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Inspection on 25/01/10 for Brockhampton Court Nursing Home

Also see our care home review for Brockhampton Court Nursing Home for more information

This is the latest available inspection report for this service, carried out on 25th January 2010.

CQC found this care home to be providing an Excellent 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

People have their needs checked to help make sure these can be met by the home. They feel well looked after and staff understand how important it is for people to be treated as individuals and with respect for their dignity. People have lots of choice about how they spend their time and are offered the chance to take part in a wide range of activities. They are supported to have regular contact with their families. The food is good and provides a healthy, varied diet that takes people`s preferences and needs into account. People living at Brockhampton Court feel safe. They know how they can raise any concerns they may have. Managers and staff are trained to know what they must do if it is felt that someone may have been abused or neglected in any way. Brockhampton Court is an imposing but welcoming building in attractive surroundings. The house is well maintained and comfortable. The staff are well trained and caring . There are usually enough staff to make sure people get the attention they need. The right checks are done when staff are employed to reduce the risk of anyone unsuitable getting a job at the home. The home is managed well and people feel valued and respected.

What has improved since the last inspection?

No areas for improvement were highlighted at our previous inspection.

What the care home could do better:

Brockhampton Court is a well managed home providing an overall high standard of care. When shortfalls are found the manager recognises this and takes action to put things right. We highlighted a small number of care matters which need attention; these related to some gaps in care records and information for staff when people are prescribed `as required` medication. In respect of the premises we have recommended that the heating in some areas is improved and that the electrical wiring check is renewed.

