Inspection on 25/08/09 for Furzeham Lodge Care Home

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

Furzeham Lodge Care Home 06/07/06

Furzeham Lodge Care Home 06/12/05

Furzeham Lodge Care Home 10/05/05

Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Key inspection report Care homes for older people Name: Address: Furzeham Lodge Care Home Higher Furzeham Road Furzeham Green Brixham Devon TQ5 8BL     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Rachel Proctor     Date: 2 5 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Furzeham Lodge Care Home Higher Furzeham Road Furzeham Green Brixham Devon TQ5 8BL 01803856657 01803859440 furzehamdash@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Howard Norman Dennis,Mrs Sarah Jane Mary Dennis,Mr David Malcolm Baker,Mrs Angela Martha Christin care home 21 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home Furzeham Lodge is an extended detached building that provides 24-hour residential care for up to 21 persons in the categories of old age, physical disability and dementia over the age of 65 years. The home has a large communal lounge with a dedicated dining area attached. All the rooms are on suite; there is one double room available the remainder are all single occupancy. The home has two floors with a vertical lift provided for less mobile service users. Furzeham Lodge is situated by the green at the top of the hill above the harbour of Brixham. The home has a well-stocked garden with a central lawn area with easy access provided for residents; to the side of the building Care Homes for Older People Page 4 of 29 Over 65 21 21 0 0 0 21 Brief description of the care home is a hard standing car park, which is large enough for several vehicles. The weekly cost of care at the home is, lowest #500.00 and the highest #600.00 at the date of this report. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced key inspection, which took place on the 25 th August 2009 between 9:30 am and 4:30 pm. Four people living at Furzeham Lodge and three staff returned anonymous surveys prior to the inspection. Some comments made in these have been included in our inspection report. Two people had their care followed, this included looking at the way their plan of care was recorded and speaking to them about the service they were receiving. The manager provided information for the inspection prior to the visit to the home. This gave information about how Furzeham Lodge was meeting the Care Standards. People living at Furzeham Lodge, their relatives and staff working at home were spoken with as part of this inspection. A tour of the home was completed and some records were inspected. Care Homes for Older People Page 6 of 29 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 Care Homes for Older People Page 7 of 29 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 29 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 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The information provided for people living at Furzeham Lodge was sufficient to enable them to make an informed choice about whether the home can meet their needs. The assessment process adopted by the manager should ensure peoples care needs are assessed in a way that ensures their care needs are met. The home does not offer intermediate care. However Furzeham Lodge will provide for short stay respite placements when beds are available. Evidence: The manager provided the revised statement of purpose and service users guide for the inspection. This gave clear information for people who live at the home or those who may be considering moving there. People spoken with during the inspection said they were given information about the home prior to moving in. The manager advised that the person and/or their family representatives are encouraged to visit the home Care Homes for Older People Page 10 of 29 Evidence: prior to admission. Two people had the care followed as part of this inspection. This involved speaking to the person where possible, visiting the room they occupied in the home and reviewing the care records being held. The assessment process for people living at Furzeham Lodge has improved since our last inspection. The assessment templates provided sufficient prompts to enable the persons care needs to be fully assessed. Examples of the new completed assessment forms were seen in one persons care plan that had recently been admitted to the home. In addition to the homes assessments a copy of the Care Trusts care plan was available with a persons care plan. As part of the assessment process the manager has introduced a section called my story which is completed with the person. These were seen in the care plans of the two people whose care was followed. One of these people spoken with said they had told staff about their life, their work and family and had agreed the content of my story. This persons relative commented that their relative had enjoyed talking about their working life and family with staff. Furzeham Lodge does not provide intermediate care. However they do offer short respite stays if beds are available. Care Homes for Older People Page 11 of 29 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 live at Furzeham Lodge have their care given by staff who understand their health and personal care needs. People are treated with respect and dignity by the staff team who care for them. They can have confidence that they will be consulted about what is important to them. Administration of medication was safe and reliable. Evidence: The two people whose care was followed had clear plans of care in place, which had been developed from their assessment need. These provided