Inspection on 20/07/09 for Highground Nursing Home

This is the latest available inspection report for this service, carried out on 20th July 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

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Highground Nursing Home 7 Waterford Road Oxton Birkenhead Wirral CH43 6US     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: Paul Kenyon     Date: 2 0 0 7 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 29 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 29 Information about the care home Name of care home: Address: Highground Nursing Home 7 Waterford Road Oxton Birkenhead Wirral CH43 6US 01516529448 01516510015 highground@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Southern Cross Healthcare (Focus) Limited Name of registered manager (if applicable) Mr Brian Jones Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who may be accommodated is 41. The registered person may provide personal care (including nursing) and accommodation to service users of both sexes whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (Category OP). No more than 41 places. Physical Disability (Category PD). No more than 2 places. Date of last inspection Brief description of the care home Highground is a 41-bed care home providing nursing and personal care to elderly people. Care Homes for Older People Page 4 of 29 care home 41 Over 65 41 0 0 2 Brief description of the care home The home is set in its own landscaped grounds, and offers a choice of accommodation over two floors (including the ground). 24 hour RGN cover is provided, along with care and support staff. The home provides various activities and actively encourages families to play a large part of the resident?s lives. Situated on a quiet road near Oxton Village, the home is a few minutes from a main bus route and local amenities. Fees charged per week range from 472 pounds to 582 pounds. 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 a key inspection of Highground. The service were not aware that we were to visit on that day. During the visit we looked at records relating to the support provided to individuals and toured the premises. We also spoke with staff, people who use the service and families in order to gain their experiences of the standard of care provided by the service. We also held discussions with the manager. We sent surveys out to staff and to individuals who use the service and their families but only one staff survey was returned. Any surveys returned after this visit will still be used as part of our ongoing assessment of the quality of care provided by Highground. The service sent in an Annual Quality Assurance Assessment before we visited and when we asked them to. This provided information on the quality of care provided at Care Homes for Older People Page 6 of 29 Highground and this assessment was used to form judgements about the quality of care at Highground for the purposes of this report. What the care home does well: What has improved since the last inspection? Care Homes for Older People Page 8 of 29 The health and safety of people is now promoted through the safe management of medication. The people who use the service now live in a well maintained building. 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 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 10 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who come to live at Highground have their needs thoroughly identified before they come to stay and as a result have their needs met by the service. Evidence: We looked at information relating to five people who had come to live at Highground since our last visit. Some individuals have their care paid for by a Local Authority. In those instances, the service had obtained a copy of the Local Authority assessment outlining their needs before the person came to stay at the service. In addition to that, the service had conducted its own assessment on the person. For those who pay for their own care, the service again has assessed their needs before they come to live there. The services own assessment includes a summary of their personal care needs, any continence issues they may have, risks they may face from pressure sores, their medication, their nutritional needs and any other needs they may have. The services own assessment has been devised by the organisation that runs the service. The Care Homes for Older People Page 11 of 29 Evidence: Manager stated that he considered the assessment to be comprehensive and allowed a full indication of peoples needs to be obtained. Discussions with relatives noted tat they confirmed that they had been given literature relating to the service when they had enquired about placing their relative at Highground. This included a service users guide and statement of purpose. They had also had the opportunity to look at the most recent inspection report that we had completed. Given that the service uses its own document for assessing those people whose care is paid for by a local authority and the information they are provided with before they come to Highground, we consider that this standard has been exceeded on this occasion. Care Homes for Older People Page 12 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 use the service have their needs met by the care plans used by the service which identify peoples needs and fully involve the individual and their families in the care provided. People have their health maintained by the way the service provides their care. Their health and safety is promoted by the safe management of medication and all individuals are supported in a dignified manner which promotes their privacy. Evidence: We looked at five care plans relating to people who had either come to live at Highground recently or had been there for longer-all care plans are accompanied by initial assessment information made on the needs of individuals as they are admitted. The care plan showed evidence of involvement from families and individuals in a variety of ways. There was some evidence that care plan reviews had taken place and had