Inspection on 29/04/09 for Eastfield

This is the latest available inspection report for this service, carried out on 29th April 2009.

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

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

Other inspections for this house

Eastfield 06/09/05

Eastfield 17/05/05

Eastfield 09/03/05

Eastfield 02/06/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

Key inspection report CARE HOMES FOR OLDER PEOPLE Eastfield 76 Sittingbourne Road Maidstone Kent ME14 5HY Lead Inspector Wendy Mills Unannounced Inspection 29th April 2009 10:30 DS0000023932.V375303.R01.S.doc Version 5.2 Page 1 This report is a review of the 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. 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. Eastfield DS0000023932.V375303.R01.S.doc Version 5.2 Page 2 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 Eastfield DS0000023932.V375303.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Eastfield Address 76 Sittingbourne Road Maidstone Kent ME14 5HY Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Category(ies) of registration, with number of places 01622 755153 01622 755153 david.titherington@njch.co.uk Bureaucom Ltd Mr David John Titherington Care Home 43 Dementia (0), Old age, not falling within any other category (0) Eastfield DS0000023932.V375303.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following Old age, not falling within any other category (OP) 2. Dementia (DE). The maximum number of service users to be accommodated is 43. Date of last inspection Brief Description of the Service: 8th May 2007 Eastfield is a residential care home providing personal care for up to forty three older people. The home is a large detached property situated on a main road approximately one mile away from the centre of Maidstone where there are shops, post offices, banks, pubs and restaurants as well as a bus station and two railway stations. There is a bus stop near to the home and Junction 7 of the M20 is about a mile away. The home has a large, open plan communal lounge and dining area and conservatory. The bedrooms are located on the ground and first floor. There is a shaft lift between these floors. Seven of the bedrooms offer double accommodation; some of these are currently being used for single occupancy. To the rear of the property there is an accessible, safe and secluded garden and patio area. There is parking for approximately six cars to the front of the home. The weekly fees, given on the day of inspection, range between £359 to £650. Additional charges are made for hairdressing, chiropody, newspapers and toiletries. Eastfield DS0000023932.V375303.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was unannounced and formed part of the annual inspection process of the newly formed Care Quality Commission (CQC). The inspection was carried out in accordance with the Care Standards Act and takes into account information we have gathered during this visit and information we have received prior to this visit. The information we have received prior to this visit includes information that the home that the home is required to give us, such as their Annual Quality Assurance Assessment (AQAA) and notifications about events that affect people who use this service; and things that we have been told about the service from other sources such as relatives comments and the views of visiting health and social care professionals. The evidence we have gathered during the inspection process will result in the home being given a stare quality rating. During this visit we examined important documentation such as care plans, written medication policies and procedures and staff files. We talked to five of the people who use this service, in the privacy of their own rooms and five others whilst making a tour of the home. We spoke to relatives and supporters both during the visit and in telephone conversations, spoke to three members of staff in confidence and discussed the service in depth with the registered manager. Telephone conversations were held with the area manager and the registered provider. We made a tour of the home and used direct and indirect observation throughout the time spent in the home. The people who use this service say that they would like to be referred to as, “Residents”. Therefore, this is the term that is used to refer to the people who use this service throughout this report. Residents and their supporters were generally very happy with their care and life in the home. There were some concerns about the deterioration in the way the home is maintained but we were assured by the registered provider that these issues would be dealt with as a matter of urgency. The quality rating for this home is 2 Stars. This means that the residents experience good outcomes in all aspects of their care whilst living in the home. What the service does well: The home provides a welcoming and homely environment with good access to safe and secluded gardens. The home provides prospective residents and their supporters with good information about the home. Eastfield DS0000023932.V375303.R01.S.doc Version 5.2 Page 6 The home caters for the diverse needs of the residents. This is reflected in the various aspects of daily life in the home. There is a good range of activities on offer, including celebrations of birthdays and significant festivals such as Christmas, Chinese and Jewish New Years. Residents described the meals