Inspection on 18/09/09 for The Chase

This is the latest available inspection report for this service, carried out on 18th 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

The Chase 14/12/07

The Chase 07/06/07

The Chase 04/01/07

The Chase 23/05/06

The Chase 10/11/05

The Chase 06/05/05

The Chase 11/10/04

The Chase 27/04/04

The Chase 09/02/04

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: The Chase 53 Ethelbert Road Canterbury Kent CT1 3NH     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: Mark Hemmings     Date: 1 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 29 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 29 Information about the care home Name of care home: Address: The Chase 53 Ethelbert Road Canterbury Kent CT1 3NH 01227453483 01227463483 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Purelake (Chase) Ltd Name of registered manager (if applicable) Mrs Theresa Wall Type of registration: Number of places registered: care home 31 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users to be accommodated is 31. 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: Dementia (DE). Date of last inspection Brief description of the care home Up to 31 people who have difficulties with their comprehension can make their home in The Chase (the Service). All of those currently in residence are older people. The property is a two storey detached older house that has been extended and adapted for its present use. There is a passenger lift that gives step-free access around the accommodation. When full, four of the bedrooms can be shared by two people each. Each bedroom has a private wash hand basin. Four of them have a private toilet and one of these rooms also has its own bath. All of the bedrooms are connected to a call bell system. There are flexible extension leads to make the call points easier to reach. Care Homes for Older People Page 4 of 29 Over 65 0 31 0 8 1 2 2 0 0 8 Brief description of the care home Each bedroom has a television aerial point. People can have their own televisions if they want or alternatively the Registered Provider will supply one. There are telephone points in each bedroom and people can pay to have them connected up to an external line. There is a mobile phone that people can use free of charge if they want to. The bedrooms are laid out as bed sitting areas with there being a comfortable armchair and bed side table. There are two main lounges and there is a lounge in a conservatory. There are an adequate number of bathrooms and toilets. There is a level walled garden at the front of the property and another level garden at the back. There is a ramp that leads from the conservatory to the back garden. In the front garden, there is a patio area where there is a garden table and chairs. The property is in a residential area. It is about one mile from Canterburys city centre. There are no shops within easy walking distance. There is a bus stop nearby. The nearest train station is about half a mile away. There is both off street and on street parking. The Registered Provider is a private limited company. The weekly fee for living in The Chase runs from £398.63 to £475.00. 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: 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 12 December 2008. For the present Key Inspection, we arrived unannounced at the Service at about half past eight in the morning and we were there for about seven and a half 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 it on time and it is reasonably detailed. Further, we considered any information that we have received about the Service since our last Key Inspection. During the inspection, we spoke with five of the people who live in the Service. We also Care Homes for Older People Page 6 of 29 spent time in the company of eight other people when they were sitting in the lounge watching television or looking at magazines. We spoke with the Manager, three care workers, the activities coordinator and the chef. We walked around parts of the accommodation and the grounds. Also, we looked at a selection of key records and documents. These included things like the individual written plans of care, medication records, the activities plan, the menu, complaints documents, the staff roster, personnel files, staff training records, financial records and various health and safety certificates. Before we visited the Service, we asked 10 of the people who live there, 10 of their relatives, 10 members of staff and five health and social care professionals to fill out a questionnaire for us. We wanted them to tell us what they think of The Chase. Six people who live there, six relatives, five members of staff and one health and social care professional kindly completed them for us. Later on in our report, we will tell you the main things that people are saying in these questionnaires. In 2008, the Registered Provider asked the relatives of some of the people who live in the Service what they think about the Service. As we go through our report, we will tell you some of the main things they are saying in their replies. