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Inspection on 09/02/10 for Mandalay Residential Home

Also see our care home review for Mandalay Residential Home for more information

This is the latest available inspection report for this service, carried out on 9th February 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

There is a welcoming and homely atmosphere. The Expert by Experience says, `there is a personal rapport with staff and residents which is warm and friendly`. The Manager consults with people before they move in. This is so that they are confident that their needs can be met. One person says, `I was told about the place and I remember asking questions and being told things about what to expect. All of the staff were kind and so I felt okay about moving`. People say that they receive the assistance they need in ways that are right for them. One person says, `the staff are really good. I can`t speak too highly of them. They`re always willing to help and they`re friendly and patient. I never have any qualms about asking if I need something because I know that they`ll be happy to help. You can`t ask for more really`. There is a good range of special equipment such as mobile hoists to help people who have reduced mobility. People can receive visitors whenever they wish and they can meet with them in private. The Manager keeps in touch with relatives so that they know how things are going. There are reliable arrangements for the ordering, storage and administration of medication. People are helped to stay in good health. This includes keeping an eye on how everyone is and then calling doctors as soon as they are needed. The accommodation is very well presented. It provides a comfortable setting. The garden is neat and attractively laid out. The kitchen meets the requirements of the local Department of Environmental Health. There is a modern automatic fire safety system. The laundry is well equipped and well organised. Most of the care workers have completed a relevant National Vocational Qualification (NVQ).

What has improved since the last inspection?

A number of improvements have been made since our last Key Inspection. The Manager has been registered by us. This means that we have confirmed that she is able to effectively oversee the reliable operation of the Service. A new system has been introduced to make sure that the individual written plans of care are kept up to date. These arrangements also make it easier for people to be actively involved in decisions that affect them. An additional medication store has been created. This makes it easier for medicines to be dispensed to everyone at the correct time. A new system has been introduced to make sure that when necessary medicines are kept refrigerated. The menu has been revised so that there is more choice and variety. A number of bedrooms, the foyer and hallway have been redecorated. New carpets have been laid in the foyer, hallway and in the lounge. More care workers have obtained a National Vocational Qualification. This has enabled them to further develop their skills and knowledge. The Registered Provider regularly audits the Service to make sure that it is running in the correct way. All of these things contribute to the Service being better able to care for people in ways that are right for them.

What the care home could do better:

Some people would like to have a wider range of social activities. There are shortfalls in the security checks that have been completed for one care worker. This might reduce the effectiveness of the systems used to keep people safe. Some care workers are not receiving all of the training that the Registered Provider says that they need. This might result in them not having all of the skills and knowledge they need. Some parts of the fire safety procedure need to be strengthened. The present arrangements might reduce the level of fire safety protection.

Key inspection report Care homes for older people Name: Address: Mandalay Residential Home 10 Julian Road Folkestone Kent CT19 5HB     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: Mark Hemmings     Date: 0 9 0 2 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 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: Mandalay Residential Home 10 Julian Road Folkestone Kent CT19 5HB 01303258095 F/P01303258095 mandalayresidential@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Stargate Partnership Ltd Name of registered manager (if applicable) Mrs Joanne Louise Flynn Type of registration: Number of places registered: care home 46 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is: 46 The registered person may provide the following category/ies of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - OP Dementia - DE (maximum number of places 11) Date of last inspection Brief description of the care home Up to 40 older people can make their home in Mandalay Residential Home (the Service). At the moment only 35 people can be accommodated. This is because some of the bedrooms have been taken out of use in order to create a separate unit for people who have problems with their comprehension. This unit has not yet been registered. Care Homes for Older People Page 4 of 29 Over 65 0 35 11 0 0 5 0 8 2 0 0 9 Brief description of the care home The property is a terrace of three large houses that have been joined together to form one dwelling. The accommodation is on three floors. Three passenger lifts give step free access around the accommodation. All of the bedrooms are single occupancy. They are laid out as bed sitting areas. All of the bedrooms have a private bathroom. These have a toilet and wash hand basin. Each bedroom has a television. There is a payphone. There is a main lounge and a dining room on the ground floor. There are three bathrooms, two on ground floor and one on the second floor. One of them is equipped with an easy access Jacuzzi style bath, one has a conventional bath that is fitted with a hoist and one has an ordinary bath. On the first floor there is a wet room. Each of these rooms has also got a toilet and wash hand basin. All of the bedrooms, the private bathrooms and the shared use bathrooms are connected to a call bell system. There is a large, level garden that has both lawn and flower beds. There is a patio area and there are garden tables and chairs. There is a fish pond. The Service is in a quiet residential street about half a mile from Folkestones town centre. There is a large supermarket nearby. There is a mainline railway station about a quarter of a mile away. The Service does not have its own vehicle. The weekly fee runs from £328.65 to £450.00. Please contact the Manager to find out more details about the charges. 