Inspection on 29/04/09 for Edwina House

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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Edwina House 03/04/06

Edwina House 03/10/05

Edwina House 14/07/05

Edwina House 03/08/04

Edwina House 30/04/04

Similar services:

Ashlong House

Agar Grove & St Augustine`s Alcohol Treatment & Rehab

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Herbert Street

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Edwina House 64-66 Grovelands Road Palmers Green London N13 4RJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Tony Brennan     Date: 2 9 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Edwina House 64-66 Grovelands Road Palmers Green London N13 4RJ 02088866658 02088826265 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Elizabeth Ann Hurree,Mr Sooreeadeo Hurree care home 22 Number of places (if applicable): Under 65 Over 65 0 0 22 0 past or present alcohol dependence dementia old age, not falling within any other category physical disability Additional conditions: 22 22 0 22 Where service users are admitted only for intermediate care, dedicated accommodation is provided. Date of last inspection Brief description of the care home Edwina House is owned and managed by Mr Sooreeadeo Hurree and Mrs Elizabeth Hurree. The home is registered to care for twenty-two people. The home is comprised of two semi-detached two-storey houses, which are joined and extended. There are fourteen single and four double bedrooms. There are two communal areas for sitting and dining. The home has a passenger lift. There is a garden to the rear of the property. The home is within walking distance of shops and public transport links. The home aims to provide a supportive and caring environment for those who use the service. Currently the homes fees are #500 per week. Care Homes for Older People Page 4 of 28 Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is two star. This means the people who use this service experience good quality outcomes. This unannounced key inspection was undertaken as part of the annual inspection programme. We sought to confirm that the home continues to provide good outcomes for residents. Prior to the inspection the home had completed its Annual Quality Assurance Assessment. The Annual Quality Assurance Assessment provided us with information about the home and how it was seeking to provide the best outcomes for people. We also looked at any other information we had received about the home since the last inspection. This included any information regarding incidents that the home had told us about. Care Homes for Older People Page 6 of 28 The inspection took place over one day. We were assisted by Sooreeadeo Hurree, the registered manager, with the inspection. Twelve residents returned surveys. These told us about their views of the care they receive at Edwina House. We spoke with three resident and three members of staff. We observed care practice and interaction between staff and people living at the home. We toured the building and examined a number of records relating to the care, health and safety and management of the home. At the end of the inspection feedback was given to the registered manager, and areas for improvement were discussed. We would like to thank the staff that assisted us by answering questions about the running of the home. We would also like to thank the people who live at the home who discussed their views of the service they receive. What the care home does well: A resident said, The home is very nice. The residents who we case tracked had both assessments from placing authorities, and ones carried out by the home. Admissions are not made to the home until a full needs assessment has been undertaken to ensure the best outcomes for residents. All surveys received from residents said that they receive the care and support that they need. There were clearly defined actions highlighted in the care plans to meet the needs of residents. Diary notes showed that appropriate medical attention and advice is sought. All surveys from residents confirmed that they had access to the medical support they needed. Residents health is promoted to ensure their continued well being. The records of medicines received, administered and returned to the pharmacist were all complete. Medication records are fully completed, contain the required entries, and are signed by appropriate staff to ensure residents safety. One resident commented that, There is always something to do or a film to watch. Surveys from residents also confirmed that they usually have activities. People are involved in meaningful daytime activities of their own choice and according to their individual interests and capabilities. A resident said, Food is very good. All surveys from residents said that they liked the meals at the home. People are offered a variety of meals that reflect their personal preferences and meet their dietary needs. Residents with whom we spoke confirmed that they knew how to make a complaint. A resident told us, I know that I can talk to the staff about anything. The home has an open culture that allows people to express their views, and concerns in a safe and understanding environment. A resident commented that the home, Is a friendly, kind place. All surveys from residents confirmed that residents could approach staff if they had a concern. People feel safe and well supported by the home, which has their protection and safety as a priority. We walked round the home and found that it was accessible for the residents. The homes environment is appropriate to the specific needs of residents and promotes their independence. We saw that the home was clean. A relative commented that, The home is always