Inspection on 15/06/09 for The Ashford Nursing Home

This is the latest available inspection report for this service, carried out on 15th 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.

Other inspections for this house

The Ashford Nursing Home 14/12/05

The Ashford Nursing Home 28/06/05

The Ashford Nursing Home 26/10/04

The Ashford Nursing Home 04/06/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Ashford Nursing Home 407 Hythe Road Willesborough Ashford Kent TN24 0JA     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: Mark Hemmings     Date: 1 5 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: The Ashford Nursing Home 407 Hythe Road Willesborough Ashford Kent TN24 0JA 01233645370 01233645370 ashfordnursing@mail.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) : Opus Care Limited care home 22 Number of places (if applicable): Under 65 Over 65 22 old age, not falling within any other category Additional conditions: 0 The maximum number of service users to be accommodated is 22 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: Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Up to 22 older people can make their home in The Ashford Nursing Home (the Service). The people who live in the Service can receive nursing care as well as personal support. The property is a detached older house that has been adapted for its present use. The accommodation is on the ground and the first floor. There is a passenger lift that gives step free access around the place. When full, four of the bedrooms can be shared by two people each. All of the bedrooms have got a private wash hand basin and two of them also have a private toilet. There is a call bell system. This has call points in each of the bathrooms and toilets. Care Homes for Older People Page 4 of 30 Brief description of the care home There are also call points in all of the bedrooms. This means that people can ring for assistance. There are a number of bathrooms and toilets. Two of the baths are specially adapted to make them easy to get into and out of. There are banister rails in the corridors. Also, there are frames around the toilets to help people get up and down in safety and comfort. The Service is set back from a busy main road. At the back, there is an enclosed garden that has got a lawn and flower beds. There is a patio area where there is a parasol and a set of garden table and chairs. There are some shops quite nearby and Ashfords town centre is about one mile away. There is some off road parking. The Service does not have its own car. The Registered Provider is a private company. It owns another larger residential service just up the road. The weekly fee for living in the Service runs from £438.00 to £772.00. The actual amount charged depends upon the source of the funding and the particular bedroom to be occupied. To find out more about the Service please contact the Matron. 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 quality rating for this Service is 2 Star. This means that the people who use this Service experience good quality outcomes. The previous Key Inspection was completed on 18 June 2007. For the present Key Inspection, we arrived at the Service at about half past eight in the morning and we were there for about seven hours. It was a thorough look at how well things are going. We took into account information provided by the Registered Provider in its self assessment. This is called the Annual Quality Assurance Assessment (the Assessment). We received the Assessment on time and it is adequately detailed. Further, we considered any information that we have received about the Service since Care Homes for Older People Page 6 of 30 the last inspection. During the inspection, we spoke with five of the people who live in the Service and we saw three more as we were passing by where they were. We also spoke with the Manager. She is called the Matron in the Service and so we use this term in our report. We spoke with the Training and Development Manager, two nurses, two health care assistants and the chef. We looked around parts of the accommodation and we checked a selection of key records and documents. These included things such as the individual plans of care, the staffing roster, training records and health and safety logs. Before we called to the Service, we asked ten of the people who live there and 10 members of staff to fill out a questionnaire for us. We wanted them to tell us what they think of The Ashford Nursing Home. Six of the people who live there and seven members of staff kindly sent them back to us. Later on in our report, well tell you what people are saying in these questionnaires. The Registered Provider has done its own questionnaires. These have asked the people who live in the Service to say what they think. Eight people completed their questionnaires. Well tell you what they say as we go through our report. 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 Care Homes for Older People Page 8 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 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. There is clear information about the Service in the Service Users guide. This is a brochure that is available for anyone who is interested in the Service. Before they move in, people are asked in detail about what support they need and how they want this to be given. Short term support can be given to those people who want to go back to their own homes. Evidence: The Matron asks people who are thinking of moving in about what support they need and want. This is done so that everyone can be confident that moving into The Ashford Nursing Home is the right thing for them. The Matron also talks with family members and with people like medical staff and care managers (social workers). All of this information is collected so that she can build up a really good picture of how the persons nursing and other everyday needs