Care Home: Yews, The

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What the care home does well The yews provides a well maintained, accessible and safe environment for the people living there. Staff were seen behaving in a courteous manner to the people using the service and the comments made by individuals indicated that the staff team were supportive towards them and available when needed. Individuals were encouraged to maintain the skills they had in order to promote as much independence as possible. What has improved since the last inspection? The home now has a planned weekly activities programme in place and this ensures that in house activities take place on a regular basis. This includes the introduction of a weekly art shop that is provided by an external body. This has proved to be successful as many of the people living at the home have shown an interest in this activity and their art work was seen to demonstrate this. The recruitment and selection practices of the home are now more robust and the records seen demonstrated that thorough checks were undertaken before staff were employed at the home. This was to ensure they were safe to support the people living at the home. What the care home could do better: The information about the home must include details of the current staff working there and their qualifications. This will ensure everyone has up to date information about the staff team. The service needs to ensure that people who are unable to access the community independently or through family and friends, are given the opportunity to be part of their local community and the facilities available within the community. The development of a newsletter or other means of publishing should be in place to demonstrate that the service listens to and acts on the views of the people living at the home and their representatives. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Yews, The 2 Church Street Alvaston Derby Derbyshire DE24 0PR     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: Angela Kennedy     Date: 1 1 0 9 2 0 0 8 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 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Yews, The 2 Church Street Alvaston Derby Derbyshire DE24 0PR 01332756688 01332571002 brenda.towell@yewsresidential.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Rakesh Bhalla,Mrs Pushpa Bhalla Type of registration: Number of places registered: care home 27 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 who can be accommodated is: 27 The registered person may provide the following category of service only: Care home only - Code PC 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 - Code OP Date of last inspection Brief description of the care home The Yews is a residential home for twenty-seven older people situated in a suburb of Derby city. It is within its own grounds and on a corner location. Access to the first floor is via a passenger shaft lift. There are two steps at one end of the first floor. The front and side of the property is lawned and accessible. There are two lounges adjoining each other and a dining room.Items not covered within the fees Care Homes for Older People Page 4 of 30 Over 65 27 0 Brief description of the care home included:Hairdressing, Chiropody,dentist,optician. toiletries, newspapers and magazines. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The last Key Inspection of this service was on 10th October 2007. This key inspection was unannounced and took place over approximately 8 hours. Key inspections take into account a wide range of information and commence before the site visit by examining previous reports and information such as any reported incidents. The site visit is used to see how the service is performing in practice and to meet with residents and their representatives. The inspection was focused on assessing compliance with defined key National Minimum Standards. The commission had requested the service to complete an annual quality assurance assessment and the information provided within this assessment has been used to inform this report. Care Homes for Older People Page 6 of 30 Four surveys completed by people living at the home and four staff surveys had been received at the time of writing this report. The information provided within these surveys has been included within this report. Two members of the care staff team were spoken with to ascertain their views of the service, the training provided and the support and care provided to the people living at the home. Their comments are incorporated within this report. The manager and registered provider were available on the day of this inspection visit and provided the relevant information requested. Two people using the service were case tracked. Case tracking is a method used to track the care of individuals from the assessments undertaken before they are admitted to a service through to the care and support they receive on a daily basis. This includes looking at care plans and other documents relating to that persons care, talking to staff regarding the care they provide, talking to the individual if they are able to communicate or observing the care they receive. Several other people that lived at the home were also spoken with at this inspection visit. The fees at the time of this inspection visit ranged from 364 Pounds to 370 Pounds per week. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.