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Inspection on 02/07/09 for Ashdown Nursing Home

Also see our care home review for Ashdown Nursing Home for more information

This inspection was carried out on 2nd July 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.

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

Prospective residents and their Representatives are given good information about the home. Residents are looked after by a caring and well trained team of staff who we are told respect their privacy and dignity. They are offered a range of activities and good home cooked food is served. Some comments were "The staff at Ashdown are always helpful and organised when asking for a GP to call and they cope very well with a challenging group of people". "The staff work hard to look after residents well". "Staff always make me feel welcome when I visit". "I am happy here". "The home provides a homely environment for residents who are well cared for by the staff".

What has improved since the last inspection?

The Statement of purpose has been updated to reflect changes to the environment. Weekly case presentations on residents conditions are held to ensure staff are up to date and to raise awareness. Residents are consulted about the decoration of their rooms. The quality audit system for the home has been improved with many more audits being undertaken. A review of the activities as taken place and residents have been consulted about what they would like to do also they have been involved in planning menus. Staff training has been improved with more mandatory and other training being offered. The home continues to upgrade the environment both internally and externally and more specialist equipment has been purchased.

What the care home could do better:

The internal environment could be improved by more signage appropriate for people with dementia. More preferences should be incorporated into the care plans and the work obtaining life histories should continue. One resident said they would like more outings so this should be looked into and work should continue so that the rear garden is accessible for residents. In the AQAA we are told that the home plans to improve in the next twelve months include: The newly appointed manager to become registered with the Commission. Review the admissions procedure to take account of new legislation relating to Mental Capacity Act and Deprivation of Liberty and provide training for staff. Implement the End of Life Care Pathway to improve delivery of care to residents who are dying. Devise action plans to meet issues identified from audits. set up a food and nutrition group to oversee food and drinks and to start a relatives support group. Continue with the staff training and development plan and evaluate benefits. Increase the hours allocated for activities to make more available.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ashdown Nursing Home 2 Shakespeare Road Worthing West Sussex BN11 4AN     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: Ann Peace     Date: 0 2 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Ashdown Nursing Home 2 Shakespeare Road Worthing West Sussex BN11 4AN 01903211846 01903208680 mgnewcare@googlemail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Newcare Homes Ltd care home 40 Number of places (if applicable): Under 65 Over 65 0 0 dementia mental disorder, excluding learning disability or dementia Additional conditions: 40 40 The maximum number of service users to be accommodated is 40. The registered person may provide the following category/ies of service only: Care home with nursing only - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) Mental disorder, excluding learning disability or dementia (MD). Date of last inspection Brief description of the care home Ashdown Nursing Home is situated in a residential area of Worthing in West Sussex. The registered providers are Newcare Homes Ltd who purchased the home in 2004. There is a new manager in the home who is presently applying to the Commission to be registered. Ashdown is registered for 40 residents over the age of 65 years who have dementia. The Statement of Purpose continues to be updated to show the changes to the home as it is being refurbished. The improved communal areas consist of a lounge and a lounge/dining room on the ground floor and a second lounge on the first floor. There Care Homes for Older People Page 4 of 29 Brief description of the care home are other small sitting areas in the entrance hall and upper and lower corridors, which lead to bedrooms. A passenger lift is available for rooms on the upper floor. There is a garden to the rear of the property, which is not currently available for use by residents. The current scale of fees being charged at the home is from 600 to 700 pounds per week. 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: In preparation for the inspection we looked at all of the information we have received or asked for since the last inspection. This included the Annual Quality Assurance Assessment (AQAA) that was sent to us by the service. The AQAA is a self assessment that focuses on how well outcomes are being met for the people who use the service. It also gives us some numerical information about the service. We looked at the improvement plan the service was required to submit to show us how they were going to meet requirements made at the last inspection which was carried out on 9th July 2008. Seven service user, six staff and two health professional surveys were sent to us all Care Homes for Older People Page 6 of 29 made positive comments about the home . In addition to the AQAA we looked at the last inspection report and other information we have received about the home since the last visit. The unannounced visit was carried out on 2nd July 2009 at 9am and lasted five and a half hours. During that time we were able to spend time with residents living at the home both in the privacy of their bedrooms or in the communal areas. We spoke to staff on duty, one visitor to the home and we observed staff practice. We tracked assessments, care plans and supporting documentation such as daily records, health monitoring records and risk assessments to see if residents identified needs were being met. We also looked at the homes system for administration and recording of medication, records relating to the running of the home such as health and safety, complaints and untoward incidents. Staff recruitment and training files were seen. Following the inspection feedback was given to the manager. 