Inspection on 16/06/09 for Acres Nook

This is the latest available inspection report for this service, carried out on 16th June 2009.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Acres Nook 30/08/06

Acres Nook 18/11/05

Acres Nook 08/06/05

Acres Nook 14/12/04

Acres Nook 19/07/04

Acres Nook 09/03/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 12/10/2009.

Key inspection report Care homes for older people Name: Address: Acres Nook Boathorse Road Kidsgrove Stoke-on-trent Staffordshire ST7 4JA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Yvonne Allen     Date: 1 6 0 6 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Acres Nook Boathorse Road Kidsgrove Stoke-on-trent Staffordshire ST7 4JA 01782773774 01782777560 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Modelfuture Limited Name of registered manager (if applicable) Type of registration: Number of places registered: care home 72 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users to be accommodated is:72 The registered person may provide personal care (with nursing) and accommodation for service users of both sexes whose primary care needs on admission to the home are within the following categories. Old age not falling in any other category OP 72. Physical Disability PD 36. Physical Disability over 65 years of age PD(E) 48. Dementia over 55 years of age DE 14. Date of last inspection Brief description of the care home Acres Nook is a purpose built care home providing both personal and nursing care and accommodation for up to seventy-two people from the age of eighteen years. Acres Care Homes for Older People Page 4 of 29 Over 65 14 72 48 0 0 36 Brief description of the care home Nook Care Centre is a two-storey property set within its own grounds. A passenger lift and stairs provides access between the floors. The ground floor is seperated into two units, one unit dedicated to meeting the needs of elderly people with personal and general nursing care needs and the other to care of elderly people with dementia care needs. The whole of the second floor is dedicated to meeting the needs of people from the age of eighteen years who have a range of care and nursing needs. This includes continuing care needs. Although the three units are staffed seperately, integration throughout the home is encouraged with people from the differrent units engaging with each other, especially throughout activities and entertainment. The majority of bedrooms throughout the home are single and a small number have an en-suite facility comprising of a toilet and wash hand basin. Both floors have lounges, a dining room, assisted bathing and toilet facilities. The laundry and kitchen are sited on the ground floor. Externally, the home has enclosed gardens to the rear. There is a paved forecourt that is divided to provide a sitting area for the people using the service and a smalll parking area. There is also parking to the rear of the property. The home is within walking distance of the main shopping area in Kidsgrove town and is on a main bus route into the city of Stoke-on-Trent. The fees for this home at the time of the Inspection ranged from 382 to 605.40 and 825.00 for continuing health care. Items not covered by the fees include hairdressing services, newspapers, toiletries, trips and holidays. 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 quality rating for this service is 2 star. This means that the people who use this service experience GOOD quality outcomes. All of the Key minimum standards were assessed and for each outcome a judgment has been made, based on the evidence gathered. These judgments tell us what it is like for the people who live in this home. Prior to the inspection visit the Providers had completed a self-assessment tool, which is known as the Annual Quality Assurance Assessment (AQAA). Completion of the AQAA is a legal requirement and it enables the service to under-take a self assessment, which focuses on how well outcomes are met for people using the service. It gave detailed information about the services offered. The ways in which in we gathered evidence to make our judgments were as follows Care Homes for Older People Page 6 of 29 We looked at any information we had received about the home since the last Key Inspection. This included any compliments, complaints and Safeguarding referrals we had received. We spoke with the people who live in the home. We spoke with the staff who work at the home. Discussions were held with the manager and responsible individual of the home. We examined relevant paperwork and documentation at the home. We walked around the home and we visited all the units. We looked at how staff interact with and care for the people who live at the home. We completed a Short Observational Framework Inspection (SOFI). SOFI is designed to give us an opportunity to record our observations during the inspection of care homes where people have dementia or severe learning disabilities. It can enable us to look closely at practice issues and observations; it is used illustratively alongside other evidence. SOFI offers first hand experience of sitting alongside people who use the service for a couple of hours in a communal space within the care home. It gives an insight into their general well being during this time, and also into the staff interaction with the people who use the service. Observations were made of interaction between staff and people who use the service around non-personal care tasks, at lunchtime and during the Short Observational Framework Inspection (SOFI.) At the end of our inspection visit we discussed our findings with the manager and regional manager. We outlined that there were no requirements but that we have made some recommendations for improvement. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? The quality of life for people living on the dementia care unit has improved. Care is now more person centered and individual needs are met. Care Homes for Older People Page 8 of 29 People are given the opportunity to have a key to lock their bedroom if they wish to. This has helped to promote privacy and dignity for people living at the home. Care plans are reviewed regularly and, wherever possible, with the person or their representative in attendance. This means that people are involved in and are aware of their care plan. The overall management of the home has improved since the last inspection. At that time the manager had only just commenced in post and the service had been without a manager for several months. The manager has now applied to be registered manager for the service. 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 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. People are given information about the home and undergo an assessment of their needs prior to admission to the home. Evidence: In their AQAA the Providers tell us All our prospective residents are offered the opportunity to visit the home with their friends and relatives, view our facilities and amenities and meet the staff. They are also offered the opportunity to spend part of a day at the home to take a meal and meet other residents. They also say that Financial matters are explained fully before admission and that New residents are given copies of our Statement of Purpose and Service User Guide together with our brochure and menu plans. They tell us that All residents are assessed prior to admission to ensure that all their needs can be met and a pre-admission care plan is drafted. A full care plan is written within 48 hours of admission. We looked at several care plans where it was identified that the service carries out a Care Homes for Older People Page 11 of 29 Evidence: comprehensive pre admission assessment of peoples needs before they are offered a place in the home. This is often carried out in conjunction with assessments from other health care professionals including funders of care. The senior staff nurse on duty confirmed that a pre admission assessment is carried out by the Manager or the Care Manager of the service. We saw that the Statement Of Purpose (SOP) and Service User Guide (SUG) are displayed in the entrance to the home. These documents are up to date and have been changed to reflect the new management structure in place. 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. People can be assured that their care will be planned, person centered and delivered with dignity and respect. Evidence: In their AQAA the Providers tell us that All our residents have comprehensive care plans, which are updated daily via progress reports. They say that Our documentation includes assessment of all individual needs, from daily social activities to activities of daily living. They also say that The home liaises with local doctors, Tissue Viability Nurses, chiropodists, dentists and opticians. They say that We also work with the Palliative Care team who are available round the clock. Also One of the senior staff is always on call to provide advice and practical expertise and support. They tell us that We have strict policies in place regarding the management of medicines and training is organized by Boots, our designated pharmacy, to ensure the competency of staff involved in drug administration. We found the above to be a true and accurate reflection of the services provided by the home. Care Homes for Older People Page 13 of 29 Evidence: We looked at peoples care plans and identified that their needs are being met as planned. This includes diverse needs of people. We noted that a person who is registered blind and very hard of hearing has a plan of care in place to meet her specific diverse needs. Staff are aware of how to communicate effectively with her and her needs are met well. Another person has high dependency nursing needs and is fed artificially. The palliative care team and tissue viability team are closely involved in this persons care. Staff are very aware of her needs and documents are maintained to support this. We spoke with some of the people who live in the home and they told us I am very well looked after here its lovely. Yes the staff are all very kind. They help me but I try and do as much as I can for myself. We met some of the younger adults who live on the second floor. We met a person who has lived at the home for many years and we looked through his care plan with him. He told us that he is aware of this care plan and will often go through it with his named nurse. He agreed that his care plan is a true reflection of how his personal and nursing needs are monitored and met. The plan also reflected how the service involves other people in this persons care such as the Parkinsons Nurse and Diabetes Nurse. We met another person who lives on this unit and she told us The staff look after me very well. She showed us her bedroom which has been adapted to meet her needs. We looked at the care plan of another young person who lives on the unit and his needs are met well by the staff there. As a result of the Short Observation Framework Inspection (SOFI) the subsequent evidence was available. This part of the inspection was carried in the dementia care unit between 10:00AM and 1:00PM. We continually observed 4 people over the two hour period and watched how staff interact with and care for these people. We found that the atmosphere and general staff interaction was very good. Staff engagement with people with dementia care needs was good and staff appeared to understand and meet peoples needs well. Care Homes for Older People Page 14 of 29 Evidence: We looked at the process for the receipt, storage, administration and disposal of medication on the elderly care unit and the dementia care unit. This process is satisfactory with the recommendation for the staff member on the dementia care unit to take the medication trolley to the person and not dispense medication into pots from the trolley in the medication room. This will help to ensure that people are safeguarded from errors with medication. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The activities of daily life in the home are made flexible and varied and choice and autonomy is promoted. Evidence: In their AQAA the Providers tell us that they Have three activity Co-ordinators, all with different skills and approaches. They tell us that This means that we are able to offer activities to suit a wide range of tastes, from Bingo and church services to dances, cinema trips and crafts. They also say that We also offer one to one time for those who prefer this to group activities. They tell us that Care staff are very involved and participate in many activities such as day trips on a voluntary basis. We have recently visited Cadbury World and Knowsley Safari Park and have a trip planned this week to the Black Country Museum. They also tell us that We have our own minibus which we make full use of with the residents, often going on shopping trips and picnics. The service employs three people to deliver activities and entertainment to people who live in the home. We met with these people, one of whom was just leaving on an organized trip out with some of the people who live in the home. Care Homes for Older People Page 16 of 29 Evidence: We spoke to an activities coordinator who has worked at the home for many years. She explained how the programme of activities and entertainment is organized and how she tries to incorporate all of the people living in the home, irrespective of which area of the home they live in. We noted that some people from the other two units were coming down for the activity session. The coordinator plans activities and entertainment around the wishes and preferences of people who live in the home. Records are maintained and are available for inspection. The programme of activities and entertainment includes various trips out to places of interest. We saw photographs displayed around the home of these trips and other events. A recent trip out had been to Cadbury World which some of the people told us We had a really good time there and I really enjoyed that trip - I went on the ride and brought some chocolate back! Examination of activity records and case tracking of two people identified that people who have poor communication or limited abilities do not always have their social and therapeutic needs fully met. We discussed this with the activities person and with the manager with a view to providing more one to one therapy sessions for people with diverse needs. The activities person said that she would take this forward. People who live in the home also confirmed that regular church services are held and that people have their spiritual needs assessed and met. Care plans contain information about this. The service has recently held a wedding for a couple who met and who live at the home. This provided a celebration which all of the people who live at the home, and who are able, attended and joined in. The service also provides a bar which is now open at the weekends. This is a dedicated room which has been transformed into a cosy bar with chairs, tables, draft beer and other drinks. This enables people who live at the home to socialise and enjoy this facility. The service upholds and promotes personal choice and autonomy. Care plans document She likes to wake up at 9-AM and prefers going to bed at 8-8.PM. We asked this person and she said Yes its about right. Other documentation specified Methodist Likes singing and Family visit every night. Is able to feed herself but takes her time and Allow plenty of time for her to finish her meal. We observed this Care Homes for Older People Page 17 of 29 Evidence: person eating her lunch at the table in the ground floor dining room, as specified in her care plan. We Spoke to another person who told us Yes we are well fed here - the food is very good and Yes we have choice of menu. We observed that there were two choices of the main menu at lunchtime. One was roast chicken and the other cauliflower bake then rice pudding or fruit. Someone else was seen eating a salad. We saw a collection of frozen Halal meals in the freezer. The Cook told us that these had been ordered for a person who comes into the home for respite care and who is a Muslim and needs Halal meat. The Cook also explained that he caters for any special diets including soft diets and diabetic diets. Care Homes for Older People Page 18 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. People who live in the home can be assured that their concerns will be listened to and taken seriously and that the systems in place help to protect them from abuse. Evidence: In their AQAA the providers say We have a complaints procedure and a log is kept of the progress and resolution of complaints. They also tell us that Regulation 37 notification is made to the CQC when appropriate and Our complaints procedure is exhibited in our reception area. We noted that this complaints procedure is on display at the entrance to the home. Also the Service User guide contains a