Inspection on 02/03/09 for Barrington Lodge Nursing Home

This inspection was carried out on 2nd March 2009.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Barrington Lodge Nursing Home 14/01/08

Barrington Lodge Nursing Home 20/11/06

Barrington Lodge Nursing Home 19/01/06

Barrington Lodge Nursing Home 29/06/05

Barrington Lodge Nursing Home 20/12/04

Barrington Lodge Nursing Home 28/07/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Barrington Lodge Nursing Home Cirencester Road Cheltenham Glos GL53 8DS     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Wendy Kirby     Date: 0 2 0 3 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 32 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 32 Information about the care home Name of care home: Address: Barrington Lodge Nursing Home Cirencester Road Cheltenham Glos GL53 8DS 01242263434 01242260731 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) : BUPA Care Homes (CFC Homes) Ltd care home 37 Number of places (if applicable): Under 65 Over 65 37 old age, not falling within any other category Additional conditions: 0 10 residential beds for the elderly (Cat I) included within total of 37 nursing beds. To accommodate one named service user aged 57 years of age. Date of last inspection Brief description of the care home This Home is part of the BUPA Group and is situated on the outskirts of Cheltenham Spa Town. Near to local bus routes and shops, it sits back off the main road with its own private parking and gardens. The Home provides 24hr-nursing care/personal care for those predominantly over the age of 65 years of age. Internal accommodation is offered over numerous floor levels. There is a passenger lift, stair lifts and sloped floors that aid access to these levels. There are a small group of bedrooms that can only be accessed by people that are able to walk, therefore admissions to these rooms is very selective. All bedrooms have ensuite facilities of some sort. Communal rooms are on the ground Care Homes for Older People Page 4 of 32 Brief description of the care home floor. The current fee range is £775.00 to £950.00 The home does accept authority funded or health funded admissions. The home makes available information regarding previous inspections in a folder in the main reception area. Care Homes for Older People Page 5 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced Key Inspection which included a visit to the home. The visit was completed by one inspector over nine hours. Prior to the inspection we (The Commission) looked at various pieces of information to gather evidence in preparation for our visit, which included the following: The previous inspection report. The homes inspection record which gives us an account of any information we have received about the home since the last inspection. The Annual Quality Assurance Assessment known as an AQAA. The home is requested Care Homes for Older People Page 6 of 32 annually to complete and return this assessment to us by a specified time We received the AQAA on time which contained information about what the home considers it does well and what plans they have for further improvements in the coming year. We sent surveys Have Your Say to people who live in the home, staff, and health and social care professionals. Eighteen were completed and returned. We did not receive any completed surveys from health and social care professionals. Comments received are detailed throughout this report. We also looked at Personal Best comment cards, these are something that BUPA have introduced into all their homes. Anyone can use the cards, including people living in the home, relatives, friends, staff, and visiting heath and social care professionals. People can use the cards for any reason they like, for some its a way of communicating feelings either by thanking someone individually for a kindness, giving feed back on an event or expressing something they may not be particularly happy with. The messages can be anonymous if people wish, all the information is gathered by the manager and helps towards monitoring the quality of service provided in the home so that they can see strengths and weaknesses and work on improvements. Details of some of the comments received will be detailed in the report. During our visit we spoke with some of the people who live in the home, visitors, the manager, and other staff members who were on duty. We also looked at how effectively staff engage with people in the home and how they were interacting and communicating with each other. We looked at four individual care files, which included pre admission assessments, care plans, and risk assessments. We also looked at a number of records and files relating to the day to day running and management of the home. We spent time in all communal areas of the home and some of the bedrooms. We finished the inspection with a feedback session to the manager. What the care home does well: What has improved since the last inspection? What they could do better: All of the National Minimum Standards assessed at this inspection were met. No statutory requirements have been made as a result of this inspection. Care Homes for Older People Page 8 of 32 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 32 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 32 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. Peoples needs are assessed prior to admission to determine the suitability of placement. They can be confident that staff will have the resources and skills to meet their assessed needs. Evidence: We looked at the pre-admission assessments, which were very comprehensive covering all activities of daily living, a full health screen and personal history background. The information