as, “Delicious”,” Lovely”, and, “Wonderful”. The health and well being of the residents is positively promoted. Health care records are well maintained and care plans give clear direction as to health and personal care needs. The staff work well as a team and receive clear leadership and direction in respect of care needs from the head of care. The rights of residents are respected and their privacy and dignity is respected at all times. The home tries to involve residents and their supporters in the day to day running of the home. Residents said that their views are listened to and acted upon. What has improved since the last inspection? What they could do better: The home should review the flooring in the corridor leading to the kitchen, main office and some bedrooms and replace the existing carpet as a matter of urgency. This will reduce infection control and health and safety risks in the home. The home should review and risk assess the window restrictors on each window and ensure that windows open far enough to allow fresh air into the rooms whilst remaining safe for residents. The home should review the equipment stored in an alcove in the dining area to ensure it is all needed and should look at better ways of providing safe storage for essential equipment. Eastfield DS0000023932.V375303.R01.S.doc Version 5.2 Page 7 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. Eastfield DS0000023932.V375303.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Eastfield DS0000023932.V375303.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1&3 People using the 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 provides prospective residents and their supporters with the information they need to make an informed decision about moving into the home. Appropriate pre-admission assessments are made to ensure only those people whose needs can be met and who are suitable for the home are offered a place in the home. EVIDENCE: The home has a clear Statement of Purpose and Service User Guide. Residents said they had received good information about the home before moving in. The home’s Annual Quality Assurance Assessment (AQAA) told us that prospective residents are given a copy of the Statement of Purpose and Service User Guide. Since the last inspection the home has created a pictorial service user guide, which can also be used to help people with cognitive impairment understand more about the home. Where possible the prospective service user is invited to stay for a meal and given the opportunity to meet other residents. As much information as is possible is gathered so that that there is a comprehensive understanding of health care needs, likes and dislikes, interests and hobbies and other care needs. Eastfield DS0000023932.V375303.R01.S.doc Version 5.2 Page 10 New residents are encouraged to bring items from home so that they can personalise their rooms. They are given a pictorial welcome pack on admission. The care plans of the three most recently admitted residents were examined. There was good evidence that comprehensive pre-admission assessments had been carried out and that each had a clear care plan in place. Residents said that they had been able to visit the home prior to deciding to move in and that they and their relatives had been made welcome. The home does not offer intermediate care. Intermediate care is specifically aimed at those people who need further assessment and rehabilitation before a final placement is decided. It is usually funded by the local Health and/or Social Services Eastfield DS0000023932.V375303.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People using the 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 can be confident that the home will respect their privacy and dignity and promote their health and well being. EVIDENCE: All service users have a care plan in place identifying their specific needs and risks. Four care plans were examined and were seen to be up-to-date and in good order. Staff said that these are updated regularly and that where possible, residents are involved in this process. Care plans are important documents because they are one of the means by which people can be sure that their needs have been identified and met. In addition they are a source of reference for staff who must meet these needs. The care plans identify a variety of aspects of care such as health and personal care needs, religious and cultural backgrounds, likes and dislikes and previous interests. The way these needs should be met is described in the care plans. All the care plans contain detailed risk assessment including one specifically for prevention of falls. There was good evidence in the care plans, other records and discussion with staff, that Eastfield DS0000023932.V375303.R01.S.doc Version 5.2 Page 12 the home ensures healthcare appointments are made and kept. All residents are registered with local General Practitioners (GPs). One GP looks after the majority of the residents. This GP visits as requested and routinely every Thursday. The district nurses visit as needed and the home maintains good relationships with local health services. In addition, the chiropodist and optician visit on a regular basis and the dentist visits as required. Specialist equipment, such as pressure reliving mattresses and walking aids, is obtained when indicated. Nutrition assessments are undertaken regularly. There is good understanding amongst the management and staff of the