included a discussion with the individual person. In other cases, there was evidence that the relatives of the person had had the opportunity to sign the care plan to confirm that they were satisfied with its contents. Discussions with two relatives confirmed that they had been shown the care plan and had agreed with its contents. Care Homes for Older People Page 13 of 29 Evidence: The care plan uses an established nursing model so that all aspects of a persons daily life can be identified where support is needed and then provided. As a result, care plans highlighted the main needs that people had in a variety of areas such as medical issues, personal hygiene and social activities. All care plans examined were clearly written and detailed actions on how best to support people were available for care staff. There was evidence in all care plans that they were reviewed at least on a monthly basis but periodic reviews were available which included the views of the person who was being supported. All care plans were reinforced with daily records which indicated how each person was progressing in their daily lives. We looked at the way the service maintains the health of individuals. We interviewed three people. All confirmed that they were generally well but had occasions when they needed medical support. They confirmed that when this happens, medical professionals such as Doctors or Specialist Community Nurses are contacted to oversee the health of each person and hospital appointments are arranged. Records indicated that all people are registered with a general practitioner. Assessments are made in respect of the likelihood that people will develop pressure sores, their nutritional needs and an assessment of their continence needs. People have their weights monitored at least monthly and risks are assessed in relation to moving and handling. There was evidence that when specialist medical care is needed, hospital appointments are arranged and referrals are made to medical services as new medical needs arise. There was evidence also that the eyesight of individuals and their oral hygiene is taken into account. Where individuals need an optician, evidence of this is available and support required in maintaining oral hygiene and other personal care needs is clearly recorded in care plans. Discussions with two relatives were held. They confirmed that as the health needs of their relations change, the service always notifies them of any changes or of any incidents that adversely affects their health. Two individuals living at Highground have a particular health condition. This is recorded on their care plans. It was noted in daily records that on occasions when this condition affected people, some of the terms to describe this were outdated. It is recommended in this report that training in this health condition is undertaken so that the correct terms when describing it are used. We looked at the way medication is managed. No one self medicates at present and this is assessed before each person is admitted. Medication is stored in medication trolleys which in turn are stored in a lockable medication room. Medication administration records are available and noted that records are signed once medication is administered. The same records indicated that as medication comes into the service, Care Homes for Older People Page 14 of 29 Evidence: signatures are recorded to confirm receipt. Other medication needs to be stored in a refrigerator. This facility is available and temperatures are checked at least twice a day. Records are in place to confirm when medication needs to be returned to the pharmacist and there is a system in place for storing returned medication. The service uses a recognised pharmacist for its supply of medication and they were due to visit to inspect medication systems the week following our visit. Some people are prescribed controlled medication. This is separately stored and a controlled register is maintained indicting the stock levels of each medication. We checked whether the numbers of controlled tablets tallied with records and they did. The registered nurses in the service are currently responsible for the administration of medication and as nurses they are bound by codes of conduct issued by their regulatory body. A book outlining all medications known as a British National Formulary is available and was updated in March 2009. We looked at whether the people who use the service are supported in a dignified manner and whether their dignity was maintained. We interviewed three people. In all cases, they considered that they were able to enjoy their own company when they wished but always had the option to socialise with others when they wanted. They also commented that they considered that they were respected by staff and that they were able to receive visitors in private if they wished. We observed the way staff interacted with individuals. This was done in an informal and friendly manner. All individuals we spoke with considered that staff listened to them and acted upon what they said. A mobile pay phone is available to individuals and this can be moved to their rooms if they wish to make a call in private. All clothing of individuals in the laundry area was noted to be discreetly marked and a system of storing clothes is in place to ensure that the right clothing is returned to their owner. The privacy of individuals was further demonstrated when we wanted to talk to people. The individual was asked firstly if they wished to talk to us and if they did, the discussion could be held in private. The building has double rooms but these are only singly occupied. It has been a policy of the Manager to only place two people in these rooms if they are married couples who wish to share. Care Homes for Older People Page 15 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Highground are able to have access to activities that are tailored to meet their interests, are very well organised and involve relatives. People enjoy significant family contact and relatives are involved in many aspects of the service. People are able