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Inspection on 22/01/09 for Aaron Crest Care Home

Also see our care home review for Aaron Crest Care Home for more information

This inspection was carried out on 22nd January 2009.

CSCI found this care home to be providing an Excellent 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.

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

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Aaron Crest Care Home Aaroncrest Tanhouse Road Skelmersdale Lancashire WN8 6AZ     The quality rating for this care home is:   three star excellent 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: Vivienne Morris     Date: 2 2 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Aaron Crest Care Home Tanhouse Road Aaroncrest Skelmersdale Lancashire WN8 6AZ 01695558880 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): aaron.crest@new-meronden.co.uk Aaroncare Limited Name of registered manager (if applicable) Carolyn Marie Ackers Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The service is registered to accommodate a maximum of 50 service users to include: up to 29 service users in the category OP (old age not falling within any other category) up to 5 service users over the age of 45 years in the category of PD (Physical disability) up to 21 service users in the category DE (dementia) Date of last inspection Brief description of the care home Aaroncrest is a purpose built care home with nursing. The home can accommodate up to 50 older people, including five with a physical disability over the age of 45 years. Accommodation is on two floors served by a passenger lift. Ramps to the front of the home allow access for wheelchair users and a number of aids and equipment are available to assist residents with mobility problems. Care Homes for Older People Page 4 of 30 care home 50 Over 65 0 29 0 21 0 5 Brief description of the care home The majority of rooms are single, with one companion room, which is available for residents who might wish to share. Some en-suite facilities are provided, and there are sufficient washing, bathing and toilet facilities. The home has two lounges, a large conservatory and two dining rooms. There is also plenty additional communal space and seating areas around the home offering people living there plenty of choice about where to spend their time. At the time of our visit to the service fees ranged from £366 to £616 per week with additional costs for private chiropody, hairdressing, personal toiletries and confectionary. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent 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 3 star. This means that the people who use this service experience excellent quality outcomes. The site visit to Aaron Crest Nursing Home formed part of the inspection process and was conducted over one day in January 2009. It was unannounced, which means that the managers, staff and people living at the home did not know it was going to take place. During the course of the site visit, discussions took place with those living at the home, as well as relatives and staff. Relevant records and documents were examined and a tour of the premises took place, when a random selection of private accommodation Care Homes for Older People Page 6 of 30 was viewed and all communal areas were seen. Comment cards were received from twenty people who were living at the home and seven staff members and their feedback is reflected throughout this report. Every year the provider completes a self-assessment (AQAA), which gives information to the Commission about how the home is meeting outcomes for the people using the service and how the quality of service provided is monitored. We also ask for some numerical information to be given to us on this form. We observed the activity within the home and tracked the care of three people during the site visit, not to the exclusion of other residents. The total key inspection process focused on the outcomes for people living at the home and involved gathering information about the service from a variety of different sources over a period of time. What the care home does well: The needs of people were thoroughly assessed before they moved into the home, to ensure that the staff team could provide the care and support required. The plans of care were being followed in day-to-day practice so that peoples health, personal and social care needs were being met. Those living at the home were treated with respect, their privacy and dignity being maintained at all times. Good nutritional, pressure and incontinence care was provided, which involved a range of external professionals, ensuring that people living at the home received appropriate health care. The daily routines within the home were flexible and people living there were offered a variety of choices throughout the day. Visitors were made very welcome to the home and people were able to access an independent person to act on their behalf, if they so wished. Activities were provided in accordance with the needs of people living at Aaron Crest and religious needs were appropriately met. The management of meal times was good. The menu provided a choice of nutritious food and people were allowed to eat at their own pace, so that the dining experience was enjoyable for them. Special diets were provided, as was required, and the meals served looked appetising to aid in nutrition. Complaints were well managed and people living at the home were adequately safeguarded from abusive situations. Staff were provided with a wide range of training to ensure that they were able to look after the people in their care. The home was tastefully furnished and decorated to a high standard throughout and the environment was warm, comfortable and homely, providing very pleasant surroundings for people to live in. The control of infection was good, so that those living at the home were protected against infectious