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Inspection on 28/09/09 for Ancaster Court

Also see our care home review for Ancaster Court for more information

This is the latest available inspection report for this service, carried out on 28th September 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.

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

There is a Statement of Purpose and Service Users Guide that gives prospective residents the information required to enable them to make an informed choice about where they live. There are robust quality assurance systems are in place which enables the service to monitor and improve their service and care practices. There is an open-house policy which welcomes visitors at all reasonable times. There is a clear and simple complaint policy and procedure in the home, which allows people who use the service to raise any problems. Comments received included `The manager and herr staff seem to be on the ball and will always strive to be better if a situation arises`. Satisfactory arrangements are in place to safeguard residents finances. Staff provision is well maintained with a robust recruitment practice being followed and appropriate numbers of suitably qualified staff working in the home. The atmosphere at the home was pleasant with communication between staff, residents and visitors being positive open and friendly. Comments from residents in respect of the home and staff was good and included ` Really nice people, couldn `t wish for kinder care` `Staff are really pleasant, the atmosphere seems to get better all the time`. The staff surveys received were very positive about the work environment and the support from collegues and management `It has been a difficult year so far and the people are working together to support each other` `Very good support from the manager and head of care` `I am happy working at Ancaster Court`. The quality and choice of meals remain good and most residents spoken with were complimentary about the food. The AQAA recieved said that residents are involved in making the choices for the menu. The training for staff is good and covers a wide variety of resident related conditions which give the staff an understanding of the residents needs. Staff supervision is in place and takes place on a regular basis and includes all the people who work in the home.

What has improved since the last inspection?

The Service Users Guide and Statement of Purpose are given to each resident and provide clear information in respect of the services and facilities the home offer. The home staff have worked hard with the individual care documentation and evidenced a more person centred approach. The care plans and risk assessments are now reviewed monthly and were seen to be pro- active and appropriate.There are now robust systems in place for the safe administration and recording of medications that promote and protect the health of residents. There was evidence that a redecoration and refurbishment plan has been commenced.

What the care home could do better:

As discussed some shortfalls were found in the care plan documentation and risk assessments in respect of dealing with aggression and behavioural problems. These need to be developed to ensure the safety and well being of residents and staff. Information received from surveys and talking to residents and visitors indicate that the activities in the home do not suit all the residents needs and preferences. It was identified that the more physically and mentally frail need more mental stimulation and company. This is acknowledged by the home staff. Two surveys also stated more outings would be appreciated. Whilst the general cleaning has improved, surveys and evidence gathered on the site visit identified that deep cleaning in residents bedrooms would be beneficial for those living and visiting the home. The food whilst being nutritious and balenced is identified by residents and visitors as being old fashioned, boring and unintresting, however the home are endevouring to consult with residents on an ongoing basis and design menus in line with residents preferences and likes.

