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Inspection on 11/06/09 for Westley Court Nursing Home

Also see our care home review for Westley Court Nursing Home for more information

This is the latest available inspection report for this service, carried out on 11th June 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

We found Westley Court to have a relaxed atmosphere about it. Information about the home is available for people who are thinking of moving into the home. Care needs are assessed prior to admission to ensure that the home is able to meet these. Activities are available within the home, information about these is provided. The activities stimulate people living in the home and can take into account people`s interests and tastes. We found the home to be well maintained and were told about plans for continual improvements to the environment. Staff receive training suitable to their role in the home to ensure they have the skills and knowledge to meet the needs of people.

What has improved since the last inspection?

Since our last visit we have registered the manager of the home therefore ensuring that somebody within the home holds responsibility for maintaining standards, meeting the regulations and ensuring that people receive the care they require. Improvements have taken place regarding monitoring of `fridge temperatures in the kitchenettes therefore ensuring that people are safe from associated risks to the health and well being.

What the care home could do better:

There is a need to improve the written records regarding the administration and safekeeping of medication to ensure the safety of people using the service. Some people have voiced a concern about a small number of day staff who may at times be too task orientated.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Westley Court Nursing Home Austcliffe Lane Cookley Kidderminster Worcestershire DY10 3RT     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: Andrew Spearing-Brown     Date: 1 6 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 28 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 28 Information about the care home Name of care home: Address: Westley Court Nursing Home Austcliffe Lane Cookley Kidderminster Worcestershire DY10 3RT 01562852952 01562852958 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Alpha Care Homes The registered provider is responsible for running the service care home 30 Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 30 0 old age, not falling within any other category physical disability Additional conditions: 0 30 The maximum number of service users who can be accommodated is: 30 The registered person may provide the following category of service only: Care Home with Nursing (Code N); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 30, Physical disability (PD) 30 Date of last inspection Brief description of the care home Westley Court is a modern, purpose built nursing home, which is situated in an attractive rural setting, adjoining the main Kidderminster to Wolverhampton Road. The home is registered to provide accommodation and nursing care for a maximum of Care Homes for Older People Page 4 of 28 Brief description of the care home 30 older people of either sex in single rooms, with en-suite facilities. The bedrooms are situated on the ground and first floor with a connecting lift. A communal lounge/dining room is available on the ground and first floor. Car parking is available at the side and the back of the home. Westley Court Nursing Home is part of a group of homes owned by Alpha Health Care Ltd. Information within the Statement of Purpose stated that fees vary according to the accommodation and care provided. These were, at that time, from 550 to 615 pounds per week. For up to date information the reader should contact the services directly. Care Homes for Older People Page 5 of 28 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 last key inspection at Westley Court was carried out during June 2008. This inspection was unannounced therefore nobody within the home knew we were going to visit. The focus of our inspections is upon the outcomes for people who live in the care home and includes peoples views of the service provided. The process we use considers the homes capacity to meet regulatory requirements, standards of practice and focuses on aspects of service provision that need further development. Prior to our visit we looked at the information that we have received since our last inspection. We requested an Annual Quality Assurance Assessment (AQAA) from the Care Homes for Older People Page 6 of 28 home prior to our visit. The AQAA is a document completed by the home and provides us with information about the home and how they believe they are meeting the needs of people living there. We sent some questionnaires to a sample number of people living in the home and their relatives. We also sent questionnaires to some members of staff. Prior to the inspection we received 8 back from or on behalf of residents, 9 from relatives, 6 from staff and 1 from a professional. We looked around the home. We viewed records in relation to some people living in the home such as care records, risk assessments and medication records. We also viewed records relating to some members of staff and others regarding health and safety matters. We checked that the requirements from the last inspection had been addressed. We spoke to the registered manager as well as some other members of staff and some people living in the home. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 28 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 9 of 28 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. Information is available to help people make a choice about whether they would like to live in the home. The needs of people who may use the service are assessed so that individuals and their relatives can be assured that care needs can be identified and determined whether staff have the ability to meet these. Evidence: Before we carried out our visit to the home we sent some questionnaires to people living in the home. We received 8 of these back. Some of them were completed by people living in the home while others were done by relatives or others. The vast majority of people stated that they had received enough information about the home to help them decide whether it was the right place for them before they moved in. An entry in the comments book stated good information received from staff who seem very friendly. Care Homes for Older People Page 10 of 28 Evidence: During the visit we were given a copy of the homes Statement of Purpose and their Service Users Guide. The Service Users Guide was last revised in May 2009. Although it does not contain details of all the areas mentioned within the associated National Minimum Standard it does, nevertheless, contain useful information about the service. We saw a copy of a letter informing people of the recent change from the former regulator (Commission for Social Care Inspection) to the Care Quality Commission. It was reported that the guide is available in large print if required. The Statement of Purpose was last reviewed on the 16th April 2009. This document gives information about current fees. The document gives details regarding what is and what is not included within the fee charged. The Service Users Guide states that prior to coming to the care home you will have been assessed to ensure that you receive the right level of care. Neither of the documents make any reference to either visits to the home before admission or any trail period. The AQAA does however state We actively encourage pre-admission visits by relatives and service users if possible. We viewed the assessment carried out by the registered manager regarding a person prior to their admission into the home. The assessment was very detailed and contained a lot of useful information for staff to ensure that care needs would be able to be met. The assessment was a good starting point for the generation of a full care plan. Care Homes for Older People Page 11 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are generally aware of the health and personal care needs of people. There is a risk that some needs are not being met as medication records are not always being kept properly. Evidence: Each person living at Westley Court had a written care plan. The care plan is a written document designed to guide staff about the level of care required by each individual to ensure that their care needs are meet and people receive the support they require. We have previously found these care plans to be very detailed and reviewed on a monthly basis. As part of this inspection we viewed the plans regarding a small representative sample of people. The care plans seen were generally comprehensive covering aspects of care in relation to identified needs. We saw risk assessments and systems of work which described how tasks could be performed safely. Care Homes for Older People Page 12 of 28 Evidence: On person spoke to us about a concern she had regarding the creaming of her legs. This procedure needed to take place following instructions from a GP. Although the care plan made reference to cream the more recent instruction was not included. It was evident that staff had not carried out these new instructions. Although some details may be missed from care plans the hand overs we attended were comprehensive and informative. Minutes from a staff meeting showed that the registered manager is seeking a more person centred approach to care planning. The minutes showed that the manager wishes staff to pay high attention to promoting dignity in the home. The lead nurse is taking on the role of Dignity Champion and will be carrying out informal sessions for staff in addition to the 1 1/2 hour training provided by Alpha. One relative told us on a questionnaire I am glad that my mother is at Westley Court whenever I go there to visit my mother, she is always happy, very well dressed and clean. Very well looked after. One member of staff wrote Westley Court gives quality care for the resident. As part of this inspection we assessed the storage, recording and management of medication. Medication is administered by a nurse. Since our last inspection a new system is in place regarding medication. We found items to be held securely in either a locked trolley or cupboards. We looked over the current Medication Administration Record (MAR) sheets. Although the majority of sheets we viewed were completed fully we did nevertheless have some concerns about others. One sheet showed some liquid medication given on four separate occasions however the signature was then signed over the top with a code meaning that the medication was refused. As this sheet is a record of medication taken this occurrence should not be possible. On one occasion a member of staff had signed with a code that then needed to be defined; the defining was not done. We found one drug still to be within the blister pack however on checking the MAR sheet it was signed as given. We had some concerns about the lack of accounting for drugs on a carry forward basis. This made it difficult for us to audit some medication. One bottle of tablets was dated May 2008. The number of drugs within this bottle was not recorded as a carry Care Homes for Older People Page 13 of 28 Evidence: forward and we could not establish when