diseases. Aaron Crest was being well managed and the health, welfare and safety of people was promoted, so that those living at and those working at the home were protected by the robust policies and procedures which were in place. One member of staff wrote on the comment card, I believe that Aaron Crest is a very good, caring home. The staff team make my job very easy and an enjoyable experience and another told us, I love my job and I am proud to work at Aaron Crest. It is good to go to work and enjoy your job. We sent out 20 comment cards for people living at the home to complete and all were returned. All 20 told us that the staff listen and act on what they say, which was a consistent positive response. The time spent observing what life was like at Aaron Crest found staff to be patient, spending quality time talking with residents and taking time to ask people questions in relation to their preferred routines rather than making decisions on behalf of the people living at the home. Care Homes for Older People Page 8 of 30 When asked what the service does well one person living at the home wrote on the comment card, Aaron Crest provides a caring and supportive environment. It is excellent in its provision of nursing care, another told us, Aaron Crest is a friendly, happy home with a good atmosphere and it provides excellent care and a third said, Aaron Crest allows people choice in how they want to live and it provides a homely environment. The residents needs always come first. 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 9 of 30 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs were thoroughly assessed, where practicable, before they were admitted to the home to ensure that the staff team could deliver the appropriate care. Evidence: Information about the home was readily available for the people living at Aaron Crest and their relatives. We received 20 comment cards from people living at Aaron Crest, 19 of whom said that they had been given enough information about the home before they moved in, so that they could decide if it was the right place for them to live. We tracked the care of three people living at the home during the course of our inspection. We found that detailed information had been gathered from a variety of sources for two of these people before they were admitted to Aaron Crest. The home Care Homes for Older People Page 11 of 30 Evidence: had also conducted thorough assessments to ensure that the staff team were certain that they could meet the needs of each individual. One person whose care was tracked had been admitted under emergency circumstances. However, all relevant information had been obtained about the needs of this person within a short timescale following admission so that staff could plan the care required by this individual with the involvement of their relatives. When asked what the service does well, the registered manager wrote on the homes self-assessment, we provide a homely atmosphere and promote choice at all times by providing all relevant information to residents and relatives and allowing pre-admission visits to take place prior to making choices. Each resident has a pre-admission assessment completed prior to admission and careful consideration is given to this before admission is agreed to ensure the staff are skilled to meet the needs of the prospective resident. The manager operates a surgery where residents, families or friends may discuss issues with the manager, this is arranged for the same time and day each week and there is a sign displayed prominently to notify people of this. Care Homes for Older People Page 12 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal care needs were fully met, their privacy and dignity being respected at all times and the management of medications was good. Evidence: The care records examined were person centred and contained a lot of detailed information, providing staff with clear guidance about the assessed needs of people living at the home and how these needs were to be met. The plans of care showed that where possible people were supported to be independent and that their privacy and dignity was respected. Staff were seen treating people with respect and talking to them in a nice manner by discussing things that the people living at the home were interested in. One person whose first language was not English was able to converse with a member of staff who could speak the same language. This persons relatives were very involved with the care planned and were able to interpret for staff, when necessary. Picture Care Homes for Older People Page 13 of 30 Evidence: charts were also effective in communicating with this individual, giving them the same opportunities as other people living at the home, which was considered to be good practice. The service users guide showed that privacy and dignity was respected at the home and dignity in care information was displayed on the notice board in the reception area so that people had easy access to it. People living at the home or their relative had been involved in the care planning process and a notice was displayed in the reception area of the home inviting relatives to have some input into the planning of care. It was pleasing to see learning material for staff incorporated into the care records in relation to peoples specific medical needs. Care plans seen had been reviewed on a monthly basis or more often if required and any changes in need were reflected well so that staff were kept up to date about the changing needs of people in their care. The plan of care for one person living at the home demonstrated that equality and diverse needs were taken into consideration so that this individual was offered the same opportunities as other people living at the home. Records showed that a wide range of external professionals were involved in the care of people living at the home to ensure that all their health care needs were