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Inspection on 12/05/09 for Acocks Green Nursing Home

Also see our care home review for Acocks Green Nursing Home for more information

This is the latest available inspection report for this service, carried out on 12th May 2009.

CQC found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

People can be confident that their health and personal care needs will be met whilst living at the home. People are supported by staff who are enthusiastic, understanding and are deemed to be suitable to work with older adults. People are supported to keep in touch with their families and friends so that they do not lose relationships that are important to them. People are offered a choice of meals that meet any special dietary requirements. People living at the home and the people important to them are confident that actions will be taken to address any concerns that they may raise. Systems are in place to protect people from harm. People are provided with a comfortable living environment and are encouraged to personalise their rooms with items that are familiar to them, so that they are relaxed in their surroundings. Health and safety is well managed so that people live in a safe home. People living at the home, their relatives and staff told us: "There is good attention to my Husband`s personal care". "I am fine. I love to read. I get the paper every day". "I am made to feel welcome here. I visit five times a week". "Staff are good. If I have a problem I talk to the staff and things get dealt with quickly". "We have the equipment that we need to do the job".

What has improved since the last inspection?

All previous requirements had been met, which demonstrates that the management team are keen to improve the service provided for people living there. Improvements had been made so that the garden was a pleasant area for people to enjoy. The home was fresh and clean throughout so that people live in a hygienic environment. A system has been introduced so that people are consulted about whether they wouldprefer a male or female carer to assist them with their personal care needs. There is a robust system for checking that peoples` money is held at the home in a safe manner. People told us: "I have met the new manager, she comes over very well. I feel that things have picked up since she came".

What the care home could do better:

Information about the home should include details of fee rates so that people will know what they have to pay to live there. Prior to coming to stay at the home people should be aware of the arrangements in place for people who choose to smoke, so that they can make an informed decision about whether they want to live there. People are not provided with a choice of whether they would prefer their bedroom doors to be shut or left open whilst resting in their bedrooms. This means that their privacy and dignity is compromised. People are not always supported to lead fulfilling and interesting lives. The noise level of the telephone system may have a negative impact on the daily lives of people living at the home.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Acocks Green Nursing Home 1079-1081 Warwick Road Acocks Green Birmingham West Midlands B27 6QT     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: Amanda Lyndon     Date: 1 2 0 5 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 29 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 29 Information about the care home Name of care home: Address: Acocks Green Nursing Home 1079-1081 Warwick Road Acocks Green Birmingham West Midlands B27 6QT 01217072611 01217076549 acocksgreen@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Southern Cross Care Management Limited Name of registered manager (if applicable) Mrs Mary Khan Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 56 The registered person may provide the following category of service only: Care Home with Nursing (Code N) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Physical disability (PD) 56 Old age, not falling within any other category (OP) 56 Date of last inspection Brief description of the care home Acocks Green Care Centre provides general nursing care and accommodation for up to fifty six older people. Some of these people also have dementia care needs. The home is situated close to shops leisure activities and public transport links. There is ample off road car parking to the front of the building and there is a secure garden that is Care Homes for Older People Page 4 of 29 care home 56 Over 65 56 0 0 56 Brief description of the care home accessible to all people living at the home. Peoples bedrooms are spread over two floors and are mainly single rooms. Twenty five of these have an en suite toilet facility. Upper floor rooms are accessed via a passenger lift. There are six dining and lounge areas. The home has an outside smoking area and a hairdressing room. There are assisted bathing and toilet facilities which meet the assessed needs of the people who live at the home. Corridors are spacious and allow people to move around freely with any mobility aids required. The home has hoists and pressure relieving equipment to meet the assessed needs of individual people. In the reception area of the home there is a range of information which may be of interest along with details of forthcoming events. A copy of our last inspection report statement of purpose and service user guide are displayed so that people can read them if they choose. Current fee rates are available from the home on request. Care Homes for Older People Page 5 of 29 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 focus of our inspections is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice, and focuses on areas that need further development. The date of the last key visit at this home was 5th June 2007. An annual service review was completed on 28th May 2008, and the outcome of this was that the home continued to provide a good standard of service for the people living there. Prior to the visit taking place we looked at all the information that we had received or asked for. This included any complaints made or notifications received from the home. Care Homes for Older People Page 6 of 29 These are reports about things that have happened in the