the last tablet was dispensed from this bottle. It was possible that the contents had past their expiry date. It was evident that some tablets were dispensed on a certain date however we were unable to account for medication not in the pack prior to the day when dispensed. The registered manager was unable to account for this. Medication was generally booked into the home however we saw an occasion when this did not happen which again made it difficult for us to carry out a full audit. Some drugs were prescribed on a variable dosage. Staff had not always recorded the actual dose given therefore we could not fully audit a box of painkillers against the records held. We checked some controlled medication and found it them to balance correctly with the records held. We discussed our findings with the registered manager who acknowledged our concerns and undertook to address them. Within our last report we stated that the home provides excellent support for people towards the end of their lives. Staff work within the Gold Standard Framework, which aims to ensure that people receive a gold standard of care at the end of their lives and to help them to live well until they die. In June 2008 Westley Court was assessed as continuing to provide this level of support for people. On a questionnaire we received a GP told us that the home does well at providing palliative care as well as sensitivity to the needs of individuals. Care Homes for Older People Page 14 of 28 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. People are encouraged to take part in social and recreational activities which reflect their personal preferences. People generally enjoy all or some of their meals and receive assistance from staff. Improvement is needed int he quality provided. Evidence: A dedicated activities coordinator is employed for 20 hours per week. We saw evidence of different events that were scheduled to take place during the week of our visit. Most people told us that the home orgainsed activities that they could take part in. During our visit we saw a quiz taking place in the upstairs lounge and some musical entertainment taking place in the downstairs lounge. The activities coordinator keeps good records of the events that have taken place to ensure that the individual needs of people are meet. The Service Users Guide states that the home has an open visiting policy and that family and friends are welcome at any time. We did not see many visitors during our inspection, however we have no reason to believe that visitors are not welcomed. One Care Homes for Older People Page 15 of 28 Evidence: person wrote on a questionnaire that the home does well as it welcomes visitors. The Statement of Purpose states that the local Vicar and the Priest attend the home regularly. The Service Users Guide adds that Spiritual advisers of all faiths and denominations are welcomed to the care home. One person told us about visits by the Salvation Army. People are able to bring in personal possessions to make their own rooms more homely, we noticed that many people had their own television set. During our visit we took the opportunity to join a small group of residents for lunch. The meal was well prepared and enjoyable. People with whom we sat also told us that they had enjoyed it. Staff were attentive and supportive. The meal was unhurried. We did however receive some mixed comments about food both from our questionnaire and during our visit. On the questionnaire we asked people they like the meals. Two people answered always, three people answered usually and three answered sometimes, one person added improved with they response. Other comments included Some meals not good, tough meat some meals nice The meals at dinner time are sometimes cold and could be a lot more varied. Two people commented on the need to improve on the availability of fresh fruit and vegetable. Somebody else wrote about good choice of food and drinks.During our visit we received very similar comments about the food to those received within our questionnaires. During our visit a number of people spoke to us about concerns regarding the time they receive their breakfast. We discussed these points with the registered manager who was aware of these matters as were other members of staff. We were assured that improvements were in hand to ensure that the timing of breakfast is improved. Care Homes for Older People Page 16 of 28 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 can be confident that their complaints will be listened to and appropriately handled. The home protect people from abuse and staff are aware of their responsibilities in relation to safeguarding. Evidence: The complaints procedure was displayed near to the reception desk. Although the font (size of type used) was small the procedure did nevertheless make it clear that complaints can be made via the regulator at any stage. Within the Service users guide it was not so clear that complaints can be sent to the commission at any stage although details about the new regulator (CQC) were included. We saw a copy of a letter advising people of the change in regulator. We also saw a leaflet in the reception area called How to make a complaint. Although the postal address of the commission was not written into the document, it is nevertheless a useful document and in a larger print. We also saw copies of a concerns or comments card in the reception area. The AQAA stated that the home had received 2 complaints over the previous 12 months. The document states that they were both investigated within 28 days and neither were upheld. The AQAA stated that the home values complaints and concerns and that these are viewed as a way of improving the service. Care