Inspection on 08/09/09 for Solent Mead

This is the latest available inspection report for this service, carried out on 8th September 2009.

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

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

Other inspections for this house

Solent Mead 07/11/06

Solent Mead 25/10/05

Solent Mead 25/05/05

Solent Mead 02/11/04

Solent Mead 29/06/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Key inspection report Care homes for older people Name: Address: Solent Mead Church Lane Lymington Hampshire SO41 3RA     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: Patricia Trim     Date: 0 8 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) 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 30 Information about the care home Name of care home: Address: Solent Mead Church Lane Lymington Hampshire SO41 3RA 01590674687 01590678616 ssnfjm@hants.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Hampshire County Council care home 36 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 36 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 Mental Disorder, excluding learning disability or dementia - MD Date of last inspection Brief description of the care home Solent Mead is a Hampshire County Council run home, providing accommodation and support for thirty- six older persons who may have dementia or mental health problems. Accommodation in the home is provided over two floors with access via a passenger lift or stairs. The home is separated into small units, each with bedrooms, lounge, dining Care Homes for Older People Page 4 of 30 1 0 0 9 2 0 0 8 36 36 0 Over 65 0 0 36 Brief description of the care home room with small kitchen area, assisted bathrooms and toilets. There is a large enclosed garden to the rear of the property. Solent Mead is located within the town of Lymington, on the edge of the New Forest. The fees charged ranged from £420.00 to £469.00 per week. 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 information used to write this report was obtained in the following ways. We used some of the information the provider gave us about the service in a form called the Annual Quality Assurance Assessment (AQAA). This is a form the service has to fill out every year to tell us what they are doing to make sure the home gives the people who use the service the care that they want. It also gives us some numerical information. The AQAA sent by the registered manager arraived by the date it was required. It was very detailed and gave good information about how the service is run and what improvements are planned. We also looked at any information the service had given us about what might have happened since we last visited. Care Homes for Older People Page 6 of 30 We used information we received from surveys. We sent surveys to nine people who use the service to ask what they thought about it. We received six surveys back. We also sent four staff surveys to the home and asked them to give them to staff but did not receive any back. A six hour visit was made to the home by one inspector to carry out a key unannounced inspection. She was accompanied by an expert by experience. This is someone who is not employed by the Commission but has personal experience of care services. During the visit both the inspector and the expert were able to involve 15 people who use the service in the inspection. Time was also spent talking to visitors to the service and observing the daily routines of the home. . There was also an opportunity to get the views of two members of staff who worked in the home and to talk with the registered manager about planned improvements. A random selection of documents was viewed. Three people who use the service were case tracked. This means their records were looked at to see how the provider identified their needs and made sure they were met. Care Homes for Older People Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: People who use the service commented they would like to be able to go on more outings. The registered manager said she was already aware of this and was taking action to improve opportunities for people to go out more. Some people were also unhappy that they had to choose what they wanted to eat a week in advance. The Care Homes for Older People Page 8 of 30 registered manager agreed to discuss this with people who use the service and to review the practice. The AQAA clearly identified improvements the service wishes to make over the next year. It recorded We wish to continue to develop service, provide evidence of compliance, or reasons for non compliance. 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 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. The admission procedure is comprehensive and ensures people who use the service are only offered a place if their identified needs can be met. Evidence: Five out of six people who completed survey forms felt they had enough information to enable them to decide whether they wished to move into the home. One person was just moving into the home. They had come for several short stays before deciding to move in permanently. The AQAA recorded that eveyone wishing to move into the home had to have an assessment of need completed by a care manager. Copies of these were seen. In addition the registered manager said she, or a member of the management team, always visited anyone who wished to stay at Solent Mead, to give them information about the service and to complete a comprehensive assessment. Copies of these were seen. They were very detailed and gave a clear picture of what people could do for Care Homes for Older People Page 11 of 30 Evidence: themselves as well as what help they would need. Peoples current interests and daily routines were identified and this information used to write the care plan. For example, the assessment seen for one person identified they sometimes became anxious. This information was recorded in the care plan, with instructions to staff to support the person stay calm by doing deep breathing exercises. A number of assessment tools were completed prior to admission, such as activities of daily living, moving and handling and falls risk assessments. These were regularly reviewed after the person moved in to identify any changing needs and to monitor whether care plans needed amending to reflect the changes. 