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Inspection on 17/05/10 for Blackwell Vale Nursing Home

Also see our care home review for Blackwell Vale Nursing Home for more information

This is the latest available inspection report for this service, carried out on 17th May 2010.

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

The manager makes sure that all those wishing to move into Blackwell Vale have a full assessment of their health and social care needs before offering them accomodation. All prospective residents and their families are invited to the home to look round, meet the staff and speak to the people already living there. This gives an opportunity for people to decide if Blackwell Vale is the place in which they would like to live. Every resident has a detailed plan of their health and social care needs. This is developed from the initial assessment of needs and with the help of the resident and family members if appropriate. The care plans provide staff with clear information and guidance about meeting the needs of each resident. Comments received from people living in the home included; `The staff are lovely and so kind`. All the girls look after me well and I see Helen (manager) most days`. I like my room and living in the home`. We have a good cook and I enjoy my meals`. We spoke to members of staff during our visit and they said they enjoyed their work and that, `on the whole it was a good place to work`. They also agreed that they received good support from the manager. One of the visitors told us his wife had recently moved in and he was `very happy with her care`. He told us the the staff had been very helpful when she moved in and had helped her to settle down. We received survey forms back from social and health care professionals and the comments included; `The home works well in partnership with our service and endeavours to cater to individual needs and likes. They try to ensure meaningful activity is maintained`. (Care home liason nurse) `I have always found Helen, the manager, and her staff have utter respect for all their residents and empathy as well. They do their best to ensure a great equality of care for all`. (Student social worker) We found that medication is handled correctly and safely and all the records were up to date. During our visit we spoke to one of the visiting doctors. He told us that `this home is one of the better ones I visit and the manager works extremely hard`. Staff are recruited safely and are supported in their work through regular supervision and relevant training. There is a stable staff team, with many having worked at the home for a number of years. This helps residents to receive consistent and reliable support from staff they know well.

What has improved since the last inspection?

During the last key inspection we made some statutory requirements about the environmental standards within the home. Part of this inspection was to undertake a tour of the building to ensure these requirements had been met. On this occasion we found that all of them had been met satisfactorily. Two new `state of the art` baths had been installed and were fully functional. One bathroom had been completely refurbished, including new tiles and sanitary ware. The other was almost complete with the manager only having to hang pictures and place ornaments. Tiling and fittings here had also been replaced. The shower facilities have been renewed and were now fully usable. This will ensure that the total bathing experience for all residents is greatly improved. Two sluices have been purchased are are now in place. Carpeting has been ordered for the first floor lounge and one of the bedrooms and internal decorating is in-going. Finance has been made available for the garden area to be made suitable for residents to use and the manager is just waiting for a start date. Care plans have become more person centred and staff have become more flexible in their approach to care. Residents` falls are being more closely monitored to identify patterns in an effort to reduce the number. Activities, particularly in the dementia care unit have improved in order to help with independence and well being. The complaints procedure is now displayed in every bedroom and available in different formats to suit different needs. Work practices are regularly audited by the manager and senior staff.

What the care home could do better:

It was recommended that the manager should continue trying to recruit a deputy manager to join the senior team as this appointment would help her and enhance the management team. There were no requirements and only one good practice recommendation made as a reult of this inspection and we believe the manager will continue with the improvements already in place.