can best be met. After she has got all of this information, she can then decide if the Service can support the person in a way Care Homes for Older People Page 11 of 30 Evidence: that is right for them. We looked at the information that has been collected for one person who has recently moved into the Service. We wanted to see what sorts of things are being considered. There is lots of useful information. This includes things such as the way they need to be helped to get about and how they can best be helped to manage their continence. There is also other information about quality of life things such as the time they like to get up and go to bed. The Matron says that when she gets the information she shares it with nurses and with the health care assistants. This is done so that they know in advance about what nursing care and support they will need to provide. We asked two nurses and two health care assistants about how all of this works out in practice. They say that they are indeed told about people who are about to move in. They say that as a team they discuss how best to help the person in the first few days, while they get to know them better. One person says, were told a lot about new people and this helps us reassure them because we know about their main care needs from the start. We can then help the person to settle in and to get to know us. The Matron recognises that moving into a residential setting is a big step for anyone to take. She says that she wants to do everything possible to put the persons mind at rest. She says that as part of the introduction process, people are invited whenever possible to visit The Ashford Nursing Home. This is so that they can see what the place is like first hand. During these visits, people can ask any questions they want. There is also the Service Users Guide and a more detailed document called the Statement of Purpose. Together, these give lots of information about the facilities and services that someone moving in can expect to have. If someone decides to move in they are also given a written account of the fees they will have to pay and of how these are worked out. In our questionnaire we ask people who live in the Service, did you receive enough information about this home before you moved in so you could decide if it was the right place for you? Everyone says that yes they did. Nearly all of the people who move into the Service do so with the intention of making it their longer term home. However, there is the chance that someone will only want to stay for a shorter period. This might be so that someone who cares for them at home can have some time to themselves. Or, someone might move in because they have been in hospital and are not quite ready to go home yet. When someone moves into a residential setting there is always the risk that their stay might become longer than is necessary. The Matron is aware of this and helps to make any arrangements that are Care Homes for Older People Page 12 of 30 Evidence: necessary for people to leave as planned. 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. People are provided with the personal care and health care they need. Medicines are handled safely. People are treated with kindness and respect. Evidence: The people who live in the Service say that the nurses and the health care assistants offer them all the assistance they need. There is a written individual plan of nursing care and personal support for each person. These are important because they are one of the ways that people can say what assistance they want to have and how they want it to be done. Also, the plans give information to nurses and health care assistants so that they know what to do. We looked at three of these plans. They give a clear account of who needs to do what and why. For example, there is useful information about things such as health care, helping people in the bathroom and about keeping people safe. In more detail, one person needs to be cared for in bed. Someone else has difficulty understanding long sentences. They find it helpful for people to say things in a straight forward way so that they can give short answers. Care Homes for Older People Page 14 of 30 Evidence: Two nurses and health care assistants were able to tell us about the nursing care and support needs of the people we selected. This matched the information in the written assessments. This means that people can be confident that their particular needs are known and will be met. In our questionnaire for people who live in the Service we ask, do you receive the care and support you need? Everyone says that they always do. The Registered Providers questionnaire also deals with this matter and asks, what do consider (is) the quality of care provided? Five people say that its good and three people say that its average. In our questionnaire for members of staff we ask, are you given up to date information about the needs of the people you support and care for (for example in the care plan)? Three people reply always, three people say usually and one person says sometimes. The support plans are kept up to date so that they are accurate. This involves nurses and health care assistants making daily notes about how things are going. There are then monthly reviews. This is when the Matron and the nurses check out with the person concerned, with their relatives and with the health care assistants how things are going and what might need to be changed. In our questionnaire for people who live in the Service we ask, do staff listen and act on what you say? Two people say that they always do, two people say usually and one person says that they sometimes do. Sensible steps are taken to ensure that people do not have any avoidable accidents. For example, some people are a bit unsteady on their feet. They are accompanied by a nurse or a health care assistant so that they do not lose their balance. There are