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: The quality rating for this Service is 2 star. This means that the people who use this Service experience good quality outcomes. We arrived unannounced at the Service at half past eight in the morning. We were there for about seven hours. It was a thorough look at how well things are going. We took into account information provided by the Registered Provider in its self assessment. This is called the Annual Quality Assurance Assessment (the Assessment). We received this on time. It gives us a reasonable account of developments within the Service. Some parts of the Assessment are only completed in brief detail. Several sections are not completed at all. Further, we considered any other information that we have recently received about the Service. We did our last Key Inspection on 15 April 2009. We then did a Random Inspection on 5 August 2009. This was done so that we could check that improvements Care Homes for Older People Page 6 of 29 we required at the Key Inspection had been done. We concluded that a lot of progress had been made and that more was planned. During the present inspection, we spoke with eight of the people who currently live in the Service. We spent time in the company of another 10 of them while they were in the lounge or in the dining room. We spoke with the Manager and the deputy manager. We also spoke with four care workers and a housekeeper. We looked around parts of the accommodation and the grounds. Also, we looked at a selection of key records and documents. These included things like the individual written plans of care, medication records, the activities plan, the menu, complaints documents, the staff roster, staff training records, financial records and various health and safety certificates. Before we visited the Service, we asked some of the people who live there, some relatives, some members of staff and some health and social care professionals to fill out a questionnaire for us. We wanted them to tell us what they think of Mandalay Residential Home. Two people who live in the Service, one relative and two health and social care professionals kindly completed them for us. Later on in our Report, we will tell you the main things that are being said in these questionnaires. The Registered Provider has also asked people who live in the Service to fill out a questionnaire on what they think of their home. We will tell you some of the points they make in their replies. We were joined by an Expert by Experience. She has a thorough knowledge of the special needs of older people. She spent about three hours in the Service. During this time, she observed what was going on in the lounges. She also talked with people who live in the Service and with members of staff. She had a look around the main parts of the accommodation. This included going into some of the bedrooms by invitation. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? A number of improvements have been made since our last Key Inspection. The Manager has been registered by us. This means that we have confirmed that she is able to effectively oversee the reliable operation of the Service. A new system has been introduced to make sure that the individual written plans of care are kept up to Care Homes for Older People Page 8 of 29 date. These arrangements also make it easier for people to be actively involved in decisions that affect them. An additional medication store has been created. This makes it easier for medicines to be dispensed to everyone at the correct time. A new system has been introduced to make sure that when necessary medicines are kept refrigerated. The menu has been revised so that there is more choice and variety. A number of bedrooms, the foyer and hallway have been redecorated. New carpets have been laid in the foyer, hallway and in the lounge. More care workers have obtained a National Vocational Qualification. This has enabled them to further develop their skills and knowledge. The Registered Provider regularly audits the Service to make sure that it is running in the correct way. All of these things contribute to the Service being better able to care for people in ways that are right for them. 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 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are thinking of moving in are asked about what care they need and how they want this to be done. They are encouraged to visit the Service to get a first hand feeling of what it is like. People who want to stay for only a short time will be supported to go home again. Evidence: The records show that the people who are thinking of moving in are asked about what care they need and want. They and their relatives are also invited to visit the Service. This is done so that they can be confident that moving in to Mandalay Residential Home is the right thing for them. If necessary the Manager also talks with people such as health and social care professionals. All of this helps her to build up a really good picture of how the person can best be supported. There is a Service Users Guide. This is a brochure that gives useful information about the facilities and the services that people can expect to