clean. Effective infection control measures are in place to make sure that residents are safe. A resident told us that, Staff always come and help. Staff said that the current staffing level allowed them to meet the needs of residents. The staffing level is reviewed regularly to make sure there are sufficient staff to meet the needs of Care Homes for Older People Page 8 of 28 residents. We looked at two staff files. These contained all the necessary documentation to ensure that these members of staff were safe to work with residents. Residents said they felt that staff could be trusted. Robust recruitment procedures are followed to ensure the safety and well being of people. Both residents and relatives commented positively on the management and leadership of the registered manager. The registered manager has a clear understanding of how to deliver good outcomes for residents. The home has a system for obtaining the views of the quality of the service it provides. Residents views are sought and provide the bases for improving the quality of the service. 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 set out 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 who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The statement of purpose is an accurate description of the service provided. Residents needs are assessed prior to admission to the home to make sure they receive the care and support they need. National Minimum Standard number six is not applicable to this service, as the home does not provide intermediate care. Evidence: We found that the needs of the people case tracked were in line with those specified in the statement of purpose. The statement of purpose identified the skills and staffing resources available to meet the needs of residents. A resident told us, The care is good here. The majority of surveys from residents confirmed that they had been given information about the home. This had helped them to decide if it was the right place for them to live. The home provides a statement of purpose that is specific to the Care Homes for Older People Page 11 of 28 Evidence: home and the resident group that they care for. The statement of purpose confirmed that the cultural and religious needs of people would be respected. The annual quality assurance assessment identified that residents cultural and religious needs would be identified in initial assessment and their care plans. We spoke with the registered manager who told us that cultural and religious needs would be addressed and identified through initial assessments and care planning. Initial assessments and care plans for the residents case tracked reflected their cultural and religious needs. All the surveys from residents said they felt that they were treated well by staff. Residents are supported to maintain their cultural and religious identity. Residents have varying degrees of disability. The environment has been adapted so that it is accessible. We observed that residents were able to move about the home safely. The homes environment is adapted to meet residents diverse needs. A resident said, The home is very nice. The annual quality assurance assessment stated that there were comprehensive pre admission assessments in place. The residents who we case tracked had both assessments from placing authorities, and ones carried out by the home. These identified the individuals needs for support and care. All surveys from residents confirmed that they received the care and support they needed. Admissions are not made to the home until a full needs assessment has been undertaken to ensure the best outcomes for residents. A resident told us, Staff are caring. Care staff spoken to were able to explain the individual needs and preferences of the residents who we case tracked. We observed the interaction between staff and residents. We found this supported their continued well being. The annual quality assurance assessment highlighted that there was a need for more training. We found that there are a number of areas where staff needs to receive training. This includes training in person centred dementia care. This is discussed in more detail in the staffing section of this report. Admissions to the home only take place when staff have the necessary skills to meet the assessed needs of perspective residents. 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 who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Peoples personal, social and medical care needs are fully planned for. People who use the service are fully protected by safe procedures for handling medication. Residents right to privacy is supported. Evidence: All surveys received from residents said that they are given the care and support they need. We found that the care plans of all the people case tracked were detailed and clearly identified how the needs of people would be met. Care plans were based on initial assessments of the people case tracked. We found that care plans were in place that covered all areas of residents needs. There were clearly defined actions highlighted in the care plans to meet the needs of people. The care plans for the people case tracked were found to reflect their choices and preferences. Residents said that they had been asked about how they wish to be Care Homes for Older People Page 13 of 28 Evidence: supported by staff. Staff were observed to interact respectfully and sensitively with people living at the home. The majority of surveys from residents confirmed that staff listen to, and acted on what they said. One resident told us, Staff talk to me, and are interested in my opinions. Residents said that staff respected their privacy. Residents with whom we spoke told us that they felt staff understood