special rails fitted to most of the beds. This has been done so that people do not have to worry about rolling out of bed. People are helped to keep healthy. There are special mattresses fitted to most of the beds. These are designed to help prevent things like pressure sores. Nurses and health care assistants keep a tactful eye open so that a doctor can be called if someone is becoming unwell. Since our last inspection, people have seen their doctors as and when necessary. There have also been contacts with specialist hospital based medical staff. In our questionnaire for people who live in the Service we ask, do you receive the medical support you need? Everyone says that they always do. At the moment, none of the people who live in the Service manages their own medication. They have asked the nurses to do it for them. The Matron says that people will be helped to do their own medication in the future, if they want to and if it is safe for them to do so. Care Homes for Older People Page 15 of 30 Evidence: There is a system to check that the correct medicines are received from the chemist. Once in the Service, they are stored securely. There is a system to make sure things like eye drops do not go beyond their use by date. Also, there are special security arrangements for some medicines. Only the nurses give out medication. There is a procedure for administering medicines. This is designed to double check that the right medicines are given to the right people at the right time. Once a medicine has been given, it is recorded. We examined three sets of these records for a period of several recent days. They are being correctly completed. We looked at three medicines in more detail to see if the remaining stock matches what should be there. Again, we found things to be in order. People say that the nurses and health care assistants are courteous and attentive. They are very positive about members of staff. Two people summarise the general mood in their comments to us. One of them says, the staff are very kind indeed and theyre always willing to help. Actually, theyre very good and kind and Ive no complaints with them at all. The other person says, I like the carers and nurses because they always help me and its nice to see them smiling and around the place. The Registered Providers questionnaire asks, are you satisfied with regards to the overall service provided? Everyone who replies, says that yes they are. Nurses and health care assistants are relaxed and informal in their approach. People are discreetly helped when they need to use the bathroom so that their privacy and dignity is respected. People are helped to wear neat and clean clothes so that they can present themselves how they want. They are given their post promptly. Also, they are helped to deal with it if something is difficult for them. People can use the phone if they want. Peoples spiritual needs are respected in that they can attend acts and worship of their choice. 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. There are some interesting things for people to do. People are free to receive visitors and to spend the day as they wish. Good quality meals are served. Evidence: There is an activities coordinator who organises low key social events one day each week. This includes things like quizzes in the lounge and one to one time with people in their bedrooms. About once every couple of months, there is an outside entertainer who comes in to play music. In our questionnaire for people who live in the Service we ask, are there activities arranged by the home that you can take part in? Two people say that there always are and three people reply that there sometimes are. The Registered Providers questionnaire also asks about this subject. It says, do you think that there are adequate social activities in the home? Most people say that yes there are. When we were in the Service, people commented about this to us. One person says, I like to see the staff around the place and we have a chat. There are things that you can do with (the activity coordinator) but most of us like to have time to ourselves. Things are okay as they are. People are helped to keep in touch with members of their families, if this is necessary Care Homes for Older People Page 17 of 30 Evidence: and if this is what they want. Family members and friends are welcome to call to the Service at any reasonable time. The Matron keeps in touch with family members so that they know how things are going. The Assessment says that more attention has been given recently to this so that relatives feel themselves to be fully involved in what is going on. Most people get help from members of their families or from the local authority in dealing with their financial affairs. The Registered Provider does not get involved in this. The Assessment says that people are encouraged to make their bedrooms their own private space. They are asked to bring in things from their own homes so that they can have personal items around them. We saw lots of examples of this. People have their own photographs and ornaments so that their bedrooms feel more like being home. The records of the meals provided show that people are offered a varied menu and that they can choose between alternatives. People say that they receive good quality meals and that they have enough to eat. One person says, the meals are really good and Ive always got more than enough to eat. Weve plenty to eat and the foods really tasty. In our questionnaire for people who live in the Service we ask, do you like the meals? No one says that they always do. Four people say that they usually do and one person answers sometimes. The Registered Providers questionnaire asks, do you think that the homes catering arrangements are satisfactory? Everyone who answers says that yes they are. People can have drinks and snacks throughout the night. 