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Inspection on 29/06/09 for Park View Care Centre

Also see our care home review for Park View Care Centre for more information

This is the latest available inspection report for this service, carried out on 29th June 2009.

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

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

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

It is evident through us talking to members of staff that the emotional health of the residents is of a high priority to the home and that staff are pro-active in maintaining and supporting residents with their emotional needs in order to maintain their quality of life in accordance to their plan of care. Staff demonstrate their commitment to achieving best outcomes for residents. Staff stated they expressed job satisfaction and confidence in the management of the home. Residents who spoke to us confirmed in their own words that they receive a good quality of care from staff who are courteous, respectful, communicate well, are experienced and deliver care in a individualised and professional manner. All the residents spoken to confirm that their privacy is respected and that staff knock on doors before entering, many residents prefer not to lock their doors and are happy with this arrangement. Observation of interaction between staff and residents throughout the visit confirmed that privacy and dignity is respected in the home. The management of the home has been faced with various challenges since the previous inspection. Shortfalls identified at the previous inspection have been actioned and the manager has evidenced her capability to improve standards within the home to provide better outcomes and quality of care for the residents. Many comment cards received about the home reflected a very positive experience of the home and further evidenced that the home works towards providing a high level of care.

What has improved since the last inspection?

It was evident through the inspection process that the home has taken steps to improve the standards of care. All of the outstanding requirements from the previous inspection on the 14th July 2008 have been met. Significant improvements have been made in care planning, risk assessment, training, odours, and abuse training.

What the care home could do better:

The home was requested to review its medication disposal system to ensure that it provides for a secure method of disposal. Some limited suggestions and recommendations were made to improve the service provision.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Park View Care Centre Field View Park Farm Ashford Kent TN23 3NZ     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: Robert Pettiford     Date: 2 9 0 6 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: Park View Care Centre Field View Park Farm Ashford Kent TN23 3NZ 01233501748 01233501757 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) : Ranc Care Homes Ltd care home 88 Number of places (if applicable): Under 65 Over 65 0 88 dementia old age, not falling within any other category Additional conditions: 88 0 The maximum number of service users to be accommodated is 88 The registered person may provide the following category of service : Care home with nursing (N) to service users of the following gender; Either whose primary care needs on admission to the home are within the following category: Dementia (DE) Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Park View Care Centre is an 88-bedded, purpose built two storied home located on the outskirts of Ashford. It is set in its own grounds, surrounded by well maintained gardens and has plenty of parking spaces. The Inspection report is available and on display. Current fee levels are: Between £457 and £900 dependant on needs. Care Homes for Older People Page 4 of 30 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: The inspection took place at 9:00AM on 29th June 2009 We agreed and explained the inspection process with the registered manager. The focus of the inspection was to assess the home in accordance with the Care Home Regulations 2001 and the National Minimum Standards for Older Persons. In some instances the judgement of compliance was based solely on verbal responses given by those spoken with. We used a varied method of gathering evidence to complete this inspection, pre inspection information such as the previous report and discussion and correspondence Care Homes for Older People Page 6 of 30 with the registered provider/manager was used in the planning process. This was to support us to explore any issues of concern and verify practise and service provision. The home had completed an annual quality assurance assessment questionnaire (AQAA). This provided us with information relating to What the home considers it does well, What we could do better, What has improved within the last 12 months and plans for improvement. The judgements have been made using the Key Lines of Regulatory Assessment (KLORA), which are guidelines that enable the Commission to be able to make an informed decision about outcome areas. Further information can be found on the Commissions website with regards to information on KLORAs and AQAAs. Documentation and records were read. Time was spent reading a sample of written policies and procedures, reviewing care plans and records kept within the home. Other areas viewed included risk assessments, pre-admission assessments, rotas, and training records. In addition an environmental tour took place. The Commission had the benefit of having the assistance of an expert by experience. The Commission is committed to involving experts by experience in both service and regulatory inspections. The Commission uses the term experts by experience to describe people who use services of have experiences of services. The report provided by the expert by experience has contributed towards helping the Inspector making judgements about the home. We identified a sample of residents for case tracking (a review of the level of care and support needed, and if it is being provided in a way that treats them with respect and dignity). What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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 8 of 30 Care Homes for Older People Page 9 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 10 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. Residents can be confident their needs are assessed prior to admission. Intermediate care is not provided. Evidence: People who are considering moving into the home are provided with an informative information pack. This contains a statement of purpose and residents guide. These documents inform people about what it is like to live in the home. People who move into the home can be confident that their needs will be met. Six pre assessments were inspected. Evidence from these demonstrated that a thorough pre admission assessment is carried out to enable the unit manager to make a judgment as to whether the home will be suitable for and can meet the needs of the individual. These assessments include information gathered from care managers and health Care Homes for Older People Page 11 of 30 Evidence: professionals. Upon admission, a further assessment is undertaken by the unit manager. Information from all the assessments informs care planning and risk assessment. The AQAA shows that visits to the home by prospective residents can be done anytime as no appointment needed. The home offers a respite period prior to admission (if a bed available) to make the settling in period less traumatic especially on the dementia units. Bedrooms are tastefully decorated prior to admission. Own pictures, some furniture allowed to make the room as homely as possible and to create individuality. Residents can have own private phone lines in the rooms should they require this service. The assessment and care planning process recognise equality and diversity needs and the importance of promoting such rather than just meeting needs in a reactive manner. The assessment had provision for gaining information on equality and diversity needs, in that questions re diversity were asked or expanded upon. It is recommended that the staff and the management team receive equality and diversity training to ensure that the needs of all groups are recognised and supported to further evidence the homes good practice. Care Homes for Older People Page 12 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from living in a home where the management of the home ensures that residents are competently assessed and supported with regard to their health and personal care needs and can feel confident that their needs will be met. Those who need help to manage their medication are supported by trained staff and are protected by the homes policies and procedures for the safe storage and administration of medication. Evidence: People who live in the home confirmed that arrangements are made for them to see the chiropodist, doctors and other health care professionals when they need to. All the residents spoken to confirm that their privacy is respected and that staff knock on doors before entering, many residents prefer not to lock their