Key inspection report Care homes for older people Name: Address: Blackwell Vale Nursing Home Rear 61 Durdar Road Carlisle Cumbria CA2 4SE     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: Margaret Drury     Date: 1 7 0 5 2 0 1 0 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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: Blackwell Vale Nursing Home Rear 61 Durdar Road Carlisle Cumbria CA2 4SE 01228512456 01228810994 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): www.fshc.co.uk Laudcare Ltd (a wholly owned subsidiary of Four Seasons Health Care Ltd) Name of registered manager (if applicable) Mrs Helen Joyce Smallbone Type of registration: Number of places registered: care home 60 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The registered person may provide the following category/ies 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: Old age, not falling within any other category - Code OP (maximum number of places: 28) Dementia - Code DE (maximum number of places: 32) The maximum number of service users who can be accommodated is: 60 Date of last inspection Brief description of the care home Blackwell Vale Care Home is owned by Four Seasons Health Care Limited and is located on the outskirts of Carlisle near to the racecourse. There is a bus stop nearby and ample car parking is provided. The home is divided into three areas with the ground Care Homes for Older People Page 4 of 28 Over 65 0 28 32 0 1 0 0 8 2 0 0 9 Brief description of the care home floor providing nursing care for service users within the category of registration of Older People. The second floor accommodates and provides nursing care for people with Dementia. The home was purpose built and each unit has its own lounge and dining room. There is a conservatory and two other lounge areas on the ground floor. Fees payable at the home vary according to the level of care required and can be discussed with the manager. There are additional charges for hairdressing, private chiropody, personal newspapers and magazines, toiletries and taxis for personal travel. The home makes information about its services available through its own brochures, its service user guide and statement of purpose. These are available within the home. This home does not provide intermediate care. 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: This was a main or key inspection following on from a random visit on the 21st of January this year. The assessment of this service takes into account all of the information we have received from previous inspections and annual service reviews. The inspection included a visit to the home to look at a variety of records the home is required to maintain and to check if the requirements made during the last key inspection had been met. Part of our assessment of the service was to send out survey questionnaires and comments from those surveys are referred to in this report. During our time in the home we spoke with the manager, care staff , catering staff, visitors and a visiting doctor. The manager had completed an annual quality assurance assessment (AQAA) and returned it to the Care Quality Commission (CQC) within the required timescale. The AQAA provides us with information about the service and helps us to check the information gathered during our visit. Care Homes for Older People Page 6 of 28 Care Homes for Older People Page 7 of 28 What the care home does well: The manager makes sure that all those wishing to move into Blackwell Vale have a full assessment of their health and social care needs before offering them accomodation. All prospective residents and their families are invited to the home to look round, meet the staff and speak to the people already living there. This gives an opportunity for people to decide if Blackwell Vale is the place in which they would like to live. Every resident has a detailed plan of their health and social care needs. This is developed from the initial assessment of needs and with the help of the resident and family members if appropriate. The care plans provide staff with clear information and guidance about meeting the needs of each resident. Comments received from people living in the home included; The staff are lovely and so kind. All the girls look after me well and I see Helen (manager) most days. I like my room and living in the home. We have a good cook and I enjoy my meals. We spoke to members of staff during our visit and they said they enjoyed their work and that, on the whole it was a good place to work. They also agreed that they received good support from the manager. One of the visitors told us his wife had recently moved in and he was very happy with her care. He told us the the staff had been very helpful when she moved in and had helped her to settle down. We received survey forms back from social and health care professionals and the comments included; The home works well in partnership with our service and endeavours to cater to individual needs and likes. They try to ensure meaningful activity is maintained. (Care home liason nurse) I have always found Helen, the manager, and her staff have utter respect for all their residents and empathy as well. They do their best to ensure a great equality of care for all. (Student social worker) We found that medication is handled correctly and safely and all the records were up to date. During our visit we spoke to one of the visiting doctors. He told us that this home is one of the better ones I visit and the manager works extremely hard. Staff are recruited safely and are supported in their work through regular supervision and relevant training. There is a stable staff team, with many having worked at the home for a number of years. This helps residents to receive consistent and reliable Care Homes for Older People Page 8 of 28 support from staff they know well. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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. People using this service have their health and social care needs assessed prior to moving in to Blackwell Vale. This helps to ensure that the home will be suitable and able to meet their needs appropriately. Evidence: The home has a comprehensive admissions process and the manager and staff work hard to ensure the admissions procedure is as relaxed as possible for those moving in. All prospective residents are fully assessed before an offer of accommodation is made. The manager also takes into account the needs of those already living in Blackwell Vale when completing her assessment. The manager obtains copies of assessments that have been carried out by social workers or health care professionals. This information helps to ensure that Blackwell Vale will be suitable and able to meet the assessed needs in a way that is acceptable. Relatives we spoke to confirmed they were invited to look around the home to meet Care Homes for Older People Page 11 of 28 Evidence: the staff and view any vacant rooms before deciding, with their family member, whether or not to take the offer of accommodation. 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. People using this service receive care and support based on their individual needs and expectations, taking into account their rights and choices. Evidence: During our visit to Blackwell Vale we looked at a sample of care records that detail what the assessed needs are and how these are to be met. Each resident has a plan of care outlining their individual needs and giving the care staff sufficient information to provide the appropriate level of care and support. Personal information about people living in the home is carefully recorded and stored securely. Staff have prepared, with the help of families, a pictorial life history of each of the residents that is kept in their rooms. It is their life story in pictures and can be used as a reminiscence activity. We were able to look at three of these and found them to be exceptionally good. The manager told us that residents can find these very therapeutic to look at and is always a good topic of conversation. All the care plans were up to date and are reviewed at least every month, more often Care Homes for Older People Page 13 of 28 Evidence: if there is a change in circumstances or dependency level. it is, generally, the responsibility of the trained staff to review and update the care plans but the manager is currently allowing some of the key workers to update relevant parts of the plan. Care plans are discussed in order that all the staff are kept up to date with information about the residents, which means that the care and support provided is appropriate. Staff told us that they work well as a team and, in the main, Blackwell Vale was a nice home to work in. Care plans contained information about personal preferences, risk assessments and nutritional needs. Details about professional health care intervention when required is recorded. This includes doctors visits and input from, chiropodists, dentists and opticians. Nutritional screening is undertaken and weights recorded. The catering staff are aware of any special dietary needs and prepare meals accordingly. Access to mental health professionals is also available when required and the manager works closely with the social workers when necessary. The new clinical room is now complete and provides safe storage for all medication and the relevant records. The qualified staff agreed that it was much better knowing that all medication was stored in one secure space. There are policies and procedures in place with regards to the receipt, storage, administration and disposal of all medication. All relevant staff are provided with training to ensure all medication is handled correctly. All records are audited daily when staff administer medication and the manager also audits the records on a regular basis. These processes help to ensure the safety of those living in Blackwell Vale. We did look at a sample of the medication records kept at the home and found that the medication needs corresponded with those written in the care plans. A photograph of each resident is attached to the individual record as a further safety measure and reduces the risk of medication errors. If medication is prescribed mid month for any reason, this is entered on to the records and countersigned by 2 people to ensure the details entered are correct. We were able to speak to one of the visiting doctors during our time in the home. He spoke very highly of Helen, the registered manager and was pleased to tell us that, in his opinion, Blackwell Vale was one of the better homes he visited. Observation during our visit evidenced that the staff treated the residents with dignity and had a very good rapport with all those living in the home. There was a warm and friendly atmosphere in both units and staff were seen providing care and support in an acceptable manner. Care Homes for Older People Page 14 of 28 Evidence: End of life care is provided through The Liverpool Care Pathway and staff receive training from the manager to enable them to provide the right level of care at what can be a very difficult time. Care Homes for Older People Page 15 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. People living in Blackwell Vale are able to participate in a variety of social and leisure activities if they choose. Routines are sufficiently flexible to allow residents to enjoy maintaining contact with relatives and friends. Evidence: The routines within Blackwell Vale are sufficiently flexible to allow a relaxed lifestyle for those living there. There is no set time for rising or going to bed and some people were having a lie in when we arrived to start our inspection. There is always something going on as the home employs 3 PALs- Personal Activities Leaders- who spend time organising activities throughout the week, one of which is preparing the life history files of all the residents. The weekly/monthly activity programme has been