Key inspection report Care homes for older people Name: Address: Ancaster Court 24 Hastings Road Bexhill On Sea East Sussex TN40 2HH     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: Deborah Calveley     Date: 2 8 0 9 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 28 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 28 Information about the care home Name of care home: Address: Ancaster Court 24 Hastings Road Bexhill On Sea East Sussex TN40 2HH 01424-213532 01424221925 sowerbya@bupa.com www.bupa.co.uk BUPA Care Homes (CFC Homes) Ltd care home 51 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 5 The registered person may provide the following category of service : Care home with nursing (N) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: old age, not falling within any other category (OP) Dementia (DE) Date of last inspection Brief description of the care home Ancaster Court has 51 registered beds that can be used to provide nursing care and admits people who are privately funded and those who are funded by Social Services. A secure unit on the second floor now provides separate accommodation for 12 of the 51 residents, requiring general nursing and dementia care. Ancaster Court is owned and managed by BUPA Care Homes Ltd. The bedrooms are found on three floors and an 8-person passenger lift accesses all accommodation used by residents. Four of the bedrooms are registered for double occupation, but only one of these is now used for Care Homes for Older People Page 4 of 28 Over 65 0 51 51 0 2 9 0 9 2 0 0 8 Brief description of the care home shared occupancy. 16 bedrooms have en-suite facilities. Ancaster Court is a Victorian building that has been converted and adapted to its present use. It is located in a residential area approximately half a mile from Bexhill town centre, seafront and mainline train station. The home has a garden to the rear of the property. There is parking to the front of the home for approximately 15 vehicles. The current range of activities includes bingo, quizzes, poetry club and PAT the dog visits. Holy Communion services take place on a monthly basis. A copy of the latest inspection report is kept in the ground floor lounge. Care Homes for Older People Page 5 of 28 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 reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term service user to describe those living in care home settings. For the purpose of this report those living at Ancaster Court will be referred to as residents. This was a key inspection that included an unannounced visit to the home and follow up contact with residents representatives and visiting health and social care professionals. This unannounced inspection was carried out over 6.5 hours on the 28 September 2009. There were thirty-four residents living in the home on the day of which five were case tracked and spoken with. During the site visit eight other residents both male and female were also spoken with. Care Homes for Older People Page 6 of 28 The purpose of the inspection was to inspect the key standards against the information received from the completed Annual Quality Assurance Assessment (AQAA) and the Care Quality Commission surveys. During the site visit a range of documentation was viewed including the Service Users Guide, Statement of Purpose, care plans, medication records and recruitment files. Three carers, two registered nurses, ancillary workers, the cook were spoken with as well as the registered manager Mrs Sowerby and the maintenance person. Telephone contact was made with health and social care professionals following the visit. The information received verbally has been incorporated into this report along with the information received from resident/relative and staff surveys and the competently completed AQAA. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? The Service Users Guide and Statement of Purpose are given to each resident and provide clear information in respect of the services and facilities the home offer. The home staff have worked hard with the individual care documentation and evidenced a more person centred approach. The care plans and risk assessments are now reviewed monthly and were seen to be pro- active and appropriate. Care Homes for Older People Page 8 of 28 There are now robust systems in place for the safe administration and recording of medications that promote and protect the health of residents. There was evidence that a redecoration and refurbishment plan has been commenced. 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 28 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 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The robust admission policy and procedure ensures that service users are admitted only on the basis of a full needs assessment undertaken by people competent to do so. Residents have the opportunity to visit the home and know that it is able to meet their individual care and support needs. Evidence: There is a comprehensive Statement of Purpose and Service Users Guide which contains clear information about the home, the range of fees charged and the services and facilities the home provides. These documents have been reviewed since the last inspection and are now service specific and user friendly. It was confirmed that the contract arrangements are clear and uncomplicated. The homes certificate of registration is prominently displayed in the home and was correct on the day of the inspection. Care Homes for Older People Page 11 of 28 Evidence: Three pre admission assessments to the home were reviewed as part of the inspection process and confirmed that they are completed by the registered manager or a senior trained nurse. The assessment (part of the quest tool) documentation contain all the information required to ensure that new admissions to the home are suitable and that the home have the staff knowledge and environment to meet the care needs identified. More written information could be documented, rather than totally relying on the Quest