doors and are happy with this arrangement. Observation of interaction between staff and residents throughout the visit confirmed that privacy and dignity is respected in the home. Care Homes for Older People Page 13 of 30 Evidence: Confidential information is handled discreetly and sensitively. Eight care plans from all four units were inspected. All care plans inspected contained evidence of individuals needs, with further evidence of regular review and updating of care plans. Detailed support needs were seen in care plans viewed. All support needs are recorded to ensure residents receive appropriate support, and staff are clear on what support is required. The plan is person centred and focuses on the individuals strengths and personal preferences. The plan might be called a living description, essential lifestyle plan, path, map, personal futures plan or support plan were well written with the individual, or their representative where possible, and included a range of information that is important to them. This showed information on those sampled, such as who and what is important to them, how they keep safe, their goals and aspirations, their skills and abilities, and how they make choices in their life. It included information about their health; this could be called a health action plan. It sets out in detail how all their current requirements and aspirations are to be met through positive individualised support. Plans are all different and highly individualised and they include evidence that the service values improving outcomes for people using the service. A variety of different and creative methods are used to help people who use the service to contribute to the development of their care plan and the ongoing review process. Staff have the specialised training and skills to support, engage and encourage the individual to be fully involved The service will know and record the preferred communication style of the individual, and will use new and innovative methods that enable the person to fully participate. The plans viewed were an up to date working tool used by the individual and all involved staff. The care plan can be easily used by people who are not familiar with the individual to deliver a personalised and consistent person centred service. Plans are reviewed regularly, and as the individuals needs change. Reviews focus on asking questions about what has worked, where there is progress, achievements, concerns and what the plans are for the future. The care plan includes a comprehensive risk assessment, which is regularly reviewed. The service has a can do attitude and risks are managed positively to help people using the service lead the life they want. Any limitations on freedom, choice or Care Homes for Older People Page 14 of 30 Evidence: facilities are always in the persons best interests. The individual understands and agrees any limitations; they are fully documented and reviewed regularly. The service works creatively and actively with other services and organisations to ensure that the persons whole life needs are met, and goals addressed. The service recognises its own limitations and when to seek support from others to meet the individual needs of people. Evidence to make these judgements were obtained by reviewing a sample of the care planning process and taking to management staff and residents. Additional information included surveys and a review of the AQAA. We viewed the storage arrangements and some records including Medication Administration Record (MAR) sheets, and the protocols for the administration of PRN/s Required Medication. The home has a clinical / medication room. Medication cabinets and trolley were evident in a dedicated room. The medication record sheets observed were completed correctly. The disposal of medication brought to the Commission some concerns however on how the throughput of medication could be audited to a high standard. It was the view of the Commission that the current system could be open to abuse. We commented on the homes drug disposal policy and asked the manager to review to ensure it meets with current guidance to ensure that it complies with The Royal Pharmaceutical Society of Great Britain (RPSGB) 2007. The Handling of Medicines in Social Care, this provides professional pharmaceutical guidance for staff working in every area of social care to improve the safety and quality of medicines. The manager stated that the current disposal system would be reviewed. Care Homes for Older People Page 15 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from being supported to make choices and a wide range of activities, that are tailored to meet their needs. Residents can feel confident that they are offered a well balanced and varied diet and supported to eat their food where they choose. Evidence: People who live in the home are supported to live their lives as they choose. Routines are flexible. Restrictions are kept to a minimum within a risk management framework. There is a variety of activities on offer such as art and craft, sketching, hand massage, knitting, reminiscence and exercise, which they may choose to, take part in if they wish. The expert by experience spoke at some length to both the Activity Organisers who were highly motivated and had a good and pleasant manner to all residents. A varied activity programme is changed weekly and was on display. This included two mornings of flower arranging, examples of which were in many of the bedrooms and Care Homes for Older People Page 16 of 30 Evidence: the lounges. This added a personal touch to the Centre which was bright and cheerful. Musical afternoons were frequent with volunteers who regularly played the piano, accordion, guitar and organ. This enabled all kinds of music to suit many tasted, i.e. from folk dancing to old time musical. The expert by experience spoke to residents who told her how much they looked forward to these afternoons. Cake making was planned twice weekly as well as bingo sessions. The expert by experience spoke to residents who said they looked forward to these activities but did not feel pressured to participate if they didnt want to, as there was the opportunity to do sponge painting (which we did observe) basic board games and jigsaw puzzles. Televisions were all flat screened and large enough for everyone to feel comfortable with. A reminiscent area adjacent to the Hairdressing room had been set up which was cosy and comfortable with newspapers showing key past events, books from musicals and old photographs. There were also reminiscent hampers in all lounges which were regularly replenished. A sensory room had been set up which contained a sofa, soft lights, music and coloured lamps and different textured items. This has been used regularly with comments from the residents noted on each visit. The expert by experience was also shown a box with target boards for soft ball