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 8 of 30 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Needs assessments were undertaken before admission was agreed. This ensured the home could be confident that individuals needs could be met. People were able to make an informed decision because they were able to visit the home before making a decision about living there. Evidence: From the records seen of the two people case tracked and the discussions held with some of the people living at the home, it was confirmed that individuals needs were assessed before admission was agreed. This was to ensure the home and the services provided was suitable for each person and would be able to meet their needs. As stated in the self assessment pre inspection information there was evidence to show that needs assessments were carried out by the home and that these assessments were then used to develop care plans. Care Homes for Older People Page 10 of 30 Evidence: At the time of this inspection visit the information within the Service User Guide was being amended. This was because there have been changes to the management of the home and staffing structure. Evidence was seen to show that the manager and provider of the home were in the process of these amendments and they had confirmed this within the pre inspection self assessment information. From the surveys returned and discussions held it was confirmed that the home has provided sufficient information to individuals and their relatives about the home and the services it provided. This enabled individuals to get a clear picture of the home before they made a decision to move in. One person spoken with also confirmed that they and their family had looked around the home before they made a decision to move in. Care Homes for Older People Page 11 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals health, personal and social care needs were met and they were supported to take their medicines in a safe way. Peoples right to privacy was respected and the support they received from staff was given in a way that maintained their dignity. Evidence: The level of support that individuals required was clearly documented within the care plans seen and addressed personal, health and social care needs.This included detailed information in care plans regarding medications prescribed, whether staff were to administer the medication or if the person was able and chose to self administer their medication and any difficulties the individual had in taking their medication such as swallowing or compliance issues. Detailed information regarding dietary requirements, preferences regarding meal choices and the preferred place to take meals and level of support needed was also recorded. This included any areas of concern regarding nutrition/ diet and actions to be Care Homes for Older People Page 12 of 30 Evidence: taken. One person case tracked did not live at the home on a permanent basis and the format used for their care plans was different to that of the people living there on a permanent basis. The information contained within this persons care plan was in general sufficient to inform staff of the level of support they required in their personal, health and social care needs. However one area of health care that was managed by the district nurse was limited in information to the staff team. Discussions took place with the manager regarding the development of this care plan, such as providing specific guidelines on what actions were to be taken if any problems or concerns were identified by the staff at the home. The records seen demonstrated that individuals were encouraged to maintain their independence as much as possible. One example of this was a step by step daily routine that was in place for one person to follow. This person had some short term memory loss and this written routine enabled them to manage their own personal hygiene needs and in doing so promoted their independence, dignity and privacy. Discussions took place with this individual who confirmed that staff were supportive and enabled them to retain as much as Independence as possible. Discussions with other people living at the home also indicated that they were able to follow their preferred daily routine with staff support when needed.One person spoken with confirmed that they lived a reasonably independent life, although they did require some support from staff due to their visual needs. However this person confirmed that the staff were very supportive and did everything they could to enable them to maintain their independence and preferred daily routines. Records were in place that demonstrated that individuals health care needs were met. This included records of visits to health care professionals and hearing and vision tests. Weight records were also in place including if weight was gained or lost. However it was noted that the weight recording chart did not include a column for any actions that needed to be taken. This was discussed with the manager and it was agreed that this would be a useful aid in monitoring weight and ensuring staff were aware of any special diets or referrals made to specialists. In general the health care records seen demonstrated that staff had clear instructions on the support and observations they were required to undertake.This ensured that individuals health care needs were met. Risk assessments were in place that addressed all areas of care and not just areas where a risk was identified. This provided staff with information on peoples abilities Care Homes for Older People Page 13 of 30 Evidence: and strengths as well as areas where a risk was identified. Any actions to be taken for identified risks were recorded.This ensured that staff were able to support people in a safe way whilst maintain their independence as much as possible. The staff demonstrated a clear understanding of the need for care plans and other records to be maintained and updated. From discussions with some staff it was clear they had a good understanding of the needs of individuals and the level of support they required. As stated in the self assessment pre inspection information the records regarding the support provided to each person and any significant events was updated at the end of each shift. This ensured that each member of staff had up to date information on each person to enable them to meet their needs by providing the appropriate support. Neither of the two people case tracked self administered their medication. Disclaimers confirming they wished the staff to administer their medication was in place.The medications for two people case tracked were seen and were stored correctly. This ensured their medication was kept safe and was only accessible to staff that were trained to administer medication. The medication administration recording sheets for these two people was also looked at and the records seen had been signed and dated correctly. No errors were noted and no gaps in records were seen.This demonstrated that