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? A number of improvements have been made since our last Key Inspection. These include the following things. A more user friendly way is being developed to record information in each persons individual plan of care. This should make it easier for people to say what support they want to receive. A new activities coordinator has been recruited. Her role will be to extend the range of social things that people can choose to do. The complaints procedure has been strengthened so that people know all of their rights. We have registered the Manager in her post. This means that we have confirmed that she is a fit person to manage a residential care service. Various parts of the accommodation have been redecorated and some new items of furniture have been provided. Care workers have attended various training courses. More training courses are planned for the near future. Most of the care workers have completed a relevant National Vocational Qualification (NVQ). All of these things contribute to the Service being better able to care for people in ways that are right for them. Care Homes for Older People Page 8 of 29 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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. People who are thinking of moving in are asked about what support they need and how they want this to be done. People who stay for shorter periods are helped to go home again. Evidence: The Manager asks people who are thinking of moving in about what care and assistance they need and want. She also invites the person (or their family members) to visit the Service. This is done so that they can be confident that moving into The Chase is the right thing for them. She also talks with family members, care managers (social workers) and if necessary with doctors. All of this is done to help her to build up a really good picture of how the person can best be supported. When answering our questionnaire, everyone says that they did receive enough information before moving into the Service. We looked at the information that was collected for one person before they moved in. There is information about practical Care Homes for Older People Page 11 of 29 Evidence: things such as the help they need to do everyday tasks. There is information about their physical health and how this can be promoted. Other information is about quality of life things. Such as the sorts of social activities the person likes to do. Care workers say that the Manager shares the information with them so that they know what support they will need to provide. 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 care worker says, we know its daunting to come to a new place and so we do make a special effort to help the person to settle in. We help them get to know the building and to feel comfortable with the routines of daily life. People need time to adjust and they get to be made to feel welcome. This is their new home and we want them to think of it like that, not just somewhere to stay and to put up with. 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. The Manager says that arrangements will be made from the start to support the person to go home again. Since our last Key Inspection, two people have returned to live in their own homes. 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. People are provided with the personal and health care they need. Medicines are handled safely. People are treated with kindness and respect. Evidence: Each person has an individual plan of care and support. These plans are kept up to date by the care workers making daily notes and by more detailed reviews. The plans help care workers provide the right support to people. The plans are quite detailed which is helpful for care workers. However, this can make it more difficult for people who live in the Service to use them. The Manager recognizes this and she is working on a new and more user-friendly system. Care workers know how to respond to each person in ways that are helpful for them. When answering our questionnaire, people say that they always receive the care and support they need. Sensible steps are taken to ensure that people do not have any avoidable accidents. For example, some people may like to have the re-assurance of having bed rails. Care Homes for Older People Page 13 of 29 Evidence: These can help to prevent them rolling out of bed. The records show that the Manager carefully considers each persons circumstances. This is done to make sure that bed rails are the most helpful thing for their particular circumstances. People are helped to keep healthy. Care workers keep a tactful eye open so that a doctor can promptly be called if someone is becoming unwell. Since our last Key Inspection, people have seen their doctors as and when necessary. There have also been visits by other professionals such as district nurses and dieticians. When answering our questionnaire, everyone says that they always receive the medical care they need. People can manage their own medication if they want to and if it is safe for them to do it. At the moment everyone prefers to have care workers sorting out their medication for them. There is a system to check that the correct medicines are received from the chemist. The completion of these checks is helped by the fact that most of the medicines are put in blister packs by the chemist. This means that there is much less chance of medicines getting mixed up. Once in the Service, medicines are stored securely. The Assessment says that medication is only given out by care workers who have been trained to do so and who know what they are doing. There is a written procedure for administering medicines. The records show that medicines are being given correctly and in a reliable manner. We watched when a care worker was giving out medicines. She did it in the correct way. People say that the care workers are courteous and attentive. Several people sum up the general mood. One person says, I get on okay here with everyone and the (care workers) are fine with me. We have a joke like at home. Things are fine and dandy. Someone else says, the staff are very good and help me and chat with me. Theyre kind to me. A health and social care professional says that The Chase, has a pleasant and welcoming atmosphere. In their answers both to our questionnaire and to the Registered Providers one, nearly all of the relatives say that they are happy with the care provided in The Chase. Also, most relatives think that care workers are helpful and approachable. 