to be as independent as possible in their daily lives and their dietary preferences are met. Evidence: We looked at the daily lives of individuals. Assessment information completed before people come to live at Highground takes their social interests and their lives before they came to live at Highground into account. This included details about their families, past occupations and interests. The service provides activities both within and outside of the service. Details of forthcoming activities are on display within the building. These indicated that a summer fair was to take place soon as well as events to mark certain occasions through the year and the use of outside entertainers. The service employs an activity co-ordinator. This person was not available during our visit but steps had been taken to ensure that activities continued during the afternoon despite this. The people we spoke with stated that there was a lot of activities available at Highground and that they had always had the choice to participate or Care Homes for Older People Page 16 of 29 Evidence: otherwise. An activities room is available and this contained material for board games, art and crafts and visual material such as videos and DVDs. The co-ordinator maintains records on the activities that take place, the people who wished to be involved in them and gains the views of people afterwards to see if the activity had been enjoyable to them. Relatives are aware of the activities programme and were able to confirm the holding of the summer fair that week. They were also able to confirm which activities were available on what days during the week and that they got involved with their relations in some of the activities. One person who uses the service was knitting goods for sale at the summer fair when we spoke with them. This suggested that individuals were able to be involved actively in events taking place. Records indicated that events take place through the year to mark birthdays and times of the year such as St Valentines Day, Easter and St Patricks Night. We spoke with three people who use the service. All confirmed that they receive visitors and in all cases they were able to see them in private. We spoke with two relatives. They stated that one of the things they liked about the service was that there was no restriction on visiting and that they could come at anytime. They stated that they were made to feel welcome and were always offered a drink. They stated that staff maintained a friendly attitude to them when they visited and we witnessed this during our visit. We witnessed discussions between three relatives. They were fully aware of the activities within the service, which activities were to be held that day and the holding of a summer fair later that week. A visitors book was available. This evidenced that there were many visitors who came to see their relations during the week. We spoke with three people who use the service. In all cases they considered that they had had their independence maintained and were still able to do some tasks for themselves. One person stated that they were able to move independently through the building and could do this without the need for interventions by staff. Another person stated that they were generally independent with their finances and could draw on monies from their own account for their own use during the week. The service does not deal with the finances of people. This tends to be left with the individual or their families to deal with. No advocacy services are used at present. One person relies on support from their social worker given that they have no immediate family. A tour of the premises noted that individuals are able to personalise their rooms in whatever manner they wish. There were many rooms which included personal items Care Homes for Older People Page 17 of 29 Evidence: such as photographs and other personal items. We met with one person. This person supports a local football team and has been able to personalise his room to reflect his support. We looked at the provision of food at Highground. At the point of which people are assessed before they come into the service, they are assessed to see if they have any preferences, food allergies and a full nutritional assessment is completed. This assessment of their nutrition is continued and reviewed on a monthly basis. This ensures that no-one suffers from malnutrition. Records indicated that some people have health needs that mean that the meals provided have to take this into account. Other people were noted to have food allergies. Information was present in the kitchen to highlight these dietary needs and allergies so that catering staff were aware of these. Information is also available to catering staff about the presentation with means. A number of people need meals to be presented to a softer consistency to assist them with eating and specialist cutlery to assist is also recorded as information for catering staff. A four week menu is available and a record of food preferred is recorded. Menus are available in the dining room area on each table. Comments about food were positive. One person did stated that they wished there could be more variety during the evening meal. Evidence was available to suggest that a discussion about menus had been held at a residents meeting in January 2009 and as a result, the menu had been altered. Menus included evidence of choice and alternatives available if wanted. A dining room is available although some people prefer to eat in their own rooms. A smaller lounge is located close by and this is used by a handful of people who require a lot of support to eat. Lunchtime was indirectly observed during our visit. It was noted that those who are able to eat independently are enabled to do while others are provided with discreetly support. Staff interactions with people were noted to be helpful during this time. The service employs catering staff and a kitchen area is available. As well as containing information about the food preferences of people, the kitchen contains a number of appliances for the preparation