medication was given as prescribed to ensure their health and well being was maintained.Cold storage medications were looked at and were stored at the correct temperature and records were in place to demonstrate this. The preferred names of the two people case tracked was recorded in their care plans.This indicates that people are treated in a respectful way. Discussions with some of the people living at the home confirmed their privacy and dignity was met. They confirmed their relatives could see them in their private accommodation , rather than the communal areas of the home if they preferred. As stated earlier in this report individuals daily routines were recorded and this demonstrated that their dignity was upheld and they were treated as individuals. Staff were observed being courteous to the people living at the home.An example of this was that they were seen knocking on doors and waiting for a response before entering individuals private accommodation. Care Homes for Older People Page 14 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were treated as individuals but were not always supported to follow their personal interests and activities within the local community. Individuals were able to keep in touch with family and friends and had the opportunity to make the most of their abilities. The meals provided a balanced diet but did not cater for the varying tastes of individuals. Evidence: Evidence was seen that demonstrated that in house activities and events took place on a regular basis. Information regarding these events was available on the notice board in the entrance of the home. This included songs of praise for 2008, which were held on a Monday every month. The dates of these services were provided on the notice board and included special services that were arranged for Christmas Carols and harvest festival. Holy Communion was available at 10.30am on Wednesdays each month. The name and contact details for the local Vicar was also available on the notice board. A price list for the hairdresser was also available on the noticeboard. The hairdresser Care Homes for Older People Page 15 of 30 Evidence: visited every week on a Thursday and was at the home on day of inspection visit. She stated that due to popular demand she also came on Wednesday afternoon to do perms. People spoken with confirmed that they used this service and that they were very happy with it. Information regarding the events organised were on display this included external entertainers and in house activities. Discussions with people living at the home confirmed that there was sufficient in house activities but they felt that generally there should be more community based activities, such as trips out, shopping days. Discussions with one person indicated that trips out were generally for special events like trips out at Christmas to the theatre, but felt that regular local trips out were less likely. It was indicated by this person that people that went out regularly were either able to do this independently or with their family/ visitors. This information was fed back to the manager and provider and it was agreed that this would be further discussed at the next meeting held with the people living at the home. It was confirmed by the people spoken with that their visitors were able to visit whenever they chose to and were able see them within their private accommodation if they wished to. As stated earlier in this report there was clear evidence within the records seen and discussions held that demonstrated that people were supported to maintain their independence and make choices regarding their daily lives.This was seen in the daily routines recorded to ensure that staff respected peoples preferred routines and wishes thereby promoting personal autonomy. Information regarding Independent Mental Capacity Advocates, known as IMCAs was provided on the notice board in the entrance to the home. This included information for anyone making decisions on behalf of someone else who lacked capacity and this information included the legal duty these people may have in referring the person to an IMCA. Discussion with the cook took place regarding the choices of meals available and menus were seen that demonstrated that alternative choices were in place. It was confirmed that a small number of people required soft diets. The presentation of these soft diets was discussed and it was agreed that food moulds would benefit the people requiring soft diets as the meal presentation would be enhanced making the meals look more appealing. From discussion with some of the people living at the home and from the information provided in surveys, it was apparent that some people still felt the meals lacked Care Homes for Older People Page 16 of 30 Evidence: variety. Discussion with one resident confirmed that there still appeared to be some issues regarding the variety and quality of meals provided. This person was able to confirm by showing the minutes of the residents meetings that meals had been discussed and this included some suggestions for improvement.They also confirmed that some issues regarding the meals had been acknowledged and some improvements had been made. Care Homes for Older People Page 17 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. If people have concerns they or the people close to them know how to complain. Any concern is looked into and actions taken to put thing right. The practices in place safeguards people from abuse. Evidence: A complaints policy was seen within the entrance of the home that informed people that they could raise any concerns they had with the us. The address for the commission stated the local office rather than the regional office where written complaints should be made to. This was fed back to the manager and provider. The self assessment pre inspection information stated that people were provided with a copy of the complaints procedure on admission to the home. The format used to record complaints enabled clear records to be maintained that showed the nature of the complaint and who it was made by, who investigated the complaint, the actions that were taken and the outcome of the complaint. One concern had been raised since the last inspection visit