throwing, large soft/sticky snakes and ladders games which were suitable for group exercises. Both Activity Organisers encouraged residents to join in activities and although (because it was lunchtime) nothing was taking place at the time, residents were told what was going on later that afternoon. Monthly outings are arranged but are only available to 8 people at a time including 2 wheelchair users. Some residents said they didnt want to go on outings, others said they enjoyed the trip to Kearnsey Abbey, although other venues had been tried this was by far the most stimulating for residents. Doors to the garden were open and in use by some of the residents who were able to sit outside in the sun or shade whatever their preference. The AQAA states the three activities co-ordinators provide comprehensive program for a group as well as individuals with a variety of activities focussing on the needs of the individuals e.g. trips on a minibus for the mobile residents, bingo, scrabble, outside entertainers offering singing, dancing, pantomimes, where residents can participate. Church service is offered once a week within the home but visits from other religions are also organised for the individuals needs when required. Care Homes for Older People Page 17 of 30 Evidence: Encouraging new skills should the resident wish to participate e.g. gardening (raised beds have been built in the garden) offered to the residents who wish to participate. The home does shopping for personal items for some of the residents as well as taking some residents to the local Tescos to do their own shopping Dining rooms on both floors were in use during the inspection, with a good ratio of staff to assist residents. The food was well prepared and waste was limited. We observed a new resident who had not finished her meal which was by then getting cold. A member of staff did observe this and arranged for something more suitable for her lunch to be given to her. The expert by experience was shown the weekly menu which was nutritious and varied and was told that staff members asked residents what they would like to eat. We did not see this as it had clearly been done earlier as I noted from the daily sheet. Residents the expert by experience spoke too said they enjoyed their meals and showed their almost empty plates. The home takes particular care to ensure that food is nutritious and takes account of specialist dietary needs. The range of food available for those residents has been increased. The dining rooms are well laid out with tables attractively set, although many people choose to take their meals in their rooms. Currently the home only records what meals have been eaten by residents in the nursing section. Residents have the opportunity to attend a weekly church service held in the home. All residents have their spiritual needs recorded on their care plans. 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. The home has an effective complaints system in place which residents are aware of where capacity allows, families are also aware of its contents. Residents are fully protected by adult protection policies and procedures Evidence: The home had a written complaints procedure, which was seen. Feedback received and comments made within residents surveys confirmed they were aware of the contents and felt free to voice their concerns where capacity allows. The home has received one complaint since the last inspection. On information received from the manager complaints received have been dealt with in a positive way to achieve the best outcomes for the complainant. Any safeguarding referrals made have also been seen to be managed appropriately. The Inspectors viewed and discussed copies of the Homes Policy for the Protection of Residents, Whistle blowing procedures for staff and safeguarding adult policy. These include procedures for the reporting of suspicion or evidence of abuse with a format for the recording of any allegations and action to be taken. Full training has been provided in abuse for all staff. Criminal Record Bureau Checks (CRB) has been obtained for all staff. The Registered Care Homes for Older People Page 19 of 30 Evidence: Manager is aware of her obligations with regard to ensuring the safety of Residents and protecting them from abuse. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from living in a home that provides for a homely environment which provides safe access to comfortable indoor and outdoor communal areas. The standards of internal, external decoration and facilities were found to be excellent. Residents are protected by the homes infection control policies and procedures. Evidence: The Care Centre stands on a well proportioned plot with good sized and very well maintained gardens, with ample seating in different areas. Part of the garden is sensory with scented plants, mainly roses whilst another, which is for the use of Dementia sufferers, has a mixed herb garden. New raised flower beds have been added since the previous inspection. Several doors were open onto all the gardens as it was a nice day. The management and staff encourage residents to see the home as their own home. It provides a very well maintained, safe, comfortable, attractive home, which has all the specialist equipment and adaptations needed to meet individual residents needs. As well as a good selection of general aids such as hoists and variable height beds, the home also ensures that equipment is individualised for each resident and all staff members are trained in the safe use of aids and equipment. Care Homes for Older People Page 21 of 30 Evidence: All residents are assessed for their need to have equipment or aids before they move into the home and these are provided to them on admission. The rooms are very well planned. The fixtures and fittings are of a good quality, well maintained and adapted to meet the wishes of the present resident. There is a selection of communal areas, according to the numbers of residents, this means that residents have a choice of place to sit quietly, meet with family and friends or be actively engaged with other residents. The bathrooms include a selection of different ways to bath, for example assisted and unassisted showers and baths and there are a number of toilets strategically placed around the home. The home is well lit, clean and tidy. It was noted during the previous inspection that despite rigorous cleaning of some of the carpets the home had not been odorous. The has addressed this by replacing carpet in the hallways and high traffic areas. The expert by experience was invited into many of the residents bedrooms to speak to them and was impressed with the cleanliness of the rooms which were in good decorative order. They were bright and cheerful with many personal possessions, such as photographs, paintings, and ornaments. It was a very hot day but windows were open and the rooms were not hot and