developed following discussions with the residents and there are copies of the programme displayed in various places. Outings are arranged for groups or on a one to one basis and we observed staff taking residents out on the day we visited the home. Some of the residents we spoke to told us that they could join in any of the activities but, if they preferred to sit and watch, there was no pressure to join in. Some Care Homes for Older People Page 16 of 28 Evidence: residents like to remain in their rooms to listen to their radio or watch television and some were reading their newspapers. On the day of our visit there was enough staff to spend time with the residents chatting to them or taking them to the hairdressing room. Visitors are welcome in the home at any time and we were able to speak to one gentleman who was visiting his wife who had recently come to live in Blackwell Vale. He told us he was very happy with the care his wife was receiving and that she had improved since she was admitted to the home. He said the staff were very good indeed and that he was able to speak to the manager at any time. One of the residents who is a retired minister conducts a regular church service in the home and visiting clergy come to give communion to those wishing to take it. There is a 4 week menu that is on display on the dining room tables. They showed a variety of nutritious food with a choice at each meal. We spoke to the cook who has worked at the home for 16 years and really enjoys her job. She does speak to the residents on a regular basis to see if there are any preferences that are not met and menus are also discussed during residents meetings. Special diets are catered for and the nutritional screening showed that the weight of each resident was fairly consistent. We observed lunch being served and found it to be relaxed with assistance, when required, given in a dignified manner with staff being sensitive to the needs of those residents they were assisting. 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. Those living in Blackwell Vale know any concerns raised will be listened to and acted upon. They are protected wherever possible at all times. Evidence: Blackwell Vale has a comprehensive policy for dealing with any complaint or concern raised and there is now a copy of this located in every bedroom as well as other parts of the building. It is available in different formats and languages and the manager is hoping to produce a pictorial complaints flowchart for display in the dementia unit. This will ensure that everyone is aware of how to make a complaint knowing that it will be listened to and acted upon. All complaints are investigated and dealt within the timescale set down in the organisational policy. Residents and visitors we spoke to during our visit all confirmed that they had never had a reason to complain but would not be afraid to speak to the manager. There is a complaint log in place but there has only been one to record that had already been settled. The manager had notified the Care Quality Commission about this matter. There were no complaints recorded on the returned survey forms received prior to our visit . The manager has an open door policy and residents and visitors alike know they can approach her at any time to discuss any concerns they may have. There have been a number of referrals made to Adult Social Care regarding incidents between residents and the manager always ensured she notified CQC about all of Care Homes for Older People Page 18 of 28 Evidence: these incidents. They have all been dealt with correctly with the necessary input from social work and adult protection teams. Staff have completed training in safeguarding of vulnerable adults and the care staff we spoke to during our visit were aware of their roles and responsibilities in reporting any incidents. Training in aggression also helps staff to be able to diffuse any potential incident and prevent it from escalating. Care Homes for Older People Page 19 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. The home is now maintained to a good standard and people living in Blackwell Vale are provided with accommodation that is warm safe and comfortable. Evidence: Blackwell Vale is a purpose built care home with accommodation over two floors, the upper storey being accessed by a passenger lift. Residents with various forms of dementia live on the upper floor and residents who are physically frail live on the ground floor. There are dining and lounge facilities on both floors and there is further communal space in a conservatory also on the ground floor. At our last key inspection we made three statutory requirements regarding necessary improvements to be made to the environmental standards withing the building. As part of this key inspection we toured the building with the manager to see if these requirements had been met and in all instances they had. Two new state of the art assisted baths have been installed and are fully functional. One bathroom is now completely re-furbished and the other will be complete when the pictures have been hung and ornaments put in place. Residents can now enjoy the experience of taking a bath in much more pleasant surroundings. Work to improve the shower facilities on both floors has also been completed. Two new sluices have been purchased and are now functioning. Care Homes for Older People Page 20 of 28 Evidence: New carpeting has been ordered for one of the bedrooms and the first floor lounge and internal decorating is ongoing. The clinical room on the first floor is now complete and means that all medication and records are safely and securely stored. The qualified staff we spoke to agreed that the facilities for storing medication were much improved. We looked at a sample of residents rooms and found them to be suitable, if rather small in some instances. Not all of the rooms have en-suite toilets but there are plenty of toilet facilities in the home situated near where the residents