importance of good nutrition. Nutrition is well managed in the home and residents are provided with an interesting and healthy diet. Since the last inspection there has been a move to involve the kitchen assistants more fully at mealtimes. This gives them better insight into nutritional needs and improves the monitoring process to ensure meals are eaten, help given if necessary and alternative choices offered if a resident appears to not be eating well. Each resident has a key worker. This means that a named member of staff takes responsibility for ensuring that an individual’s care plans are up to date, to ensure that any concerns that individual resident may have are brought to the attention of the appropriate member of staff and acted upon and for raising concerns on behalf of the individual if they are unable to do so themselves. Staff were observed to treat the residents with respect at all times throughout this visit. They knocked on doors, used each resident’s preferred term of address and spoke in a kindly and polite way. The home encourages the residents to maintain as much control over their lives as possible by encouraging self care where possible. Some residents said that they like to take part in some of the household chores. One said, “I like to dust my own room as I have quite a few knick-knacks around”. A named member of staff is responsible for the ordering, returning, and documentation of medicines. Storage of medicines is in line with the recommendations of the Royal Pharmaceutical Society of Great Britain and is safe and secure. Residents may self medicate if they wish, subject to a risk assessment being carried out. Three residents were asked about their views on self medication. They all said that they had chosen to let the staff administer their medicines. One said, “They’ve got better memories than us and they put it all down on paper – I don’t want that bother”. Only staff who have received training in the management and administration of medicines administer medicines. The home has established good working relationships with a local pharmacist who offers advice on best practice, and conducts an annual audit of our systems, stock, and storage. Eastfield DS0000023932.V375303.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People using the 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 provides a wide range of activities and food services in the home are very good. This means that residents can lead interesting, enjoyable and meaningful lives whilst living in the home. EVIDENCE: Five residents were asked how they spend their time and what activities they enjoy in the home. Their answers were diverse. One preferred to spend time in her room, watching television and spending time with her visitors, others said they enjoyed joining in the activities and one said she liked to go out to visit friends in her old neighbourhood. They all said that there are organised activities in the home. Some said they enjoyed these whilst others said they are pleased that they are not expected to join in. They all said that they can please themselves when they get up and go to bed and what they do. In house activities take place twice to three times a week when there are individual and group activities. Group activities include; music and movement, quizzes, bingo, group giant crosswords and arts and crafts. One to one activities might include taking an individual out for a walk, manicures, hand massage, or just spending time chatting. Written records of activities are kept. Eastfield DS0000023932.V375303.R01.S.doc Version 5.2 Page 14 The home provides variety of outside entertainment such as singers, dancers, mini shows, films, demonstrations, talks, and reminiscent activity. Festivals such as Christmas and New Year, Chinese and Jewish New Years, and Halloween, as well as birthdays, are celebrated with special meals, relevant activities and decorations. Residents are encouraged to help decorate the home for these occasions. On the day of this visit two residents were busy making paper flowers for the summer fayre. Representatives from local churches visit the home and church services and Holy Communion are arranged in the home. Some residents are still able to attend their local church on a regular basis. Visitors are welcome at any time and encouraged to visit frequently. Visitors may stay for a meal if they wish. A small charge is made for this to cover the basic cost of the food. Visitors can visit in private in the resident’s room. Relatives visiting the home on the day of this visit said they are always receive a friendly welcome and are offered refreshments. Food services at the home are excellent. There is a wide choice of breakfast, from a full cooked English breakfast, to cereal, fruit or toast. The main meal is taken at lunchtime and there is a good menu choice. There is a varied menu at every meal and snacks and drinks are available outside mealtimes. The menu is reviewed and adjusted to take into account special events such as birthdays and special celebrations. Special diets are catered for and the cook visits each resident daily to ask what they would like to eat. Food choices are also discussed at residents’ meetings. We were told that there are no restrictions on the budget for food. Residents all said that the food in the home is very good. One said, “The food here is wonderful, the kitchen staff are marvelous, they give us plenty of tasty food. I especially like some of the Chinese food and you can always ask for something different if you don’t like what’s on the menu”. Meals can be taken in the resident’s own room or in the dining room. The home encourages meals to be taken in the dining room as it is an opportunity for a change of scenery and social interaction. Although they knew they could have their meals at any time, the residents spoken to all said that they like to stick to set mealtimes in the dining room as they see these as social occasions. Indirect observation at mealtimes showed that those residents who needed help were given it in a discrete and kind manner. Eastfield DS0000023932.V375303.