Key inspection report Care homes for older people Name: Address: Brockhampton Court Nursing Home Brockhampton Court Nursing Home Brockhampton Herefordshire HR1 4TQ     The quality rating for this care home is:   three star excellent 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: Denise Reynolds     Date: 2 5 0 1 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: Brockhampton Court Nursing Home Brockhampton Court Nursing Home Brockhampton Herefordshire HR1 4TQ 01989740239 01989740289 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Dr Christopher John Allen Name of registered manager (if applicable) Mrs Joanne Debra Parker Type of registration: Number of places registered: care home 58 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 58 The registered person may provide the following category of service only: Care Home with Nursing (Code N) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 58 Physical disability (PD) 58 Date of last inspection Brief description of the care home Brockhampton Court is a Grade II listed building set in six acres of attractive landscaped gardens including paths and seating so people can go outside and enjoy the surroundings. It is in the village of Brockhampton, midway between Hereford, Ledbury and Ross-on-Wye. There is a village post office. Public transport is limited with a local bus which goes to Hereford one or two times a week. The Home provides a car Care Homes for Older People Page 4 of 28 Over 65 58 0 0 58 Brief description of the care home driven by a member of staff to take people out. The owner is registered in respect of the home to provide care and nursing for up to 58 people. The home provides a service to people who have health and personal care needs due to the ageing process or because they are in poor health due to a specific illness. There is a passenger lift to all floors. Information about the fees for the home and the service user guide should be obtained direct from the service. 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: three star excellent 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: One inspector spent a day at the service for this inspection. During our inspection we spent time observing day to day life, speaking to people who live there, visitors and some staff. We also looked at a range of essential records needed to support the care of people and the overall safety and management of the service. The focus of our inspection was to look at the outcomes for people who live at Brockhampton Court and to find out what they think about their care. To help us with this we looked in detail at the care of two people. This included observing some aspects of their care, looking at care records and where possible, speaking with them. We were joined for this inspection by an Expert by Experience. Experts by Experience are people who have first hand experience of care services because they or a relative has used them. The Expert by Experience spent several hours at the home and spoke to staff and people who live there as well as looking around the building, seeing what Care Homes for Older People Page 6 of 28 the food was like and what was happening during the day. They then told us what they found and gave us a written report which we have taken into account and quoted in this report. Some months previously the service had sent us their Annual Quality Assurance Assessment (AQAA). This is a self assessment tool which services use to describe what they do well, what they need to do better and what their plans are for improvement in the coming year. At this time we also sent surveys to some people using the service, their relatives, some staff and some health and social care professionals. We used all of this information to help us build a picture of the quality of the service people at Brockhampton Court are receiving. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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 8 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 9 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 who move to Brockhampton Court have their needs checked to help make sure these can be met by the home. The information is developed as staff get to know more about a person and the care they need. Evidence: People who sent surveys back to us confirmed that they had been given the information they needed to help them decide if Brockhampton Court would be the best place for them to move to. The manager goes to meet people and their families before they come to the home to find out about the care and support they will need. Copies of assessment information is obtained from funding authorities to help build a full picture. This helps to make sure that people are not offered a place if the home is not suitable for them. People thinking of moving to the home have the chance to visit and spend time in the Care Homes for Older People Page 10 of 28 Evidence: home to help them decide if they wish to move there. On the day we inspected we observed the morning staff handover. During this there was a detailed discussion about a person who had moved in recently. The discussion showed that staff were familiar with the persons care needs and that they were working as a team to deal with a specific care need. We met the person and they told us they were pleased with how their move to the home had gone and that the staff were being good to her. The information in the initial assessment was echoed in the staff discussions and our observations of the care the person was having. We saw daily records that showed staff are aware of the need to help people settle when they first arrive at the home. We noted that the written information in two pre-admission assessments and initial care plans did not cover everything to do with the care of the people concerned. The manager explained that they like to develop the written information over a period of a few weeks as people settle in and their needs become clearer. While the outcomes for the two people appeared positive it is important that the hands on care and verbal communication is well supported by clear written information. Care Homes for Older People Page 11 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Brockhampton Court have attentive care from staff who understand how important it is for people to be treated as individuals and with respect for their dignity. Evidence: Each person living at Brockhampton Court has a written plan for their care based on their individual needs. The care plans are laid out so they are easy to refer to and include information about any risks specific to individual people. We saw an example of how staff had carefully balanced a persons wishes with the possible risks and found ways to reduce these so the person would be safe but not have their right to choose curtailed. The care plans we looked at included important things such as nutrition, moving and handling and pressure area care. We saw that most information is reviewed regularly although we found some examples where information had not been updated recently. The manager told us that recent internal checks had identified areas where the written information needed to be improved. She and the owner had acted on this by allocating a senior member of staff Care Homes for Older People Page 12 of 28 Evidence: to a new role as a staff mentor with oversight of care provision and care records. The staff handover we observed provided good evidence that staff discuss each persons care needs at least daily and that this is a two way process between staff and the manager. There was a detailed exchange of information about how people were and specific people took responsibility for making sure things were dealt with or checked. The effective communication was illustrated well by this comment in a staff survey I like it when we dont understand something, matron always finds a way of making us understand. She gets it across to us, especially to me as Im doing my NVQ at the moment. Information in the surveys from people and their families gave a generally positive view. In answer to questions about getting the right care and staff being available when needed people answered that this always or usually happened. People considered they always get the medical attention they need. Most comments were positive eg I just feel very lucky that the frail old