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. There is a complaints procedure. There are arrangements to make sure that complaints are dealt with properly. However, the way complaints are recorded needs to be strengthened. People are kept safe. Evidence: Three people told us that they would feel quite okay about making a complaint. They said that they feel safe to do so and their relaxed manner when discussing this suggests that there is a supportive culture in the Service that encourages people to speak up without being fearful. In our questionnaire for people who live in the Service we ask, do you know how to make a formal complaint? Everyone says that yes they do know. There is a written complaints procedure. This explains how to go about making a complaint or raising a concern about something. Several informal issues have been raised with the Matron since our last inspection, but these have not been documented. We were told that they have been successfully resolved. The Matron agreed that documenting them would be a good way to evidence how things have been sorted out and she has agreed to do this in the future. People who live in the Service are confident that they are safe and that their wellbeing will be promoted. The Registered Provider recognises the importance of this. The Care Homes for Older People Page 19 of 30 Evidence: nurses and health care assistants are confident that people are being kept safe. One member of staff summarises the general mood when they say, all of the residents are treated really well here and we take seriously our duty to make sure that people dont come to any harm. Anything that wasnt right wouldnt be tolerated here, Im certain of that. 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. The accommodation is comfortable and pleasant. There is a modern fire safety system. The kitchen is well equipped. There is a suitable laundry. Evidence: The building is well maintained on the outside. On the inside, the accommodation is well decorated and furnished. The place has a homely, lived-in feeling to it and there is a fresh atmosphere. In the bedrooms the linen is clean and the beds are neatly made. There is a modern automatic fire detection system that is checked regularly. The Kent Fire and Rescue Service has aksed for a small number of improvements to be made. The Matron says that these will be done in the next eight weeks. The local Department of Environmental Health has given the kitchen 3 stars out of possible 5 stars. The kitchen is well equipped, clean and well organised. The chef follows good food management principles. People who need it are helped to get about. There is a special walk-in bath. This means that the side lifts up to make it easier to get in and out. Another bath has got a hoist that lifts you up over the side. There are two mobile hoists that can be used in the bedrooms. They might be needed if someone can nott manage at all to get out of Care Homes for Older People Page 21 of 30 Evidence: bed. There are two more hoists that are useful for people who find it hard to stand without assistance. At key places there are assistance poles. These are fitted to the wall and they are there for people to hold onto for extra support. There are frames near to the toilets. People find these very helpful when they are getting down and getting back up again. There are other less obvious things to help people get about. For example, there are special belts that can be used to give people that extra bit of help they might need when getting up from a chair. Also, there are special sheets that can be used to help people change position in bed. When someone moves into the Service, the Matron makes a note of what assistance they need to get about. She looks at things such as the help someone needs in the bedroom and in the bathroom. We asked nurses and health care assistants about this. They know what they are doing. We asked people who live in the Service how warm the accommodation is kept. They say that they are always comfortable even during the coldest weather. When we arrived in the Service the central heating was on and it was on when we left. The radiators are fitted with guards. This has been done to reduce the chance that someone will be burnt if they fall against them. The hot water taps that are used by the people who live in the Service are temperature controlled. This means that they will not get hot enough to scald someone. We tested a few taps and the temperature is correct. The laundry has two commercial grade washing machines. One of these has an extra cycle for items that need an especially hot wash. There are two dryers. The laundry is well organised and clean. There is a special sluice that helps the health care assistants keep the commodes clean and hygienic. New rules have been introduced to help make sure that used water does not leak back from things like washing machines into the drinking water supply. It looks like the Service already meets these rules. However, just to be on the safe side the Matron is going to contact the local water supply company to find out. She is going to do this by 1 August 2009. Peoples clothes are marked so that there is less chance of them getting lost or mixed up with other peoples things. People say that they do nearly always get their own clothes back from the laundry. Care Homes for Older People Page 22 of 30 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. There are enough nurses and health care assistants. Security checks are completed on new members of staff. Nurses and health care assistants know what they are doing. Evidence: There is always a qualified nurse on duty. During the morning on most days there are also four health care assistants on duty. In the afternoon and evening this number reduces to three. There is a waking staff presence in the Service at night. Also, there are special security arrangements in place for the night time hours. During the day, there are