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The home has a clear policies and procedures for dealing with concerns complaints and safeguarding. The complaints procedure is displayed in the lobby. This is also included in the Service User Guide and each resident is given a copy of this when they move in to the home. Those residents spoken to said that they know that they can speak to the staff or the manager if they have any concerns. None of the residents spoken to said that they ever had to make a formal complaint. One said, “The staff are very good, if there’s anything not quite right we can just mention it to the staff and the sort it out for us”. There has been one recent formal complaint that was made by a third party on behalf of a resident. This was made directly, in writing, to the registered manager. His response showed that the concerns had been taken seriously and investigated. Where necessary, measures were put in place to address the concerns. Staff receive training in safeguarding of vulnerable people at their induction and have attend further safeguarding after working at the home for some time. The staff who were spoken to were clear about of the actions they must take should there ever be any allegations of abuse or should they Eastfield DS0000023932.V375303.R01.S.doc Version 5.2 Page 16 suspect any form of abuse taking place. The homes safeguarding policies comply with the Kent and Medway Social Services Policy. Relevant checks are carried out on all new staff. This will be dealt with more fully in the outcome area that deals with staffing issues. Eastfield DS0000023932.V375303.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 22 & 26 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment requires attention. In particular, flooring must be made clean and safe and window restrictors should be reviewed. Lack of attention to these details means that residents will not to enjoy a pleasant environment. EVIDENCE: The home was mostly clean and well furnished and decorated. Bedrooms are redecorated as they become vacant. However, the carpets in the communal areas are very faded and are showing signs of wear. The carpet on one corridor, leading from the main foyer to some bedrooms, the kitchen and main office are in a very poor and unacceptable condition. The carpet in this area is worn, badly marked and yellow and black tape has been used in places to cover splits. The carpet area outside the kitchen was blackened with grease marks. We were told that there were plans to fit new carpets as soon as the better weather arrived. However, when the health and safety risks of leaving the corridor carpet in place were pointed out, the registered provider agreed to fit new flooring in this area as a matter of urgency. Eastfield DS0000023932.V375303.R01.S.doc Version 5.2 Page 18 The communal areas are open plan with two main lounge areas, a dining area and a conservatory. A quiet room is available for use. A recess in the dining area of the home is used for storage of wheelchairs, hoists and walking aids. This area gives a cluttered appearance to this area. We were told that all the equipment is in use and that there is nowhere else to store it. The home should review this equipment to ensure it is all needed and should look at better ways of providing safe storage for essential equipment. The home has a safe, secluded and accessible garden and patio. Residents said that they enjoy using this area for drinks or meals in good weather. The home also holds events such as summer fetes in the garden. The residents’ bedrooms are homely and residents said that they have been able to bring things from home such as small items of furniture, ornaments and pictures to personalise their rooms. One said, “It’s nice to have a few of my own things around me – it gives me something to dust! I enjoy keeping things looking nice”. Window restrictors are fitted to all windows but these have been further modified by the home’s maintenance service to make sure the windows cannot be opened far. This means that it is difficult to air the rooms sufficiently and one room visited was very hot stuffy and the resident in this room was not comfortable. Residents said that they would like to have more fresh air, especially in the hot weather. The home should review the window restrictors, make appropriate risk assessments and ensure that those residents who wish, are able to open their windows sufficiently in order to let fresh air into the room. Toilets and bathrooms have the necessary equipment provided such as liquid soap, disposable hand towels and lidded foot operated pedal bins to help minimise risk of cross infection. The laundry is small but well organised, clean and tidy. Eastfield DS0000023932.V375303.