Inspection on 16/04/09 for Oakdene Nursing Home Limited

This is the latest available inspection report for this service, carried out on 16th April 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Oakdene Nursing Home Limited 27/04/07

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 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Oakdene Nursing Home Limited 32-34 Stamford Road Lees Oldham Lancashire OL4 3LH     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: Helen Dempster     Date: 1 6 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 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 30 Information about the care home Name of care home: Address: Oakdene Nursing Home Limited 32-34 Stamford Road Lees Oldham Lancashire OL4 3LH 01616244594 01616330904 susan.hopkinson@regencyhomesltd.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Regency Homes Limited care home 37 Number of places (if applicable): Under 65 Over 65 9 37 dementia old age, not falling within any other category Additional conditions: 0 0 The home is registered for a maximum of 37 service users to include:- *Up to 37 service users in the category of OP (Old age not falling within any other category) *Up to 9 service users in the category of DE (E) (Dementia over 65 years of age) Date of last inspection Brief description of the care home Oakdene is a detached Victorian house situated close to Lees village, close to amenities and public transport. The home is registered to provide nursing and residential care for up to 37 service users. Accommodation is provided in 15 single rooms, six of which have en-suite facilities. There are 11-shared rooms, two of which have en-suite facilities. At the time of this inspection, four of the shared rooms had been allocated as single accommodation. Three of the shared rooms and three of the single rooms are below the National Care Homes for Older People Page 4 of 30 Brief description of the care home Minimum Standards in respect of size. The home provides adequate toilets and bathrooms, situated close to bedrooms and communal areas. Information about the service can be obtained from the Service User Guide, or directly from the manager. The ranges of fees charged are #343 to #610. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key unannounced inspection, which included a visit to the home, took place on Thursday 16th April from 11am to 7:15pm.. The manager and staff did not know that this visit was going to take place. Prior to the inspection, we sent surveys out to people who use the service and staff to ask what they thought about the service. Three members of staff and five people who use the service returned their surveys. Comments from these surveys are included in the report. We asked the manager of the service to complete a form called an annual quality assurance assessment (AQAA). This form gave the manager the opportunity to tell us Care Homes for Older People Page 6 of 30 what they felt they do well and what they need to do better. This helped us to determine if the management of the service see the service they provided in the same way that we saw it. All of the key inspection standards were assessed at the site visit and information was taken from various sources. This included observing care practices, talking with people who use the service, their relatives, the manager, a senior manager and other members of the staff team. The care of three people was looked at in detail to learn about their experience of the service from when they first used it to the present-day. A selection of records were looked at, including medication records, training records and care records. What the care home does well: What has improved since the last inspection? A new manager had been recruited since the previous inspection. The staff told us that since commencing work at the home in August 2008, the manager had worked very hard to improve the service for the benefit of people using the service. We saw that the manager had addressed all the requirements and recommendations made at the previous inspection. The improvements made include the following: The manager had improved the way that people received information to help them to make decisions about their service. She had also improved the way that peoples needs were assessed and the way that their care plans were written to provide staff with all Care Homes for Older People Page 8 of 30 the information they needed to support people in the way that they wanted to be supported. She also made sure that peoples needs and preferences were regularly reviewed. Throughout the inspection, staff talked about the way that the manager had improved the running of the home. In particular, staff said that care plans were better, staff who had not previously received an induction had received one since the new manager started, access to training had improved, the standard of care was, a lot better now, that, the whole running of the home is more organised, and that, staff know more as the manager makes sure they have the training. One member of staff concluded that the home is, more efficient, that the manager is, on the ball and get things done, and that the manager, tells you straight and listens and takes notice of what you say. People and their relatives were also happy with the manager and talked about, feeling at home, at the service. Comments about the manager included that she was, great, very approachable, and, very professional. People using the service, relatives and staff said that they trusted the manager. Visiting community nurses said that they had never seen any practice in the home that caused them any concern and that the manager was, very good. The manager had made improvements to the environment by replacing some carpets, curtains and furniture and refurbishing four bedrooms. Staff said that the level of hygiene in the home had improved and people were happy with this. The manager had recently completed a quality assurance audit, which she was in the process of collating to make sure that peoples