information about the health problems the person had and how staff should assist them. One person whose care was followed had severe arthritis. The care plan identified how staff should assist them to move using a manual handling risk assessment process. The person self-care ability was also identified as part of their care plan. This meant the person only had assistants with the things they were unable to do for themselves. When this person was spoken with they said staff encourage them to do the things they could do themselves and help them with the things they couldnt. Care Homes for Older People Page 12 of 29 Evidence: How individual peoples care was managed and recorded was discussed with the manager. She advised that the person, their family, their key worker and senior care all influenced the development of the plan of care. A system for recording when individual care plans were reviewed was in place. However the two people whose care was followed had not had the care plans review recorded since May 2009. The manager advised that peoples care needs are reviewed on an ongoing basis and changes are made to their care plan as required. An example of the persons care plan which had been reviewed more than monthly was provided. The manager advised that the new deputy manager had been appointed and they would be assisting with the monthly records of care plan reviews. The manager advised that the owners had purchased hospital style profiling beds for the two people who needed them as well as pressure relief equipment. Two people whose rooms were entered during the inspection had hospital style profiling beds fitted with air flow pressure relief mattresses. The manager confirmed that the district nurse team regularly reviewed these people to ensure they were receiving the health care they needed. District nurses were seen attending the home during the inspection. The involvement of health and social care professionals was clearly recorded in the care plans of the people whose care was followed. They showed when the GP had visited and advise treatment or a district nurse or physiotherapist had visited. One person whose care was followed advised that the district nurse came regularly to change the dressing. A separate record of the district nurse intervention was recorded and kept in the home. The manager advised that the district nurses are always helpful and ready to offer advice and support for the individuals they care for. The manager was using a recognized nutritional risk assessment tool to assess whether people were at risk of malnutrition. Where a risk had been identified a plan of care was put in place to guide staff how to reduce this risk and manage the persons nutritional needs. The way peoples medication was being managed was discussed with the manager. The medication storage and record keeping was reviewed with the manager for the two people whose care was followed. Medication records had been signed each time medication was administered. In addition to this a record of topical treatment creams applied was being kept. Stock control for the medication people needed was good. The controlled drug record was checked against the amount held for one person as correct. Controlled drug storage and record keeping meets the required standard. A record of medication returned to the pharmacy was being kept this had been signed by the Care Homes for Older People Page 13 of 29 Evidence: member of staff completing the returns book. In addition to the basic information for peoples medication the manager had added an information sheet for staff, which recorded what the medication was used for and the possible side effects. The manager confirmed that only staff who had received medication training administered medication for people. A risk assessment process was in place to assess whether a person was able to manage their own medication. One relative spoken with during the inspection said they were very happy with the care and attention their mother was receiving at Furzeham Lodge. They went on to say that staff always treat mother with respect and dignity and they take her wishes into account. Staff observed during the inspection were speaking to people in a friendly supportive way which valued the persons individuality. All the people spoken with during the inspection said how kind and helpful the staff at the home were toward them. Care Homes for Older People Page 14 of 29 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. The people who live at Furzeham Lodge can have confidence that their personal preferences will be taken into account and where possible their personal life style choices facilitated. Meal times are a pleasant experience for people living at Furzeham Lodge . Thought had been taken to ensure food given was nutritionally balanced and attractively presented. Evidence: The activities coordinator is a qualified occupational therapist she was organising a craft session during the inspection. Those taking part appeared to be enjoying doing this. The activities coordinator keeps a record of peoples individual interests and what activities they have taken part in. This was in addition to the care plans for individuals. Clear information was being kept in the activities book and peoples individual care plans about the activities they enjoy taking part in. People spoken with during the inspection said they had activities they could take part in arranged for them. Two people asked said they really enjoy the quizzes, which are arranged on a regular basis. One person advised that they had been able to go to watch the fireworks with staff and they had really enjoyed this. Another person said staff had enabled them to