Inspection on 07/04/10 for Handford House Care Home

This is the latest available inspection report for this service, carried out on 7th April 2010.

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

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

Similar services:

Claremont House

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Mabbs Hall Nursing Home

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Holmwood Residential Home

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Chilton Meadows Residential & Nursing Home

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Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2010.

Key inspection report Care homes for older people Name: Address: Handford House Care Home 27A Cumberland Street Ipswich Suffolk IP1 3PA     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: John Goodship     Date: 0 7 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Handford House Care Home 27A Cumberland Street Ipswich Suffolk IP1 3PA 00 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Life Style Care PLC Name of registered manager (if applicable) Mrs Alison Rachel Lovelock Type of registration: Number of places registered: care home 50 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: The maximum number of service users who can be accommodated is: 50 The registered person may provide the following category of service only: Care Home with Nursing Code (N) to service users of the following gender Either whose primary care needs on admission to the home are within the following categories Dementia Code DE(E) Old Age - Code (OP) Physical disability - Code (PD) Date of last inspection Brief description of the care home Handford House Care Home is purpose built to care for up to 50 people who require nursing care by reason of their frailty, dementia or physical disability. The accommodation is on two floors with large passenger lifts. There is a landscaped garden, with a secure courtyard. All bedrooms have their own en-suite facilities. There Care Homes for Older People Page 4 of 30 0 0 50 Over 65 50 50 0 Brief description of the care home are assisted bathrooms and shower rooms on each floor. The home is situated near a main road into Ipswich, close to shops and entertainment venues. Care Homes for Older People Page 5 of 30 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: We visited this service during the daytime to provide the homes first rating after it had been registered in November 2009. We toured the building talking to residents,relatives and staff. We interviewed two staff, and spoke to two visiting relatives about the care provided to their family member. We also case tracked the care of two residents through their care plans, through talking to staff and by observing how they were supported. Before the inspection, we asked the manager to circulate a survey to residents, and one to staff to give their views on the home. We received three back from residents, and six back from staff. In addition the manager was required to complete an Annual Quality Assurance Assessment, which provides the opportunity to describe what the home does well, and what plans there are to develop the quality of care. We have used information and comments from all these sources, as well as our own Care Homes for Older People Page 6 of 30 observations, to compile this report. Care Homes for Older People Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 30 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 30 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. Prospective residents can be assured that they will be given sufficient information and opportunity to decide if the home is where they want to live, and that the home will assess whether it can meet their needs appropriately. Evidence: The home provided a copy of the Statement of Purpose and Service User Guide setting out the aims, objectives, and philosophy of care of the service to all service users, current and prospective. This combined document welcomed people to Handford House and gave them detailed information about the services and accommodation available. It also included information about the registered manager, staff, and their relevant qualifications and skills. We were told that this document would be regularly updated to ensure that information was current. The document detailed the number of beds available and the care categories catered for at Handford House Care Home. The service user guide Care Homes for Older People Page 10 of 30 Evidence: provided information on aspects of the daily routine in the home and there was an appendix which detailed costs which may be incurred for additional services within the home, for example hairdressing. We noted that the home placed a copy of their service user guide in all bedrooms and there was also a copy in the main foyer. We saw that there was also an additional copy available in the foyer in large print and in a pictorial format to help with the understanding of the information. There was also a coloured brochure with pictures of the home. In our survey, all residents told us that they had received enough information to help them decide if this home was the right place for them. One relative said that because their family member was admitted as an emergency, they had not had a choice, although they told us how pleased they were with the care provided. The information documents detailed the homes contract and terms and conditions of admission. We saw an example of a contract for an existing resident, which specified the fees payable, and by whom, the room to be occupied and the rights of the resident. The AQAA told us that a full needs assessment was conducted prior to admission. Following receipt of the individual assessment of needs from Social Services where available, the potential resident would be visited by either the Team leader of the relevant unit