views influenced the way the service was run. What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 9 of 30 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 10 of 30 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 11 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are given information, and, wherever possible, have their needs assessed before moving into the home, so they know that their needs can be met. Evidence: In the AQAA the manager stated, we provide the service user guide in plain English and this is available in large print. Needs assessments are robust and identify the needs of the prospective service user prior to admission. To find out whether this was the case, we looked at a range of documents and we looked carefully at the care provided to three people from the point of their admission to the present time. We also talked to people using the service and looked at the information in surveys that five of the people using the service and three of the staff had filled in. Care Homes for Older People Page 12 of 30 Evidence: A new manager had been recruited in August 2008. Since her recruitment, it was evident to us that the manager had been working hard to improve the way that peoples needs were assessed and met at the home. The manager had started this process by reviewing and updating all the information that is provided to people who are considering moving to the home. This information is provided in two booklets which are the statement of purpose and the service users guide. Both these booklets provided a range of information about what a person can expect from the service. The relative of one person described the admission process. This person explained that their relative was admitted after suffering a lot of falls at home and having had some respite care. The relative said that the admission process was very positive, that their relative was initially admitted for a short stay and made their own decision to stay because they felt that the home was, very nice and that they were, very happy here. When we looked at the assessments for three of the people who use the service, we saw that the manager had ensured that a requirement made at the previous inspection had been addressed by improving the way that assessments of needs were carried out, so that information was more detailed and thorough to enable a clear care plan to be formed. It was recommended that assessments and all other paperwork concerning people using the service is always signed and dated. Five people who use the service filled in surveys to tell us their views. Four of these people said that they had received enough information about the home before they moved in to decide if it was the best place for them. The remaining person had been admitted urgently from hospital so had not had the opportunity to do this. One person added that, Age Concern were consulted on the recommendation of local nurses. A visit confirmed that the home was satisfactory. Two members of staff who completed a survey said that they were usually given upto-date information about the needs of the people they cared for. Care Homes for Older People Page 13 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal care needs were met in the way they preferred and with respect for their privacy, dignity and independence. Evidence: In the AQAA the manager stated that care plans, were reviewed at least monthly according to need and were changed as required. The manager added that this included looking at peoples medical needs, the protection of peoples skin, any accidents and medication issues. As was the case for assessments of peoples needs, the new manager had made significant progress to improve peoples care plans and had ensured that she had addressed a requirement and a recommendation from the previous inspection that care plans reflected peoples assessments, provided sufficient detail to staff in which to carry out their care duties and that communication systems had improved to keep the staff informed of peoples changing needs needs. Care Homes for Older People Page 14 of 30 Evidence: The manager had achieved this by developing new care plans, written from the point of view of the person receiving the care, concerning daily routines, personal care, sleeping/night routines, continence promotion, risk assessments/personal safety, nutrition, mobility, communication, short-term memory loss/cognition, activities/social interests, family/friends/social contacts and any specific issues e.g. medical conditions and treatment. The three care plans we saw were clear and detailed and provided staff with the information they needed to care for people in the way that they wished to be cared for. One particularly good practice was obtaining a personal history of each person using the service, which was detailed and helpful and gave a clear picture of what was important to each person historically and currently. We also saw that care plans contained the fine details of peoples preferences, e.g. how they liked their bed made up, what their preferred routines were. Most importantly, care plans contained clear advice to staff about how they should approach and communicate with each individual and how to provide reassurance and respect for their dignity when delivering personal care. This is good for people using the service. Regular reviews of peoples needs were being completed and one member of staff said in a survey that, more information is given on care plans and is a lot more in-depth since the new manager commenced work. People who use the service and their relatives were pleased with the care received. Once relative said that staff were good about privacy. A person using the service said that the staff, look after me beautifully, are, incredibly kind , and are, good about privacy, always apologising when moving me. This person concluded, Ive no complaints at all, they dont neglect me in any way. A relative also concluded that they were, very happy with standard of care. Community nurses visiting the home were also