lady I brought here has improved so much and has enjoyed so much her daily life. Very good care. I feel confident in the care and attention I receive. One comment was made about staff not always answering the call bell quickly at busy times and that there is sometimes a wait for help to wash and dress. However, this person added With the exception of this there is little room for improvement. A happy, well run home. A relative wrote - My family and I are so grateful we found Brockhampton. Its an outstanding care facility and we have no concerns over the level of care my mother receives. I cannot praise it enough. An equal proportion of people said either always or usually to our question about staff listening to them and acting on what they say. During the inspection everyone that we and the Expert by Experience spoke to were positive about the attention and approach of staff and none raised any concerns. Care Homes for Older People Page 13 of 28 Evidence: The home has made a committment to providing a high standard of end of life care and at the time of our inspection was hoping to shortly achieve the Gold Standard Framework award. The home has good arrangements for the management and storage of medication. Medication records are well kept and a member of staff has delegated responsibility for monitoring and auditing the medication systems. This includes effective stock control systems. During our inspection we did a spot check of one persons medication and this balanced accurately against the homes records and stock. We noted that the home does not have written guidance describing the circumstances when as required medication should be used. This information should be available to help make sure that staff have the information they need. Throughout the inspection we saw and heard staff being polite and caring in their contact with people. We saw that staff always knocked on doors and waited to be invited in before opening doors. The Expert by Experience gained a very positive view of the quality of the service and observed the sensitive care being given to a family whose relative was very unwell. She reported to us, The outstanding feature of this home is its warm friendly atmosphere manifested by the very obvious efforts made to build an appropriate package which reflects the often very complex needs of the clients AND Care is administered by all levels of staff in a dignified professional manner. She also observed that All the residents were well groomed wearing their own freshly laundered clothes. 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 excellent 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 Brockhampton Court have a choice about how they spend their time and are offered the chance to take part in a wide range of activities. People are supported to have regular contact with their families. People have a healthy, varied diet that takes their preferences and needs into account. Evidence: People and their families gave us a positive view of daily life at Brockhampton Court. Lots of varied activities are provided and people are free to choose which they take part in. These include music and movement, access to the large gardens, a scrabble club, regular film shows, and events to celebrate seasonal and religious occasions during the year. The staff find out peoples views at regular meetings where they are asked what they think about things like the food, activities and things to do with the building. Routines are very flexible and residents can make choices in all areas of their life. People are actively encouraged to keep in contact with family and friends living in the community. The staff make visitors welcome and people can have their family join them for a meal if they choose. In one survey a person told us how appreciative they are that they can visit for lunch with their spouse every day. Care Homes for Older People Page 15 of 28 Evidence: Peoples answers in our surveys showed they always or usually enjoy the food. We saw part of a mealtime and observed that the dining room was a pleasant room and that tables were laid attractively with nice china and glass. The mealtime was very sociable with a buzz of conversation between people and with staff. There were enough staff to give people the help they needed and some staff were allocated to help the people in their rooms who need support to eat. We saw that there was good information available for kitchen staff about the individual preferences and dietary needs of people. The expert by experience also gained a positive view of the range and quality of things for people to do, she reported Every avenue of possibility is explored when devising imaginative outlets for the residents. One resident was eagerly awaiting the delivery of a personal computer. Care Homes for Older People Page 16 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. People living at Brockhampton Court feel safe and know how they can raise any concerns they may have. Managers and staff are trained to know what they must do if it is felt that someone may have been abused or neglected in any way. Evidence: People living at the home, their families and staff know that there is a complaints procedure and what to do if someone has a concern about something. The responses from relatives showed that their concerns had always been dealt with to their satisfaction. There is a complaints procedure and this is given to people when they come to the home. People we spoke to said they feel safe and would have no concerns about speaking to the manager or staff if something was bothering them. The home has received few complaints and these have been recorded to show the action taken and the outcomes. We saw a polite explanatory letter to a person who had made a complaint showing their concerns had been taken seriously. Staff working at the home are given training by the manager about adult safeguarding processes so that they will know what to do if they think that someone may have been neglected or abused. We discussed a situation with the manager involving an incident that had been dealt with by her through internal enquiries and resolved. The manager said she was clear that the matter had not needed to be referred to the multi-agency safeguarding process. The manager showed a good understanding of the importance Care Homes for Older People Page 17 of 28 Evidence: of whistleblowing and believed that staff at the home would all follow this path if they had concerns. Both the manager and deputy have done the safeguarding training for managers provided by Herefordshire Council. Throughout the inspection we observed open and relaxed communication between all staff and with the manager who was readily available to people living at the home and to staff throughout the day. Having spent a lot of time speaking to people in the home and to staff the expert by experience drew the conclusion that The home provides a safe, caring environment for its elderly residents. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Brockhampton Court have attractive surroundings that are safe, well maintained and comfortable. Evidence: People living at Brockhampton Court are encouraged to make their own room as individual to them as possible by having familiar things around them. The house is well maintained and safe. The communal rooms and peoples own rooms are warm, clean and comfortable. If people need equipment to help make sure they are cared for safely and comfortably this is provided, for example hoists and variable height beds are used for people who need them. The size of individual bedrooms exceeds the national minimum standard and the rooms have on-suite facilities. Furniture and decor is of a high quality and helps create pleasant surroundings for people to live in. One person we spoke with in their bedroom told us how much she liked it and that she appreciates the layout which gives her a separate sitting and bedroom area. There are several different places for people to spend their time so they can choose where they want to sit. There is also plenty of room for group activities in what used Care Homes for Older People Page 19 of 28 Evidence: to be the ballroom of the house. This means people do not have activities forced on them if they prefer to sit quietly in one of the other rooms. There is good provision of bathrooms and toilets around the home in addition to the ensuite toilets attached to the bedrooms. All the rooms we went into during the inspection were clean and most were warm. We noticed two areas that were chilly; a sitting room by the entrance hall and an area leading into the conservatory style room in the newer part of the building. The manager explained that no-one goes into the sitting room in the morning and so the heating does not need to be on. We suggest that not having the heating on would deter someone who may like to sit there earlier in the day and that consideration should therefore be given to heating it all day. The other area was close to a short corridor linking the old and new parts of the house. A solution needs to be found to improve the heating and/or insulation in this area to make it warmer. The management has a an infection control policy, clinical waste is properly managed and stored and their are supplies of disposable protective clothing for staff to use when helping people with personal care. Call bells are left within reach of residents and these are responded to promptly. The management monitors the effective function of the system. 