home that they have to let us know about by law. We sent out random questionnaires to ten people who live at the home in order to obtain their views about the service provided. These had not been returned to us at the time of writing this report. The annual quality assurance assessment was not due to be returned to us at the time of the visit. The visit to the home was undertaken by two inspectors over one day, and we, the Care Quality Commission were assisted throughout by the home manager, external managers and the staff team on duty that day. The home did not know that we were visiting. There were fifty one people living at the home on the day of our visit. Two people from each floor were case tracked. This involves discovering their experiences of living at the home and focuses on the outcomes for these people. We also spent time observing care practices and speaking to staff about the care they provided to these people. In addition we spent time speaking with six other people living at the home, one relative, one health care professional that was visiting the home, and eight staff. We sampled care, staffing, and health and safety records. We looked around the areas of the home used by people case tracked to make sure it was warm, clean and comfortable for them. What the care home does well: What has improved since the last inspection? All previous requirements had been met, which demonstrates that the management team are keen to improve the service provided for people living there. Improvements had been made so that the garden was a pleasant area for people to enjoy. The home was fresh and clean throughout so that people live in a hygienic environment. A system has been introduced so that people are consulted about whether they would Care Homes for Older People Page 8 of 29 prefer a male or female carer to assist them with their personal care needs. There is a robust system for checking that peoples money is held at the home in a safe manner. People told us: I have met the new manager, she comes over very well. I feel that things have picked up since she came. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 29 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 29 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. Admission processes are thorough and people living there can be confident that their care needs will be met. Evidence: A statement of purpose and service user guide had been produced, and these included information about the services and facilities provided at the home. These are produced in large print formats, and are available in in other languages and formats on request, so that everyone can access the information. Details about fee rates was not included, and this will prevent people from having this information when deciding whether to live there or not. The manager did however state that this information is available on request. The service user guide incorrectly stated that there was a designated smoking area within the care home. Service user guides had been distributed to people living at the home, however those sampled in peoples bedrooms identified the wrong names and room numbers. Actions were being taken by the manager to rectify this. We spoke Care Homes for Older People Page 11 of 29 Evidence: with a person who had recently come to live at the home, and she said that her family had visited the home prior to her coming to stay there. We met with a person who had come to live at the home on the day of our visit. We saw that a comprehensive pre admission assessment had been completed in order to ensure that the homes staff are confident that they can meet this persons assessed care needs whilst living at the home. We saw that specialist equipment required for this person had been arranged, and was ready for use prior to the person arriving at the home. Intermediate care is not provided at Acocks Green Care Centre. Care Homes for Older People Page 12 of 29 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. Systems are in place to ensure that peoples personal and health care needs are met. Evidence: Assessments of peoples individual physical and social care needs are undertaken on admission to the home, and care plans are derived from this information. These are individual plans written with the involvement of people and their representatives, about what people can do for themselves, and in what areas they require support. We sampled four care plans, and found that they had been personalised and identified the specific support required by staff, so that people should receive care and support in the ways prefer. These included comprehensive care plans that had been written for people that required nursing tasks to be undertaken as part of their care. We saw that the written instructions included in the care plans reflected the actual care provided. From discussions with people living at the home, staff, a relative, sampling of care records and from our observations on the day, we identified that people were receiving the appropriate care and support in order to meet their assessed needs. Care Homes for Older People Page 13 of 29 Evidence: One relative met during the visit said There is good attention to my Husbands personal care. Risk assessments, for example regarding moving and handling, had been undertaken and these included details of the specialist equipment that people required in order to be transferred in a safe manner. In response to a recent concern raised by the primary care trust regarding the choice of hoisting equipment used by individuals living at the home, all moving and handing assessments had been reviewed by a person qualified to do so. The outcome of this was that the type of hoisting equipment chosen for people was deemed to be suitable for use, with the exception of one person who required a different type of hoist. Actions were taken to address this, and we were told that the staff were now using the correct type of equipment for all people deemed to be in need of support in this area. People can retain their own doctor on admission to the home, if the doctor is in agreement. The manager said that a good rapport had built up between the home and the local doctors, and we saw that a number of people were being reviewed by their doctor on the day of our visit. Advice can