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. Staff have the information they need to provide care to people who use the service in a way which supports their rights to privacy and dignity. People have access to a wide range of health care support that meets their health care needs. Staff have the information and training they need to manage medication safely. Evidence: New care plans have been introduced that are completed by involving the person concerned where possible. Plans seen reflected the individual choices and needs of each person. For example, one plan recorded that someone who needed a lot of help with personal care was able to wash their face independently. Another plan recorded that someone was able to choose what clothes they wore each day. There was clear evidence that the information in initial assessments had been used to inform the care plan. For example, the assessment for one person recorded they could not drink coffee. The plan recorded that the person always had tea. Each plan identified where there was a possible risk and an assessment completed Care Homes for Older People Page 13 of 30 Evidence: that identified the level of risk and gave staff detailed guidance on how to manage it. Risk assessments were completed for mobility, moving and handling, falls and nutrition and were reviewed on a monthly basis. The registered manager said she now completed a monthly audit of the care plans as part of the quality assurance system. Evidence of this was seen on the files that were viewed. Comments made to the expert by experience showed people who use the service felt they received their care in the way they liked it. One person told her they had a weekly bath which was all they wanted. Someone else said Although these ladies are busy they always come and check that I am all right, yes my bell is always answered quickly. The expert also commented Throughout my wanderings around the building I observed all staff knocking on room doors before entering and every one of the residents was treated with courtesy and dignity. Daily records showed people were able to see health care professionals when they needed to. During the visit a doctor was called to see someone who was feeling unwell. He commented Its good here, I have been in several times. They always ask us to call when needed. The registered manager said the service was in the process of trying to achieve a Gold Standard in End of Life care. Staff were having palliative care training. A meeting had been arranged to explain and discuss this with the people who use the service. A requirement had been made at the last inspection that creams prescribed to individuals must be kept securely. The minutes of the last residents meeting showed the reasons for this had been clearly explained to people who use the service and creams were now being kept in each persons locked drawer. Arrangements were being made by Hampshire County Council to provide more lockable space for people so they had more space for storing private items. A requirement was also made in respect of the management of controlled medication. Practice had been reviewed and records and storage seen were found to be satisfactory. Medication is now being regularly audited by the service manager as part of the quality audit system. A member of staff was observed giving out medication at lunchtime. Each person was given their medication and the administration record signed. The records seen matched the amounts of medication kept. The majority of medication was prescribed Care Homes for Older People Page 14 of 30 Evidence: in a monitored dosage system. This was checked on receipt to make sure the correct amounts had been sent. A record was kept of any unused medication returned to the pharmacist. People who use the service were supported to remain as independent as possible. For example, where the initial assessment showed someone wished to continue to self medicate, a risk assessment was completed to give staff guidance on how to help them do so. This was kept under review to make sure the person continued to be able to manage their medication safely. 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. People who use the service are involved in choosing the activities offered and are encouraged to give feedback about them. This ensures they have a wide range of activities and entertainments that they enjoy. They are actively involved in choosing what meals are offered which ensures there is a wide range of meal choices that meet their diverse needs .. Evidence: People who use the service are supported to make choices about their daily living. Care plans record peoples preferences about their daily routines, such as getting up and going to bed. For example, one person liked to get up about 7 a.m., whilst another preferred to get up later. On admission people are asked about their daily routines and plans recorded individual information such as likes the television on for company and likes the bedside light on at night. People told the expert by experience that they felt able to make choices about how they spent their day. People in one lounge told her they liked to have the television on in the morning to catch up on the daily news which they discuss with one another. Another person was waiting in the lounge for someone from the Roman Catholic Care Homes for Older People Page 16 of 30 Evidence: Church to visit to give communion. She told the expert she had just had her 90th birthday and had a wonderful party with a cake and everything. The expert found a wide range of activities on offer. She found staff actively supporting people and commented One lady has very poor mobility but was encouraged gently to mobilize and to return to her room as she had requested as she did not want to join in the group activity. The activities room was well situated, and very well organized. Folders were available for every activity, good records were kept of activities done and by whom, and appropriate activities were on offer. Up to date photos were on display along with recent art and larger project work. The residents in this home have a huge choice of activities; arts and crafts, word games, board games, reminiscence, cards, dominoes, books and so much more, all available from the shelves or on request from the staff. She also found that people were encouraged to continue with hobbies they had prior to moving in. For example, one person had always enjoyed painting. They were able to use the activities room when they wished and also attended an art class run by Brockenhurst College in the activities room during term time. The expert observed people joining in a musical entertainment. This is provided by an external entertainer on a regular basis. The expert noted He played the clarinet, whilst all 17 residents present, joined in with various hand held musical instruments; maracas, bells, tambourines etc. He also had recorded backing music which the residents were able to sing along too. They were all given song sheets and a wonderful time was had by one and all. Even the visitors were joining in. People did tell the expert that they felt they did not have enough opportunities to go on trips. The registered manager agreed this had been the case during the summer, but steps were being taken to address this. The residents minutes showed people were able to give feedback about the daily routines of the service and the activities provided. For example, people had requested the next band concert was held earlier as they thought it had started too late in the evening. This