their needs. A resident commented, I like it here, Id get everything I want. We saw that staff members relate well with residents, for examples speaking to residents in a way that was appropriate given their age. One of the residents told us, Staff take time to ask how I want things done. Care plans were personalised, and referred to the cultural needs of people. This included whether or not they wish to take part in religious services. People are involved in the planning of their care that affects their lifestyle and quality of life. Detailed nutritional, tissue viability, falls and manual handling assessments are in place. People were being weighed regularly and action taken if their weight changed. The people case tracked all had nutritional assessments. One of the residents case tracked is currently being fed varia a PEG. We saw that there were clear guidelines on how this resident was to be supported. The appropriate professional support had been obtained. A record of the residents food and drink intake was being maintained. The guidance in the care plan was being followed. Residents needs are supported with the appropriate professional involvement to make sure their well being is maintained. Diary notes showed that appropriate medical attention and advice is sought. All surveys from residents confirmed that they had access to the medical support they needed. Diary notes also confirmed that the people case tracked had access to their General Practitioner when necessary. A resident told us, The doctor always visits regularly. Where the General Practitioner had recommended specific medical interventions these were followed up. Peoples health is promoted to ensure their continued well being. The records of medicines received, administered and returned to the pharmacist were all complete. We were able to confirm that people were getting their medication as prescribed by their general practitioners. We found where the General Practitioner had made changes to peoples medication this was signed to confirm the change had been made. We found that the medication for each of the people case tracked was accurately recorded. For example, one resident was proscribed Warfarin. We found that the appropriate professionals were regularly monitoring this. Guidelines were in place to make sure that this medication was administered safely. Medication records are fully completed, contain the required entries, and are signed by appropriate staff to ensure residents safety. Care Homes for Older People Page 14 of 28 Evidence: Medicines were stored safely. All medicines are stored at the appropriate temperature. Separate records were maintained for controlled drugs. The registered manager monitors staff to make sure that the correct procedures are followed when administering medication. Regular management checks are carried out to make sure that medication is administered safely to residents. Training has been provided on the safe administration of medicines. Training records confirmed that this training had taken place. We were able to observe staff administering medication, and confirmed that this was done safely. Staff understands how to administer medication safely to residents. 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 who use this experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living at the home are provided with varied activities to meet their needs. People living at the home are supported to maintain contact with relatives and other representatives of their choice. The menu offers a balanced diet to people living at the home. Evidence: We spoke with residents who told us that they are provided with regular activities. One resident commented that, There is always something to do or a film to watch. Surveys from residents also confirmed that they usually have activities. We observed that activities were taking place at various times throughout the day. We saw that residents were enjoying playing a broad game, talking with staff and listening to music. Residents interests were recorded as part of their care plans. We found that the residents who we case tracked had their emotional and personal interests recorded in their care plans. Diary notes showed that residents had regular contacts with family and friends. People are involved in meaningful daytime activities of their own choice Care Homes for Older People Page 16 of 28 Evidence: and according to their individual interests and capabilities. We observed that staff spend time talking with people who live at the home and listening to what they had to say. Staff spoken to understood the importance of one to one contact for residents. A relative commented in one of the surveys that, Edwina house staff are an amazing group of people who look after my mother with so much care and support. The home supports residents to maintain and develop their family and personal relationships. The menu showed that options are offered at each meal. We spoke with residents who were generally pleased with the quality of the food provided. A resident said, Food is good. All surveys from residents said that they liked the meals at the home. People are offered a variety of meals that reflect their personal preferences and meet their dietary needs. Meals were balanced and nutritious. Residents dietary needs are recorded as part of their care plans (for example if they were diabetic or needed a puree meal). We observed that meals were well presented in a warm and friendly way. We saw that people were supported to eat. We observed that this was done at the pace of the people being assisted. People are able to enjoy the food they prefer and like. 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. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are confident that their complaints will be listened to, taken seriously and acted upon. The homes procedures protect people from abuse. Evidence: The annual quality assurance assessment confirmed that a clearly defined complaints policy with agreed timescales for managing complaints was in place for people to use. We found that the detailed policy was in place. Residents told us they had received a copy of the complaints policy. No complaints had been referred by the Commission to the home since the last key inspection. A complaints book is available to record all concerns, allegations and complaints. We found that the complaints book recorded the actions that had been taken to address issues. There have been no complaints since the last key inspection. We found that there was a number of compliments from relatives about the care residents had received. The majority of surveys from residents said that they knew how to make a complaint. Residents with whom we spoke confirmed that he knew how to make a complaint. A resident told us, I know that I can talk to the staff about anything. The home has an open culture that allows people to express their views, and concerns in a safe and understanding environment. There were policies on handling abuse and protection. A resident commented that the Care Homes for Older People Page 18 of 28 Evidence: home, Is a friendly, kind place. All surveys from residents confirmed that they could approach staff if they had a concern. Residents felt confident that any concerns they raised would be handled sensitively and appropriately. A resident told us, I can tell staff about things, they always listen to me. There had been no adult protection issue since the last key inspection. We found that staff had received training on adult protection. We discussed with the registered manager about how future training on adult protection would be provided. He agreed to explore the training the trainer training provided by the host local authority. This would allow the registered manager to provide training to his staff on adult protection. Staff spoken to could recognise the signs of potential abuse, and explained how they would respond to it. People feel safe and well supported by the home, which has their protection and safety as a priority. 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. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People live at home that provides a safe and homely environment. The home is clean and hygienic. Evidence: We walked round the home and found that it was accessible for the residents. We observed that people were able to access all areas in the home safely. The home has the necessary adaptations to support residents to move around safely. Bathrooms and toilets were fitted with appropriate adaptations to meet the needs of residents. These are accessible to residents who have mobility difficulties. We saw that the home was appropriately decorated and furnished. There are dining and sitting areas for the use of residents. The homes environment is appropriate to the specific needs of residents and promotes their independence. The annual quality assurance assessment, and discussions with the registered manager highlighted that a number of improvements had been made to the homes environment. We saw that bedrooms have been redecorated. A resident told us, My bedroom is nice and comfortable. The home makes sure that the environment is developed to provide improved outcomes for residents. Care Homes for Older People Page 20 of 28 Evidence: We saw that the home was clean. A relative commented that, The home is always clean. This was also confirmed all the surveys received from residents. We found that appropriate measures are in place to prevent cross infection. The home has policies on the prevention of cross infection. Staff have received training on infection control measures. Staff spoken to understood how to work to minimise the possibility of cross infection. Staff confirmed that they had access to disposable gloves and aprons. Liquid soap and paper towels were available throughout the home. Effective infection control measures are in place to make sure that residents are safe. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. Sufficient staff are always available to meet the needs of people who live at the home. Training needs to be consistently delivered in all areas to make sure that the assessed needs of people who live at the home are met. People who live at the home are protected by the homes recruitment practices. Evidence: The majority of surveys from residents confirmed that there was always enough staff available to meet their needs. The rota showed that a consistent staffing level was being maintained in the home. We observed that staff were available to provide individual care for residents. A resident told us that, Staff always come and help. Staff said that the current staffing level allowed them to meet the needs of residents. The staffing level is reviewed regularly to make sure there are sufficient staff to meet the needs of residents. Training records showed that staff had been on a range of courses relating to the needs of residents However, the training on statutory required areas was not provided regularly to make sure that all staff had the necessary basic skills to meet the needs of residents. The annual quality assurance assessment had highlighted that there was a Care Homes for Older People Page 22 of 28 Evidence: need, For more training. This was discussed with the registered manager who agreed to develop a program of training source from external providers. This would make sure that the identified training needs of staff are met in a consistent way for the benefit of residents. The