Inspection on 23/04/09 for The Ashford Nursing Home - Brabourne Care Centre

This is the latest available inspection report for this service, carried out on 23rd April 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 -... 24/05/06

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 10/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Ashford Nursing Home - Brabourne Care Centre Hythe Road Ashford Kent TN24 0QJ     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: Wendy Mills     Date: 2 3 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 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 29 Information about the care home Name of care home: Address: The Ashford Nursing Home - Brabourne Care Centre Hythe Road Ashford Kent TN24 0QJ 01233643555 01233645370 ashfordnursing@mail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Opus Care Limited care home 82 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodates is 82 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 The Brabourne Care Centre is a purpose built, large, detached three storied building with plenty of car parking space. It is set in newly planted gardens and situated on the Hythe Road close to its sister home, the Ashford Nursing Home, the town centre and junction 10 of the M20 motorway. The home is served by public transport with local Care Homes for Older People Page 4 of 29 Over 65 0 82 82 0 Brief description of the care home amenities nearby. The home is on three floors. The top and ground floors comprise 53 beds for older people with nursing needs, the middle floor has 29 beds for older people with dementia related needs. All the rooms are single en-suite. Every floor provides a number of communal areas, including a lounge, dining and quiet areas. There are two passenger lifts. At the time of the inspection, the acting manager advised that weekly fees are in the range of £448,37 to £481,92 and £833.10 to £900. Additional extra costs are clearly identified in the Welcome and Introduction Pack, which is given to all prospective residents. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This visit was unannounced and formed part of the annual inspection process of the Care Quality Commission (CQC) under the Care Standards Act. The report uses evidence that we gathered during this visit. It also takes into account information that we received prior to this visit, such as, notifications of incidences that the home is required to tell us about; the Annual Quality Assurance Assessment (AQAA) that the home sends us; and information we have received from other sources such as relatives, Social Services and visiting health care professionals. As a result of this evidence we have made a judgment about the star quality rating for this service. During this visit five residents, one relative and four members of staff were spoken to in private. Time was spent in discussion with the home manager and deputy manager. Documentation, including five residents care plans and four staff staff files, was examined. Information contained in these files was tracked to other records such as Care Homes for Older People Page 6 of 29 the daily records, medication records and staff training records. A tour of the home was made. Both direct and indirect observation was made throughout the time of the visit. The people who use this service said that they would like to be referred to as, Residents. Therefore this term is used to refer to them throughout this report. The residents were all very positive about the care given in the home and the environment in which they live. Staff also said that they believe the nursing and care given in the home is of a high standard. The residents, their supporters, staff, deputy manager and home manager are all thanked for the welcome they gave and their assistance throughout the visit. The star quality rating for this home is 2 stars. This means that the residents experience good quality outcomes in all the key areas of care. What the care home does well: What has improved since the last inspection? What they could do better: The home should review the way it is currently using some bathrooms as storage areas Care Homes for Older People Page 8 of 29 and for staff lockers and work toward making the bathrooms more homely so residents can enjoy their bath times. 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 9 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home gives prospective residents and their supporters good information about the home so that they can make an informed decision about moving into the home. Thorough pre-admission assessments are made to ensure that only those people whose needs can be met are offered a place at the home. Evidence: The home has a clear Statement of Purpose and Service User Guide. In addition the manager and administrative staff are available to more give information about the home. There is also plenty of information in the foyer of the home. The pre-admission documentation of four recently admitted residents was examined. There is a thorough assessment process and good evidence that a pre-admission assessment had been carried out in each case. The deputy manager told us that either she or the manager always go out to see a prospective resident before offering a place Care Homes for Older People Page 11 of 29 Evidence: at the home. Prospective residents are welcome to visit and have trial periods although this is not possible in all cases as some people are admitted directly from hospital. In these cases their relatives may visit on their behalf. The home has six beds that are publicly funded to provide intermediate care for those people who may need extra time between hospital discharge and home or need further assessment before a choice of home is made. When rehabilitation services such as occupational therapy and physiotherapy are needed for those people receiving intermediate care, these are supplied by the local health services. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home promotes the health and well being of the residents and upholds their privacy and dignity so residents can feel confident that they can live as healthy a life as possible and to be treated with kindness and respect. Evidence: The home has clear policies and procedures for all aspects of care. There are qualified nurses on duty in the home at all times. Infection control policies are sound. Indirect and direct observation showed that staff treat the residents with kindness and respect. Privacy and dignity was seen to be upheld at all times throughout the day and staff spoken to confirmed that they have good induction training and supervision that includes these basic principles of care. A ten percent sample of care plans was examined. Care plans are important documents as they are one of the means by which residents and their supporters can be assured that their care needs will be met in the way that they wish. In addition, they provide an important source of reference for staff who must ensure that they Care Homes for Older People Page 13 of 29 Evidence: deliver care in the agreed way. The care plans are up-to-date and identify cultural, religious and care needs as well as some background histories. The home caters for a number of terminally ill people and care plans show that, where a resident wishes, funeral plans are in place. The Annual Quality Assurance Assessment (AQAA), that the home is required to complete under the Act, told us that care is person centred. The way that individual care is to be given is carefully detailed in the care plans and includes personal preferences such as where a resident prefers to eat, how their personal care should be given and how they like to spend their time. Nutritional monitoring in the home is very good. A nutritional assessment is carried out for all new residents and others at risk of poor nutrition. The residents spoken to said that the food is very good and that they eat well. The home uses the, MUST, nutritional assessment tool to make a judgment about nutritional status and diets are planned accordingly. The MUST score takes into account a number of aspects of nutrition including weight, underlying medical conditions and skin condition. The home works hard to prevent pressure sores developing on those people who are in poor health. The home has pressure reliving equipment in place where required and the AQAA told us that the home has achieved a reduction in pressure sores since the last inspection. However, there was one occasion where poor recording of the pressure area status of a resident on admission caused some concern. The home has now taken steps to address this issue and the care plans showed that recoding of pressure areas and potential risk of pressure sores is much more diligently recorded now. The care plans showed that residents are registered with GP and visits to the dentist, optician, chiropodist and other health care professionals are arranged. If the resident is unable to leave the home then arrangements are made for them to be visited in the home. or the health care professional may visit the home to see individuals who cannot leave the home. The home promotes multidisciplinary team working. Visiting health care professionals are positive about the way the home works with them. Currently work is being done in conjunction with the local GPs and other health and social care professionals to develop clearer care pathways. Clear care pathways are important as they are designed to to ensure consistency in care and safe and smooth transfers between hospital, nursing and care homes and a persons own home. The home deals well with end of life issues. Bereavement support is given and there Care Homes for Older People Page 14 of 29 Evidence: has recently been a half day study day for staff on bereavement. CRUISE, a national bereavement voluntary group, is asked to become involved where appropriate. The manager stated that the home maintains good relationships with the local Primary Care Trust (PCT). She said that there has been a lot of joint working with the PCT particularly in respect of updating policies and procedures. The home offers clinical placements for nursing students from a nearby college. This not only helps the students but it ensures that nurses working in the home keep up to date with best nursing and care practices so that they can help the students to establish good clinical skills. Residents expressed positive views about the staff and the way care is given. One said, Im very happy with the care here, everyone is nice and kind. Residents said that they do not have to wait long should they need to ring their buzzer to ask for a member of staff to help them. One said, I dont often have to ring for attention as they usually offer help before I have to ask. Medicines are stored safely and there are clear policies and procedures in place for the management and administration of medicines in the home. The Medicines Administration Records (MAR) were examined. These were in good order and there are clear policies and procedures in place. For example, there are clear procedures that staff follow should medicines be refused or should a resident be asleep at the time the medicines are initially offered. Staff confirmed that they are given enough training to enable them to care properly for the residents. The qualified staff all have good evidence that they maintain their continuing professional development and retain their registration with the Nursing and Midwifery Council (NMC). Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a wide ranges of activities that make the daily life in the home enjoyable and interesting. This means that the residents can continue to live meaningful lives whilst in the home. Evidence: The self assessment quality assurance document (AQAA), that the home sent us, identified that there is a wide range of social activities on offer. Meetings for residents and their supporters are arranged every three months. Since the last inspection the social programme has increased and a support group, The Friends of Braybourne, has been formed. The AQAA confirmed that the home values equality and diversity. This is reflected in staff training and recruitment practice, policies and procedures and in the care plans where individual preferences, religious and cultural needs are noted. Family and life histories are also noted in the care plans of those people who wish to share this information. The manager told us that there is very good support for the home by relatives and friends and that the Friends of Braybourne group is attracting a lot of support. Visitors Care Homes for Older People Page 16 of 29 Evidence: are welcomed at any reasonable time and support is given to those who may wish to visit at other times if their relative is very ill. There are two full time activity co-ordinates