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. Care Homes for Older People Page 14 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 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, but some people would like to do more. People are free to receive visitors and to spend their day as they wish. Most people like their meals. Evidence: There are various social activities that people can do if they want to. Once a week someone calls to take an art session. Also, there are weekly aromatherapy sessions but there is an additional charge for these. Twice a month someone calls to lead karaoke singing and once a month there is music for health. Since our last Key Inspection, an activities coordinator has been appointed. She is currently asking people what additional social things they might like to do. She says that these will include one to one things such as reading and puzzles. She also plans to lead small group activities such as craft work and watching DVDs. The Service does not have its own transport. There have not been any trips out since our last Key Inspection. In their questionnaire answers, everyone says that there are always or usually social things for them to do. When we were in the Service, we received different accounts from people about the calendar of activities. One person says, its home here and I like to stay in quite a lot. I suppose it would be nice to go out more when the weather is nice. Someone else says, I can get a bit bored sitting here. The girls are wonderful Care Homes for Older People Page 15 of 29 Evidence: really, but they only have one pair of hands and theyre too busy sometimes. It might be nice to go in the garden more when its sunny. Most relatives in their answers to the Registered Providers questionnaire think that the frequency and the variety of social activities is only average. People are helped to keep in touch with members of their families, if this is necessary and if this is what they want. Family members and friends are welcome to call to the Service at any reasonable time. The Manager says that she keeps in touch with family members so that they know how things are going. For example, if someone is not well, or if they are admitted to hospital. In their answers both to our questionnaire and to the Registered Providers one, nearly all of the relatives say that they are told about important developments. 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. There is a choice of dishes at each meal time and the records show that people are choosing what they want. There is a normal variety of meals being served. The main meal of the day is lunch and the sorts of dishes available are things like gammon in gravy and roast chicken. The Assessment says that people can have drinks and light snacks at any time including during the night. However, there is not routinely a bowl of fresh fruit in the lounge. When answering our questionnaire, most people say that they usually or sometimes like their meals. No one says that they always do. One person adds, the food is good and I like my meals. We get tasty things and Im not hungry at all. Ill have to watch my weight, wont I. Care Homes for Older People Page 16 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. People are free to make a complaint if they want to. People are kept safe. Evidence: There is a written complaints procedure that explains how people can go about raising a concern. Since our last Key Inspection it has been updated. This has been done to remind people that they can come directly to us at any time if they are concerned about something to do with the Service. When answering our questionnaire everyone says that they know how to make a complaint. One person says, I can say what I think and staff will listen and want to help and I do things well around here like home and Im good with things that you see. Since our last Key Inspection, we have received one formal complaint about the Service. It was alleged that various things were wrong with the accommodation. We have looked into it. We will tell you in the next section of our report what we think of the accommodation. The Registered Provider has also recently received a complaint. This was about a care-related matter. The records show that the Registered Provider investigated the complaint and concluded that there was no basis for the concern. We understand that the relative concerned has accepted this conclusion. People who live in the Service are confident that they will be kept safe. The Assessment commits the Registered Provider to ensuring this. There is a written policy and procedure that explains what members of staff can do if they become concerned Care Homes for Older People Page 17 of 29 Evidence: about someones wellbeing. One of the care workers says, Im confident that the residents are treated really well here and that they are kept safe and sound. I wouldnt hesitate to speak out if something wasnt right, but Ive never seen any unkindness. I think that in general The Chase is a happy place for the residents to live and relatives can be confident that they are well cared for. People who use the Service are adequately protected from financial abuse. The Registered Provider does not get involved in handling peoples financial affairs. For example, it does not run bank accounts or sign for things in their name. Instead, most people get help from members of their family or from the local authority. The Manager says that the Registered Provider is committed to promoting diversity in the Service. By this she means respecting each person who lives there as an individual who is inherently valuable in their own right. The records show that all members of staff receive training about the need to guard against any form of prejudice or discrimination. The Manager also says that this commitment to promoting diversity is expressed in practical terms. For example, in the way that each person