spend their time. All the rooms we looked at were nicely furnished and personal to each individual with items brought from home. Residents told us they were pleased with their accommodation and remarked that they were always kept clean. People who may have problems with mobility are well supported by the provision of hoists, toilet and bathing aids and handrails throughout the home. Corridors are wide enough to facilitate wheelchairs which adds to the mobility of any resident that may have difficulty walking around the home. As there are no shared rooms in Blackwell Vale privacy and dignity are ensured at all times especially when personal care is being given. The home employs 3 domestic staff and the housekeeper ensures the home is clean and sweet smelling at all time. This was certainly the case on the day of our visit. Protective clothing is available for all staff which minimises the risk of cross infection. Laundry facilities are situated in an external building well away from the kitchen and food preparation area. Work has started on the garden area of the home and the services manager for the organisation told us that money had been made available to continue with the work until it is finished. The manager is just waiting for a date when the remaining work will start. Care Homes for Older People Page 21 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. Those living in Blackwell Vale are supported and cared for by the staff team that is trained and experienced. Evidence: We discussed staffing levels with the manager, who always tries to ensure she has sufficient staff on duty to meet the needs of those living in the home. During the day there are usually 2 qualified nurses and 9 carers between the two floors. This is reduced to 2 qualified nurses and 5 carers through the night. the largest number of carers being deployed on the dementia unit. The home also employs 3 domestics, 3 activity co-ordinators, 1 maintenance manager, 1 laundry assistant, 2 cooks and a kitchen assistant. In addition there is the registered manager and the administrator. The staff provide a variety of skills and experience and the manager ensures her deployment of staff is best suited to the home and the needs of the people living there. There is a robust recruitment and selection policy with the manager responsible for administering it. All applicants for positions in the home must complete an application form, supply the names of two referees, one being their current employer, and then attend for interview. No new member of staff starts work without the required legal checks being completed and all staff have enhanced Criminal Records Bureau checks in place. Care Homes for Older People Page 22 of 28 Evidence: Staff training is ongoing with 50 of the care staff having completed NVQ training in care at level 2 with a further 4 just having completed the award. Much of the staff training is organised through Four Seasons training department and courses completed include, manual handling, infection control, care of medicines, fire safety including updates and safeguarding of vulnerable adults. Dementia care training had been completed shortly before our visit. We saw evidence that staff put into practice their training when caring for those people living in the home. There was a warm atmosphere and staff had a very good rapport with all the residents. Care Homes for Older People Page 23 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. Effective management and quality monitoring help safeguard people using this service. Procedures are in place to promote their interests and promote their health and safety. Evidence: Blackwell Vale is well managed by a qualified and experienced manager who always has the best interests of the residents at heart. She has managed the home for some time and is registered with the Care Quality Commission. Since her appointment she has worked hard to ensure the home is run in an open and positive way. Staff told us that she is always available to speak to and residents told us that they see her often around the home. A relative visiting the home told us she was very helpful when his wife was admitted to the home. There are few, if any, of the residents able to manage their financial affairs and so the home does hold small amounts of personal monies for residents. Monies are held Care Homes for Older People Page 24 of 28 Evidence: securely with well kept records showing cash received or spent. Each transaction is checked and signed by 2 members of staff as an added safeguard. Four Seasons has a policy and procedure in place to ensure all money is handled correctly and accurate records are kept. The manager completed the Annual Quality Assurance Assessment when we requested it. She included information about the home, in particular where improvements had been made and also any plans she may have for the future. Quality audits are completed annually and the overall result of the latest one completed in December of last year showed 88 satisfaction with the service provided. Three monthly health and safety meetings are held and minuted for reference. Actions to address any problems are put in place as soon as possible. Residents and staff meetings are held to discuss the running of the home. All equipment is maintained through annual service level agreements. All risk assessments are in place and reviewed on a regular basis. The maintenance manager works closely with the regional estates team to maintain the upkeep of the home. We looked at the way in which staff are supervised and supported in their work. All staff meet with their line manager every 2 months to discuss their personal and professional development. 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 1 32 It is recommended that the manager continues to look to appointing a deputy manager to assist her with the running of the home. 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. 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