or the home manager and a detailed assessment completed. This assessed the level of nursing need required and also recorded the individuals capabilities and wishes. The purpose of this assessment was to ensure that the home was able to meet the persons needs and also meet the needs of people already living in the home. We saw examples of these assessments in the care plans we examined. They covered all the key aspects of a persons health, social and mental health needs. The manager told us that from this assessment an individualised and person-centred plan of care was developed with the resident on admission to the home. Where possible, the AQAA told us that family and other representatives would be invited to be involved in the assessment, as well as the prospective resident. The AQAA told us that all prospective residents were invited to visit the home and trial any of the services available including a trial admission prior to them or their representatives making a decision for a permanent or respite placement. This could include coming in to the home for a period of time which may include morning coffee/afternoon tea or coming in for a meal with or without their family as appropriate. They would also be invited to join in any activities which may be going Care Homes for Older People Page 11 of 30 Evidence: on. This provided individuals the opportunity to get a feel for the home if they did not want a trial admission. Care Homes for Older People Page 12 of 30 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. Residents can be assured that their needs will be identified with them and monitored to ensure that proper support is given to them. Evidence: From the pre-admission assessment, a care plan is developed with input and agreement from the resident, family and other related professionals, where possible. This helped to ensure that all aspects of care including health, personal and social care needs were met as well as individual wishes and needs. We examined two care plans and saw that they were drawn up using the provider companys format. Each area of need was organised under needs/problem, and then the care objectives for that need. All areas of physical, social and emotional need were covered, with clear guidance for staff in how to support the person. The plans were reviewed monthly with dates of each review. We could see how some needs had changed over time, and how the guidance for staff reflected these changes. We noted that one of the residents we tracked was assessed at the last review as now able to feed themselves, with prompting. We saw this happening during lunch. Each review Care Homes for Older People Page 13 of 30 Evidence: produced an updated score for dependency, nutrition and continence as well as mobility and weight measurements. The home was able to weigh non-weight bearing residents on a hoist with integral weighing scales. Staff were instructed to refer any weight loss of two kilograms and over to the dietitian. The tissue viability assessments included the specification of appropriate pressure relieving equipment such as different types of air mattress. Care plans also included risk assessments for mobility, falls, pressure areas and catheter care. One person had been recorded as having several incidents which were recorded as falls, when they were found on the floor. They had been referred to the GP for a review of medication. Since then, there were no more falls recorded. One person wished to smoke. A risk assessment had led to them being allocated a ground floor room with a patio door giving access to the garden. Care plan audits were undertaken monthly by the manager. These were recorded, and showed that each aspect of the plan had been checked for completion, and that monthly reviews had been done. Any gaps had been dealt with. There was a daily record sheet for each resident. It included a record of their food intake, a fluid balance chart, and their leisure and social activities. It specified in particular whether they had enjoyed the activities. Staff we spoke to, and those completing our survey, felt that they had sufficient information about residents, and about changes in their needs, to support them properly. Medication was only administered by qualified nursing staff that had the knowledge to recognise adverse events and reactions and know how to respond appropriately seeking urgent medical intervention as required. Medications and procedures were audited within the home on a monthly basis by the Home Manager and Regional Manager. We followed a nurse on one unit while they administered the lunchtime medication. This person knew the residents well and was able to identify those who sometimes refused their medication. They were able to tell us the strategies they used to persuade them to take it. The process was conducted calmly and unobtrusively to maintain dignity and privacy. A drug trolley was used which was securely locked when not in use. The drug room was maintained at a temperature of 16 degrees Celsius. The room and the drug fridge temperature were recorded daily. All bedrooms were single en-suite allowing assistance with personal care to be given in the privacy of the residents room. The manager told us that staff were trained to ensure that residents were given privacy at all times, for example when they had visitors or were entertaining, receiving a visit from their GP or any other specialist Care Homes for Older People Page 14 of 30 Evidence: visit. There was a family room with comfortable chairs, and some toys, to enable families to talk to their relative outside their bedroom. The AQAA told us that, as part of induction, staff were taught to knock before entering a residents room and await a response if appropriate or an invite before entering. We saw examples of this happening. The policy of the home following death was that residents continued to be treated with dignity and