that had been addressed thoroughly by the provider, who had consulted the commission and the Health and Safety executive on the correct actions to take. This demonstrates that the provider works in an open and transparent way in addressing any concerns in the best interests Care Homes for Older People Page 18 of 30 Evidence: of the people that live at the home. One complaint was received by us since the last inspection visit and we referred this to the provider to investigate. The provider investigated this complaint and took the appropriate actions to address the issues raised. Information within surveys from the people living at the home indicated that people knew how to make a complaint and were confident that their concerns would be taken seriously and addressed. This was also confirmed in discussions with people at the inspection visit. The self assessment pre inspection information stated that the home had introduced a suggestion box to enable people to leave any comments and views about the home. It also confirmed that the people living at the home had been extremely receptive in informing the provider and manager of their views and how they felt the service could improve. It was stated that the home planned to form a committee of the people living at the home. From discussions with one of the people living at the home it was confirmed that this committee is now in place and minutes of the meetings held were seen to demonstrate this. At the last inspection visit a recommendation was left for the Safeguarding Policy to be amended. This was to ensure that the role of the Local Authority in Safeguarding matters was made clear, as they are the lead investigators in all Safeguarding concerns or suspicions. However it was confirmed by the manager that this had not yet been amended. It was stated that all policies and procedures were due to be reviewed and this would be addressed within these reviews. Staff spoken with demonstrated a good understanding of the Safeguarding procedure that should be followed and the training records demonstrated that staff were kept up to date in Safeguarding training. This ensures that the home safeguards people from abuse. Care Homes for Older People Page 19 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People stay in a clean, comfortable, safe and well maintained environment that has enough space and facilities to meet their needs. Evidence: A tour of the building was undertaken and as stated in the self assessment pre inspection information the home is accessible for disabled people with well maintained grounds.A passenger lift and internal ramps were in place for people to access the library area and individual bedrooms. The spacious communal area with its hexagonal lounge remained a popular area that was used by most of the people at the home.Discussions with two people sitting in this lounge concluded that the popularity of this room was due to its size, the large windows that let in lots of light and the wall mounted wide screen plasma television that was easier to see. It was also noted that this room had large ceiling fans that would be beneficial on warm days for the people using this room. As some people were spoken to within their private accommodation their rooms were seen. The bedrooms seen incorporated en suite facilities. All of the people spoken with confirmed they were happy with their private accommodation. Care Homes for Older People Page 20 of 30 Evidence: The large laundry area was seen and housed the required equipment to launder individuals clothing to the appropriate temperatures and met the disinfection standard. Two staff were employed within the laundry and the laundry was staffed everyday to ensure an ongoing laundry service was provided. Throughout discussions with people living at the home and from comments in surveys no concerns or comments were raised regarding the laundry service provided. As stated in the self assessment pre inspection information all of the staff had attended health and safety and fire safety training to ensure a safe environment was maintained for the people living at the home, the staff and visitors. Evidence was seen to demonstrate that this training had been undertaken by the staff team. As stated in the self assessment pre inspection information a recently appointed maintenance person was responsible for maintaining the internal and external facilities of the home. This person was on duty on the day of the inspection visit and was seen undertaking maintenance work.This demonstrates that the maintenance of the home is provided on an ongoing basis to ensure the people living at the home stay in a safe well maintained environment. All communal areas seen provided pleasant, clean and comfortable surroundings and attractive furnishings. People spoken with indicated that the standards of hygiene maintained were good and confirmed they were happy with the standard of decor in place. Care Homes for Older People Page 21 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have safe and appropriate support as there is enough competent staff on duty at all times. Evidence: From the staff rotas seen and from discussions with some of the staff it was indicated that people had appropriate support as there was enough staff on duty at all times. Some of the people living at the home were asked if they felt there was enough staff on duty to support them and they said that they felt there was. The staffing rotas seen also demonstrated that there was sufficient catering, housekeeping and maintenance cover to ensure ongoing services were provided within the home. As stated in the self assessment pre inspection questionnaire the majority of the care staff team were trained to the National Vocational Qualification (NVQ) at level 2 in care.Senior staff were trained or in the process of training to NVQ3 in care and the two cooks employed also had an NVQ in catering. This demonstrates that people are supported by trained and competent staff. The recruitment records of two members of staff were looked at and all of the records Care Homes for Older People Page 22 of 30 Evidence: required by law were in place. This demonstrates that the service carries out the appropriate checks before staff are