Care Homes for Older People Page 15 of 29 Evidence: go to the fair, which was parked on the green just outside the home. People had access to books and other reading material in the home. The manager provides a newsletter for the people living in the home and their relatives. These were seen during the inspection. The newsletter provided information for people living in the home about activities planned and forthcoming birthdays for people living in the home are mentioned. Two of the newsletters contained photographs of activities people had enjoyed taking part in the previous month. At Christmas reminiscence book had been prepared for Christmas 2008. this contain pictures and information about life in the war years, products and places. The manager arranges residents meetings where people living in the home can express their views about the services offered. The manager and the activities coordinator said that following a residents meeting the menus had been reviewed. And new meals plans had been developed with the people living in the home. Minutes of the residents meetings were available during the inspection. Visitors were coming and going throughout the inspection. The manager advised there was an open visiting policy at Furzeham Lodge. Three people visiting the home were spoken with during the inspection. They commented how helpful and friendly the staff were, they also said they were kept informed. People individual rooms entered during the inspection had been personalised items of their choice. This included photographs, ornaments and small items of furniture. The manager advised that people are encouraged to personalise their rooms to make it feel more like home. The lunchtime meal observed was unhurried with people eating their meals at their own pace. People who were able were given the opportunity to help themselves to the vegetables from a serving dish. Other people who needed help were asked by staff which vegetables theyd like and how much. People who needed assistance to cut their food were asked by staff if they wanted help before help was given. The dining room was large enough for all the people living at Furzeham Lodge to have their meals in one sitting. Six people living at Furzeham Lodge were asked about the meals. All said that they liked the food and were offered choice. One person said sometimes the portions are too large and they have to remind them they like small portions. The chef was spoken with during the inspection, he advised that an alternative to the set menu was always provided. He also advised that freshly made quiche, home-made soups and cakes were available each day. Care Homes for Older People Page 16 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live at Furzeham Lodge can have confidence that any concerns they raise will be dealt with sensitively by a staff team who understand them and have their best interests at heart. Evidence: A copy of the complaints policy and procedure was readily available in the home. The manager advised that Clients are supported to use the homes system and a full account of any complaint and the action taken is recorded, our home recognizes the need for an advocacy service and this will be gained on their behalf if this is required. People spoken with were confident that if they raised an issue it would be taken seriously by the management and resolved for them. The Commission has been made aware of one safeguarding referral relating to care provided for one individual. This was not substantiated. The manager had followed the safeguarding protocol and co-operated fully during the investigation. No other concerns or complaints have been received by the Commission or the home since our last inspection. The manager has provided reference material for staff in relation to the Mental Capacity Act and Deprivation of Liberty Act. Contact details were also available for staff for the Care Trusts safeguarding alerts. The pre- inspection information provided by the manager in the AQAA (Annual Quality Assurance Assessment) gave the following statement. All staff are trained in POVA (Protection of Vulnerable Adults) and fully understand the importance of this training, all staff entering the home are Care Homes for Older People Page 17 of 29 Evidence: fully checked by references, POVA and CRB (Criminal Record Bureau(police checks)) checks, staff are required to read and sign all policies as understood including Whistle blowing policy. All staff receive yearly mandatory updates on POVA, all staff are required to read and sign a letter regarding Wills, Gratuities and Bequests as part of their application pack for employment. The information available and observation made during the inspection found this to be the case. Care Homes for Older People Page 18 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes management have continued to improve and up date the homes decor. This should ensure that the people who live at Furzeham Lodge continue to have a pleasant, clean fresh and homely place to live in that is able to meet their needs. Evidence: A tour of the home was completed as part of this inspection. All the communal areas and disabled bathroom and toilet facilities were viewed. Some individual peoples rooms were also seen. The home has three dedicated communal areas, which join together. A large lounge, which houses the TV, the homes bird cage and a range of easy chairs. This area gives direct access to the patio area through two large patio doors and a ramped area down to the garden where there is a varied choice of seating and umbrellas for sunny days. The smaller quieter lounge provides seating and the homes fish tank. One person said they enjoyed