positive. They said that the support they received when they were seeing their patients was, good, and that staff always accompanied them to the patients room and left them in privacy. The nurses said that they had never seen any practice in the home that caused them any concern. We saw risk assessments which addressed a range of risks. However, some were more detailed than others. It was clear that the new care plans and recording systems constituted work in progress, and that the manager was continuing to work to ensure that all the care plans and risk assessments were very detailed. It was recommended that risk assessments, including those concerning the risk of falls, contained more details to support staff to minimise the risk and more details of the history of the problem e.g. the history of risk of falls. Care Homes for Older People Page 15 of 30 Evidence: Medication was dispensed from a monitored dosage system. The manager said that people can choose to self medicate if they are assessed as being able to do so, and each person has a safe in their room to facilitate this. Since the previous inspection, the manager had introduced a risk assessment process to use when a person wished to self medicate. Medication was administered from two appropriately secured drug cabinets to patients who were in receipt of nursing care by trained nurses, and to people receiving personal care by four senior carers. We saw that records, including the records of controlled drugs, were well maintained. Photographs of each person for whom medication was being administered, and some basic details of their needs, were seen. It was recommended that a care plan which detailed a persons specific needs concerning their medication, what it is prescribed for, and any possible side-effects was completed. The manager felt that this would prove helpful and said that the recommendation would be implemented. Care Homes for Older People Page 16 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from choices to enable them to exercise day to day control over their lives and enjoy the food of their choice. Evidence: In the AQAA the manager stated that the service has, an activities program which takes into account residents interests, that the home has, open visiting, and that, families are invited to activities and entertainments and occasional meals. To assess whether this was the case, we talked to people, their relatives and staff, had a meal with people who use the service and looked at the programme of activities. We found that the practice of taking a detailed personal history for each person enabled staff to understand what had been, and what was, important to each individual. The service provides some one-to-one activities and a range of planned activities that everybody can join in. A hairdresser attends every week and the home has its own salon. The manager said that in the afternoon staff are encouraged to spend time with people giving manicures, having one-to-one chats and generally interacting with people on a one-to-one basis. The manager said that if people wish to help with chores like setting the table, they are encouraged to do so as this gives Care Homes for Older People Page 17 of 30 Evidence: people, purpose. The manager purchases the services of several organisations that specifically provide activities. The activities included movement to music, quizzes and dance exercise. Each week a charity organisation called, pets are therapy visit the home, bringing a dog to the home for people to interact with. We saw that leaflets describing all activities available were on the residents noticeboard. The manager had improved communication in the home with people using the service since the last inspection by introducing a newsletter, a copy of which was displayed on the residents noticeboard. The newsletter had details of new residents at the home and new members of staff. It also had details of birthdays and events and other information about any changes/improvements at the home. Peoples religious needs are recorded and Roman Catholic services are provided each month and the Church of England minister visits twice monthly. We had lunch with people who use the service in the main dining room. We saw that people are offered alternatives to the main menu and can make specific requests. The meal was hot and tasty and well presented and people said that they had enjoyed it. The atmosphere was relaxed and unhurried, as there were plenty of staff to serve the meals and support people. Some people choose to eat in their own room and this choice is respected. People said that the food is plentiful and hot and alternatives are always offered. Relatives we spoke to praised the cook, who was described as, very nice. Two relatives talked about the efforts made to ensure that people were provided with the food they liked, cooked the way they liked it. One relative talked about the cook encouraging their next of kin to eat by tempting them with food. All the people we spoke to and their relatives said that visitors to the home are made welcome. We witnessed visitors being greeted by the manager and staff and saw that they were friendly and welcoming in their approach. One person said of staff that they, do all the things that are important to you, they do anything you ask and added, they always bring a nice pot of tea and a tray. One persons relative said that staff were very friendly, that the home had open visiting and that they were always made welcome and given a drink. This relative concluded that they always, feel welcome and confirmed that they had joined in activities with their relative and others. Care Homes for Older People Page 18 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were confident that the manager and staff would listen to their concerns and staff training in the protection of vulnerable adults ensured that people were safeguarded from abuse. Evidence: In the AQAA, the manager stated that, the complaints procedure has been refined to enable staff/residents/family a telephone number