be sought, as needed, from a range of other health and social care professionals. We met with a healthcare professional who was visiting the home, and positive comments were made by this person about the service provided there. Care records identified that people living at the home and their representatives are invited to care reviews with the homes staff and social workers, in order to discuss their care and put forward any suggestions for improvements. Staff met during the visit had a good understanding of the system in place for the management of medication. Where a variable dose of medication is prescribed, the number of tablets given have not been recorded, which means that there is not an accurate record of the dose administered. Drug audits are undertaken, however a system is yet to be developed in order to assess staff competence in this area. In addition a comprehensive audit has recently been undertaken by the primary care trust and the home are awaiting the report. We observed staff assisting people in a respectful manner, and this maintains their dignity. Since our last visit, a system has been introduced so that people are consulted about whether they would prefer a male or female carer to assist them with their personal care needs. Peoples preferred names were recorded within their care plans, and we heard staff greeting them by these names. During the visit, we observed that a number of bedroom doors had been left open, Care Homes for Older People Page 14 of 29 Evidence: despite people resting or sleeping on their beds. Records sampled did not evidence that people had been given a choice about this, and arrangements should be reviewed in order to promote peoples privacy and dignity. We case tracked a person who was approaching the end of their life, and spoke to staff regarding the care and support provided to this person and their family. It was evident that the homes staff were respecting the wishes of the person and their family and making sure that care was provided in a sensitive and respectful manner. Care Homes for Older People Page 15 of 29 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 that live in the home receive the support that they need to make choices and decisions about their day to day lives. Activities provided do not meet the needs and expectations of all people living at the home. Evidence: Social profiles gave limited information about the interests of people living at the home. We spoke to the activity co ordinator who had recently begun working at the home. We were told that plans were in place to develop individual activity plans for people living at the home based on their interests and abilities. This includes people who are unable or do not wish to join in with group activities. One person living at the home met during the visit said I am fine. I love to read. I get the paper every day. Another person said I am okay. It is nice to have someone to talk to for a change. I cant remember what I have done today. We did not see any activities provided throughout our visit and people were either sitting in lounges or resting on their beds. The latest edition of the homes newsletter was on display. This included information Care Homes for Older People Page 16 of 29 Evidence: about life at the home so that people were kept updated about current issues. The hairdresser visits each week, and there is a hair salon so that people can enjoy the experience of having their hair done. One person met during the visit said I like having my hair done its my one vice. Arrangements are in place so people can follow their religious beliefs if they wish. People are encouraged to maintain relationships with the people important to them. There is an open visiting policy and people can choose where they meet with their visitors. One relative met during the visit said I am made to feel welcome here. I visit five times a week. People have a choice of where they are served their meals, and menus identified a variety of nutritious meals including hot options for breakfast each day. A choice of meals is always available, and in addition people have the option of choosing snacks at other times. One person living at the home met during the visit said The food is okay, tea can be a bit repetitive. We get plenty of drinks. Special diets can be prepared for reasons of health, culture, and religion, however we identified that current arrangements in place for the storage and preparation of halal meat required review. During our visit, menus were available in a folder, however did not reflect the meal choices of the day, and had been left out of peoples reach. The manager told us that plans were in place to produce individual menus in a large print format. People met during the visit told us that they had forgotten what they had ordered, however confirmed that staff inform them of the choices available. In addition we saw that a daily menu option list is completed with the involvement of people living at the home. During the visit, people told us that they were enjoying their meal. Dining tables were laid attractively, drinks were served, and seating was arranged to promote social interactions between people living there. An environmental health inspection had not been undertaken at the home for a while, however the majority of food safety checks sampled during our visit were satisfactory. This means that food is prepared in a hygienic manner. Care Homes for Older People Page 17 of 29 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. Arrangements ensure that the views of people living at the home are listened to, and they are safeguarded from harm. Evidence: The complaints procedure was on display in the home, and was included within the service user guide. It was produced in a large print colour format, making it easy to read, and included easy to understand information. In addition there were comment and compliment cards and books available for people to complete. One person living at the home met during the visit said If I am not happy about something I will tell the person concerned. I express myself loud and clear. I get on fairly well here. Another person said I have no complaints. One relative met during the visit said Staff are good. If I have a problem I talk to the staff and things get dealt with quickly. Since