Homes for Older People Page 17 of 28 Evidence: We asked people as part of our questionnaire whether they knew how to make a formal complaint. The vast majority of people who responded replied yes. One person wrote under what the home does well Willingness to listen to clients concerns and needs and then act upon them. During our visit to the home we were able to ask people whether they knew who to complain to should they need to. Everybody indicated that they did and most people made mention of the registered manager. The majority of people were confident that their complaint would be listened to and appropriate action taken. A copy of the previous inspection report was available for people to read. Details of an advocacy service are given within the Statement of Purpose. We are not aware of any safeguarding (protection of vulnerable people) referrals to social services since our last inspection. We are not aware of any incidents within the home which would have needed a referral to be made. During our visit we spoke to a number of members of staff who were able to confirm that they had attended training in safeguarding and the signs of actual or potential abuse. Staff were able to demonstrate suitable action to be taken should they become aware of abuse taking place within the home as they stated that they would contact head office and the commission. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People reside in a clean, comfortable and well maintained environment. Evidence: Westley Court is a modern purpose built nursing home located in a rural setting close to Kidderminster. The home is part of a larger building which forms retirement apartments. The home is set in extensive grounds which are well maintained. There is a small patio area with a water feature. This area provides a pleasant place for people to sit and relax. We found the home to be bright, clean and tidy. An entry in the comments book stated Most impressed. Very clean and caring environment. Another stated home is very light and airy. The results of a survey conducted in January 2009 showed that 72 of those who responded found housekeeping to be either excellent or good. A total of 9 answered either unacceptable or didnt know. During our visit people confirmed that the home is kept clean and tidy. The bedrooms are situated on both the ground and first floor. All the bedrooms are single occupancy and all have en-suite facilities. We saw that people are able to bring in their own personal possessions to make their own rooms more homely and individual. Care Homes for Older People Page 19 of 28 Evidence: A kitchenette is provided on both the ground and first floor. The units in the ground floor one although adequate appear tired and would benefit from refurbishment. Records are held regarding fridge temperatures and the items within the fridges were in date. These facilities can be used to provide hot drinks for people when they wish to have one. The lounge / dining room on the ground floor provides a pleasant area for people. New carpeting was in place along the ground floor corridor. We were told that the carpet upstairs is also due to be replaced. People were complementary about the service they receive from the laundry. The laundry is located separately from the main body of the home but easily assessable. We found it to be clean and had appropriate equipment for the washing of items. Other than seeing a bar of soap in one bathroom we have no concerns regarding infection control practices. Systems are in place to carry out audits within the home to ensure the health and safety of people regarding environmental matters. We did however query whether the doors to some hot water tanks were suitably secure to prevent unauthorised people gaining access. Care Homes for Older People Page 20 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Westley Court benefit from suitably recruited staff and trained staff. The majority of staff are well motivated and therefore provide good consistent care. This position could be compromised by a minority number of staff who may remain more task orientated. Evidence: The rota shows that the usual staff complement is 6 care staff in the morning and 5 during the afternoon. A trained nurse is on duty 24 hours per day. A senior carer is not always on duty every shift. We noted that at 8.00 am only 4 carers were present at the handover. We were given an explanation for this and the number of staff on duty was 6 by 8.30 am. We asked staff whether they believe sufficient staff are on duty. Most answered always with most of the remaining answering usually. One member of staff commented that the training is good however another commented about needing more in house training. Staff told us that the training they receive is relevant to their role and that it helps them to both understand and meet the individual needs of people. Care Homes for Older People Page 21 of 28 Evidence: We saw a training matrix which showed training undertaken during 2009 as well as when each individual had previously attended that training. We were told that induction training lasting 5 days which covers areas such as the principles of care, communication, moving and handling, adult abuse(safeguarding), infection control and health and safety takes place. A member of staff confirmed these arrangments. The registered manager was able to account for any gaps on the training matrix and it was evident that he had plans to ensure that people attend the required training. The lead nurse at Westley Court has attended training to enable her to train staff in moving and handling. As a result of this staff can receive on going support and assistance in the techniques used. During a handover it was