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People using the 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 good team working and staff morale is good. Recruitment practices are sound. This means that the residents are cared for by a well vetted and cheerful staff team. EVIDENCE: The home operates a shift system providing twenty four hour daily care staff cover. Additional staff are rostered on duty at busy times for example, in the busy morning time when residents are getting up. The care staff are supported by a team of ancillary workers including domestic and cleaning staff. The home no longer has a maintenance person as these services are provided centrally by the registered provider. The home does not have to use agency staff. The home’s staff cover any extra shifts caused by unexpected circumstances such as staff sickness. Staff said they were happy with this arrangement and did not feel pressure to work shifts they did not wish to do. However, they said that they did not feel it is appropriate to take them from caring duties to cover catering and domestic chores when there are staff shortages in these areas. We were told that all staff have a thorough induction and those with no experience in care will shadow experienced staff until they are confident to work alone and be included in the rota. Staff receive statutory training, including infection control and safeguarding. This is updated regularly. Eastfield DS0000023932.V375303.R01.S.doc Version 5.2 Page 20 Three members of staff were spoken to in private. They demonstrated a good knowledge of best care practice and are clear about their roles and responsibilities. They confirmed that they receive good support from the management team and that there is regular staff supervision. The home has sound recruitment policies and procedures. Three staff files were examined. Two belonged to the most recently recruited staff. These files contained good evidence that all necessary checks, such as Criminal Records Bureau (CRB), safeguarding checks (POVA First), written references, health checks and comprehensive application forms, had been made before a job applicant was offered a post at the home. The files also showed that induction training had been undertaken and that there is on going training in specialist areas such as dementia care. Eastfield DS0000023932.V375303.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 &38 People using the 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 an open management culture and the home is run in the best interests of the people who use this service, involving them in decision making about life in the home. EVIDENCE: The registered manager has managed the home for over eleven years. Prior to his time he worked in other care settings and the entertainment industry. He holds the City in Guilds Advanced Management in Care Award, a qualification that is on a par with the National Vocational Award in Management and Care at level four. He maintains his continuing professional development and has recently undertaken dementia training. In conversation he showed a good understanding of the needs of individual residents. He said that he tries to run an “open door” management culture. Staff confirmed that he is approachable and said that they feel comfortable talking over difficult issues with him. An area manager visits the home frequently and carried out monthly quality assurance checks in accordance with Regulation 26. There are clear lines of accountability. Residents and staff said Eastfield DS0000023932.V375303.R01.S.doc Version 5.2 Page 22 that they can put forward ideas and that the managers listen to them and act when necessary. Regular residents and staff meetings are held. The home does not manage the finances of any residents. There is an invoicing system for items such as chiropody and hairdressing. The health and safety of residents, staff and visitors is generally well managed. Equipment is serviced regularly and relevant checks are carried out. Environmental and fire risk assessments are regularly reviewed and the manager is aware of his responsibilities regarding reporting of incidents and accidents. One significant health and safety hazard was noted during a tour of the home. This was the condition of a carpet in the corridor leading from the foyer of the home to the kitchen, main office and some bedrooms. This has already been described in this report in the outcome area about the environment. The registered provider agreed, following this inspection, to replace the flooring in this area as a matter of urgency. Eastfield DS0000023932.V375303.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 STAFFING Standard No 27 28 29 30 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 2 X 3 X X X 2 Score 3 3 3 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 3 33 3 34 X 35 3 36 X 37 X 38 2 Eastfield DS0000023932.V375303.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP7 OP19 OP33 Good Practice Recommendations It is recommended that residents be involved in the drawing up of their care plans. It is recommended that alterations to the ramp leading to the patio from the living area be made as advised by the occupational therapist. It is recommended that the manager obtain a copy of the amended regulations and to develop the quality assurance systems. Eastfield DS0000023932.V375303.R01.S.doc Version 5.2 Page 25 Care Quality Commission Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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