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. People who live at Brockhampton Court are looked after by well trained and caring staff. There are usually enough staff to make sure people get the attention they need. The right checks are done when staff are employed to reduce the risk of anyone unsuitable getting a job at the home. Evidence: People who sent surveys to us said they like the staff and made comments such as Staff are friendly. Staff always happy and positive. Friendly staff, proficient in what they do. During the inspection we observed that staff behaved in a calm and professional way and were friendly, caring and respectful when they dealt with people who live at the home. Staff recruitment procedures are well organised and the correct checks are done before someone starts work at the home. If people start before their CRB check arrives this is only on the basis of having a satisfactory ISA check and they are fully Care Homes for Older People Page 21 of 28 Evidence: supervised during this period. Checks of registered nurses PIN numbers are done before they start work and then periodically afterwards. The staff team is well organised into teams that work in the different parts of the house. At the staff handover each morning the manager or senior on duty checks that everyone is aware of what they need to be doing and that specific tasks are allocated to a named member of staff. This is a good way to help make sure that things are not overlooked. The number of staff on duty showed that the home has good core staffing levels. However, comments in a small number of surveys highlighted that at times people need to wait longer than they would wish to for help and that staff feel they would like more time to spend talking with with people who are very unwell. Staff are encouraged to do the training they need to be competent in their roles. Most of the care staff have completed an NVQ level 2 qualification and a number are doing NVQ level 3. The range of training organised covers mandatory topics such as first aid and moving and handling as well as care and nursing related subjects. The manager and deputy explained that they link with the local hospice for much of their palliative care related training. One staff member confirmed in their survey that first aid, moving and handling, health and safety and fire safety training is updated every twelve months and others also listed recent training they have done. The information in the staff surveys showed that staff consider their induction and ongoing training supports them to do their jobs well. Staff provided extensive and thoughtful feedback to us in their surveys and in doing so illustrated their understanding of what good care involves. The following comments give an indication of some of the things staff wrote Information is cascaded to care teams at all levels which ensures the smooth running of the home An induction period is effective (way of ) ensuring that all staff are fully informed and understand their role. The number and length of comments made by staff mean we can only give an overview of these. Staff gave a picture of being happy and proud to work at the home and of being well trained, valued and supported by the manager. 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 excellent 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 Brockhampton Court benefit from a well managed service where management and staff work together effectively to create a safe, caring and friendly environment. Evidence: The registered manager is a qualified and experienced professional who is committed to providing a high quality service at Brockhampton Court. She has a firm grasp on all aspects of how the home operates and knows all of the people who live there well. A part time administrator is employed to support the manager, including providing a reception service. We saw that this was effective in making sure visitors and phone calls were dealt with promptly during the day without staff being distracted from their care work. We observed that the manager communicates with staff in a firm but friendly way and has clear expectations that everyone must contribute to making sure people at the home are well cared for. The staff surveys showed that the staff team hold the Care Homes for Older People Page 23 of 28 Evidence: manager in high regard and feel valued and supported by her. As we explained in the staffing section, staff gave us so much information that we can only give a flavour of what they told us but some of their comments included It is a first class home with a first class matron to run it. One and only best employer I have ever had with all the support and appreciation for each of us - well done. Residents and family are treated openly and with respect. The owner and manager use various ways to monitor standards at the home. These include meetings for staff and people who live in the home and the use of structured quality assurance methods. Dr Allen produces regular reports about standards in the home and for the last three years has used an external consultant to carry out a full quality assurance audits. We saw the results of the 2009 audit which showed that the home had scored very highly in all areas using information gathered by the consultant from people living at the home and their families. If people are able to they are encouraged to deal with their own finances and money. If people are not able to do this the home asks families to take responsibility. The home does not look after peoples personal spending money. Maintenance records were available to check and these showed that keeping the building safe is given high priority. The 5 yearly check of the electrical wiring was overdue and needs to be arranged. The home has a 4 star (very good) rating from Herefordshire Council in respect of food hygiene. One person who lives in the home wrote in their survey The general management is very satisfactory. Dr Alan is a very pleasant director and the matron is in our opinion very warm and very competent and maintains a high standard and sets an example to the staff who, with very few exceptions are always bright, cheerful and willing. and comments from relatives included A well run happy place which could be used as a model of how it should be done! ........ Communication on all matters is first class. This surpasses all I could have wished for my dear mum. Care Homes for Older People Page 24 of 28 Evidence: Excellent services, care and setting supported by excellent management and staff. 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 2 It is important that the hands on care and verbal communication is well supported by clear written information to help staff provide consistent care. Written information should be available about the circumstances when as required medication should be given to the person it is prescribed for. All parts of the building which people living in the home use should be kept at a comfortable temperature. An electric wiring check in the building should be arranged to ensure that no maintainance work is required. 2 9 3 4 19 38 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). 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