good to hear verbal instruction given to staff regarding somebodys changing care needs. From the AQAA we established that just over 50 of the care staff have completed their NVQ (National Vocational Qualification) level 2 in care. These figues slightly differed at the time of our inspection however approximately 50 , which is the National Minimum Standard, have done this training. Other carers are currently undertaking their NVQ. Staff on duty confirmed to us about the NVQ training that takes place. We viewed the files of some recently appointed members of staff. Some information was not available however this was faxed to us from head office. From the evidence seen we are confident that the home has sufficiently robust procedures to protect people from the employment of unsuitable members of staff. In our last inspection report (June 2008) we stated We received many comments from residents and relatives about the staff. Most were complimentary, but some people who use the service had concerns about the attitude of a small minority of the staff. Unfortunately we received similar comments both within our questionnaires and while at the home as part of this inspection. One person wrote under what the home does well Majority of carers are kind and excellent particularly all the night staff We were told that the nurses are good. However one person wrote that some carers seem to not realize they are at the home to be kind, caring and considerate. The person continued by saying that fortunately this is only occasional. Another person wrote that some staff could be more attentive. More positively another person wrote they (the staff) take good care of me and try to make sure I am safe and happy in my every day life here. We did however also see some positive feedback to the home within the comments book such as Very nice and very friendly staff who look after residents with great care. Care Homes for Older People Page 22 of 28 Evidence: During the inspection one resident told us that the night staff are good, therefore similar to the comments within the questionnaires. The same resident told us that the day staff are not always as good although this has improved. The same resident did assure us that staff are not unkind. We were told that staff are sometimes under pressure due to the work. Due to the comments we received prior to the inspection and our findings during the previous inspection we observed staff practices. We saw nothing to give us any concern. Staff seen were caring and attentive. We do however have some concerns and these we discussed with the registered manager who agreed to continue with the work unready undertaken to improve issues regarding staffing practices. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that the service is well managed and safe due to the systems and procedures that are in place. Evidence: Since our last inspection the manager has successfully become registered with us. The registered manager was present throughout most of our inspection and was keen to assist us while also showing a dedication to both his job and the service provided at the home. We obtained a range of comments about the registered manager. We saw an entry within a comments book describing him as very helpful. One member of staff said that he is the best boss in care. One resident told us that the manager is a very good manager and carer, would have nothing but praise for Sam. Alpha have a number of quality audits that are regularly carried out by the registered Care Homes for Older People Page 24 of 28 Evidence: manager. A representative of Alpha visits on a regualr basis and a written report under regulation 26 is prepared. Minutes of a recent staff meeting were seen. These demonstrated that the home was making efforts to improve standards and seeking an improvement in its quality rating from us The Service Users Guide states that Alpha Care Homes cannot accept responsibility for any valuables or personal belongings brought into the care home. It is important that you arrange personal insurance cover to protect your belongings in the event of loss, theft or damage. Some people do have money kept in safekeeping within the home. The records balanced with the amounts held although we did make some recommendations regarding the people who have access to the information in order to protect peoples right to confidentiality. Staff confirmed that they receive regular formal supervision in line with the associated National Minimum Standard. The certificate of registration and public liability were on display in the home. The AQAA did not give us the information about the date when maintenance of equipment had taken place. As a result we asked to see the records regarding some areas such window restrictors, water temperatures and hoists. All these records were in good order. The checks are carried out by the homes handy person however they are also signed off by the registered manager which is to be commended. Care Homes for Older People Page 25 of 28 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 26 of 28 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 1 9 13 Regulation 13 (2). Ensure 11/09/2009 that medication records are signed and show the amount of medication held correctly. This is to ensure that medication is managed safely. 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 1 2 15 35 A review of the food should take place in relation to its quality. A review of who has access to the balances of money held in safekeeping should be carried out in order to maintain peoples confidentiality. Care Homes for Older People Page 27 of 28 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. 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