to contact the organisation out of hours. The manager added that, policies and procedures are are adhered to, to ensure the protection of our vulnerable adults. To see if this was the case, we looked at policies, procedures and records and talked to people, their relatives and the staff. We saw that the complaints procedure was displayed on the residents noticeboard and had been recently reviewed. We saw that there was a complaints record, but that no complaints had been recorded. The manager said that she tends to deal with complaints as and when they happen. It was recommended that these complaints and the action taken should be recorded to demonstrate the way the home deals with complaints positively. It was also recommended that copies of the outcomes of complaints held by the company head office should be held at the home. We saw that policies and procedures concerning the protection of vulnerable adults were in place. Twenty three of the staff had received training in the protection of Care Homes for Older People Page 19 of 30 Evidence: vulnerable adults and a further seven staff were about to receive this training in May 2009. All five people who had filled in a survey said that the staff listened to and acted on what they said. One person said, the staff are responsive to any matters raised and considerate of any action required. All of these five people said that they knew how to make a complaint and all three staff who filled in a survey said that they knew what to do if anybody had concerns about the home. People said that the manager and staff were approachable. Without exception, people, their relatives and the staff said that they could go to the manager with any problem and would not have any hesitation in telling the manager about anything that concerned them. One relative said that the manager was, very approachable, and, very professional and added that they trust the manager. This relative found the manager to be reassuring as she, explains more than doctors,and takes time out to explain to relatives. Care Homes for Older People Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefited from a comfortable, clean, safe and well maintained environment. Evidence: In the AQAA the manager stated that the environment was, clean and that the grounds were, neat and tidy. The manager also described improvements made since the last inspection. This included employing a maintenance manager, refurbishing four bedrooms, creating an upstairs lounge area to allow more sitting areas, providing new curtains and some new carpets in bedrooms, replacing the carpets in the lounge, dining room and corridors and purchasing new beds, new furniture and new dining chairs and tables. This had significantly improved the environment for people. Of the five people who filled in a survey, two people said that the home was always fresh and clean, two people said it usually was and one person said it sometimes was. One person added, the home is very clean. Not surprisingly for an establishment of this kind, sometimes unpleasant smells are noticeable, but this tends to be the exception. One of the cleaning staff talked about the fact that the manager had significantly improved the level of hygiene at the home. Care Homes for Older People Page 21 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service benefit from support provided by experienced and committed staff who they trust. Evidence: In the AQAA the manager stated that, all new staff complete the common induction standards and that staff training includes training in, protection of vulnerable adults from abuse, moving and handling people, fire training, nutrition, pallitative care, tissue viability, first aid and health and safety. The manager added that recruitment procedures had improved to make them, robust. To see if this was the case we looked at the recruitment procedure, staff files and training records and we talked to people, their relatives, the manager, and the staff. We saw that the recruitment procedure includes potential staff completing an application form, being interviewed, providing references and the manager ensuring that a Criminal Records Bureau (CRB) check was undertaken for each staff member employed. This ensured that people were cared for by staff that had been vetted. When looking at staff files, we saw that a full employment history wasnt always taken to identify any gaps in employment. It was recommended that all applications were carefully checked to make sure that a full employment history was provided. Care Homes for Older People Page 22 of 30 Evidence: The service employs 33 staff in total. This includes seven nurses, 16 care staff and 10 ancillary staff. The manager actively encourages staff to complete training. We saw from records that 10 of the care staff hold the National Vocational Qualification (NVQ) level 2, that five of the care staff were studying towards this qualification and that three of the care staff are studying towards NVQ level 3. In addition, five of the ancillary staff were about to complete NVQ level 2. We also saw a copy of the training matrix, which demonstrated that staff receive a wide range of training and that the access to training had improved significantly since the new manager was employed. This was confirmed by staff in surveys and in person. In particular, all three staff who completed a survey said that they had been given training which was relevant to their role, helped them to understand and meet the individual needs of people, and kept them up-to-date with new ways of working. One member of staff commented that, new equipment and training courses have been offered since the new manager started. People and their relatives were very happy with the staff. Comments included,staff are very nice, very friendly and that, staff are accommodating. One persons relative said that they visit at all hours of the day and witness staff talking to residents in a, pleasant ,way. This relative concluded that, theyre lovely the way they talk to the residents, and that, they explain