copy of this. People told us Oh yes I can speak to any of the staff if anything is bothering me and I have raised a couple of things before with the manager and she has sorted them out. We looked at the log of complaints maintained by the service and noted that there is a Formal Complaints Record maintained to keep a log of complaints received. However this does not identify what the outcome of each complaint has been. This was discussed with the manager and regional manager at feedback and they said that they would add onto this to include the investigation and outcome of the complaint. Care Homes for Older People Page 19 of 29 Evidence: We, the commission, have received two complaints since last inspection. One was from Social Services about the service not meeting the needs of a person living in the home. Miranda informed us that the conclusion of this had been that the placement was not suitable for this person. The second complaint we received was an anonymous complaint that the home was not clean and was very untidy. During this unannounced visit we walked around all of the units and found the home to be clean and well presented. We, the commission, have not received any Safeguarding referrals since the last inspection. Miranda told us that she and the Care Manager have completed the Deprivation Of Liberty Safeguarding (DOLS) training and will be cascading this training down to all staff and will be incorporating this policy into care plans. We spoke to 3 staff about Protection Of Vulnerable Adults (POVA) training and they all confirmed that they have received this training and know what to do in the event of abuse. The senior nurse is aware of the safeguarding policy when she is in charge. We looked at the training records for these people and identified that this training takes place regularly. The manager of the service has many years experience in managing safeguarding referrals. Care Homes for Older People Page 20 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. The home is clean, well presented and adapted to meeting the needs of the people who live there. Evidence: In their AQAA the Providers tell us We have a redecoration and refurbishment programme and are consulting residents as we carry it out and We have a preventative maintenance programme, monitored weekly. They say that All hazard alerts are examined by the manager and appropriate action is taken. They also tell us that We use more hours than previously for our domestic team and hygiene and tidiness standards have greatly improved. We walked around the home and visited all three units. The Dementia care unit is very clean and well presented. We met the domestic assistant who was cleaning on this unit at the time. Also this unit is very well adapted to suit the needs of people living there. The unit has been decorated, furnished and adapted for people with dementia care needs. People have their own front doors. There are themed murals along the corridors and the bedrooms are very personalized. There is a lovely enclosed garden which the service are in the process of improving further. The maintenance person was carrying out Care Homes for Older People Page 21 of 29 Evidence: some building work at the time of the visit. The remainder of the home is well presented, clean and adapted to meet peoples needs. There is the provision of different types of hoists, bed rails, special mattresses, ramps, adapted baths and toilets. The young persons unit is very well adapted and personalized. One of the people living on this unit showed us the adapted bath which he uses every other day. He said I love this bath and hope they dont change it. He also had an abundance of Cds and DVDs in his bedroom and proudly showed them to us. Another person living on this unit wanted us to see her bedroom. She asked if we liked the new decor which she said she had chosen. It is very pretty and feminine with butterflies on the wall. She also showed us pictures on her bedroom wall which she has made at craft sessions. She was obviously pleased with and proud of her room. A lady living on the ground floor nursing unit showed us her room. This is very personalized with picture plates of dogs, of which she said she used to have one. She then showed us her patio garden and plant collection. As part of our case tracking we visited the bedrooms of two other people on this unit. Both of these people have diverse needs. The key worker showed me the bedroom of one person who is registered blind and hard of hearing. He explained how she likes her tables set out when she is in bed, One either side with her drinks on and the call bell within reach. Another person who is nursed in bed is nursed on a special air wave alternating mattress and a nursing bed is provided. The home is well adapted for people using wheelchairs. At this service people who live at the home make good use of the outdoor space and often sit outside in front of the home outside the entrance under the gazebos. We also visited the kitchen and laundry which are clean and well presented and meet with the requirements of Environmental Health. The service has an infection control policy and guidelines in place. Staff confirmed that they receive training in this area and all staff preparing and delivering food have undertaken food hygiene training. Care Homes for Older People Page 22 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 who live at the home are cared for by a skilled and competent staff team who are trained to meet their needs. Evidence: On their AQAA the Providers tell us Our rotas maintain staffing levels above recommended ratios and We have very low level agency use. At the time of the