employed. This is to make sure the staff are suitable to care for the people living at the home. Peoples needs were met by staff that received the relevant training and support from their manager.The staff training records demonstrated that staff were kept up to date in their training plan. This included all mandatory training such as fire safety, moving and handling, health and safety, infection control and safeguarding adults. Records of other training that were specific to the needs of the people living at the home was also seen such as dementia awareness and low vision training.Records were also seen of training that had been arranged up until June 2009. Staff spoken with confirmed that training at the home was provided and comments included, the training is good,the manager is very supportive, we have training booked right through to next year. Care Homes for Older People Page 23 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living at the home are confident that the home is led and managed appropriately and is run in their best interests. The environment is safe for people because the appropriate health and safety practices are carried out. Evidence: The home has been without a manager for several months. The new manager has been in post since July 2008. She confirmed that she was in the process of applying for registration with the commission. From discussions held it was confirmed that the manager had several years of experience within the care profession and in managing a care service. Records in the two staff files looked at showed that supervision and staff appraisals had taken place in place in August and September 08. Discussions with staff indicated that there was a positive attitude towards the manager. It was confirmed that she was Care Homes for Older People Page 24 of 30 Evidence: professional, supportive and had an open door approach to everyone.One member staff said that we managed well without a manager and work well as a team but its so much better now . Discussions with people living at the home indicated that they were confident in the new manager. Comments included, she seems very nice, she comes round every day to say good morning to everyone, its nice that she makes herself known to us and she seems very nice, very happy and friendly As stated earlier in this report records of meetings held by the people living at the home were seen and discussions confirmed that peoples views and ideas were listened to by the manager and provider of the home. The information within the self assessment pre inspection document also confirmed that that the views of the people living at the home were actively sought and encouraged. This demonstrates that the service is managed in their best interests. The manager discussed plans that were in place to produce a newsletter for the people living at the home and other interested parties regarding the events at the home and the feedback sought from people living at the home about the services provided. Monies were held in safe keeping for some of the people living at the home. As neither of the people case tracked had any monies held for them, the monies of two people chosen at random were checked against the financial transaction records held. Both records provided information on each transaction and all transactions had two signatures in place. The balances recorded corresponded with the monies held. This demonstrates the home safeguards the monies of those people who are unable to do this independently ensuring their best interests are maintained. The service is safe for the people that live there and the staff team because the appropriate health and safety checks are carried out. The self assessment pre inspection information stated that all the maintenance of equipment within the home was kept up to date and that fire safety records were maintained. At the inspection some of the maintenance certificates were looked and were up to date. The record of weekly fire tests was also seen and were up to date. Care Homes for Older People Page 25 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 1 5 The service user guide must be updated to provide the relevant staffing structure and the qualifications and experience of the registered provider, manager and staff team. This will ensure people are provided with up to date information about the management and staff team. 11/03/2009 2 12 16 The people living at the 11/03/2009 home must be consulted about their social and recreational interests and arrangements must be made to engage them in local social and community activities. By supporting people to follow their interests their personal autonomy will be enhanced. Care Homes for Older People Page 27 of 30 3 15 16 The people living at the 11/03/2009 home must be consulted about the variety and quality of the meals provided. To enable the varying tastes of individuals to be catered for. 4 33 24 Feedback from people living 11/03/2009 at the home and other interested parties, should be published and and made available to current and prospective residents, their representatives and other interested parties. This will ensure people living at the home and other interested parties can see how the service is led and managed in way that ensures peoples best interest are met and promotes their autonomy. 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 7 When a health care need is managed by an external professional, there should be specific information within that persons care plan that enables staff to identify any problems or concerns regarding that need and informs them of the actions to be taken. Food moulds should be used to enhance the appearance of soft diets. This will make them more appealing for the people eating them. The complaints policy should provide the address of the Commissions regional office in Cambridge and not the local office in Nottingham. The safeguarding policy should be ammended to state the 2 15 3 16 4 18 Care Homes for Older People Page 28 of 30 role of the Local Authority in all safeguarding referrals, allegations and investigations. Care Homes for Older People Page 29 of 30 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). 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