tool. It was not possible to view a recent admission to the home as there had been a voluntary ban on all prospective admissions from January to May 2009. This was as a result of a safeguarding and police investigation. Subsequent safeguarding meetings confirmed that the home was now able to admit new residents from June 2009. Prospective residents are seen either in their home or hospital before admission and it was confirmed that wherever possible the family or representatives are involved. It was evidenced that the home now confirms in writing that having regard to the assessment that the home can meet the assessed needs of the prospective resident. Mrs Sowerby was able to verbally demonstrate her knowledge and awareness of the different specialities required in the home and ensures that the staff employed have attended relevant courses to deal with the needs of the elderly and also specialised courses for certain diseases. The senior Staff are pro active in ensuring that the physical needs of residents are monitored and seeks advice and support as required. Trial visits to the home can be arranged, this is clearly stated in the Statement of Purpose and in the statement of terms and conditions. Intermediate or rehabilitative care is not provided Ancaster Court. Care Homes for Older People Page 12 of 28 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. Comprehensive care plans enable staff to meet the assessed needs of residents in a structured and consistent manner. Residents are protected by the homes medication policies and procedures. They are treated with respect and encouraged to make decisions about their day-to-day living. Evidence: The care documentation pertaining to five residents was reviewed as part of the inspection process. These residents were also met and spoken with during the site visit. The care documentation contained a good level of personal information in respect of individual residents health and social needs. They include clear guidelines for staff to follow so as to provide a consistent and person centred approach to the care they are to receive. As discussed there are some areas identified for development which include behavioral traits and aggression. These need to include clear guidelines as to the action staff need to take. Risk assessments for the physical health and safety of the residents are in place and updated monthly. On the whole the care documentation demonstrated that the care Care Homes for Older People Page 13 of 28 Evidence: was reviewed and evaluated on a regular basis. Residents are registered with a GP from local surgeries and all residents are enabled and supported to have access to health professionals in respect of their health needs. There was evidence that the health needs of residents are met with evidence of good multi disciplinary working taking place on an as required basis. There are policies and procedures in place for the ordering, safe administering and recording of medication, which promote and protect the people they care for. The medication administration charts (MAR) were reviewed and were seen to be in the main competently completed. There has been a definite improvement in the standard of medication practices. The MAR are regularly audited by the senior management. It would be beneficial for staff if residents medication was listed along with possible interactions and side effects, so as to raise staff awareness of the need of regular review with the practitioner. The staff on duty were seen to be respectful and considerate to all residents and whilst attending to their needs. The interaction observed was open and friendly. The comments from residents included: Staff are really great, they work very hard and are caring Wonderful people Really improved over the past nine months Nothing is too much trouble. There is a Privacy and Dignity policy in place that guide staff in to ensuring that the privacy and dignity of residents are promoted and protected. The protection of residents privacy and dignity is highlighted as one of the main aims of the home in its Statement of Purpose and Service User Guide. Each of the residents were addressed by their preferred term and dressed appropriately in well-laundered clothing. The residents personal hygiene is attended to in a manner that promotes their dignity and individual preferences. Attention to residents appearance was evident as residents were seen to wear jewellery, make up and their nails and hair were clean. Some concerns were raised in respect of the cleanliness of personal belongings such as glasses and watches and the manager confirmed she would look into it. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are enabled and supported to maintain contact with family and friends as they wish. They benefit from a flexible lifestyle and social life and meals that are balanced and nutritious. Evidence: There are two activity co ordinators in the home which provide the activities to all the people who live in the home. One specific co ordinator takes the responsibility of the dementia unit whilst the other works with the rest of the home. The activity programme for the home is displayed in the main communal areas and in individual rooms and all residents can choose to join in if they wish to. The care documentation includes a life cycle chart which is a valuable document and invites a person centred approach to meeting individual social needs. The dementia unit remains colourful but the decor is now little tired particularly in the communal areas. However thought has gone into making the residents bedroom special for them with their own tapestries, photographs and paintings. The co ordinators have found this to be a useful therapeutic tool which allows them to engage positively with residents. Two relatives of residents that live in the dementia wing gave their views on the activities offered. Would like to see more stimulation I think they do a very good Care Homes for Older People Page 15 of 28 Evidence: job. The main activities in the dementia unit