being appropriately met. The assessed needs of people were recorded well within the plans of care, which we found were being followed in day-to-day practice. We spoke to a visiting General Practitioner during the inspection who was very happy with the care his patients were receiving whilst living at Aaron Crest. He said, this is a good home. The staff are on their toes. I dont have any complaints about Aaron Crest. A wide range of risk assessments had been conducted for each person to ensure that any potential hazards were identified and strategies had been implemented to eliminate or minimise the element of risk so that the safety of those living at the home was protected. Of the 20 people who submitted comment cards and who lived at the home, 17 said that they always received the care and support that they needed. Two of these people said that they usually did and one felt that they sometimes received the care and Care Homes for Older People Page 14 of 30 Evidence: support needed. All 20 of these people said that they received the medical support that they needed. Comment cards were received from seven members of staff, all of whom said that they were always given up to date information about the needs of people they supported. The management of medications was, in general, good. However hand written entries on the Medication Administration Records had not always been signed, witnessed and countersigned in order to reduce the possibility of transcription errors. When asked what the service does well the registered manager told us, each resident has a robust care plan generated from comprehensive assessments which are regularly reviewed. These provide good information for the care team to implement high quality care to meet residents needs and provide the basis for the care to be delivered. Residents are consulted on their care plans if able and contribute as much as practical on a daily basis. Care Homes for Older People Page 15 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The daily routines of the home were flexible and people were encouraged to maintain their leisure interests and activities whilst living there. The management of meals was very good and visitors were made welcome to the home. Evidence: Detailed social care assessments were in place for those whose care was tracked, showing that peoples leisure interests were considered whilst living at Aaron Crest and demonstrating how people were supported to maintain their hobbies and interests whilst living at the home. The type of lifestyle people preferred was recorded well and their likes and dislikes were clear within the plans of care. Two activity co-ordinators were responsible for planning and implementing the programme of activities for those living at the home. We were told that they were in the process of arranging a three month agenda. The activity programme currently in use was displayed in the reception area of the home, which included the celebration of any special events and activities suitable for the people living at Aaron Crest. Some staff had attended a training course in relation to activities for older people, which was considered good practice. Care Homes for Older People Page 16 of 30 Evidence: The routine of the home was seen to be flexible so that people living there were able to spend their day how they wished to do so and staff were observed offering people a variety of choices during the course of the day. The homes monthly news letter was displayed in the reception area, which provided a host of interesting information and a residents forum was in the process of being developed in order to encourage families to become more involved in the social aspect of the home. One person told us that they were being taken into town and looked pleased that they were having a trip out, but they also told us of other outings into the community that are provided. We spoke to one of the activities co-ordinators who explained what people in the home enjoyed doing and she showed us records of participation which were retained so that activities were offered fairly and so that any isolation could be identified. When asked if there were suitable activities arranged by the home a high percentage of those who returned comment cards said there always were and others said that they were either unable to join in the activities or they chose not to do so. When asked about the food served 11 people who returned comment cards said that they always enjoyed the meals at the home. Others indicated that they usually did and one person wrote, I prefer sandwiches. Im not keen on vegetables, but would like more fish. A Reverend was visiting at the time of our inspection showing that religious needs were being respected and that people were able to continue to follow their faith whilst living at the home. Arrangements for visiting were well published and organised. Those spoken to said that they were made to feel very welcome at the home and were able to visit people in private if they wished to do so. Records showed that some people living at the home were supported by the local advocacy service, so that they had an independent person to act on their behalf and information was readily available within the home telling people how they could access these services, should they wish to do so. The menu was on each dining table, which offered people a wide range of choices and as we observed lunch being served it was quite clear that those living at the home, where possible, had selected their preferred meal. One person said that he didnt fancy anything on offer for lunch so a staff member said, you can have whatever you want. Just say what you would like. The request made by this person was arranged, which was pleasing to see. Food served was well presented to aid in nutrition and it was noted that staff would go to great lengths to meet the dietary needs of people living at Care Homes for Older People Page 17 of 30 Evidence: the home. People were encouraged to be independent, where possible, whilst others were being supported with their meals in an appropriate way. The dining tables were pleasantly arranged and condiments were available for people to help themselves. Both hot and cold beverages were offered at lunch time and people were able to eat at their own pace so that meal times were an enjoyable experience for people living at the home. One person said, the food is always very good and there is always a lot of choice. When asked what the service does well, the registered manager told us, The activity co-ordinators seek the views of the residents in order to promote a variety of daily activities, sometimes on an individual basis other times in group sessions, to ensure the residents individual needs are respected. The home is renowned for its home made food, offering choices at each meal, together with snacks and drinks throughout the day and night. The new menu now includes vegetarian and healthy choice menus in addition to other special diets which are catered for. Care Homes for Older People Page 18 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints were managed well and people living at Aaron Crest were adequately safeguarded by the robust policies and procedures adopted by the home. Evidence: The complaints procedure was clearly displayed within the home and it was included in the service users guide available in each persons bedroom. This enabled people living at the home and their relatives to access relevant information about making a complaint if they wished to do so. Any complaints received had been recorded and addressed in accordance with the policies and procedures of the home to ensure that complaints were dealt with appropriately. A high percentage of those who returned comment cards said that they would know who to speak to if they were not happy at the home and that they would know how to make a complaint if they needed to do so. One person wrote, I can communicate with staff well and they seem to understand me. All staff who returned comment cards said that they would know what to do if a person using the service, their relative or advocate had concerns about the home. One of these people wrote, this would be co-ordinated by the home manager or area director to ensure effective communication and another commented, the manager is always on hand to help with any concerns people may have. The recent introduction of logging Care Homes for Older People Page 19 of 30 Evidence: all concerns and issues has been excellent in achieving effective communication. The registered manager told us how the service had improved in the last twelve months and she wrote on the homes self-assessment, we continue to develop relations with residents and representatives that encourage open discussion of all matters relating to welfare and contentment. People living at Aaron Crest were protected from harm by the robust policies and procedures adopted by the home and staff spoken to told us that they had received relevant training in relation to the Protection Of Vulnerable Adults and that they would know what to do should they have concerns about someone in their care. Care Homes for Older People Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provided a safe and comfortable environment for the people living there. Evidence: We toured the premises during the course of our inspection, when we viewed a randomly selected number of bedrooms and all communal areas. We found that the environment was fit for its purpose, providing lovely surroundings for people to live in. The quality of furnishings and decoration was of a high standard and the home was well maintained so that people were provided with a comfortable and safe place in which to live. The bedrooms seen were adorned with peoples personal belongings, which made the private accommodation individualised and homely. The home was warm, clean and pleasant smelling. The communal areas were well furnished and tastefully decorated so that those choosing to spend their day in these areas could do in comfort. One person living at the home told us that they were very happy with their bedroom and that it was very comfortable. During our visit to the service we observed some good hygiene practices so that the risk of cross infection was minimised. Clinical waste was being disposed of appropriately and robust policies and procedures were in place in relation to infection control and disposal of clinical waste so that staff were aware of necessary precautions. Records showed that staff had received training about infection control Care Homes for Older People Page 21 of 30 Evidence: measures and those spoken to confirmed this information. When asked if the home was fresh and clean 18 of those who returned comment cards and lived at the home said it always was and two felt that it sometimes was fresh and clean. Care Homes for Older People Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The number and skill mix of staff on duty met the assessed needs of those living at the home. The recruitment practices adopted by the home could have been better. Evidence: A clear duty rota was in place at the home and staffing levels were calculated in accordance with the assessed needs of those living at Aaron Crest. When asked if staff were available when they were needed, people living at the home said that in general they were. It was pleasing to note that there was a very low turn over of staff, which promoted continuity of care. When staff were asked if there was anything else that they would like to tell us one of them wrote on the comment card, I enjoy my job. I have been a carer in this home for 14 years. Staff spoken to and comment cards sent to us by staff indicated that, in general, there were always enough staff on duty to meet the needs of those living at the home. One wrote, I am not aware of any situations when there were insufficient staff