receives individualised support that recognises their preferences and wishes. Care Homes for Older People Page 18 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The accommodation in general is homely. There are enough facilities. There is a modern fire safety system. The kitchen is adequately equipped and run. There is a suitable laundry. Evidence: The building provides a suitable range of facilities for the people who live there. These are in line with what the Registered Provider has committed itself to deliver in its Statement of Purpose. This is a legal document that describes the facilities and the services that are available in The Chase. Since our last Key Inspection, some large trees have been removed from one side of the garden. This allows much more light into that part of the grounds and into the nearby rooms. The gardens are level and in general are laid to lawn. There is not much in the way of flowers and shrubs. On the inside, the accommodation in general is homely and clean. Recently, the first floor lounge has been redecorated as have some of the bedrooms. Some of the hallways have been repainted and others are going to be done quite soon. Some new items of furniture have been provided. However, there are things that detract from the overall standard achieved. In two places in the hallways, the ceilings are stained where there have been old water leaks. In one place, part of the wall in a hallway has Care Homes for Older People Page 19 of 29 Evidence: been removed to enable another water leak to be fixed. Elsewhere, there is a length of skirting board and some ceiling coving that is missing. Some of the painted plaster wall finishes are scuffed and marked and some of the doors have been quite badly scraped by wheelchairs. The paintwork on the front door is discoloured and some of the doors panes of glass are cracked. The Manager says that plans are in place to address all of these problems. There is a modern automatic fire detection and containment system. The records show that in general it is being checked regularly to make sure that it remains in good working order. However, one set of the required checks is overdue. The Manager says that this oversight will be corrected without delay. The local Department of Environmental Health says that the kitchen in general is well equipped and well run. It has given the Service three out of a possible five stars. A small number of improvements have been recommended. The Manager says that all of these will be completed in the near future. We looked in the kitchen too. It is clean and well organised. The chef checks to make sure that the fridges and the freezers keep foods cold enough. There is also a system to make sure that foods are used promptly once they are opened. The chef knows about and follows good food hygiene practices. There are various things to help people who have difficulty getting about. Two of the three bathrooms have hoists so people do not have to step over the baths sides to get in and out. There is also a walk-in shower. There is a mobile hoist that can be used in the bedrooms and in the lounges. There is another piece of equipment that is helpful for people who find it hard to stand. Other things include moving belts that are useful if someone is not steady on their feet. There are also special sheets that help people change position in bed. There are frames around the toilets. These assist people to use them in safety and comfort. People say that the accommodation is kept comfortably warm. The radiators are fitted with guards. This has been done to reduce the chance that someone will be burnt by a heated surface. Most of 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 two of the taps and the temperature was satisfactory. The Manager says that all of the remaining taps will be temperature controlled in the course of the next year. One of the bedrooms does not have any water supply at the moment. The Manager says that a plumber is looking into what is causing the problem. Care Homes for Older People Page 20 of 29 Evidence: The laundry has a large commercial washing machine and two dryers. The room is quite small, but it is well organised and clean. There are special arrangements for cleaning items that need a hot wash. There are two sluices. These are useful for rinsing things before they are washed. 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. There are enough care workers on duty. Care workers receive training and they know what needs to be done to support people in the right way. Security checks are completed on new members of staff. Evidence: The records show that there is a minimum of three care workers on duty from early in the morning until later in the evening when the night care workers come on duty. At night there is a waking staff presence. There are special security arrangements at night. There is a chef on duty each day. On most days, there is a housekeeper who does most of the cleaning. When answering our questionnaire for members of staff, everyone says that there are always or usually enough staff on duty. One person says, it depends, some days its fine but other days things can get very rushed. If someone is unwell or if theres someone on with you who doesnt like to work it can be stressful to get the work done. Another person says, the home meets the care needs of the clients. As far as I am concerned, the home is doing everything very well. When we were in the Service, we kept a look out for things that might give us a clue about how well the place is being staffed in practice. We noticed that one person who wanted to use the toilet was assisted straight away. The call bell sounded on at least Care Homes for Older People Page 22 of 29 Evidence: nine occasions. Each time it was answered in less than one minute. We checked the employment records for two care workers. They show that the