are still one to one sessions and therapy sessions. The AQAA stated that they are looking into providing more male orientated activities and that there are plans to develop a gardening club. Two residents spoken with commented, I do not like activities and so dont go Not my cup of tea. There were five surveys received from residents and/or their representative that they felt more outings would be beneficial, one said that the residents that were confined to bed had little or no interaction and four felt that activities could be improved. This is acknowledged by the home and the staff are hopeful that new admissions will encourage people to attend the group sessions. Holy Communion services are organised at the home on a monthly basis and lay people from other religious denominations visit residents at the home as required. Residents independence is promoted and encouraged within the home and it was confirmed that wherever possible residents are enabled and supported to make choices and take decisions affecting their life and daily routine. Residents and visitors confirmed that there is open visiting hours as long as consideration is shown to all the people living in the home. The dining area was pleasantly furnished and staff were observed assisting residents discretely ensuring their dignity was upheld. Since the last inspection a new cook has been recruited and has been involved in reviewing the menus. The Bupa Menu Master helps ensure every menu used is customer led and nutritionally balanced. The home has a Nite Bite menu allows residents to choose to eat when they feel like it providing healthy choices at any time through the night. No one spoken with uses this service, but one gentleman confirmed he was aware of it. The meals at the home are wholesome, nutritious and devised in-line with the residents likes and preferences. However three residents spoken with had no idea what they had ordered the day before. The cook was open to discussion and will review the way they take residents orders. The home caters for specials diets such as diabetic, pureed and vegetarian, the chef also confirmed that they will cook anything that a resident wishes (within reason). The menus were seen and demonstrated a varied and nutritious diet. The communication between the kitchen and staff is said to be good. The cook did not have any knowledge of the safer cooking better business book as recommended by the environmental health agency and this will be looked in to by the manager. Care Homes for Older People Page 16 of 28 Evidence: Comments regarding the provision and standard of food continues to be varied, The food is okay, but a bit like school dinners Pretty tasty Presentation could be better especially the soft diet Nice food, really enjoy it. Care Homes for Older People Page 17 of 28 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. The open and inclusive atmosphere within the home enables residents staff and visitors to express any concerns confident that they will be listened to and acted upon. Residents are safeguarded from abuse through relevant staff training and robust policies and procedures. Evidence: The complaint policy and procedure is clear and uncomplicated and a copy of this is readily available in the home and the Service Users Guide. A system of recording complaints was demonstrated during the site visit to the home. The home has received two complaints since the last inspection and they were responded to within the stated timescales. Relatives and residents spoken with confirmed that they were confident that any complaints or concerns that they had would be listened to and responded to effectively. The home has relevant guidelines on the protection of vulnerable adults and staff have received appropriate training. The management team has a clear understanding of adult protection guidelines and are aware of how to initiate an investigation if required. There has been one safeguarding referral since the last inspection which is at present still on going. Care Homes for Older People Page 18 of 28 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. Ancaster Court provides a comfortable and safe environment for those living in the home and visiting. There is now a plan of renewal and redecoration in place. Residents are enabled and encouraged to personalise their room and rooms are homely and reflect the residents personalities and interests. Evidence: Ancaster Court is a Victorian building that has been converted and adapted to its present use. The home has a garden to the rear of the property and plans for a new sensory garden. There is evidence that the home are following a refurbishment and redecoration plan which has improved the outcomes for the people living in the home and those visiting. The middle floor has been upgraded with new furniture and nursing profile beds. The communal areas in the home are comfortably furnished, however the conservatory continues to be out of use for safety reasons. Specialised equipment is available in the home to encourage independence, e.g handrails in bathrooms, hoists, wheelchairs and lifts to all areas of the home. There is a call bell facility in all areas that residents have access to. The home has a range of pressure relief and preventative equipment for people who have tissue damage or Care Homes for Older People Page 19 of 28 Evidence: those who have been assessed as being at risk to tissue damage. The maintenance person keeps up to date records of all the checks carried out on all equipment, heating and water that promote and protect the well being and safety of the residents, staff and visitors. Door closing devices have been fitted in all areas so as to protect the residents safety in case of fire. The home was adequately clean and free from offensive odours on the day of the site visit. As discussed the cleaning could be improved in certain areas. This was attended to immediately by Mrs Sowerby and will be continually monitored in future. The laundry room was organised and has the necessary equipment to