stuffy. Many of them had flower arrangements and their own small televisions. All those spoken too were pleased to see staff members and visitors. We were told by many that they liked their rooms, the staff were kind and they were pleased to be there. The expert by experience spoke to a new residents relatives who told her that they were pleased that it was a safe and happy environment for their relative and although making a decision for residential care was not easy, they felt they had made the right decision. The garden was easily accessed and was well set out with different areas of seating and shade with many plants to stimulate the eye. The garden would be the centre of the Summer Fete on 18th July, preparations for which were under way. Of particular interest were the signs indicating toilets, dining room and the sensory room. These made places recognisable to those with dementia. The toilets in particular were indicated by a red toilet and indeed had red toilet seats which made it easy for residents once they were inside. This demonstrated that the home excelled in its aims to meet residents needs. Care Homes for Older People Page 22 of 30 Evidence: The management has a proactive infection control policy. Staff wear protective clothing (gloves & aprons) when providing personal care or handling soiled linen. The manager stated that comprehensive infection control guidelines are followed The laundry room is situated downstairs and is an appropriate environment. The washing machine has a sluice facility and can provide a hot wash at 95C. Care Homes for Older People Page 23 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can feel confident that their care, social and emotional needs are fully promoted by the employment of care staff in sufficient numbers to meet their needs at all times and trained to the required standards. Residents are fully protected by the recruitment procedures within the home. Evidence: The ratios of care staff to residents are determined according to the assessed needs of residents. Following discussions with the manager, a review of the rota and observations made during the inspection. The Commission were of the opinion that sufficient care staff were on duty to support residents to meet their personal needs and take all reasonable steps to ensure their health and safety. However it was noted that activities were limited due to staff absence. Evidence at time of the inspection confirmed that their needs were being meet and that the residents spoken with were happy and content. Feedback from surveys confirmed that residents are generally well supported with their needs. The manager stated that staffing is constantly kept under review. The home employs a higher than average number of ancillary staff in the view of the Inspectors who work as cleaners, laundry, cooks, gardener and maintenance staff. Care Homes for Older People Page 24 of 30 Evidence: Thus allowing care staff the time to meet the needs of residents. The staff training records indicated undertaken training. Individual and group staff training needs had been identified. From documentary evidence seen the standard of staff training was good overall with the large majority of staff completing basic courses and the home has achieved an NVQ (National Vocational Qualification) Level 2 or above care qualification for at least 50 of care staff. Staff training is ongoing and further training is booked. The manager confirmed that the home has a development programme for all new staff, which meets Sector Skills councils workforce training targets and ensures staff fulfil the aims of the home and meet the changing needs of residents. The previous inspection showed that it undertakes a recruitment practice including submission of an application form detailing all previous work history, requests proof of identity and copies of qualification certificates, seeks two written references, and confirms work status. The homes recruitment files at the previous inspection were seen not to include all the information as required. The manager stated that this has now been addressed and that the recruitment files now comply with the standards. This standard was not fully inspected on this occasion and only partially inspected to evidence compliance with the requirements from the previous inspection. All qualified Nurses working within the home on evidence seen are currently registered with the Nursing and Midwifery Council. It was evidenced that all staff have a current CRB and POVA (Protection of Vulnerable Adults) check. This was seen as a shortfall at the previous inspection which has now been addressed. Care Homes for Older People Page 25 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents on the benefit from living in a well run and managed home. Residents and or their relatives can be confident that their views and opinions effect how the home is run and be assured that residents best interest are wholly safeguarded by appropriate policies and procedures and that the management of the home is sound. Evidence: The management of the home has been faced with various challenges since the previous inspection. Shortfalls identified at the previous inspection have been actioned and the manager has evidenced her capability to improve standards within the home to provide better outcomes and quality of care for the residents. The manager is able to describe a clear vision of the home based on the organisations values and corporate priorities. The manager communicates a clear sense of direction, Care Homes for Older People Page 26 of 30 Evidence: is able to evidence a sound understanding and application of best practice operational systems, particularly in relation to continuous improvement, customer satisfaction, and quality assurance. Quality assurance was discussed and the views and opinions of many of the resident are sought where capacity allows. They confirmed a great deal of satisfaction in living within the home and felt confident that the staff and management valued their views and opinions. The manager confirmed that the home does undertake quality assurance by means of asking residents to complete questionnaires. The views of other stakeholders are also sought. The registered provider of the home does visit the home but does complete what is known as a Regulation 26 visit (Statutory documented visits by the provider to monitor standards within the home). This requires the provider to assess the quality of care within the home and ensure that it is meeting with the required National Minimum Standards. Health and safety not inspected on this occasion. The standard was met at the previous inspection. Care Homes for Older People Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 28 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 29 of 30 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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