gathered pre-admission should provide a sound benchmark of the persons ability, state of health prior to admission and subsequent needs when they move into the home. People wishing to live in the home, family and carers are involved in the pre-admission assessment wherever possible and all information is used to determine the suitability of the placement. Where possible the manager also obtains comprehensive Care Homes for Older People Page 11 of 32 Evidence: assessments and care plans from other health and social care professionals involved, for example, social workers and hospital staff. We spoke with the manager who was able to clearly demonstrate the importance of pre-admission assessments in order to ensure that the home can meet individuals identified needs. The home does not provide designated rehabilitation care. Care Homes for Older People Page 12 of 32 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. Because they are consulted about their health and social care needs people should be assured that their views and expectations will be considered and that the care received will be individualised. Safe systems of practice are in place for receiving, storing, administering and disposing of medications which will help protect and promote the health and well being of people living in the home. People can be confident that staff have a good awareness of their needs and that they will be treated with dignity and respect. Evidence: From the pre-admission assessments the staff are able to develop a set of care plans based on identified needs. During the first months trial period the plans are reviewed weekly and developed accordingly. The plans that we looked at were fairly detailed and person centered, including personal preferences and likes and dislikes. Care Homes for Older People Page 13 of 32 Evidence: The plans showed consistency in assessing, planning and evaluating care as required. Regular care reviews take place for people living in the home, which can include family members and Key Workers wherever possible. This allows the opportunity to discuss and evaluate care and any issues or concerns people might have. Records of General Practitioner (GP) visits and the outcomes were recorded. Specialist referrals and visits from other professionals including, Chiropodists, Dentists and Opticians were also seen. Health care needs are monitored and documented in peoples care files. Nutritional assessments are completed on admission and reviewed monthly, people are weighed as part of this review. Care plans are written for people who are nutritionally at risk and how this is to be managed. Specialist health care support is often sought and referrals are made to Community Dieticians and the Speech and Language Therapists. We spoke with some staff who demonstrated good relationships with individuals and were knowledgeable about the care needs of those living in the home. Staff agreed that they had up to date information about peoples needs and confirmed that care plans were reviewed at least monthly unless there were any other significant changes. Five out of nine people living in the home told us in our surveys that they always received the care and support they needed and the remaining four said usually. Comments from people included, Excellent care and attention is given at all times, and The staff are always helpful. Some of the comments seen in the Personal Best cards included, Can I thank the member of staff who stayed in the A&E department with my relative, five hours after their shift should have finished. You were kind, professional and very caring. We are very impressed and Can I thank you for the delightful treat I had being dressed and got up this morning by such a charming person!. Policies and procedures for receiving, storing, administering and disposing of medications were examined and discussed with the trained nurses. All systems in place are effective, well managed and audited. The home operates a monitored dosage system for the administration of medication, which is supplied at regular intervals by a local pharmacist. Six monthly medication reviews for people living in the home are completed by GPs. The home promotes privacy and dignity to all people who use the home. Staff attend training on induction, which covers aspects such as closing doors and pulling curtains Care Homes for Older People Page 14 of 32 Evidence: when delivering personal care and knocking on doors and waiting for an invitation to enter before going in to their bedrooms. We saw staff knocking on peoples doors before entering, members of staff spoke respectfully about individuals needs. Further evidence of promoting dignity is detailed further in the report. Care Homes for Older People Page 15 of 32 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 and supported to live a lifestyle which is both enjoyable, stimulating, and meets individual preferences and expectations. People will be happier when the activities coordinator returns, however they will benefit from the temporary replacement in the interim. The home actively promotes individuals to exercise choice and control over their lives. People maintain family contact and staff encourage family and freinds to join in activities, events, and outings. People receive a varied and wholesome diet that they are able to influence Evidence: Although Barrington is a large premises it does have that home from home feel and people living in the home looked comfortable and relaxed in their surroundings. Any interests and hobbies are identified on admission to the home to ensure that people know that they will be encouraged to exercise choice and control over their lives at all Care Homes for Older People Page 16 of 32 Evidence: times. All surveys