watching the fish. The manager advised that this person had alerted staff to the fact that the fish had laid eggs. The dining area contains tables and chairs, which are laid out for socializing, people can choose to eat in either the dining area or in their private room. The way the communal areas are laid out should provide people with choice. The manager provided the following information prior to the inspection. Our home provides the basic requirements such as bed and clean bedding, wardrobe, chest of drawers, bedside table, TV and telephone. Although our rooms are pleasant and Care Homes for Older People Page 19 of 29 Evidence: comfortable our clients and their families are encouraged to personalise and make their rooms as cosy as they wish. To ensure the client is surrounded by personal memories, which mean so much to our clients. Peoples individual rooms entered had been personalised with items of their choice. People spoken with during the inspection said they were very happy with their rooms. One person said they had been given the opportunity to move to a room up stairs that had a better view of the green and they were just beginning to settle in. Specialist profiling beds and hoists were available for the people who needed them. People have access to a pleasant garden area, which is enclosed. This means that people are able to go into the garden when they want to. The home was fresh and clean in all areas that the people who live there have access to. Three relatives commented that their relatives rooms were always kept clean and fresh. All commented that the home was always fresh and clean when they visited. Cleaners were working in the home during the inspection. Gloves and aprons were easily available for staff use when providing personal care for people. Infection control policys and procedures were in place and easily accessible for staff use. The manager advised us that 17 staff had completed infection control training. The laundry is sited away form individual peoples rooms and the food preparation area. Hand wash facilities are provided for staff use. Care Homes for Older People Page 20 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The commitment of the homes management team to ensure staff have qualifications in care should ensure that people who live at Furzeham Lodge are in safe hands at all times. The recruitment practices in place at Furzeham Lodge should protect people from unsuitable staff. The people who live at Furzeham Lodge can have confidence that the staff team who care for them have access to training that will unsure they have the knowledge and skills to provide for their care needs. Evidence: The manager provided a duty rota, which showed the number of staff on duty and in which capacity they were employed for each shift. This showed that more staff were on duty at peak times. The manager has introduced a key worker system. Each member of staff being responsible for a set number of people living in the home. The key worker responsibilities included ensuring the person had the things they needed. The staff observed and people living at the home spoken with during the inspection demonstrated that sufficient staff were available on duty. In addition to the care staff the home also employs ancillary staff, which includes domestic staff that carry out cleaning and laundry, cooks and an activity coordinator. The manager advised that Care Homes for Older People Page 21 of 29 Evidence: Dedicated staff cover holiday and sickness periods as all staff appreciate how important it is to have continuous care by staff who are known by our clients, therefore we do not use agency staff this is in the best interest of our clients. People spoken with during the inspection said how helpful and supportive the staff who cared for them were. The manager provided a list of staff who were in progress of completing an NVQ (National Vocational Qualification) in care or had already achieved this. The following information was provided with the AQAA (Annual Quality Assurance Assessment) All senior staff are NVQ level 3 or have a nursing background. All but two care staff have achieved or are undertaking NVQ levels 2 or 3. The home domestic has completed level 2 in infection control and is at present undertaking health and safety level 2. The cook has NVQ level 2 in catering, our activities coordinator is extremely qualified in her field,. Night staff are NVQ level 2 or have a nursing background. The manager has completed NVQ level 4. This information showed that the home had achieved more than 50 of its staff with NVQ level 2 or above. The manager confirmed that the homes management team are still committed to ensuring staff receive the training they need and new staff would be working toward this award. Staff spoken with during the inspection said they had good access to training that helped them do their job well. Three staff files were viewed during the inspection. This showed that staff had the necessary pre-employment checks completed prior to starting work. This included a completed application form, references and police checks. However one staff member whose file was viewed did not have a copy of their current work permit and or their student visa easily available with their staff file. A copy of their work permit from their previous employer and a letter from the homes management team to the Home Office advising of the change of work were provided. The manager confirmed in writing these were provided following the inspection. The staff files viewed also contained a contract, which included a statement of the terms and conditions of employment. Staff training was discussed with the manager. She