other members of staff on duty. They work in the kitchen or do most of the housekeeping. In our questionnaire we ask people who live in the Service, are the staff available when you need them? Five people say always and one person says that there sometimes are. The Registered Providers questionnaire asks, are you satisfied with the homes staffing levels? Seven people say that yes they are and one person says no. In our questionnaire for members of staff we ask, are there enough staff to meet the individual needs of all the people who use the Service? Two people say always, four people reply usually and one person says sometimes. When we were in the Service, we kept a look out for things that might give us a clue Care Homes for Older People Page 24 of 30 Evidence: about how well the place is being staffed. We noticed that someone who asked to be helped to use the toilet was assisted straight away. Another thing we looked at was the time taken to answer the call bells. It went off twice when we were in the Service. On both occasions it was answered promptly. This indicates that the staffing levels are right for the needs of the people who currently live in the Service. The Matron says that all of the shifts are being reliably filled. The written roster confirms this. The records show that the Registered Provider completes a number of security checks on new nurses and health care assistants. These include things such as confirming their identity, taking up references and doing a police check. This is done to make sure that they are trustworthy people to work in the Service. The records show that the nurses and health care assistants are doing quite a lot of training. This includes introductory training for new members of staff. In our questionnaire for members of staff we ask, did your introductory training cover everything you needed to know to do the job when you started? Six people answer very well and one person says mostly. After their introduction, there is ongoing training for both the nurses and the health care assistants. These include how to safely support people move about, basic first aid, food hygiene, keeping people safe and infection control. In our questionnaire we ask members of staff, are you being given training that is relevant to your role and that keeps you up to date with new ways of working? Everyone says that yes they are. There is a total of 13 health care assistants and five of them have completed a National Vocational Qualification (NVQ) at Level 2 or 3 in health and personal care. The Matron says that all new health care assistants will be encouraged to study for the award. Our observations show that nurses and health care assistants are supported by the training they receive to make sure that people receive the individual care they need. 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. Things are well managed. People are asked what they think about their home in general, but this needs to be a bit more organised. People are helped to buy what they want. There are sensible health and safety things. Evidence: The Matron has a good knowledge of how things are going. She is a qualified nurse. She also holds a particular management qualification. The nurses and the health care assistants say that in general there is good team work between them. There are handover meetings at the beginning and end of each shift. These are held so that nurses the health care assistants can be kept up to date with developments. In our questionnaire for members of staff we ask, do you feel that you have enough support, experience and knowledge to meet the different needs of the people who live in the Service? Three people say that they always do, three say usually and one person says sometimes. Care Homes for Older People Page 26 of 30 Evidence: The Assessment says that people who live in the Service are regularly asked what they think about their home as part of everyday life. Each year the Registered Provider also asks the people who live in the Service to fill in the questionnaires that we have already quoted from. While this is useful, there are some further improvements that can be made. Fewer than half of the people who live in the Service recently chose to or were able to fill out a questionnaire. A different approach might be needed for people who do not want to fill in a questionnaire. Also, more can be done to tell people who live in the Service what has been said and what is going to be done to introduce any suggested improvements. The Registered Provider helps most of the people who live in the Service to manage their personal spending money. This is done so that everyone has enough funds to pay for things that they want. The records show that the Registered Provider pays for things and then sends a bill each month normally to the relatives. Everyone has agreed to this arrangement in advance. The records show that there are fire drills and all members of staff have regular fire training. This is important because the level of protection largely depends upon members of staff doing the right thing at the right time if there is a fire safety emergency. There are up to date reports from engineers about the gas appliances, the wiring installation, the passenger lift, the mobile hoists and the stair-lifts. They say that everything is in good working order. The records show that there have not been many accidents in the Service over the past six months. Most of them have been minor bumps and bruises. The Matron keeps an eye on what accidents happen. This is so that whenever possible she can take action to prevent them from happending again. The building is regularly checked to help make sure that there are no hazards that might result in someone having an accident. The records show that things are being dealt with promptly. 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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