stated that people enjoy the activities the home provides including, games, crafts, music, and outings, however the activities coordinator has been on long term leave and it was apparent that they were greatly missed by the people living in the home. Comments included, The activity person was an asset and is greatly missed, and In the absence of the coordinator staff have instigated some entertainment. Well done. Staff also agreed that this was a disappointment for everyone. The manager told us that a temporary replacement would be joining the home soon. Personal profiles called Maps of Life are also being completed for everyone living in the home, these were detailed, interesting and told us a lot about peoples lives prior to moving into the home, their personal preferences and how they choose to live their lives now. People in the home are able to choose how they wish to spend their day and there doesnt appear to be any rules in the home, daily routines are flexible. People told us, I like to stay in my room the staff always pop in and see me and thats enough for me, I like to sit on my own and I have my painting books to keep me occupied and I choose not to participate in many things in the home, I look forward to things like Wimbledon. We spoke with staff who seemed knowledgeable and respectful about what people want. They told us that people decide what they want to do on a daily basis, Some like to stay in bed late on a weekend and have breakfast in bed and Its important they remain as independent as possible, even when choosing what to wear that day. People are supported to attend their local place of worship. A member of the local Church visits monthly for an ecumenical communion service. People are free to worship as they wish and any arrangements for services or communal prayers within or outside of the home are made in accordance with individuals wishes. The home also has a salon where people book their own appointments and enjoy the socialisation of this service and the independence it provides. The lounge provides good entertainment systems including, television, video, DVD player, and musical systems. The home operates an open door policy for visitors to the home. People are welcome to invite visitors to join them for a meal and can arrange for private celebrations with families and friends for example a birthday party. One Personal Best card said, Thank you lunch was lovely today and it was completely unexpected when we were Care Homes for Older People Page 17 of 32 Evidence: asked to stay. One person celebrating a recent birthday arranged for eight guests to come to the home for lunch and staff volunteered to work on after their shift as waitresses. The size and layout of the dining room made it possible for everyone to enjoy the social advantages of dining together. Staff had used their expertise and knowledge of peoples personalities, preferences, and ability to eat independently when seating them for lunch. The dining room was light spacious and the tables were attractively laid with tablecloths, condiments, jugs of juice and water, menus, and flowers. Trays with pretty doilies were laid for those people who had chosen to receive meals in their rooms. It was noted that some trays were taken to people with both their hot meal and pudding choice. This would mean that the pudding maybe cold by the time the first course was finished. The manager told us that this practice had been seen before and that staff had been told to stop doing it. We were told that staff would receive a reminder. People that required assistance with eating their meals were supported by staff members, this was performed in a respectful sensitive way without rushing and staff were sat at the same level as the people requiring help. Staff were polite and helpful when serving the meals. We saw staff introduce themselves and told people who had sight impairment what food was on the menu. We spent time with the cook who demonstrated a good awareness of individual requirements and needs including special dietary requirements and personal preferences. The menus displayed traditional meals and choice was available at each setting. The menus are reviewed to reflect seasonal trends and availability of produce, there are three courses at each mealtime. Extras are ordered on request for birthdays and special occasions and special requests are catered for where people can ask for their favourite food and drinks to be ordered. The cook told us that she spends time with people living in the home on a daily basis to see if they have enjoyed their meal and if they are happy with the menus, she also attends the meetings held for people living in the home. Food and drink is available twenty four hours a day and people often order tea and biscuits when their visitors come to the home. Fresh fruit and vegetables are delivered daily and bowls of fruit are passed around to people throughout the day. The kitchen was very clean and spacious. Stores exhibited a good range of foods. Food hygiene training was up to date for all staff. Documentation was provided and required temperature checks were being carried out on fridges and freezers and food was also Care Homes for Older People Page 18 of 32 Evidence: being probed after being cooked and before serving. Care Homes for Older People Page 19 of 32 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. There are good policies and procedures in place to manage complaints and people can be confident that their concerns will be listened to and acted upon. There are good arrangements in place for staff training and the awareness of protecting vulnerable adults so that people living in the home are further protected from abuse. Evidence: The complaints policy and procedure