of food. Refrigerators and freezers were well stocked and fresh fruit and vegetables are made available. Care Homes for Older People Page 18 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 use the service and their families can be confident that any concerns they have will be investigated appropriately. The people who use the service are protected form abuse. Evidence: We looked at the way in which the service manages any complaints. A complaints procedure is available and this outlines the way in which the service will deal with complaints and our role in receiving complaints. The service maintains complaints records and these suggested that no complaints had been made about the service since February 2008. There was evidence that the service had investigated the complaint and had taken action to the satisfaction of the complainant. We interviewed three people who use the service and asked them about complaints. In all cases, people stated that while they did not have any complaints, they would speak to the Manager and felt confident that he would deal with any issues to their satisfaction. We also spoke to two relatives. Again they knew how to make a complaint and felt had confident in the Manager to take their concerns seriously. We looked at the way the service protects the vulnerable adults in their care. The service has a copy of the Local Authority procedure for the reporting of abuse allegations. Discussions with the Manager noted that he was aware of the reporting procedure and how staff who have been found to have harmed people could be Care Homes for Older People Page 19 of 29 Evidence: referred to the protection of vulnerable adults list. The service has not been the subject of any allegations of abuse since our last visit. We found that staff had received information and training about protecting individuals. Staff training records suggested that staff had received training in safeguarding people and interviews with two members of staff also confirmed that they had received training. Information is available for staff about how they should not be involved in receiving gifts and being involved in wills. In situations where individuals display physical aggression, there was evidence that these individuals had been referred to health professionals in order to deal with such situations. Care Homes for Older People Page 20 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 people who live at Highground live in a well maintained and hygienic environment. Evidence: We had a tour around the building. The building has undergone some refurbishment especially to carpets and individual bedrooms. One person had just moved back to their room after it had been redecorated and was very happy with the result. Other people we spoke with stated that they were happy with their bedrooms. A refurbishment plan is in place and maintenance staff are employed to ensure that repairs are effected as soon as possible. The tour around the building noted that there were no concerns in relation to the standard of decoration. Some bathroom areas need to be refurbished. The Manager has applied to the organisation for funding with this. We support this application and recommend that this refurbishment goes ahead so that the people who use the service benefit from more pleasant facilities. A garden is area is available and this is to the rear of the building and receives sunlight in finer weather. Access is available to all areas for those who use wheelchairs. The exterior of the building is well maintained. Some weeds are growing in a gutter to the front of the building. It is recommended that these are removed given that they detract form the appearance of the building. No close circuit television is in operation at Highground. Relatives commented that the building was very homely. Care Homes for Older People Page 21 of 29 Evidence: The tour of the premises noted that there were no offensive odours present in any area of the building. Domestic staff are employed in the home to maintain hygiene. The service has a clinical waste disposal system and protective equipment such as aprons and gloves are available to staff. Soap and towels are in place at all hand wash areas. A laundry is available. This is well organised and separate from food preparation and storage areas. The laundry contains industrial appliances and hand wash facilities are available. A sluice is also available yet this is separate from toilet and bathroom areas used by the people who use the service. Relatives commented that there were no offensive smells in the building and that it was always fresh and clean. Care Homes for Older People Page 22 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 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 Highground have their needs met by staff who are sufficient in numbers and skills, trained and qualified to meet peoples needs and who are recruited in a way which protects vulnerable adults. Evidence: We looked at the way Highground meets the needs of people by the number of staff it has during the day and night. A staff rota is available providing details of staff designation. A separate record was available indicating which staff were actually on duty during our visit. This noted that as well as Registered Nurses on duty, there were senior health care staff, healthcare staff ancillary and administration staff. The mix of staff available enables each group to concentrate on their own tasks and for care staff to focus on the care and support of those living at Highground. We asked people who live at Highground about staff. They stated that they were happy with the standard of the support they provided and considered that staff always listened to them and acted on what they said. They also considered that there was always enough staff available. We interviewed members of staff. They confirmed that they thought there was always enough staff available. The Manager stated that when there are shortfalls in staff, the service tended to ask for staff from other services run by the same organisation as Highground rather than rely on agency