resources. People working at the home told us that a lot of training was provided for them so that they were kept up to date with current ways of working and the changing needs of Care Homes for Older People Page 23 of 30 Evidence: people in their care. At the time of our visit to this service there were 37 care staff employed, with 21 having achieved a recognised qualification in care, showing that a good percentage had been appropriately trained. Recruitment procedures adopted by the home could have been better. The staff files of two people employed were examined, when we found that although all relevant checks had been conducted, the Criminal Record Bureau Disclosures had not been obtained before the commencement of employment, to ensure that people living at the home were consistently protected. All staff who sent us comment cards said that their employer carried out relevant checks before they started work and that their induction covered everything they needed to know to allow them to do the job properly when they started. One person wrote, I had a few days induction, which continued after commencement of employment and another told us, my induction training was appropriate and extensive. All staff members said that they were given training which was relevant to their role, helped them understand and meet individual needs of people using the service and kept them up to date with new ways of working. A detailed induction programme was in place for all new staff and a training matrix had been developed, which showed that an extensive range of training was provided, including mandatory courses and training relevant to the specific needs of people living at Aaron Crest. One staff member wrote on the comment card, as well as in house and on the job training I have been given training in the protection of vulnerable adults, health and safety and basic food hygiene and another commented, the training I have received is all very good and it does help me. Care Homes for Older People Page 24 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was well managed so that the health, welfare and safety of the people living and working at Aaron Crest was protected. Evidence: Aaron Crest was being well managed and the health and safety of those living at the home was evidently of great importance. The manager of the home was appropriately qualified and was registered with the Commission for Social Care Inspection. She had a lot of experience in the management of care services and was knowledgeable about current guidelines and legislation. Staff who sent us comment cards told us that their manager meets with them regularly to give support and to discuss how they are working. One staff member wrote, the manager liaises with us daily and meets with us almost every week and another commented, we get excellent support and regular progress discussions with our manager. Care Homes for Older People Page 25 of 30 Evidence: A business plan was in place and the quality of service provided was monitored well, with a variety of surveys being conducted for people living at the home, their relatives and stakeholders in the community, the results of which were produced in graph format for all interested parties to see, should they so wish. It is recommended that the home now ask staff working there to complete questionnaires so that their views can be taken in to consideration also. Monthly inspections were carried out by someone from the company, following which a report was written showing any strengths or weaknesses so that managers could see where improvements were needed. Aaron Crest had been accredited by an external professional organisation, who audited the service at regular intervals so that an outside body was involved in assessing the quality of service provided. A wide range of risk assessments and internal audits had been completed by the home to ensure that the standard of service provided was monitored and that the safety of those living at Aaron Crest was promoted. A variety of meetings were held regularly and minutes were retained so that those concerned were provided with relevant information. The finances of people living at the home were protected by good record keeping and the practices adopted by Aaron Crest. The personal allowance records were examined and were found to be satisfactory. There was a robust health and safety policy in place and we looked at a random selection of service certificates to ensure that systems and equipment within the home had been appropriately checked and deemed as safe to use, so that the people living at and those working at Aaron Crest were protected. Accident records had been completed appropriately so that any incidents could be monitored and to ensure that people living at the home were as far as possible protected. Emergency fire procedures were widely displayed so that everyone in the home was made aware of what they should do in the event of fire. Comments from those living at the home included, I think the home is very good and lovely and I am really happy here. Care Homes for Older People Page 26 of 30 Care Homes for Older People Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 28 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 29 19 A person must not be employed to work in the care home unless a Criminal Record Bureau disclosure has been obtained. To ensure that people living at the home are consistently protected 31/03/2009 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 9 Any written entries on the Medication Administration Records should be signed, witnessed and countersigned to avoid any transcription errors. It is recommended that surveys be conducted for staff, so that their views are sought about how the service is performing and what it is like working at the home. 2 33 Care Homes for Older People Page 29 of 30 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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