home is registered to meet the needs of people who have dementia. We spoke with staff and found that not all of them had been on dementia care training. Those that had had only been on a one day short course on this subject. This was discussed with the registered manager who agreed to develop a detailed programme of dementia care training. There is no ongoing programme of training in dementia care. This needs to be put in place to make sure that residents are supported in person centred ways that maintain and enhance their well being. The registered manager was able to show 50 per cent of staff have achieved the National Vocational Qualification in care. The registered manager explained that a number of staff are also either working towards or have completed their national vocational qualification in care at level three. Training records we examined confirmed this. Training in the national vocational qualifications had provided staff with the skills needed to support residents. We looked at two staff files. These contained all the necessary documentation to make sure that these members of staff were safe to work with residents. Their employment record had been checked. Two references and a POVA first/CRB check had been obtained prior to them starting work at the home. This showed that the home followed a clear recruitment procedure that ensures the safety of people. The staff group reflect the cultural backgrounds of residents. Residents said they felt that staff could be trusted. Robust recruitment procedures are followed to ensure the safety and well being of 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. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Appropriate management structures are in place to ensure that people receive the care they need. People who live at the home are consulted about the quality of the service, and encouraged to make suggestions for improvement. People who live at the home have their financial interests protected by the homes procedures. People who live at the home and staff are protected by the homes health and safety procedures. Evidence: Both residents and relatives commented positively on the management and leadership of the registered manager. The registered manager has extensive experience of managing a service for older people. He has a clear understanding of the key principles and focus of the service to make sure that people receive the care they need. We observed that the registered manager spent time talking to residents. The registered manager has a clear understanding of how to deliver good outcomes for residents. Care Homes for Older People Page 24 of 28 Evidence: Staff spoke very highly of the registered manager. They said they felt well supported and received clear directions and leadership. The registered manager and staff work to make sure that the home is running in the best interests of residents. We observe this throughout the inspection. The home is managed to makes sure that the needs of residents are met. We saw that the front door is being kept locked. The registered manager explained that this was due to the risk that two residents might leave the building. The registered manager agreed to have this reviewed in the light of the introduction of the Mental Capacity Act and the associated deprivation of liberty safeguards. The home has a system for obtaining the views of the quality of the service it provides. The home makes sure that any areas for improvement are addressed. A survey of the views of residents, relatives and professionals had recently been carried out. The findings of this survey had been action to improve the home. Staff meetings take place to make sure that staff are aware of how they should support and care for residents. Residents views are sought and provide the bases for improving the quality of the service. The home does not hold money for residents. The home invoices their families or the relevant social service department for any expenditure made on their behalf. A system is in place to ensure receipts are obtained for any expenditure. Residents can have confidence in the homes procedures for handling their money safely. The home has a consistent record of meeting the relevant health and safety requirements and closely monitors its own practice. Fire drills were taking place and the fire alarm was tested regularly. We found that the fire risk assessment includes an assessment of all the potential fire risks in the home. We questioned staff on the fire safety procedures and found that they understood fire safety issues. All health and safety policies were available. Certificates for gas, legionella and electrical testing were in date. COSHH guidance was in place and chemicals were stored safely. We discussed health and safety issues with staff and they demonstrated their understanding. The home has an effective system for monitoring accidents to ensure the safety of residents. The temperatures of the fridges and freezers were recorded and within safe limits. Health and safety checks and procedures make sure that residents are safe. 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 1 30 18 The registered persons must 26/06/2009 make sure that a programme is put in place so that all areas of statutory training are met. Staff needs to have all the relevant skills to support residents safely. The registered persons must 26/06/2009 make sure that training on dementia is provided as part of an ongoing programme. Residents with dementia need to be supported in ways that are person centred and enhance their well being. 2 30 18 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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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