staff. The service Care Homes for Older People Page 23 of 29 Evidence: has Senior Healthcare assistants. The Manager stated that he was seeking to develop their role by extending responsibilities especially in the area of medication. We received information from Highground before we visited the service. This provided information on how many staff had attained a National Vocational Qualification at Level 2. The information suggested that 70 per cent of care staff had attained the qualification at Level 2 with some moving on to complete Level 3. This level of staff exceeds what we expect the service to do. We looked at three personnel files of staff who had come to work at Highground in recent months. These files related to one nursing member of staff and other support staff. The files were noted to be in order and contained evidence that references had been sought as well as interview notes, application forms and police checks confirming their suitability to do their job. Information was available for the nursing member of staff to confirm that they were registered as a nurse and details of their current registration. We looked at the training that staff received. Interviews confirmed that apart from staff receiving training in mandatory health and safety topics, there was training available in other areas such as the protection of vulnerable adults and dementia awareness. A nurse was able to confirm that the service took their own professional development into account through the training they received. Training records were available as well as details of training that was about to take place in the forthcoming weeks. Evidence was also available to suggest that new staff undergo an induction process. Records were available suggesting that all aspects of the home and care practice are covered during induction. Care Homes for Older People Page 24 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 service is managed by an experienced and qualified individual. The views of the people who use the service and their families are taken into account. The financial interests of individuals is safeguarded. The health and safety of all is promoted by the practices of the service. Evidence: Since our last visit, the Manager, who was previously working in an Acting capacity has applied to us and become the registered manager. He is a qualified nurse and has had many years experience in supporting older people. We interviewed people who use the service, relatives and staff. We asked them about how the service was managed. In all cases, they stated that they thought that the service was managed well and had confidence in the Manager. Quality Assurance: We looked at the way the service examines its own standard of care that it provides. A representative from the organisation which runs the service Care Homes for Older People Page 25 of 29 Evidence: visits the service on a monthly basis and produces a report on their findings. These reports were examined and these evidenced that all aspects of the care provided were inspected and comments made about how the service was progressing. In addition to this, surveys have been sent out to families about the care provided to their relations. These have been completed and were viewed during our visit. A sample of returned surveys suggested that families were satisfied with the care provided. The service have addressed all requirements we raised during our last visit we were able to interview staff, individuals and their families in private as well as make all records available to us. The service does not deal with the management of peoples finances. Records and interviews with people confirmed that they either dealt with their own monies or rely on their families to do this for them. The service does have provision for the safekeeping of monies and have adopted a safe and accountable system to ensure that their financial interests are protected. We looked at the way the service maintains the health and safety of the people who use the service. Training records confirmed that staff had undertaken health and safety training such as fire awareness, manual handling, infection control, food hygiene and first aid. This training was also confirmed through interviews held with the staff. The service ensures that fire detection systems are tested regularly. Fire drills take place on a regular basis and a fire risk assessment has been completed. It was noted that fire extinguishers had not been serviced since June 2008 and that the deadline for re-servicing had expired. This was addressed on the day of our visit. There were records suggesting that portable electrical appliances had been tested as well as gas systems and electrical wiring. Provision was in place for the control of hazardous substances and these were noted be locked away when not in use. Information on such substances were available in laundry and kitchen areas. A passenger lift is available and this had been serviced along with other lifting hoists in bathrooms and portable hoists. Security of the building is taken into account through the provision of coded locks on all main entrances to the building and to areas such as the laundry which potential could poses a risk to individuals. Window restrictors are in place on upper floor areas. Accidents are recorded as evidenced by accident record books. 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 8 The service should ensure that staff receive up to date training in epilepsy so that records can more accurately describe those occasions when individuals experience epileptic seizures. The weeds growing in the gutter to the front of the house should be removed as they detract from the appearance of the building The bathrooms and toilet areas should be refurbished to ensure that the people who use the service are provided with a pleasant environment. The application by the manager to the organisation to fund this is supported by the Inspector. 2 19 3 19 Care Homes for Older People Page 28 of 29 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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