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. Care Homes for Older People Page 8 of 29 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. Prospective residents and their representatives are given good information about the home and can visit to make a choice as to whether or not they would like to live at the home. Pre assessments and assessments are carried out to ensure staff will be able to meet their needs. Residents are given contracts. Intermediate care is not provided at Ashdown Nursing home although respite care is available. Evidence: The home has developed clear information to people understand what services the home offers. There is a statement of purpose which clearly sets out the objectives and philosophy of the home, certain procedures and what residents who choose to live there can expect. Care Homes for Older People Page 11 of 29 Evidence: There is a copy of the statement of purpose in the hallway of the home along with a copy of the latest CQC inspection report, the annual improvement plan for the home and various other leaflets relating to the services offered including information on the latest legislation relating to Deprivation of Liberty Safeguards. A visitor whose mother had recently moved into the home told us that they were given good information including a copy of the statement of purpose in order to make a choice and that they were invited to visit the home to see what it was like before making a decision. A resident also told us that they had visited and spent time in the home before moving in. We saw in records examined, that residents had been pre assessed to ensure the home would be able to meet their needs, all had fuller assessments on admission and these were regularly updated. All residents have contracts stating terms and conditions of the home. 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. Residents all have a health and social plan of care to ensure their identified needs are met. The medication policies and procedures are safe and residents get their medication as prescribed. We are told that staff treat residents with respect and their privacy is upheld. At the time of death staff will treat residents and their families with care, sensitivity and respect. Evidence: We looked at records to see if the assessed needs of residents are being met and how they are being cared for, also if equipment that is assessed as being needed has been provided. All records had the information, risk assessments and documentation that was needed by legislation and to ensure staff can meet the specialised needs of residents and that risks are minimised. Since the last inspection weekly case presentations of individual residents and their specialised needs have been introduced for staff to ensure they focus on person centred care. Care Homes for Older People Page 13 of 29 Evidence: Care plans are individualised and in part person centred but more preferences could be recorded. We were told this is very difficult for some residents who have no relatives so staff are unable to gain a past history and some of these residents cannot tell them. Social care plans are in place and are being further developed, life histories taken and records kept. Individual treatment programmes are compiled where the need arises. For one resident who is a diabetic, the records were pertinent to their condition with the action staff are to take in an emergency clear and concise. One resident was at risk of malnutrition and was reluctant to eat, the care plan said weigh weekly as opposed to monthly as is the normal procedure, we could see that this was being done and the staff were trying hard to maintain the residents weight by tempting them with different food. Records showed that the GP and the relatives were involved and were being kept informed of the ongoing condition of this resident. We could see from ongoing monitoring records both health and social that another resident health and wellbeing was gradually improving compared to when they were admitted. During our visit the relative of a new resident came to visit and we overheard the manager explaining clearly about the care plan and what was needed, the resident was not able to take part in the meeting but relative was asked if they agreed to the plan or if they had any concerns. They were then asked to sign on behalf of the resident. Residents are accommodated both upstairs and downstairs and there is a lounge upstairs with staff in attendance all of the time. Some residents like to wander and we saw some wandering freely and happily around the corridors which have handrails for safety. We saw that staff were constantly on hand to check and reassure them without stopping them doing what they wanted. During the visit we sat and observed what was going on in the home for a short period of time and noted that staff were on hand when needed but did let residents make choices about what they wanted to do and where they wanted to be. Residents were at ease with the staff and the interaction was good throughout the visit. None of the residents showed they were unhappy during the visit they all looked contented and comfortable. Throughout the visit we saw staff display a patient caring and attentive attitude. We saw on the notice board an article that had been in a local newspaper dated June 2009 in which a grateful relative was praising the home and the staff for the care they gave to their relative who had recently been in the home. Care Homes for Older People Page 14 of 29 Evidence: Medication policies and procedures were updated in March 2009 qualified nurses administer medication and they have signed to say they have read and understood them. Medication Administration charts had been completed appropriately to show residents are getting the medication they need at the right time. A medication audit had been carried out by the new manager during the night before our visit and was satisfactory. A local GP and a Nurse Practitioner completed CQC surveys and were generally positive about the home, they said assessment arrangements always ensure right information gathered and right service planned for residents. They said residents health needs are always properly monitored, reviewed and met. They said that the home always seeks advice and acts upon it to meet residents social and health care needs and improve their wellbeing. They said staff respect residents privacy and dignity and give them support to live the life they choose. They say staff usually have to right skills and experience to support residents social and health care needs and that staff always respond if any concerns have been raised. Comments were Staff respond very well with a challenging client group. Staff work hard to look after the residents well. Ashdown nursing home provides best care and support for all residents. My husband has received excellent care and attention from all of the staff he is kept clean comfortable and is content. All of the surveys returned from residents or their relatives were positive, they all said the care staff and managers treat them well they listen to and act on what they say. The home is planning to implement the Liverpool Care Pathway for best end of life care, we could see that training for this is presently being arranged. During our visit by watching staff, talking to residents and a relative and by looking at what we were told in the surveys we concluded that at the time of their death staff would treat residents, their friends and relatives with care sensitivity and respect. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Routines in the home are flexible and residents are encouraged to make choices. Activities are provided to meet individual needs and residents are offered good home cooked food which they have chosen. Families and friends are encouraged to visit and are made welcome. Evidence: During our site visit we could see that routines are flexible within care needs, staff were heard and seen to give residents choices throughout the day and respect what they wanted to do. An activity co-ordinator is employed and there is a weekly activity programme on display. Surveys sent back to us said they were happy with what was provided, one survey did say they would like more outings. We told the manager about this. We spoke to the enthusiastic activity co-ordinator and were shown records of activities, which residents take part and which ones do not. Some of the activities included: Gardening, armchair exercises, word games, hand massage and manicures, ball games, cake baking and local news discussion. Because of their dementia some of the residents are unable to participate fully and one to one activities are provided. There was a poster advertising a forthcoming BBQ and photographs were on the notice board of recent outings one of which was to a garden centre for tea and cakes. Care Homes for Older People Page 16 of 29 Evidence: Motivational (qualified) therapists come into the home on a regular basis to provide other activities for residents. We were told that one resident who had been quite withdrawn had improved since a member of staffs dog started visiting the home so the manager is arranging to have PAT dogs visit on a regular basis. An audit of the activities programme has recently been carrried out and residents/relatives asked their opinions, from this, a report was written so plans can be made for the future. A fish tank had been set up in the lounge/diner after a resident said they were interested. We could see from the visitors book and we were told that residents are able and encouraged to maintain contact with family and friends. One relative told us that she is always made welcome and offered refreshments, we were told that staff are always cheerful and friendly. We were also told that night staff are helpful when they ring to find out about their relative. Residents are given good home cooked food and recently three residents were involved in drawing up menus which resulted in some changes being made and more choices given. Some of the changes included the addition of liver and bacon, corned beef hash, meatballs and sweet and sour chicken on the menu and home made soup every day. Pictoral menus are available for those residents who are unable to say which choice they would like, we were told that these are being added to all of the time. Residents were having their midday meal outside in the sunshine accompanied by the activity co-ordinator. One choice of meal on the day of our visit was beef stew with boiled potatoes and vegetables, we sampled this and it was tasty and well presented. One resident was having cheese on toast through choice and another an egg salad. We saw the menus and they looked nutritious, well balanced with many choices and the surveys sent back to us were complimentary about the food. On the day of our visit we asked residents and a visitor about the food and they were all positive and said they always got what they wanted even if it was not on the menu. Residents are able to have a cooked breakfast if they wish. Records are kept of what residents eat so that their intake can be monitored. We saw staff constantly offering cool drinks throughout the day and during lunchtime staff were noted to help residents with their meals sensitively and patiently. Most meals were served at the same time to those who were independent with eating, but we noted that as good practice meals were not served to those who needed help until Care Homes for Older People Page 17 of 29 Evidence: staff were ready, which meant that the food was still hot. There is a new courtyard area leading off the dining room which has tables and seating for residents. A ramp and handrails are in place. The ground in the courtyard has been covered with a special soft type of covering that minimises injuries if residents should fall. There is a small garden which residents have helped plant. There is a larger rear garden that has been cleared but is not at present suitable for residents to wander independently. We are told that the refurbishments and improvements are still ongoing and that there are plans for the garden to be relaid. Care Homes for Older People Page 18 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. Residents and their relatives are confident that their complaints will be dealt with in a timely manner. Safeguarding policies and procedures are in place and staff are trained to recognise and report abuse. Evidence: The home has a clear large print complaint procedure in the hallway of the home and in the statement of purpose for the home. All surveys sent to us said people knew how to complain and who to. When we asked staff if they knew what to do they were all confident that they would be able to take a complaint forward to the manager or the provider. Records are kept of complaints and any action taken. There are no outstanding complaints at the present time. Policies and procedures for safeguarding adults are available and staff spoken with knew what to do if abuse was suspected. They all said they would take appropriate action to safeguard residents and report it to the manager or provider. They told us that they had received training and records confirmed this. In the last twelve months there have been two safeguarding alerts regarding Ashdown, these were investigated by Social Services and neither allegation was substantiated. However some recommendations were made for good practice and these have been Care Homes for Older People Page 19 of 29 Evidence: put in place by the home. There is a flow chart on the notice board in the home to show a simplified procedure for anyone to follow if abuse is suspected. The recruitment procedure for the home is robust as all staff have been checked to ensure they are suitable to work with vulnerable people. Care Homes for Older People Page 20 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a safe, well maintained comfortable environment and have access to safe indoor and limited outdoor communal facilities. There are sufficient toilet and washing facilities and specialist equipment is provided. Evidence: In the last year the providers