is detailed and requires all the relevant information, this can be found in the service user guide and welcome back which is given to people on admission. It is also displayed on notice boards throughout the home. People told us that they knew who to speak to if they were not happy and how to make a complaint. Staff also confirmed that they knew what to do if people had any concerns. In the last twelve months BUPA has appointed a dedicated director of Quality and Compliance who has the ultimate responsibility to ensure all complaints, comments, and compliments are dealt with promptly, give clear responses, and indicate if there is a need for the complaint to be referred to a higher level within BUPA. Care Homes for Older People Page 20 of 32 Evidence: The Personal Best customer care initiative, which emphasises on improving communication with people who use the service should also help relieve any unnecessary anxieties or frustrations that people may have. The manager told us that monitoring complaints will help ensure that lessons are learned in order that the service can continue to improve. There are policies and procedures as well as a range of guidance information on the topic of protecting vulnerable adults from abuse. The availability of this information should increase staff awareness and their role in protecting people in the home. We were told that the home actively promotes staff training in this area and staff receive an annual update. A number of staff are enrolled on the National Qualification (NVQ) in Care Award which also adressess issues about protecting vulnerable people. Care Homes for Older People Page 21 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean, comfortable, and decorated and furnished to a good standard. It provides a safe, peaceful, and well maintained environment for everyone. The bedrooms, communal rooms, and facilities are suitable for their purpose and meets the needs of the people living there. Evidence: We walked around the inside of the home and viewed some of the bedrooms and the communal areas. Most rooms are spacious for their stated purpose There is an ongoing decoration plan and most areas of the home were tastefully decorated, clean and well maintained. Attention had been given to help make areas seem homely including, pictures, ornaments, and plants. People had been supported to personalise their bedrooms and the rooms were lockable so that they can maintain their privacy and keep their personal possessions secure. All rooms had profiling or divan beds dependent on individual need and good quality bedroom suites, lounge chairs and a small table. The lounge areas allow for people to be seated together enjoying the entertainment systems on offer. Care Homes for Older People Page 22 of 32 Evidence: The home was very clean. People told us that the home was always clean and smelled fresh and pleasant throughout We did see that some sheets and towels were badly frayed and in need of replacing, the manager dealt with this during our visit Care Homes for Older People Page 23 of 32 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 home promotes staffing levels and skill mix of staff in order to help ensure that peoples needs can be met. The recruitment policies and procedures set up in the home should help ensure that people living in the home are supported and protected. The training provided to staff should help ensure that staff have the skills and resources to meet peoples needs. Evidence: The manager told us that staffing levels are indicative of needs and the level of care required. She confirmed that levels of staff would rise should dependency levels increase. In general staff agreed that there were enough staff to meet individual needs of people living in the home. Some told us that they can be short staffed on the weekends. When there have been staff vacancies regular agency staff have been used to provide continuity and the permanent staff often cover extra shifts. Unfortunately there will be occasions when staff phone in sick at short notice and it is not always possible to get cover. Care Homes for Older People Page 24 of 32 Evidence: People living in the home told us that usually staff were available when they were needed. Comments included, Sometimes levels of cover seem slightly low and Staff are under pressure and not always available immediately. The staff are always courteous and attentive when they are available. We were told by the manager that there had been a recent recruitment campaign and that it was difficult to find suitable staff in order to fulfill the roles and responsibilities expected of them. The home is vigilant in taking their time in this process so that they can find the right person for the job, where they have the right skills and attitude to look after and care for people. Recruitment has improved and some vacancies have been filled, it is hoped that by taking their time and recruiting the right people for the job will help ensure that staff are committed and remain in the home. A sample of staff recruitment records were looked at and showed us that the home follows a good recruitment procedure. This will help ensure that people living in the home will be further protected. Records contained completed application forms with a full employment history, two or more written references, and Criminal Records Bureau (CRB) disclosures. Qualified staff nurses are required by law to register annually with the Nursing Midwifery Council (NMC) to be able to practice, these registrations are checked by the manager to ensure that staff have done this. All of our staff surveys confirmed that relevant checks had been completed before they started working in the home. There is an induction programme which