have when they move in. Care Homes for Older People Page 11 of 29 Evidence: Copies of this document are available from the Manager. In their questionnaire replies people say that they had enough information when they were deciding about moving in. One person says, I was told about the place and I remember asking questions and being told things about what to expect. I dont remember if I visited but I probably did to have a look around. All of the staff were kind and so I felt okay about moving. At the end of the day its the staff that make a place. Care workers say that the Manager shares with them the information she has obtained about someone who is due to move in. This is done so that they know what care they will need to provide. One care worker says, of course when you move somewhere new it can be scary and we dont want that. We do all we can to make the person feel welcome and they have time to settle in and find their own balance. Most of the people who move in do so with the intention of making Mandalay Residential Home their longer term home. However, some people may want to stay for only shorter periods. This might be when relatives go for a holiday. Or they might have been in hospital and need some extra time before going home. The Manager says that she will carefully liaise with relatives and with health and social care professionals. This is so that the person can have the necessary support when it is time to leave. 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. There are written plans of care that describe what care it be provided. People are reliably receiving all of the care they need. They are treated with courtesy and respect. People have access to the medical and health care services they need. There are reliable arrangements for handling medication. Evidence: Each person has an individual written plan of care. These describe what care they need and how they want this to be delivered. Recently, a new form has been used to record these plans. There are various headings and prompts about what should be written down. The change has been done so that information in the plans is more consistent and is more clearly presented. Each person has a key worker. This is a care worker who takes a special interest in how satisfied a particular person is with the care they receive. There is a new system that involves each persons key worker liaising with them to review their individual plan of care once a month. The Manager says that additional more detailed reviews will be held when necessary. Care Homes for Older People Page 13 of 29 Evidence: In their replies both to our questionnaires and to those of the Registered Provider, people say that they reliably receive the care they need. They also say that care workers listen to them and act on what they say. One person says, the staff are really good. I cant speak too highly of them. Theyre always willing to help and theyre friendly and patient. I never have any qualms about asking if I need something because I know that theyll be happy to help. You cant ask for more really. One care worker says, we get to know the ladies and gentlemen really well over time and so we know how they like things done. Some people can manage on their own and dont want fussing over and thats fine. Others need a lot more help and were happy to give it. We always say that this is what we want for out own families and with that its hard to go wrong I think. One health and social care professional says, the residents are looked after very well. Their needs are always met. The staff are very efficient and helpful. In their replies to the Registered Providers questionnaire most people are satisfied with the response they receive when they use the call bell. We observed it ringing on a number of occasions. Each time it was answered promptly. People are helped to have a bath or a shower whenever they want to. People are also assisted to use the toilet without having to wait unduly. Each person has an adequate wardrobe of clothes so that they can choose what they want to wear. One care worker says, its really important isnt it that people have nice clothes to wear so that they can look how they want. The ladies here take a pride in their appearance, they like to dress nicely and to have their hair done. We try to make sure that they always have enough clothes to choose from and that they can vary their dress each day. The Expert by Experience says, there is a personal rapport which I observed with staff and residents which is warm and friendly. She also says, the majority of residents are able to articulate their needs and staff take a moment to speak to various individuals as well as assisting residents to the toilet and into wheelchairs. Staff are aware when assistance is needed and act promptly. One relative says, I visit often and in the main I have found the staff to be very pleasant and patient with the residents. The home is clean and warm. Sensible steps are taken to help prevent people from having accidents. For example, people can have rails on their bed if they are worried about rolling out. Care Homes for Older People Page 14 of 29 Evidence: The records show that people are receiving the medical care they need. This includes seeing professionals such as their doctor as and when they are needed. They also see specialist health and social care professionals. They give advice to the Service about how best to respond to people who have complicated personal and medical care needs. The records show that this advice is followed. For example special things have been done to help people take care of their skin so that it remains healthy. A chiropodist regularly calls to the Service. Arrangements are also be made for people to see a dentist or optician if this is necessary. People can manage their own medicine if they want to and if it is safe for them to do so. At the moment everyone has chosen to have the care workers manage it for them. There is a system to check that the correct medicines are received from the chemist. Once in the Service, medicines are stored securely. Recently, additional storage has been provided. This has been done so that it easier to dispense all of the medicines at the correct time. Also, a new system has been introduced to make sure that when necessary medicines are stored in cool conditions. There is a procedure for administering medicines. This is designed to double check that the right medicines are given to the right people at the right time. There is a record that is completed on each occasion that a medicine is given. These are being completed correctly. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can take part in social activities if they want. People are free to receive visitors and to spend the day as they wish. Good quality meals are served. Evidence: People can choose to do a range of social activities such as gentle exercise, aromatherapy, quizzes and attending in house music recitals. In the summer the garden is very popular. People can sit out and enjoy their attractive surroundings. In the past six months there have been four organised trips out. In their replies to both our questionnaire and to the Registered Providers questionnaire most people but not everyone, say that they have enough social opportunities. One person says, I dont really get bored and there is always something to join in with in the lounge if I want to. I dont really want to and thats my choice. We do have entertainers come in and I like that. Someone else says, it can sometimes be a longish day if youre not keen on things like crafts or bingo. Perhaps there could be more variety of activities and more trips out. One care worker says, we do something every afternoon in the lounge and people know they are welcome to come along. Some people are regulars others come now and then. Theres Care Homes for Older People Page 16 of 29 Evidence: always something to do if they want. The Expert by Experience says, although there is no activities co-ordinator staff seem happy as a team to take on this role. Many residents are happy to sit amongst and with others in the lounge and dining room where some conversations take place. People are free to receive visitors whenever they want. They can speak with them in the privacy of their bedroom if they wish. The Manager says that she keeps in touch with relatives so that they know how things are going. People are encouraged to make their bedrooms their own private space. They are helped to arrange them as they want them to be. People can use their bedrooms whenever they want. They can choose to have private time on their own or to be in company. The Expert by Experience says, all bedrooms are clean with matching curtains and bedspreads with an easy chair, some have televisions others radio. The rooms are mostly quite large and personalised with photographs and ornaments. Only two rooms are dark, mainly because they face on to a brick wall. They are however clean and comfortable. The Registered Provider does not get involved in helping people to manage their financial affairs. Most people are helped by their families. The records show that there is a varied menu. Recently, it has been revised in response to suggestions from people about different dishes they would like to have. The main meal is lunch and the sorts of dishes served are things like savoury mince, spinach and ricotta cannelloni, smoked haddock and cottage pie. There is a cooked option at tea time. These dishes include things such as tomatoes on toast and fish fingers. There is a choice of main dish at each meal time. There are drinks and cakes and biscuits served mid morning, mid afternoon and later in the evening. People can dine in their bedroom if they wish. In their replies to the Registered Providers questionnaire most people say that they are satisfied with their meals. One person says, the meals are very good really for such a large place. I always look forward to my meals and theyre nicely served. I always have enough to eat and theres always more if you want it. The Expert by Experience says, the food is well prepared and presented, with notice being taken of peoples individual requirements. The food is hot and served promptly in the dining room and is sent on covered plates on prepared trays to the two people in their bedrooms. Care Homes for Older People Page 17 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. There is a complaints procedure. The receipt and investigation of concerns and complaints are not being fully recorded. There are systems in place that are designed to keep people safe. People are protected from prejudice and discrimination. There are reliable systems for helping people to manage their personal spending money. Evidence: There is a written complaints procedure. This explains how someone can raise concerns about the Service. It states how and by when a complaint will be investigated. In their questionnaire replies people say that they know how to make a complaint. One person says, I can say anything I want to but I really dont have anything to complain about at the moment. If I wasnt happy about something I could talk about it with any of the staff I suppose. Another person says, Im quite okay and I dont need to say anything. I could always speak with (the Manager) and Im sure that shed listen and take anything I said seriously. Since our last Key Inspection we have not received any complaints about the Service. The Registered Provider has received one complaint about an aspect of the security arrangements in place. We understand that the matter was promptly referred to the necessary agencies and that a suitable investigation was completed. People who live in the Service are confident that they are safe and that their wellbeing will be promoted. In their replies to both our questionnaire and to the Registered Care Homes for Older People Page 18 of 29 Evidence: Providers people say that members of