respect and families were supported to spend the time they wished with their loved one in privacy or with support should they wish it. End of life care wishes were recorded in the care plan where it had been possible to obtain them. The home had good links with the Macmillan and Marie Curie service, and the Hospice at Home team. Care Homes for Older People Page 15 of 30 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. Residents are supported to follow their interests and activities, and can be assured that the meals will be varied and nutritious. Evidence: There was an activity board outside the lounge area on each floor which displayed the weeks activities plan in written and pictorial format and the individual activities plan for that day for specific residents. The manager felt that this was particularly important to encourage the whole team to support each resident in the way that they wish and to meet the specific activities needs of residents within the home. Each person had an activities profile and life history completed within the first few weeks of admission and this was kept in their care plans. The home relied on relatives to help in this. The information regarding activities and social care was then shared with the team and specific activities support planned. The home employed a full time activities coordinator. They told us that their principal duty was to develop the social profile for each new admission and produce a personalised activity programme which suited that persons wishes and interests. They were also there to guide staff to support each resident in the way they wished. Care Homes for Older People Page 16 of 30 Evidence: There were photos of activities which had taken place recently around the home, including Easter Egg making, and the Easter fair. There were a range of other activities available such as bingo, board games, hoopla, darts, quizzes, keep fit and craft work. Residents art work was displayed on the walls around the home. Staff gave us examples of residents who had surprised them by becoming interested in a particular activity when they normally did not take part in others. Sometimes the life history provided a clue to a possible way into a residents previous interests. Group outings were also arranged. One was the next day to the local theatre for a musical. The PAT dog society was shortly to start visiting. There was a monthly church service and a music therapy session. The first floor had a specialist sensory room with a variety of light and sound equipment to encourage relaxation. There were visual representations on each door of its use, eg bathroom. Each persons room could have their name on it and a design personal to them if they wished. We saw a member of staff suggest that a new resident could start to make their door sign, but they were busy looking at the newspaper so that was left to another time, and instead the staff member helped them to read the paper. On the first floor, each door had a memory box, with individual items and photos supplied by families. The activity boards on each floor contained suggestions on how staff could support individual residents with personalised activities. These boards were completed by the activities coordinator, and staff recorded the outcomes in the daily record sheet. Residents and families were encouraged to personalise the room by bringing in personal items that were important to the person. We heard that the home recommended that if the resident was unable to choose the items for themselves, that the family member sat in their relatives previous home and looked around for items that they can visualise from a favourite chair for example and this may guide them to the items that will be familiar to that person. On the ground floor was a small alcove where residents could make private telephone calls. There was also a small library here for residents to borrow books. We saw the dining rooms on each unit. The tables were laid ready for lunch, with colourful tablecloths, napkins, crockery and glass tumblers. Menus were on display with a picture for each dish. The manager told us that they were considering enlarging these photos for easier recognition by residents. The menu on the day of our visit was roast beef and Yorkshire pudding, and fresh vegetables, or vegetarian shepherds pie with swede mash. Baked rice pudding and stewed rhubarb were offered as dessert. The menu for tea time was soup, spaghetti bolognese and fruit salad. In our survey, and in talking to residents, they all said how much they enjoyed the food. We saw it Care Homes for Older People Page 17 of 30 Evidence: being served from the hot trolley. Plates were of medium size and well filled, and looked nutritious. Carers spoke to each person as they served them, to explain what the meal was, and to check if they wanted their food cut up for them. Three residents in one dining room were being fed directly by carers. This was done in a calm and unhurried way, with the carer speaking to the resident all the time to encourage and reassure them. Staff told us that residents could choose to have their breakfast in their rooms. The home had an open visiting policy and residents could receive visitors when they wished. Relatives told us that they were always made welcome. Staff and the manager are very approachable. In the Comments book in the foyer, a relative had written: What a wonderful establishment. The staff are very friendly and the ambience is second to none. Care Homes for Older People Page 18 of 30 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. Residents can be assured that their concerns will be listened to, and that they are protected from abuse by the homes policies and staff training. Evidence: The home had a complaints policy which was displayed in the foyer, and was in the service user guide, as well as being given out with the contract. All the residents in our