covers all mandatory training. The home has a mentor system where all new staff are linked with and shadow a senior staff member during shifts to help with continued training throughout the induction process. Staff told us that the induction was fairly good and covered everything they needed to know in order for them to do their job. Two Personal Best comment cards said, Thank you for the training and for your patience and efforts and Thank you for the training, you put your trust in me and gave me confidence. The home provides staff with training and development opportunities tailored to individual needs. The manager and staff attend training relevant to the care needs of people in the home and those relevant to the roles they perform. Staff told us, If there is something we dont know about with a new resident we are given information and training and I think the service is doing very well in providing us with appropriate training and provides us with the right equipment, staff and residents are protected and we can provide good care in a safe environment. We looked at staff training records and saw certificates of attendance and that all Care Homes for Older People Page 25 of 32 Evidence: annual updates had been completed. The home continues to support staff in the NVQ in care award and some have recently commenced this. We spent some time throughout the day talking and observing staff carrying out their duties and assisting people. Staff were respectful warm good humoured and sensitive toward people within a relaxed calm environment. Comments about the staff from people living in the home included, When I am despondent they are always able to make me smile again, Nothing is too much trouble and I appreciate this, and Staff members make this home feel like home. Care Homes for Older People Page 26 of 32 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. Peoples needs and best interests are central to the management approach in the home. Good accounting methods are followed when handling peoples money so they can be sure that their finances will managed correctly. Staff feel that they receive supervision and support that is appropriate to their roles and responsibilities in the home. The health and safety of people who use this service should be protected by the systems in place. Evidence: The manager has worked in the home for twelve years, seven of which have been as the manager. She has completed the Registered Managers Award and has a vast Care Homes for Older People Page 27 of 32 Evidence: amount of experience caring for older people. She continues to undertake training in order to further develop her skills and knowledge. The manager is regularly supervised by her line manager. The manager demonstrated good effective leadership and management skills that relate to the aims and purpose of the home. The manager and staff are a stable team that are committed to providing quality of care for the benefit of the people in their care. Staff told us, I think we have a good manager, if we need anything we are supported, I think we have good communication with the manager and trained staff, the managers door is always open, and I just think we could be praised and thanked a bit more often. We spent time talking with staff and asked them what they thought they did well in the home. Comments included, In our home I believe all the staff including the manager try our best to give people the best quality of care we can day and night, We pride ourselves in creating a home from home feel, and I like to think we are very approachable and that we are good at communicating. People who use the service were also complimentary about the staff and the manager. Comments included, I couldnt be happier. They are all very good and I am well looked after thank you. One Personal Best comment card said, When my hairdresser was away on holiday last week, a carer offered to shampoo and set my hair after her shift, it was very successful, they were most kind, agreeable and helpful. The home continues to monitor and assess the quality of services provided by giving people questionnaires to complete and by holding meetings for people living in the home, their relatives, families, and friends. Regular audits are carried out in the home including health and safety care documentation, medication and other procedures in the home. The policy and procedure for holding personal money was looked at, although money is not kept in the home people are able to set up an account with head office. There is an annual appraisal process which ties in with the supervision arrangements. The manager has established a formal recording of any supervision for all staff. A plan is devised for discussion including, people living in the home, work issues, staff issues, personal development, and training. Staff felt the sessions were useful and confirmed that they received them on a regular basis. Some staff ask for practical supervisions in addition to the formal ones they receive where they can develop their practical skills. Care Homes for Older People Page 28 of 32 Evidence: We spent time with the maintenance operative who told us about his roles and responsibilities. His documentation showed us that relevant checks were maintained correctly and at the required intervals including all fire alarms equipment and emergency lighting. The homes records showed us that all service contracts were up to date including gas and electrical services and passenger lifts. Care Homes for Older People Page 29 of 32 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 30 of 32 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 31 of 32 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. 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