provide a good service. Separate ancillary staff are employed for cleaning and laundry. Good practice by staff was observed in the promotion of infection control measures. Care Homes for Older People Page 20 of 28 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. There is sufficient trained and competent staff on duty at all times to meet the assessed needs of the residents. Robust recruitment procedures and appropriate staff training ensure the safety and protection of residents. Evidence: The staffing rota was viewed and the staffing levels were seen to be sufficient to meet the needs of the residents at this time. It was confirmed that there is flexibility of the staffing levels and they are adjusted according to the number and changing needs of the residents. Staff spoken with said that the staffing levels at present are sufficient to enable them to give a good level of care to each resident. Residents had no complaints in respect of the staffing levels. Comments received included Very dedicated staff Really know their stuff and look after us well. A selection of staff recruitment files were viewed and demonstrated that there is a thorough and robust recruitment process in place to protect their residents. The documentation in the files viewed supported the information supplied in the AQAA that all staff receive a thorough induction to the home. The induction and foundation training is in line with the Skills for Care guidance. Care Homes for Older People Page 21 of 28 Evidence: All new staff are required to complete an initial induction programme and undertake mandatory training including fire and health and safety. This leads into foundation training in preparation of National Vocational Qualification (NVQ) training. At present 7 of the 20 care staff have a NVQ qualification. Staff spoken with said that the training opportunities in the home are good and enable them to care for their residents competently. There is a training matrix in place, which enables the management team to track the training needs. This ensures that all staff receive the training required to perform their job competently and therefore promoting the health and well being of the residents living in the home. Care Homes for Older People Page 22 of 28 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 overall management of this home is good with effective systems to ensure the home is run in the best interests of the residents and in the main promotes their health safety and welfare. Evidence: The home manager, Mrs Sowerby is a level 1 registered nurse and has been the home manager of Ancaster Court for approximately 8 years. She has successfully attained the Registered Managers Award and has the necessary experience and knowledge to manage the home effectively The Ancaster Court staff team have worked hard over the past year to address the requirements that were made at the last key inspection. This has been accomplished. A tragic incident occurred in January 2009 which impacted on the whole home, residents and staff along with visitors and families. The home staff have dealt with this as a team, working professionally with outside agencies to ensure that the well being and safety of residents, staff and visitors was upheld and promoted. Care Homes for Older People Page 23 of 28 Evidence: The staff spoken with said that they felt supported by the management structure of the home. Most residents were aware of whom the manager is and of her role in the home. The formal quality assurance and quality monitoring systems has enabled the management to objectively evaluate the service and ensure it is run in the residents best interests. The quality assurance results are audited and action taken to address any suggestions of improvement and the results are then made available to the residents and interested parties. There has been no change in the systems used in respect of the safekeeping of residents monies. The home maintains personal monies for some residents. Records of all transactions are kept and receipts are obtained for services provided or items obtained on behalf of residents. Monies are held in a separate interest bearing account BUPA has devised a system to distribute interest proportionately. The home sometimes retains small items of importance on behalf of residents and records of the arrangement are kept. Staff supervision was discussed and staff supervision has been maintained ensuring that all staff are appropriately supervised. Staff spoken with confirmed that they receive supervision. All staff receive the mandatory training in moving and handling, health and safety and fire safety and there is evidence of a rolling plan of training that ensures that all staff are competent to perform their role in the home. It was confirmed that all staff are appropriately supervised until they have received the necessary training and induction. Mrs Sowerby confirmed and the staff training records show that all staff are kept updated on the Health and Safety policies. The manual is available to all and clearly defined with regularly updated policies and procedures and best practice guidelines. This ensures that the health, safety and welfare of the people using the service are both protected and promoted. As discussed the dates of the last review need to checked with the operations manager. The home have developed environmental risk assessments which protects residents from harm whilst enjoying the facilities of the home. The accident book was viewed and evidenced that staff record incidents and accidents Care Homes for Older People Page 24 of 28 Evidence: and then cross reference them with individual residents care plan to form an action plan in case of a re occurance. Care Homes for Older People Page 25 of 28 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 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 27 of 28 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. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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