survey said that they knew how to make a complaint, and all the staff in our survey said that they knew what to do if someone had concerns about the home. The home had received no complaints since they opened. The policy required all complaints to be logged on a monthly Complaints Monitoring and Audit form and a Complaints Log. The Log was arranged to show how the complaint was resolved, and whether this was to the complainants satisfaction. With a General Election imminent, we discussed with the manager how residents could exercise their right to vote. The manager was unaware if any residents were registered for postal votes, and said she would investigate this urgently. The staff files we examined evidenced that there was a programme of training staff in Safeguarding Adults. This was also displayed on the Training Matrix for all staff. The staff we interviewed were able to show that they understood the principles of safeguarding and they were clear on their responsibility to report any concerns to the manager. Care Homes for Older People Page 19 of 30 Evidence: Small cash accounts were kept for residents to pay for extras such as hairdressing, and any other items they wished to buy. This money was kept in the office safe with records of all transactions. We checked one account at random. The cash tallied with the account book, and all receipts and petty cash vouchers were in order. Care Homes for Older People Page 20 of 30 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. Residents live in a safe and comfortable environment. Evidence: Handford House Care Home was a new build providing accommodation, nursing and personal care for up to 50 older people with frailty, dementia and physical disability care needs. The accommodation was spread over two floors with two large passenger lifts, of which one was fully stretcher size. The lifts were key pad protected. The home had been fitted with handrails, smoke detectors and emergency lighting along corridors. External windows had been restricted. The gas central heating was distributed by a series of radiators that were of the safe low temperature surface type and individually thermostatically controlled. The hot water controlled system met water temperature control regulations for legionella, and mixer valves had been fitted to hand wash basins and baths for the prevention of scalding and all shower units were independently regulated. The maintenance person tested the hot water temperatures on a frequent schedule, and we saw the records of these, which showed all hot water outlets were within the safe Care Homes for Older People Page 21 of 30 Evidence: temperature. There was a nurse call alert system which could be acknowledged at repeater stations, but only cancelled at the call site. Residents told us that staff usually responded quickly if the call bell was rung. The catering, laundry and staff facilities were sited on the second floor with restricted access. The kitchen was large and fully fitted with industrial catering equipment and a large food storage room with an independently operated cooling system. There were several separate food storage areas. The Environmental Health Officer visited the kitchen on the 11 September 2009, and did not raise any concerns about the facility provided. The main laundry was large, with a clean/dirty flow system in place. There were two fitted industrial washing machines with an Ozone generator low temperature disinfecting system. There were also two tumble dryers. All linen and personal clothing was laundered on site. There were two sinks, one designated for hand washing. The floor and walls were washable and impermeable. The garden was landscaped with flower borders, single level paving and courtyards. The central courtyard access was secure and accessed from the ground floor communal rooms only. There were CCTV cameras to the external part of the building aimed at the surrounding streets and one at reception only. Each bedroom consisted of fully furnished new good quality furniture, and fixings were domestic in style. These included a freestanding wardrobe, bedside table with lockable drawer, chest of drawers, two chairs and bed. Some rooms had small sofas. Beds were the electric profiling type, adjustable with adaptable attachments. All rooms were colour co-ordinated. Doors were self-closing and linked into the fire alarm system. There were Yale locks on all bedroom doors if residents wished to have their own key. All bedrooms had en-suite facilities, 32 of the bedrooms had en-suite bathing facilities (wet room showers) and there were 8 communal bathing rooms (6 accessible baths and 2 showers). On the ground floor was the older persons wing with seventeen beds, and a physical disability wing with eight beds. This latter wing had not been opened at the time of our visit. Each unit had their own bathrooms, dining rooms and lounges. The first floor was set up with a dementia unit with 17 beds and a smaller unit of eight Care Homes for Older People Page 22 of 30 Evidence: beds, originally proposed to also be for people with dementia. The manager told us that the provider was planning to alter the admission criteria for this unit to allow the home to accept people with behaviour that challenged. This would require the home to consult the Commissions registration unit, as a further site visit might be needed. The rooms and facilities here were the same as on the ground floor. In addition, this floor contained the medication room, and a fully equipped hairdressing room. The home was well equipped with hoists, hand rails, grab rails, shower chairs, and a special shower stretcher hoist. One of the domestic staff told us that the home had good equipment for cleaning floor surfaces after spillages which kept the home free of bad odours. The home was free from unpleasant odours. Staff records showed that staff were trained in infection control procedures. There