staff always treat them well. The care workers are confident that people are being kept safe. One care worker says, the residents really do come first and no one would stand for anything that wasnt right for them. The records show that care workers receive training in relation to keeping people safe. The Assessment commits the Registered Provider to promoting diversity in the Service. This means respecting each person who lives there as an individual. It also means making sure that no one experiences any form of prejudice or discrimination. The records show that care workers receive training about this subject. The Manager says that this commitment to promoting diversity is also expressed in practical terms. For example, in the way that each person receives individualised care in ways that respect their preferences and wishes. One of the Registered Providers policy documents states, (people) will at all times be treated with respect. Specific needs including those arising from diversity for example from ethnicity, sex or religion will be recorded and addressed. Suitable safeguards are in place to protect the interests of people if someone needs to have aspects of their freedom temporarily restricted. People are helped to handle their personal spending money. Usually this means that relatives bring in small amounts of money that are put into safekeeping by the Manager. The money is then used to pay for things such as for seeing the hairdresser. The records show that the system is working in a reliable and transparent way. Care Homes for Older People Page 19 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 accommodation is very well presented. There is a modern fire safety system. There are some shortfalls in how this is being checked. The kitchen is well equipped. There is enough equipment to help people who have difficulties with their mobility. There is a suitable laundry. Evidence: The building provides a suitable range of facilities for the people who live there. These are in line with what the Registered Provider has committed itself to deliver in its Statement of Purpose. This is a legal document that describes in some detail the facilities and services that are available in Mandalay Residential Home. Copies of this document can be obtained from the Registered Provider. The building is very well maintained on the outside. The garden is neat and attractively laid out. On the inside, the accommodation is very well decorated and furnished. The lounges are comfortable spaces. The Expert by Experience says, the corridors, lounge and dining room have pictures on the wall. The dining room is laid with dark red tablecloths which match the curtains and lighter wall decor. The lounge is large with matching easy chairs. There are flowers on several window ledges. Since our last Key Inspection five of the bedrooms have been redecorated. The foyer Care Homes for Older People Page 20 of 29 Evidence: and the ground floor hallway have also been redecorated. New carpets have been laid in the foyer, the hallway and in the lounge. New linoleum is currently being laid in the first floor bathroom. There are some health and safety posters on the walls. These detract a little from the homely standard that is generally achieved. There is a range of equipment to help people who have reduced mobility. There are the easy to access baths and the wet room. There is a mobile hoist that can be used in the lounges and in the bedrooms. There are also other things such as special sheets to help people change position in bed. There are banister rails in the hallways. Also, rails are fitted to the wall near to the toilets so that people can hold onto them and use the facilities safely. There is a modern automatic fire detection system. This has been assessed by the Registered Provider to make sure that it continues to meet the national standard. Most but not all of the developments recommended by the assessment have not yet been completed. There are a range of ongoing checks that need to be done to make sure that the system is working in the right way. Most but not all of these checks are being done. The Manager says that all of the remaining checks will now be done. People say that the accommodation is always comfortably warm. It was warm on the day of our visit even though it was a very cold day. One person says, Im always nice and warm in here, just as well in this climate. The radiators are fitted with guards. This has been done so that their heated surfaces cannot get hot enough to burn someone. The hot water system is temperature controlled. This has been done so that it does not get hot enough to scald someone. The kitchen is clean and well equipped. It meets the requirements of the local Department of Environmental Health. The cook knows about the importance of good hygiene. Safe systems are used in the storage and preparation of food. As part of this, there are regular checks to make sure that refrigerators and freezers are cold enough to store food safely. Checks are also done to make sure that hot foods are cooked through. There is a system to date mark food so that it does not go beyond its use by date. The laundry is well equipped with large washing machines and a dryer. The washing machines are fitted with a special cycle for items that need a particularly hot wash. The area is well organised and clean. There are suitable arrangements for promoting good standards of hygiene. There is a sluice. This is used for items that need cleaning Care Homes for Older People Page 21 of 29 Evidence: before they are put in the wash. 