information was being pased to the organisers so that an earlier time could be arranged for the next concert. During the meeting people were also given information about how the amenities fund was spent. A breakdown of the money spent was being completed for the next meeting. Care Homes for Older People Page 17 of 30 Evidence: The minutes also recorded that recent activities had included a Strawberry Cream Tea, held at a local school and a weekly bingo session, run by the local Rotary Club. People were also given information about a volunteer who was going to start coming to the home to play card games. The expert found the diverse needs of people who use the service were catered for. One person commented Im not really very good at arty bits, but I do like it when we talk about the old days and I do like a game of Bingo. Another person, found in their room, knitting baby clothes for children abroad said they did not want to join in the singing etc in the lounge because they liked their own company. A third person liked to walk round the grounds and to visit the shops. They felt this gave them some independence and self respect. The majority of people liked the meals provided and felt they were offered choice. The daily menu is displayed on the units and people asked what they would like. Some people commented they did not like having to choose their meals for a week at a time. This was discussed with the registered manager, who agreed to review current practice with people who use the service and staff. Comments made to the expert included Shes a lovely cook I like all the food, my favourite is curry. I usually get at least 3 choices for my lunch and I like the soup and sandwiches for tea, All very good indeed, I have no complaints. Some people made comments about the food not always being hot enough. The registered manager said thermos flasks were now being used to try and keep things like gravy and custard as hot as possible. The main meals are prepared by dedicated kitchen staff who are expected to complete food hygiene training. One of the management staff prepare a monthly menu, and people who use the service are able to request meals to be included. For example, people recently asked for liver and faggots to be included. Changes to the way meals are served are discussed with people who use the service at residents meetings. For example, home made soup had recently replaced a hot option at the evening meal. This had been trialled for a month, then reviewed at the residents meeting to make sure it was an acceptable change. 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 who use the service have the information they need to be able to make a complaint and to be confident the service will investigate their concerns. Staff have the information and training they need to enable them to protect people who use the service against the risk of harm. Evidence: The AQAA stated that We provide all new residents with written information on how to make a complaint. We provide easy access to written information on the complaints procedure for family and other visitors. People who use the service said they knew how to make complaints and a copy of the procedure was displayed in large print throughout the home. Feedback from survey forms sent to families by the service last year showed people did not know how to make complaints. A copy of the complaints procedure had been sent to every relative with this years survey to make sure they had this information. The registered manager had a complaints log in which she recorded any complaints made, together with the action taken and the outcome of the investigation. Two complaints had been made since the AQAA had been completed. Both had been dealt with within the timescale given in the procedure and both complainants given a full explanation of the action taken. Care Homes for Older People Page 19 of 30 Evidence: Feedback from people who use the servide showed they felt they were able to make complaints, both through the complaints procedure and in the regular resident meetings. They were satisfied the management of the home took their concerns seriously and took action to address them. The AQAA recorded We have a robust Adult Safeguarding Procedure which encompasses all service users and is shared with adjacent local authority services. All staff are trained on the issues relating to adult protection. Three staff spoken with knew where the Safeguarding policy and procedure were kept and confirmed they had received training about safeguarding. The training records showed that all staff were expected to attend a safeguarding course and refresher training. The registered manager said management staff attended a more in depth course. Three staff spoken with were aware of their responsibility to report and record any allegation of abuse. The registered manager had a clear understanding of her role and responsibility in respect of safeguarding. 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 who use the service are able to live in a safe, clean and comfortable environment that they like and that meets their needs. Evidence: People who use the service said how much they liked the layout of the home. The home is divided into small units, each with its own lounge/diner and small kitchen area, bathrooms, toilets and bedrooms. Each unit has corridors painted in one colour to help people orientate themselves. Units are of different sizes so that people have some choice about the number of people they share communal areas with. For example, three people have moved to be on the same unit as they have become friends and like spending time together. Another person has moved to a larger bedroom which has a ceiling hoist. This helps staff give the assistance the person needs with moving and handling. People are encouraged and supported to spend time mixing with people from every unit. For example one person particularly liked to have lunch on Mulberry and their care plan instructed staff to make sure they could do this. People who use the service are able to give feedback about their environment. For example, the minutes of the last residents meeting showed people had complained about the dining area on one unit being cramped. The piano was moved to another Care Homes for Older People Page 21 of 30 Evidence: area to give more room. The AQAA recorded that the garden area had been refurbished with new chairs, tables and plants. People who use the service were seen choosing to sit there, using the sunshades to protect themselves from burning. Cleaners work in the home nearly every day; each being responsible for cleaning specific areas. People who use the service thought the home was kept clean and there were no unpleasant smells. The AQAA recorded that all staff had completed infection control cleaning and certificates seen evidenced this. Staff were seen wearing protective clothing when needed, using the sluices on each floor to disinfect soiled items and following