were hand washing facilities in all areas of the home with soap and paper towel dispensers. In addition Gel dispensers were located at the entrance of the home for visitors. Care Homes for Older People Page 23 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be sure that they will be cared for by well trained staff in sufficient numbers for their needs. Evidence: Although the home was registered to care for 50 residents, it had been gradually building up admissions since it was registered in November 2009. At the time of our visit there were 28 people living there. Therefore recruitment was a continuing process as needs were identified. Currently five staff including a qualified nurse were rostered on from 08:00 until 20:00. Four staff including one qualified nurse were rostered at night. There were separate laundry, catering and domestic staff, as well as an activities coordinator. Five staff told us in the survey that there were always or usually enough staff to meet the individual needs of the people using the service. One said this only happened sometimes. The manager told us that they were building up a bank of staff to help cover annual leave and sickness. A new deputy manager was due to start, and recruitment was underway for a deputy chef and kitchen assistant. All staff told us that they were given training that was relevant, helped them understand and meet the individual needs of people, kept them up to date with new ways of working, and gave them enough knowledge about healthcare. We examined Care Homes for Older People Page 24 of 30 Evidence: two staff files and interviewed two staff to examine the training undertaken. They all confirmed that staff were given proper induction training in line with the Common Induction Standards, and covered all the basic training topics such as safeguarding adults, moving and handling, food hygiene, First Aid, and nutrition. Staff were paid to attend this training. The staff files we examined demonstrated that the homes recruitment procedures followed the legal requirements to ensure residents safety, by checking their identity, previous employment, and criminal record. Nurses were additionally checked against their PIN number with the Nursing and Midwifery Council. None had commenced employment until the first level POVA check had been received. Over 30 of the care staff had NVQ Level 2 or above. The manager was trying to access funding for more staff to start an NVQ, with a suitable training provider. Care Homes for Older People Page 25 of 30 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. Residents can expect to live in a well run home where their best interests and safety are protected. Evidence: The manager was registered for this home at the same time as the home was registered. She had over 30 years nursing experience and had worked with a variety of service user groups, including older people. She held an NVQ Level 4 Registered Manager Award. Relatives commented to us on how approachable she was and how she displayed excellent skills with residents and their families. The AQAA was returned to us on time, and was completed fully with information for each national minimum standard. There were regular meetings with residents, relatives and staff. The AQAA told us that relatives meetings were held every month, and the dates were advertised in the foyer, and in the homes newsletter. We saw the minutes of two staff meetings, one in February and one in March. One item was the passing on of the result of an audit of Care Homes for Older People Page 26 of 30 Evidence: the home by an external consultant on behalf of the provider. Although this had found minor gaps in care plans, it had praised other aspects of care such as the menus, and the clear evidence of residents involvement in activities. Staff received formal supervision sessions on a regular basis. Records of these were seen in staff files. The provider had a detailed quality assurance policy and procedure. Because the home had only been open for five months when we visited, the full cycle of this policy had not yet been implemented. However a number of audit and other records were available. The manager completed a monthly care plan audit to ensure they were up to date and that reviews had been held. Medication was also audited, and both led to a corrective action form, listing any gaps or missing records. We saw the monthly reports of visiting senior managers, which met the requirements of Regulation 26. The company would distribute satisfaction surveys to residents, and to stakeholders, after a year of operation. A dignity audit would be carried out twice yearly and this would be started soon. An annual home review would also be carried out to look at the strengths and areas for development across the home. The home was covered by the appropriate insurance policies, including public liability. Although the copy of this on display in the foyer was just out of date, the administrator had the replacement certificate. We examined some of the health and safety checks done by the maintenance staff. Hot water temperatures were described under Environment. Fire equipment and fire procedures were regularly checked either in house or by outside contractors. There had been a fire drill on 22 January 2010, and a false alarm on 6 February. On both occasions, staff acted properly according to the homes fire procedure. A fire risk assessment had been developed for the opening of the home. This would be reviewed in October 2010. Window restrict ors, bed rails and water quality were also checked for the protection of residents. Care Homes for Older People Page 27 of 30 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 28 of 30 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 Care Homes for Older People Page 29 of 30 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. 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