the annual service review on 28th May 2008, we have been told about eight complaints regarding the home, including allegations of a safeguarding nature. Issues raised included concerns about the cleanliness and internal temperature of the home, staffing levels on a particular day, and the choice of hoisting , and there was evidence that actions had been taken in order to address issues raised for the benefit of people living at the home. Care Homes for Older People Page 18 of 29 Evidence: We looked at the complaint register held at the home and this included details of the complaints that we were already aware of, and an additional one. From records sampled it was evident that since the new manager had come into post complaints are taken seriously, are investigated thoroughly, and the outcomes of these are feedback to all concerned. In addition we saw that the manager had built up a good rapport with relatives of people living at the home, so that any concerns raised are addressed at the time that they occur. The training matrix identified that the vast majority of staff had undertaken recent training about the protection of vulnerable adults and their roles and responsibilities regarding whistle blowing. The adult protection policy was in line with local multi agency guidelines, and staff met during the visit had an understanding of safeguarding procedures. This should mean that people are protected from harm. Care Homes for Older People Page 19 of 29 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 and comfortable environment that meets their needs. Evidence: There was a rolling programme of redecoration and refurbishment in place, so that people were provided with a clean and homely place to live. Bedrooms were located on both floors of the home and fifty two of these offer single accommodation. We saw that people are encouraged to personalise their bedrooms with items familiar to them so that they are comfortable in their surroundings. En suite facilities are provided in twenty five of these, and communal toilet facilities are located near to bedrooms. In addition there are assisted bath and shower facilities and staff met during the visit stated that these met the needs of people living there. There are six communal lounges and dining areas for people to use. These areas were comfortable and chairs had been arranged to promote social interactions between people. Consideration should be given to providing additional tables in these areas for peoples use, for example for personal items and drinks. Staff met during the visit said that they Have the equipment that we need to do the job. This includes pressure relieving and hoisting equipment. In addition the vast majority of beds were of a profiling type that adjust to enhance the comfort of people Care Homes for Older People Page 20 of 29 Evidence: living at the home. On the day of our visit, people living at the home and staff working there appeared to be calm and relaxed, however the calm atmosphere was interrupted by the noise level of the telephone system throughout the first floor of the home. This was of concern as the ringing was within close proximity of peoples bedrooms. We discussed this with senior external managers on the day of the visit, who stated that actions would be taken to address this without delay. Smoking is not permitted within the building and a sheltered area is provided outside of the home for people living at the home who choose to smoke. In addition, a shed is used for staff who choose to smoke. It was of concern that we saw that a petrol lawnmower was being stored in the shed as this is a serious risk to the health and safety of people using the facility. This was brought to the attention of the manager who removed the lawnmower straight away. There is a garden that is accessible to and suitable for all people living at the home. Since our last visit, improvements had been made in this area and the manager was enlisting the help of volunteers to continue to make it a pleasant area for people to use. There was an effective system for the cleaning of peoples personal clothing and bed linen. We saw that the home was clean and fresh throughout. We were told that the primary care trust had recently undertaken an infection control audit at the home, and the outcome of this was a positive 90 compliance score. Care Homes for Older People Page 21 of 29 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 are supported by staff who receive training so they should have the knowledge to meet their care needs. The recruitment procedure protects people from harm. Evidence: From discussions with staff and sampling of staffing rotas, we identified that there are two nurses and between eight and nine carers on duty during day time hours. There are two nurses and four carers on duty overnight. One person living at the home met during the visit said I sometimes wait about ten minutes to be taken to the toilet day or night. Another person said The staff are very good but can be very busy at times. Too busy for them to have a cup of tea. I can call staff when I need them. The manager told us that plans are in place to have an additional care worker on duty during night time hours, and that staffing levels are always under review. Staff met during the visit told us that the staffing rotas were now managed well so that the right amount of staff were on duty and staff holidays were covered. Administration, maintenance, cleaning, laundry and catering staff are also employed. We were told that with the exception of the additional night care worker, there were currently no staff vacancies. The homes own staff cover periods of staff sickness and holidays, staff turnover is low, and agency staff are not used. This means that people are supported by staff who are familiar with their care needs. The gender mix of staff reflected that of people living at the home so that care could be provided in an understanding Care Homes for Older People Page 22 of 29 Evidence: manner. Staff recruitment files sampled for new workers contained the vast majority of information required. Confirmation that a satisfactory police check had been obtained for one person was not available, however confirmation of this was sent from the Companys head office during our visit. New workers complete