what theyre doing. Care Homes for Older People Page 23 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People and their relatives were confident that the manager ran the home in the best interests of people who live there and that their safety and welfare were promoted. Evidence: In the AQAA, the manager stated that, quality assurance questionnaires reflect that the management style is open and transparent, and that staff were free to be, open and honest. To see if this was the case we looked at records and spoke to people and their relatives, the manager and staff. The manager has extensive experience of caring for people as a nurse in acute medical wards, then more recently as the owner/manager of a nursing home for 20 years prior to the current employment. The manager has a Registered General Nurse (RGN) qualification, holds a postgraduate management qualification and a diploma in counselling and is a qualified NVQ assessor. Care Homes for Older People Page 24 of 30 Evidence: Throughout the inspection process, we got lots of feedback from staff and people to say that the running of the home has improved since the recruitment of the new manager. In particular, staff said that care plans were better, staff who had not previously received an induction had received one since the new manager started work and that access to training had improved. Staff comments included that the standard of care was, a lot better now, that, the whole running of the home is more organised, that, staff know more as the manager makes sure they have the training, that the home is, more efficient, that the manager is, on the ball and gets things done, and that the manager, tells you straight and listens and takes notice of what you say. People and their relatives were also happy with the manager. People and their relatives talked about,feeling at home, at the service and comments about the manager included that she was, great,very approachable, and very professional. People also talked about trusting the manager. Two healthcare professionals visiting the home said that the manager was, very good. Finally, we saw that all interactions between the manager and staff, and between the manager and people who use the service, were caring, respectful and reassuring. On the day of the visit to the home, a senior manager was completing a monitoring visit to look at the running of the home. We saw evidence to demonstrate that these visits take place every month. The senior manager said that the monthly visits usually take a full day. The manager said that she has regular supervision from the provider where she has the opportunity to discuss any areas of concern, management issues, staffing issues etc. As the provider has a nursing qualification, the manager said that she is able to discuss the medical needs of people receiving the service. The manager added that she holds mobile numbers for senior managers and can get support 24 hours a day as the senior management team provide 24-hour on-call cover. People using the service were billed individually for their care. Most people using the service were supported by their family to manage their finances. The manager explained that the service does not hold money for people, but uses petty cash if people need purchases to be made on their behalf. People and/or their relative then receive a bill for these purchases. One of the people using the service chose to manage their own money independently. The manager said that as each person has a safe in their own room, people do have a safe place for their money/valuables. We saw evidence that the manager had recently completed quality assurance questionnaires for residents and relatives and was in the process of collating outcomes to form an action plan to address any concerns. Care Homes for Older People Page 25 of 30 Evidence: The manager recorded information in the AQAA which demonstrated that health and safety procedures and checks were carried out at the home. Care Homes for Older People Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 3 4/5 Assessments of people?s 31/05/2008 needs must be completed in full and all paperwork must be signed and dated in order to ensure people?s needs can be met in the home. Care plans must reflect people?s assessments and provide sufficient detail to staff in which to carry out their care duties. Time scale of 31.5.07 not met. 31/05/2008 2 7 13 Care Homes for Older People Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 3 It is recommended that all assessments and care plans for people using the service are always dated and signed by the person who has completed them. This is necessary to ensure good communication of the time frame of peoples changing needs. It is strongly recommended that risk assessments, including those concerning the risk of falls, contain more details to support staff to minimise the risk and more details of the history of the problem e.g. the history of risk of falls. This is necessary to enable staff to have sufficient information to protect people from risks. It is strongly recommended that care plans are used to provide information to staff on the specific needs of people concerning taking their medication. The care plans should include details of the circumstances in which when required medication would be given, and details of any possible side-effects of medication taken. This is necessary to ensure that staff have sufficient knowledge of each individuals needs concerning their medication. It is strongly recommended that details of the investigation of all complaints and the outcomes are consistently recorded and copies of information about complaints which 2 8 3 9 4 16 Care Homes for Older People Page 28 of 30 are sent to the company head office are held at the home. This is necessary in order to demonstrate the action taken to address peoples complaints and to monitor any patterns in problems. Care Homes for Older People Page 29 of 30 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). 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