inspection visit there was an adequate number of staff on duty throughout the home to meet the needs of the people living there. The skill mix of staff is also good with three trained nurses on duty, including the manager, and a mix of care staff trained to National Vocational Qualification (NVQ) standard. Other staff are employed to work at the home including a team of domestic staff. The numbers of domestic staff employed by the service has been increased since the last inspection. There is a Cook and team of kitchen assistants employed to oversee the catering at the home. Care Homes for Older People Page 23 of 29 Evidence: The maintenance person was also on duty. He has worked at this home for many years and is now assisted by a second maintenance person. We met the three activities coordinators employed by the service, one of whom has worked at the home for many years. There is an administrator employed to provide secretarial and administrative support at the home. The manager of the home told us I believe in having plenty of staff. A nurse told us that she felt very supported at the home. She has recently completed Mentorship training so that she can supervise and train Student Nurses who are placed at the home. She also confirmed that staff receive regular updates in training including Moving and Handling, fire safety, fire drills. Examination of training records confirmed that staff undertake relevant training in oder to be able to meet the needs of people coming into the home. The service has a robust recruitment procedure in place. Staff files contain all the required information such as Criminal Records Bureau (CRB) checks. Staff told us there is a Good staff team here and plenty of training. People who live at the home told us, Oh they are very good here and look after me well. Oh yes they are a good bunch of staff and they understand my needs well enough. Care Homes for Older People Page 24 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 well managed and is run in the best interests of the people who live there. Evidence: In their AQAA the Providers tell us that The managerial and administrative functions in the home are achieved by a system of appropriate delegation to suitable qualified and skilled staff. They also say that Training of staff is a high priority and formal qualifications on our programme include NVQ 2, 3 and 4. The manager has achieved Registered Managers Award (RMA) and is awaiting delivery of certification. The service has an effective management structure in place which is in line with the Company Management Policy. The current manager Miranda has been in post as acting manager for twelve months and the Regional Manager confirmed that the Company has recently applied for Miranda to become Registered Manager for the service. Care Homes for Older People Page 25 of 29 Evidence: Miranda has all the necessary qualifications to be able to manage this service and also keeps updated with training. She told us that she has just completed Deprivation Of Liberty Safeguarding training. The Care Manager has also completed this course. Staff who work in the home told us Miranda is a really good manager and has made a lot of much needed improvements here. Yes she is a good manager and you can go to her if you have a problem. A person who lives at the home told us I talk to Miranda a lot and she listens to me. Another person told us Her door is not always open but I can arrange to speak to her and she does listen. There is an effective Quality Assurance system in place at the home. The Company has its own system with all areas regularly audited by the manager and regional manager. Regulation 26 reports are carried out monthly and we saw these for the past six months. These are short inspections of the home carried out usually by the area or regional managers or a manager from another home. These are required by Commission, when the Provider is not in day to day control of a service, under Regulation 26 of the Care Standards Act. One person told us that there is No residents committee now. Miranda told us that arrangements are in place to recommence these meetings. There is a safe facility provided where people can keep money. The system in operation for maintenance of personal allowances is the same as for all the Companys homes. The system is transparent and easily audited. We spoke to the maintenance person and he explained how he ensures that equipment is regularly checked and serviced and keeps records of this. We noted stickers on electrical items and other equipment to confirm the above. The Company ensures that generic risk assessments and regular checks are carried out in relation to Health and Safety and records are kept of this. The service also receives visits from the Fire safety Officer and Environmental Health department and certificates are maintained of these visits. Care Homes for Older People Page 26 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 27 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 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 9 The staff member on the dementia care unit who is administering medication should take the medication trolley to the person and not dispense medication into pots from the trolley in the medication room. This will help to ensure that people are safeguarded from errors with medication. More effective therapy sessions should be provided for people with communication difficulties, limiting abilities or other diverse needs, in order to ensure that their social and therapeutic needs are fully met. 2 12 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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