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. There are enough care workers on duty. Care workers are receiving most but not all of the training that is intended for them. Security checks are completed on new members of staff. Evidence: There are 32 people in residence. The records show that there are five care workers on duty from early in the morning until later in the evening. There is a waking staff presence at night. During the day there are other people who do the housekeeping and who work in the kitchen. Care workers say that there are enough members of staff on duty. One care worker says, we normally have enough staff on duty. Some days things can be hard work and theres lots to do, but we all know our jobs and the routine seems to work pretty well. Certainly, Im confident that people get the help they need when they need it. Another care worker says, it depends on the day but usually we manage okay. Theres time to chat with people and to do activities. We dont want it all to be task led, people want to have a chat with you and to feel that youre not rushing from one thing to another which we arent. The records show that most but not all of the necessary security checks are being Care Homes for Older People Page 23 of 29 Evidence: completed for new care workers. These include things such as confirming their identity and doing a police check. This is done to make sure that they are trustworthy people to work in the Service. There are some additional references that need to be sought for one care worker. The Manager is going to undertake this by 1 April 2010. Care workers do introductory training before they join the roster. One care worker says, I got a lot of training when I came. I met all of the ladies and was told about things such as how to help people get up and move about. I was also told about how people like to be helped in their own way and about the need to follow this. I was shown where the fire exits are and what to do if the alarm goes off. There really is a lot to learn and it was helpful to do it gradually. After their introduction, there is ongoing training in key subjects such as first aid, health and safety, how to help people who have reduced mobility and how best to support people who have reduced comprehension. Most but not all of the care workers have had the training that the Registered Provider has committed itself to provide. The Manager says that more training is planned for this year. One care worker says, the training is good. We seem to do quite a lot of courses and theres always something being planned for us. You can suggest additional courses to (the Manager) and shell listen and organise it if she can. Most of the care workers have a National Vocational Qualification (NVQ). Several more are studying for it. The award is designed to further develop their ability to provide people with the assistance they need. The Manager says that all of the care workers will be encouraged to obtain the qualification. 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 Manager is registered with us. There is a quality assurance system. There are reliable health and safety arrangements. Evidence: The Manager is registered in her post. This means we have confirmed that she has the knowledge and skills necessary to ensure that people reliably receive the care they need and want. She has both of the formal qualifications that are recommended by the National Minimum Standards. Members of staff say that there is good team work in the Service. One care worker says, the teamwork is pretty good. Some people have worked here a long time but they welcome newcomers. We have all got to know each other and we work together as a team. Another care worker says, this is an okay place to work. Theres no us and them in the team we all get on. Staff in general are treated with respect and we arent bossed about. Were expected to do our jobs, but thats fair enough. Care Homes for Older People Page 25 of 29 Evidence: There are handover meetings at the beginning and end of each shift. These are when care workers discuss how things are going so that they can plan what needs to be done. There are regular team meetings. As noted previously, people who live in the Service are invited each year to complete a questionnaire. There are also house meetings where people can get together to talk about the results of the questionnaires and about their home in general. There is evidence to show that suggested improvements are implemented. Someone senior from the Registered Provider calls to the Service at least once each month. The records show that they speak with people who live in the Service and with members of staff. They also check various records and look around the accommodation. All of this is done to make sure that the Service is operating in the correct way. There is also a more detailed annual audit that is done by a consultancy firm. The most recent one concludes that, Mandalay is a clean, spacious and updated property that provides it residents with a homely and friendly atmosphere. The residents appear to be well cared for and happy. The records show that members of staff receive annual fire safety training. The Manager is going to make this more frequent. This will be done by 1 April 2010. There are regular fire drills. There is a health and safety policy. This commits the Registered Provider to maintaining a safe environment in the Service. The records show that items of equipment such as the passenger lift, the hoists and the electrical wiring installation remain in good working order. There have not been many significant accidents in the Service since our last Key Inspection. The Manager monitors the occurrence of accidents. This is so that she can see if anything needs to be done to help prevent them from happening again. She says that nothing particular needs to be done at the moment. The Manager regularly completes a health and safety audit of the building and the accommodation. This is done to help make sure that there are no minor hazards that might result in someone having an accident. The Manager says that there are no particular hazards that need to be dealt with. We did not notice any either. 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 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. 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