Registered Provider completes a number of security checks on new care workers. These include things such as confirming their identity and doing a police check. This is done to make sure that they are suitable people to work in the Service. The Registered Provider is also required to take up at least two references on each person. The records show that one reference is missing for one of the people. The Manager is going to sort this out by 1 November 2009. The records show that support workers are doing quite a lot of training. This includes introductory training for new members of staff. In their questionnaire answers, most people say that their introductory training was very useful. One care worker says, I had a good introduction to the place and to how things are done. I didnt need that much because of my past experience but I was shown around and I completed some initial training. After their introduction, there is ongoing training in key subjects such as first aid, food hygiene, health and safety and how to safely help people move about. The records show that most, but not all, of this training is up to date. The Manager says that more training is about to be delivered. She also says that she intends to make sure that everyone is up to date with their training by the end of the year. In their questionnaire answers, everyone says that they are being given the ongoing training that they need. Most of the care workers have completed a relevant National Vocational Qualification (NVQ). Others are working towards the Award. The Manager says that all new care workers will be encouraged to study for it. Our observations show that the care workers are well supported by the training they receive so that they can appropriately care for the people who live in the Service. Care Homes for Older People Page 23 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. Things are well managed. Although people are asked what they think of their home, they are not as involved as they might be. People are helped to buy what they want. There are sensible health and safety arrangements. Evidence: The Manager has a good knowledge of how things are going. Since our last Key Inspection we have registered her. This means that we have satisfied ourselves that she is a fit person to run the Service. There are handover meetings at the beginning and end of each shift. These are held so that care workers can be kept up to date with developments. There are team meetings every month or so. The Manager says that she recognises the importance of good team work. One care worker says, the home provides a warm, welcoming atmosphere for the clients and Care Homes for Older People Page 24 of 29 Evidence: staff. Staff are encouraged to discuss any problems whatsoever with the manager. The Manager is always happy to listen to us whether she be at work or at home. This encourages good team spirit and provides a more relaxed approach, making staff feel more at ease. However, another person says, sometimes we need more direction and individual care workers need to be told about the importance of team work and not just do things in their own way and at their own pace. There have been arguments between staff and these do tend to rumble on. A firmer approach might sort them out. In their answers to our questionnaire, everyone says that always or usually there is good communication within the staff team. The Assessment says that people who live in the Service are regularly asked what they think about their home. This is done on an informal basis as part of everyday life. There are no house meetings or other more organized ways for people to say what they think. The Manager recognises that more should now be done to develop ways of consulting with people who live in the Service. With this in mind, she has developed a user friendly questionnaire. She says that people will be supported to complete these to enable them to give their views on their home. She also says that arrangements will be made to tell people what has been said in the questionnaires. This will be done so that they know what improvements are going to be made. Someone senior calls to the Service at least once a month to see how things are going. The records show that she talks with the people who live in the Service and with members of staff. She also looks at a selection of records and documents. There are arrangements to help people to manage their personal spending allowance. The Manager holds small amounts of cash for most people so that they have enough to pay for things such as seeing the hairdresser and the chiropodist. The records show that the arrangements are working in a reliable and transparent manner. The records show that most, but not all, members of staff have recently received training in how to operate the Services fire safety procedure. The Manager is now going to introduce a new system that will double check that all members of staff are confident about what to do if there is a fire. This is going to be done by 1 November 2009. The records show that things such as the passenger lift, the electrical wiring installation and the gas appliances remain in good working order. There is a record kept of any accident that occurs in the Service. These say what happened and what might need to be done to prevent them in the future. Care Homes for Older People Page 25 of 29 Evidence: The Manager has recently completed a detailed health and safety audit. This has involved her reviewing possible risks to peoples wellbeing. For example, she has checked that things like bleach are stored securely when they are not in use. The Manager says that there are no particular hazards that need attention. We did not notice any either. 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 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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