provided information about the training staff had received and the training planed for the next 12 months. Information was available for staff in the office of the home, which was relevant to the work they do. The manager advised that she had accessed training for staff, which had been provided by the Care Trust and was waiting for confirmation of dates for training for later in the year. In addition to this she had accessed training from the Alzheimers disease society for dementia care. The following information was provided as part of the AQAA (Annual Quality Assurance Assessment). Staff receives training relevant to their role, including yearly Mandatory updates 2 monthly observations and Care Homes for Older People Page 22 of 29 Evidence: 2 yearly appraisals. New staff undertake an induction period of 6 weeks, all staff are encouraged to achieve and undertake NVQ levels relevant to their role. The information provided and observations made during the inspection confirm that staff have access to training that improves their skills and knowledge. This should ensure that people living at Furzeham Lodge always have access to knowledgeable staff. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager and staff team have a clear plan and are developing the home in the best interests of the people who live there. People are being given the opportunity to influence the way the service was run. This should ensure people have confidence that the home will be managed in a way that takes their needs and wishes in to account. Evidence: Furzeham Lodge has a qualified, experienced and competent registered manager who runs the home in the best interests of the people who live there. The manager advised us that she had completed an NVQ level 4 in management and Health and Safety level 2 course. She also told us that the deputy manager was working to complete level 3 in palliative care. People told us that they were consulted about the service being provided both in questionnaire form and at residents meetings, which are held regularly. Minutes of residents meetings and the results of the quality audit were provided for the inspection. The manager advised that the Stakeholder Satisfaction Survey 2008 had no dissatisfaction recorded by clients, primary care team, relatives or Staff. A letter has been received from a relative in January 2009 which praised the Care Homes for Older People Page 24 of 29 Evidence: care given at Furzeham lodge. People and their relatives spoken with in private during the inspection were pleased with the care and services provided. They all indicated that they were listen to and felt able to influence the way their care was provided. The manager advised that she regularly meets with relatives and other who visit the home. People who responded to the anonymous surveys made the following comments about what the service does well. Caring above all else, lovely environment, excellent meals, friendly atmosphere General care, happiness of residents The best ever as far as I am concerned, everything Everything necessary Money held for individual people was being kept separately. A record of money received and receipts for expenditure were being kept. One persons record was checked against the amount held as correct. A relative gave money to the manager for their relatives use. This was recorded in the persons record and the money stored in a secure place. This clear, well-recorded process ensures that people are appropriately safeguarded. The manager advised that people who are able are encouraged to continue to manage their own financial affairs when possible. Supervision for staff was taking place. Records of supervision were being kept. Staff spoken with said they felt supported to do their jobs. The staff who responded to the anonymous survey all indicated they had training that was relevant to their role, which keeps them up to date with new ways of working. They also indicated that they regularly met with their line manager and had enough support, experience and knowledge to meet different needs of people who live at the home. The manager has ensured that priority was given to the health, safety and welfare of people living at Furzeham Lodge and staff who work there. Chemicals that could be a hazard were being stored appropriately. The manager has kept the Commission informed of any untoward incidents or accidents that affect people who live or work at the home. Accident records were being kept and a system for reporting dangerous occurrences was in place. The manager advised that accident records are reviewed regularly to look for theme and any actions that could be taken to reduce risks for individuals. The manager advised that she had implemented a care induction book for new staff. Staff who responded to the anonymous surveys indicated that their induction covered what they needed to know. Environmental risk assessments had been completed of the building to ensure the Care Homes for Older People Page 25 of 29 Evidence: environment was safe and all equipment regularly serviced. The recording of the fire precautions undertaken were viewed and found to be clear and up to date this should ensure that people are safe. Care Homes for Older People Page 26 of 29 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 27 of 29 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 7 29 Care plans should include a record that care has been reviewed at least monthly or sooner if care needs change. The manager should ensure that all information relating to an employees recruitment is easily available for inspection. Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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