working in the home. They are currently working to gain the National Vocational Qualification (NVQ) in Music and Movement. Residents and relatives are consulted about the daily life of the home and there is a wide variety of activities on offer from individual activities such as hand massage and nail care, and individual trips out to group outings. Entertainers visit the home and the home asks the residents which ones they prefer. Different types of visiting entertainment are tried and the popular ones used again. Birthdays and special days are celebrated. This visit was made on St Georges day. There were banners around the home and cakes iced with the St Georges Cross as well as other associated activities. We were told that other special days such as Easter, Chinese New year and Halloween are similarly celebrated. One resident said, They try to give us things to do, I like craft work - were not always very good (at the craft work) but we enjoy it and have a laugh. We dont have to join in but I usually do. The home provides placements for second and third year Occupational Therapy students. the students are visited regularly by their clinical supervisor. Their presence brings new ideas and different approaches to the activities programme. Outside there is flat, safe and accessible space with seating areas. In the summer the home holds a garden party and encourages residents to spend time in the fresh air. The food services and nutritional monitoring in the home are very good. more detail about nutritional monitoring is included in the previous outcome area. Residents spoken to said that they enjoy their meals and have plenty to eat. Indirect observation showed that there were drinks and snacks on offer throughout the day. Special diets are catered for and nutritional supplements given when indicated. The dining areas in the home are clean, airy and light and there was a relaxed and pleasant atmosphere at the mealtime we observed. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has robust policies and procedures for handling complaints and dealing with safeguarding and does all in its power to ensure the residents are protected from harm Evidence: There are robust policies and procedures for handling concerns, complaints and safeguarding. The home manager belongs to the East Kent Clinical Practice Group and is working within this group to improve care pathways, including safeguarding procedures. This work includes input from East Kent police. There has been one safeguarding alert since the last inspection. This was upheld as they home had failed to accurately map pressure areas when a resident was first admitted to the home. Examination of care plans and written procedures, along with discussion with staff and the manager, confirmed that the home has learned from these omissions and now has more robust procedures in place. The Annual Quality Assurance Assessment (AQAA) informed us that there have been four formal complaints made since the last inspection. These were all resolved in the quality standard time of twenty eight days. Residents spoken to said that they had not had to make a complaint since coming to live in the home but they knew they could speak to the manager if they needed to. Care Homes for Older People Page 18 of 29 Evidence: They said that if they have any worries or concerns they speak to the staff on duty and, They usually manage to sort it out for us . Staff spoken to were all clear about safeguarding procedures and had received training in this. They said that they can talk easily to senior staff and the manager and would always report any concerns if they ever had any suspicion that any form of abuse was taking place. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is very clean, safe and well maintained. This gives the residents a pleasant and homely place in which to live. Evidence: The home is purpose build with accommodation on three floors. All rooms are for single occupancy and have en suite facilities. There is plenty of communal space and all areas are well decorated, light and airy. Corridors are wide and all areas are wheelchair accessible. Residents have been able to bring items from home and personalise their rooms to reflect their tastes and interests. All residents spoken to said that their rooms were lovely. One said, Im very comfortable here, I know its not my own home but its the next best thing. My room is lovely and there are some wonderful views. There specially adapted bathrooms that are equipped with hoists and other moving and handling equipment. Due to lack of space for staff lockers, these have been installed in one of the bathrooms on each floor. Some clutter had also accumulated in the bathrooms accommodating the staff lockers. This distracted from the pleasant atmosphere of the bathroom and could prevent safe moving and handling. We were told that the bathrooms used for staff lockers were rarely used to bathe residents. The home should review the way it uses the bathrooms and ensure that they are clutter free and provide a pleasant atmosphere in which residents can enjoy a bath. Care Homes for Older People Page 20 of 29 Evidence: Outside there is a safe, flat and well maintained garden that surrounds the home. This is easily accessible for wheelchairs and there is a path and seating. The deputy manager told us that residents are encouraged to walk or wheel outside and that there are events such as garden parties and barbeques held in the garden throughout the summer. There are good parking facilities to the front of the home and there is an interesting and unusual water feature just in front of the main entrance. The home has a large, modern and busy laundry. Conversation with one of the laundry staff confirmed that there are sound systems for the management of laundry and that good infection control measures are in place. There are sound infection control measures in place throughout the home and a team of domestic and maintenance staff ensure that the home is clean, safe and well maintained. Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels, staff training, team work and recruitment practices are all good so residents can be confident that they will be cared for by a competent and well vetted staff team. Evidence: The home is registered to provide up to eighty-two places for older people. The accommodation is arranged over three floors and the average bed occupancy is ninety percent. Dedicated staff are allocated to each floor and staffing levels are adjusted according to need. Two floors are allocated to older people with nursing needs and the other provides residential care for older people who are no longer able to live alone due to frailty or failing mental capacity. On the nursing floors there are two qualified nurses and five carers on each day shift. On the residential floor there are one qualified nurse and five carers on each day shift. At night there are one qualified nurse and two carers on each floor. There is an on call system so that staff can call in management support if necessary. In addition to the nursing and care staff there is a team of ancillary staff who provide the non-nursing support to the home. This team includes laundry staff, the kitchen staff and domestic and maintenance staff. Care Homes for Older People Page 22 of 29 Evidence: We found good evidence to suggest that staffing levels are sufficient to meet the needs of the residents. For example, residents said that their buzzers are always answered promptly; direct and indirect observation throughout the day showed that there was a relaxed and unhurried atmosphere throughout the home; and four members of staff who were spoken in private said that they felt staffing levels are good and that they are able to spend quality time with the residents. All of the residents spoken to said that the staff are very kind and caring. One said, I couldnt ask for better, they are always there to help and it never seems too much trouble for them and sometimes they have to put up with a lot. The home has reviewed staff training since the last inspection. The home told us in their Annual Quality Assurance Assessment (AQAA) that one hundred percent of staff have received enhanced induction training. Training records showed that statutory training such as moving and handling and infection control is up to date and all new staff receive core statutory training before being allowed to work directly with the residents. The first one-to-one supervision for all new staff is carried out by the deputy home manager to ensure consistency. There are regular heads of department meetings that include housekeeping staff as well as nursing staff. The staff spoken to said that there is good communication and team working. Two carers made very positive comments about the support they receive from the qualified staff. One said, The qualified staff are wonderful, they take time to let us know what is going on and to explain things. Its made me think about going on to get more qualifications myself. Over the past year twenty eight staff have left employment at the home. Although this appears to be a significant number, several of these staff were care staff who left to begin nurse training. The home has not had to use any agency staff in the last three months. It has established a flexi bank of nurses who can be called in to cover sickness and other unexpected circumstances. The manager said that recruitment has been encouraging. Inspection of a ten percent sample of staff files, including three files of the most newly recruited staff, were examined. These were all up-to-date and in good order. There was good evidence that the home takes great care in the way it recruits staff. Criminal Records Bureau (CRB) checks were available for inspection and stored securely. Staff files showed that all new staff had been CRB checked, that POVA First (safeguarding) checks had been made, written references obtained, health checks made and an intensive interview carried out before a prospective staff member was offered a job at Care Homes for Older People Page 23 of 29 Evidence: the home. One new member of staff spoken to said that the interview had been very searching and detailed. Care Homes for Older People Page 24 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and the views of the residents, there supporters and staff are listened to and acted upon. This means that the home is run in the best interests of the people who live there. Evidence: Since the last inspection there has been a change of manager. The new manager is well qualified for the post. She is a Registered General Nurse (RGN) and there is good evidence that she maintains her continuing professional development. She has many years experience of nursing both in the NHS and the private sector. She is currently preparing her application to register with the Care Quality Commission (CQC). In depth discussion with the manager showed her to be very knowledgeable about best nursing and care practice. She is currently working with a group from a local Primary Care Trust to ensure that their polices, clinical procedures and care pathways interlink and reflect up-to-date knowledge and practice. Care Homes for Older People Page 25 of 29 Evidence: The registered provider for the home visits frequently and carries out quality assurance inspections in accordance with Regulation 26 of the Care Standards Act. The reports of these visits were available for inspection at the home. The staff spoken to were all very positive about the way the home is managed. They said that the manager provides good clinical leadership and is prepared to listen to their ideas and concerns. Residents spoke highly of the way the home is run and said that they know they can always talk to the manager if they have any concerns. There are regular residents, relatives and staff meetings. The home does not act as appointee for any of the residents but does hold small amounts of money in safe keeping for those residents who wish. These monies are kept safe and secure and meticulous accounts are kept of these. There are well established systems for staff supervision and appraisal. Staff receive one-to-one supervision at least six times each year and say this is a very useful process as they are able to identify training needs and put forward ideas during these sessions. The Annual Quality Assurance Assessment that the home sent us told us that records required by regulation for the protection of the residents and for effective running of the home are up-to-date and accurate. These include health and safety records of regular checks made on a regular basis. No health and safety hazards were noted during a tour of the home. Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 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. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!