have invested in the home to improve the environment and the internal accommodation of the home provides an environment that is suitable to meet specific needs of residents. The home is comfortably furnished and there is a programme of decoration and re furbishment in place. Many bedrooms have been re decorated and residents are being asked what colours they would like, the staff have started to personalise the outside of residents bedrooms so they can recognise them easier and we were told are planning to take this further with door knockers, bells etc. The AQAA told us that some new nursing beds have been purchased and all mattresses have been replaced. We are told that they plan to purchase more nursing beds in the next twelve months. Residents can personalise their rooms and surveys sent to us told us that the home is clean and fresh. There are sufficient toilets and bathrooms for the residents presently accommodated. Care Homes for Older People Page 21 of 29 Evidence: A full time maintenance man has recently been employed at the home and we could see that the testing of equipment and services in the home are up to date with records kept. Other specialised equipment is provided and records showed that contracts are in place to ensure the equipment is serviced as it should be. The home has joined the safer, cleaner, homes campaign run by the local PCT and from this have set up an infection control group in the home the minutes of their last meeting in June 2009 were available. Annual infection control training has been provided for staff and we noted they followed safe practices. An inspection by The Environmental Health Department has been carried out in the past 6 months two requirements were made and we could see they had been met. The external environment to the side of the home has been improved by the creation of an outside courtyard area suitable for residents to go. There is seating and tables and a small garden has been made so that residents can take part in gardening activities. An extension to the home to make a conservatory has been built, but without the correct planning permission, the Providers are in contact with the Council and are presently trying to find a way to resolve the issue for the structure to remain in place. There is a large rear garden and although it has recently been cleared it is still not suitable or safe for residents to use. This has been noted in the last two key inspections. We were told that the re-landscaping of the garden is included in the future plans for the home. Care Homes for Older People Page 22 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. Residents needs are met by caring and competent staff that have benefited from training and there are enough staff on duty to look after them. They are protected by the homes recruitment procedures. Evidence: Residents told us and surveys sent to us told us that staff in the home are caring, attentive and look after residents well. They told us that they thought there was always enough staff on duty and that staff listen to them and act on what they say. Staff rotas were available for us to see and we concluded that residents needs are met by the skill mix and number of staff on duty over 24 hours.. We were told that there is only one staff vacancy at present for a qualified nurse and they were hopeful that they had a suitable candidate to fill the post. An administrator and a new maintenance man have recently been employed at the home. On the day of the site visit the new manager told us that she had been on duty part of the previous night to carry out a spot check to make sure the night staff are supported to ensure that residents are receiving the care they need. All staff have received training in how to care for people suffering from Dementia. We could also see from records that staff working in the home have access to training at Care Homes for Older People Page 23 of 29 Evidence: all levels, all have induction, some are undertaking NVQ at levels 2, 3 and 4. Other are undertaking distance courses at a local college. Other recent training included: literacy and numeracy, equality and diversity, palliative care, infection control, nutrition, safeguarding and dementia. There is also an in house mandatory training programme in place. Staff told us in the surveys they sent back to us that training is encouraged, they are given enough support to carry out their work. They thought communication in the home was usually good and there was enough staff on duty to meet individual needs of residents. We checked the recruitment records of three new members of staff and could see that a robust recruitment is followed by the home to ensure the staff employed are safe to work with vulnerable people. Care Homes for Older People Page 24 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The newly appointed manager is not yet registered with the Commission. The views of residents and their relatives are sought and there is an annual development plan in place. Residents finances are protected by the procedures in the home and the health and safety of residents and staff are protected. Evidence: There is a new manager in post who is a Registered Nurse, has experience of working with older people and who has just completed their Registered Managers Award. They are planning to register with the Commission in the near future. There are clear lines of accountability in the home, the manager is supported by other registered nurses, one of which is deputy and takes on a supervisory clinical role. There is a staff supervision program in place and staff told us they were well supported. The approach in the home is open and there is a positive and friendly atmosphere in Care Homes for Older People Page 25 of 29 Evidence: the home. There is a quality assurance system in place and audits were available for us to see including any action that was taken as a result of feedback. There is a development plan available and showed that feedback from the audits had been taken into account. Meetings are held for residents, relatives and staff and minutes were available on the notice board. There are plans to set up a relatives support group. The provider carries out Regulation 26 visits to monitor the home and these were available for us to see. There are procedures in place to protect residents finances and the home does not a ct as an appointee for anyone living at the home. There are systems in place to protect the health and safety of residents and staff and the AQAA states that equipment is serviced as required. We could see from training records that staff have attended mandatory training in order to protect residents living at the home. Incidents and accidents are recorded and we could see they are monitored for trends so that risks can be minimised. Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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