an initial induction and comprehensive training that is in line with Common Induction Standards. This means that staff should have the necessary skills and knowledge to provide a good standard of care. We saw that the induction paperwork of one new worker had not been completed in full, and this was brought to the attention of the home manager who stated that this person had, for various reasons, been away from work since starting there. There is a rolling programme of training so that staff have access to regular sessions and updates to assist them to care for the people who live there. The manager has produced a training schedule including information about forthcoming dates of training. This is to ensure that staff are aware of the dates that they must be available to attend the training. The training matrix identified that the vast majority of staff had undertaken recent refresher training in key areas. In addition staff met during the visit said that they had undertaken recent training including the safe moving and handling of people living at the home. They also said that there had not been any dementia training for some care staff, however we saw that dates for this had been arranged. Plans are in place for staff to undertake training about deprivation of liberty so that they have the knowledge to support people in this area. There are currently over 50 of staff who have completed a National Vocational Qualification NVQ level 2 in Care, so that they should have the necessary skills and knowledge to provide a good standard of care. Records identified that staff meetings are held regularly. This means that staff are involved in the running of the home, and are kept up to date with training and development opportunities. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run in the best interests of the people living there, ensuring their safety and well being. Evidence: The manager has been in post since December 2008. She has had previous care management experience, and despite not having a nursing background, holds other qualifications relevant to her job role. She has undertaken recent training in first aid and she is qualified to train staff regarding safe moving and handling practices. She works extra to the rota and this means that she is given the time to manage the home effectively. She is supported by a deputy manager who is a registered nurse. There are clear lines of responsibility between the management team for the benefit of the people living at the home and staff working there. One person living at the home met during the visit said I have spoken to Mary the manager and she seems very nice. One relative met during the visit said I have met Care Homes for Older People Page 24 of 29 Evidence: the new manager, she comes over very well. I feel that things have picked up since she came. In addition, staff met during the visit also made positive comments about her management style such as She gets things done and We have regular supervisions and training. Regular group meetings are arranged for people living at the home and their relatives, so that they have the opportunity to discuss the services provided at the home. The minutes of recent meetings were on display so that people unable to attend the meetings could access this information. We saw that service satisfaction surveys had recently been sent out to people living at the home and people important to them, in order to find out their views about the services provided there. This information is sent to the Companys head office for analysis, and we were told that a report based on the findings will be produced and made accessible to people living at the home. Senior external managers undertake regular quality monitoring visits at the home, and there was evidence that people living there are involved in these visits. The home do not manage the money of people living at the home, however there is a robust system in place for the safekeeping of small amounts of peoples money. Health and safety and maintenance records sampled were up to date and any hazards identified were rectified. This means that that people can be confident that their health and safety is promoted. Accident records were well maintained and regularly audited, and there was evidence that actions are taken to reduce the risk of accidents of a similar nature from occurring again. Since our last visit, a new fire door had been fitted to the sluice on the first floor of the home. We saw that this was getting stuck when closing, and this means that it would not close automatically in the event of a fire. We were told however, that this door is kept locked shut at all times. We saw that this was the case during our visit. External senior managers told us that actions would be taken to rectify this without delay. Care Homes for Older People Page 25 of 29 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 29 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 9 13 Systems in place for the recording of variable doses of medication must be reviewed. 30/06/2009 So that it is possible to determine the amount of medication given. 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 1 Information about the home should include details of arrangements in place for people who choose to smoke and fee rates charged to live at the home. This is so that they have this information when choosing whether or not to live there. A system should be introduced in order to assess staff competence regarding the safe management of medication. This is to ensure that people receive their medication as prescribed. Current arrangements in place during the times that people rest on their beds should be reviewed so that peoples privacy and dignity is not compromised. Page 27 of 29 2 9 3 10 Care Homes for Older People 4 12 Current arrangements for activities provided should be further developed so that people are supported to lead fulfilling and interesting lives. Current arrangements in place for the storage and preparation of halal meat should be reviewed, and guidelines provided for staff, so that they are aware of the procedures to be followed in this area. 5 15 Care Homes for Older People Page 28 of 29 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 29 of 29 - 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!