 16 (2) (c) (k) The registered manager 24/08/2007 must provide accommodation for the residents, which is furnished and equipped to assure comfort and privacy. The carpets in Room 7 and 9 and the chair in Room 15 must be replaced to improve the standard of cleanliness and overall appearance of the rooms. 18 (1) (c) The registered manager 10/08/2007 must ensure that the persons employed to work at the care home receive training appropriate to the work they are to perform. The manager must ensure staff receive moving and handling training to ensure they have the skills and knowledge to undertake this work. The registered manager 24/08/2007 must ensure that the persons employed to work at the care home receive training appropriate to the work they are to perform. The manager must ensure staff infection control training to ensure they have the skills and knowledge to undertake this work. 2 30 3 30 18 (1) (c) Care Homes for Older People Page 27 of 31 4 30 Schedule 4 (6g) The registered manager 10/08/2007 must keep a record of all training and this includes induction. The principles of care element remains an outstanding from the last inspection in January 2007. Timescale of 9.2.07 not met) Care Homes for Older People Page 28 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 38 23 The registered person must ensure that all staff attend fire training on a regular basis. So that resident and staff safety is promoted. 17/08/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 3 It is recommended that more detailed information with regard to new residents should be gained during the pre admission assessment. This will ensure the service will be suitable for the individual residents needs. It is recommended that care plans should be audited regularly to ensure they reflect the full and changing needs of residents. It is strongly recommended that care plans should ensure further detail is recorded to show that all of the residents needs are clearly identified. It is recommended that residents should sign their care plan to ensure they agree with the care planned. It is strongly recommended that the medication auditing system should be improved to ensure errors are picked up Page 29 of 31 2 7 3 7 4 5 7 9 Care Homes for Older People quickly. 6 9 It is recommended that any unused medication should be carried forward to the next months medication record so that the service know what stock is available. It is strongly recommended that all medication received into the service should be logged onto the monthly medication records so that the service can audit them. It is recommended that the menu should show the alternative main course choice for lunch so that residents can see they have a choice. It is strongly recommended that all staff including the manager attend adult protection training so they are familiar with local procedures and therefore promote residents welfare. It is recommended that where identified window frames in the service should be redecorated and included in the maintenance plan. This will enhance the physical environment for the residents. It is recommended that provider visit records should be up to date and kept on file so that they can be viewed on inspection. It is recommended that all financial transactions should be signed by residents or their representative. It is strongly recommended that residents should sign each financial transaction and these should be audited by senior staff on a regular basis. It is strongly recommended that paperwork and files should be better organised so that it is easier to keep track of care documentation and other service information. It is recommended that all accident records should be completed fully to ensure all information is in place. It is recommended that an up to date copy of the lift service certificate should be forwarded to the Commission. It is strongly recommended that risk assessments with regard to working practices should be in place. This promotes good practice. 7 9 8 15 9 18 10 19 11 33 12 13 35 35 14 37 15 16 17 38 38 38 Care Homes for Older People Page 30 of 31 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 31 of 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!