the laundry procedure when taking washing to the laundry. The laundry is done daily, using industrial machines that have a programme suitable for the disinfection of soiled linen. Clean laundry is returned to people who use the service in individual baskets. Care Homes for Older People Page 22 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 are supported by well trained staff. Staffing levels are monitored and adapted to meet the changing needs of people who use the service. Evidence: People who use the service felt there were enough staff to meet their needs. Comments made included Although these ladies are busy they always come and check that I am allright, yes, my bell is answered quickly. and Staff always come when I need them. Throughout the visit staff were observed responding quickly to requests for assistance. At meal times staff were available to give assistance with eating to those who needed it. The registered manager explained that the normal staffing pattern was to have 5 care staff on duty throughout the day with a duty manager. There were also domestic staff to clean and do the laundry and kitchen staff. The registered managers hours were designated for her management role. Hours were also allocated for activity coordinators to make sure these hours were protected and not used to provide care. The AQAA recorded that We plan to review the dependency levels of the residents and reshape the staffing profile where possible, within the resources of the home. In order to do this we are developing a Dependency/Staffing ratio tool. The registered manager was abe to demonstrate how she had been sensitive to the needs of people Care Homes for Older People Page 23 of 30 Evidence: currently using the service. She had being managing admissions to ensure staff were available in sufficient numbers to support the people using the service. At the last inspection it was found that staff had been employed from another part of Hampshire County Council without the recruitment procedure being followed in full. A new Criminal Records Bureau (CRB) check had not been completed. This omission had been rectified with a new check completed. The employment record for a new member of staff showed the recruitment process had been followed in full, with references and CRB and Protection of Vulnerable Adults (POVA) checks completed. Staff spoken with thought the recruitment procedure had been thorough and fair. Staff records showed they were expected to complete an in depth induction programme. Staff spoken with confirmed this had included shadowing experienced staff, being assessed as competent and completing numerous training courses. Staff also said they had regular supervision and that this was used to identify training needs. Recent training included dementia care, palliative care and the safe use of medicines. The AQAA recorded that the service is introducing and implementing the Gold Standard Framework for End of Life Care to help them provide care and support to the people who use the service. The AQAA recorded that 34/40 staff had completed a National Vocational Qualification (NVQ) 2. Certificates were seen in files to evidence this and staff spoken with confirmed they had either completed it or were currently on the course. Care Homes for Older People Page 24 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 who use the service live in a well managed home, where they have the opportunity to give their views about the care they receive. The health and safety of the home is regularly monitored to ensure the risks of injury to people who use the service is minimised. Evidence: People who use the service felt the registered manager was very approachable and ran the home well. Comments made on service user surveys included I am very satisfied with everything, the home has a high level of care and the home does everything to my satisfaction. A relative commented to the expert by experience that they had great admiration for the manager and staff for the way the home was run. They were grateful for the peace of mind it gives us to know dad is so happy and so well looked after. If I have any concerns I know I can e-mail the manager to discuss things. Care Homes for Older People Page 25 of 30 Evidence: The registered manager has the qualifications required to manage the service and certificates displayed in her office showed she continued to develop her skills. Staff said they felt she managed the home well, had good leadership skills and was easy to talk to. The registered manager felt she was well supported by her line manager and the rest of the management team. People who use the service are able to give feedback about it through regular resident meetings. These are minuted and people are given feedback about the action taken to address issues. There was clear evidence that the views of people who use the service are listened to and systems changed to reflect their wishes. All systems in the service are regularly audited by the registered manager so she can monitor if they are working effectively. She completes an action plan to identify where changes are required. The service is also audited on a monthly basis by the service manager. Her report includes the views of people who use the service and she looks at a selection of records, such as medication administration records, complaints and health and safety records to make sure the service is being managed effectively. A written report of this visit is given to the registered manager, which identifies any action required. This is reviewed on the next visit to make sure any issues have been dealt wtih. As part of the quality audit an annual survey is completed. This is sent to relatives and friends. The information obtained is collated, put into a report and a copy sent to everyone who completed a survey. Feedback from people who use the service and relatives is used to inform the annual business plan. People who use the service are able to have small amounts of money looked after for them. Where this occurs, a written record is kept of money received or spent and receipts are kept for any expenditure. The amounts held are regularly audited to make sure the records are accurately maintained. As stated in the previous section, staff training is monitored and refresher courses arranged when necessary. All staff receive regular training in all aspects of health and safety such as moving and handling and first aid. The AQAA included information about the maintenance of equipment. From this and a random selection of certificates seen during the visit, it was evident that action is taken to maintain the health and safety of people who use the service. Care Homes for Older People Page 26 of 30 Evidence: Care Homes for Older People Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 28 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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. 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