Inspection on 19/01/09 for Bishops Court Care Home

This inspection was carried out on 19th January 2009.

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

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

Other inspections for this house

Bishops Court Care Home 19/10/06

Bishops Court Care Home 27/10/05

Bishops Court Care Home 01/03/05

Bishops Court Care Home 27/04/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 20/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Bishops Court Care Home Tuxford Road Boughton Newark Nottinghamshire NG22 9HY     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: Frances Shillito     Date: 1 9 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: Bishops Court Care Home Tuxford Road Boughton Newark Nottinghamshire NG22 9HY 01623862043 01623836070 jinnybullock@nottscc.gov.uk 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) : Nottinghamshire County Council care home 45 Number of places (if applicable): Under 65 Over 65 19 45 0 dementia old age, not falling within any other category physical disability Additional conditions: 19 0 5 Out of the total number of beds (45), 5 may be used for PD 55 and over Out of the total number of beds (45), there will be 19 beds for DE 55 and over and/or DE(E) Service users shall be within category OP(45) Date of last inspection Brief description of the care home Bishops Court is a Care Home providing personal care for 45 older people of both sexes, in single rooms with hand washing facilities. It is owned and managed by Nottinghamshire County Council Social Services and is a single storey building, which was purpose, built in the 1980s. It comprises of five units, each having its own lounge, dining room, bathing and toilet facilities as well as a small kitchen for the preparation of snacks. Communal space and Care Homes for Older People Page 4 of 30 Brief description of the care home lounges are also available throughout the home. There are grounds surrounding the home and a safe enclosed patio garden, which is accessible to all of the residents. Bishops Court is situated with half a mile of the centre of Ollerton, with shops, pubs, library, a doctor?s surgery and leisure facilities. The monthly accommodation charges for those residents who are self funding would be £377.96 per week. A copy of the most recent inspection report is available in the home. 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: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The focus of inspections carried out by CSCI (Commission for Social Care Inspection) is on the experiences and outcomes for people using a service, and their views on the service provided. This process assesses how well the service provider is able to meet regulations and minimum standards of practice. Our inspections also look at aspects of service provision which need further development or improvement. This was our first visit to Bishops Court since October 19 2006. An Annual Service Review had been carried out on February 6 2008. This inspection visit involved two inspectors, it was unannounced and took place in the daytime. Before the visit an analysis of the home was carried out from information gathered Care Homes for Older People Page 6 of 30 over the last year, including that from the Annual Quality Assurance Assessment completed by the manager. We also sent out survey forms called Have Your Say About... to people living at the home and six were completed and returned to us. The main method of gathering information followed is known as case tracking. This involves looking at the quality of the care received by a number of people living at the home. We also use evidence from our observations during the visit, we speak with people living at the home and their relatives, about their experience of the service. We look at records and talk with staff about their understanding of the needs of the people they care for. What the care home does well: What has improved since the last inspection? What they could do better: The quality assurance and audit monitoring arrangements for the receipt, Care Homes for Older People Page 8 of 30 administration, recording and disposal of medication should continue, to ensure good medication management within the home. All staff must be provided with the mandatory and specialist training that it relevant to their work. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are given the information and support needed to help them decide if the home is able to meet their assessed needs. Evidence: The home has an information booklet which was seen in the reception of the home. It had been confirmed in the Annual Quality Assurance Assessment (AQAA), the paperwork completed by the manager before the inspection visit took place, that the information booklet is updated regularly and sent out to people who are interested in the service, in order to give them as much information as possible about Bishops Court. This booklet is produced in Plain English, in a question and answer format, and in large print. Staff said that this can be translated into community languages on request. It contains lots of information about the service provided and the running of the home, Care Homes for Older People Page 11 of 30 Evidence: as well as the contact details of CSCI (Commission for Social Care Inspection) and the local authority Adult Social Care department. The information booklet explains how to make a complaint and there is also a copy of the previous CSCI key inspection report, and comments made by people who live at the home are featured. The home does not provide intermediate care. During the inspection visit we looked at the care records of three people. This is known as case tracking and is a method of gathering evidence on the experiences of people using the service. We saw that for each person there was a detailed assessment which was carried out before they moved into the home. Staff said that this helps the home to be confident that a persons needs can be met there. One person had been admitted to the home on an emergency basis, three days before the inspection visit took place, though they had stayed at the home before. We saw from the records made by staff that a thorough assessment had been made by the social worker, to guide staff on how to care for this person, and to develop a care plan going forward. Care planning paperwork was also seen, showing us that staff had planned develop a plan as soon as possible. Staff confirmed that they would be involving the person concerned and their relatives. They also told us that a worker who was on duty at the time this person moved into the home, would become key worker and point of contact, to help them to settle in, which is the usual practice at the home. People living at the home also said that arrangements were made for them to have a look around the home before they moved in, to ensure that they were making the right decision. They confirmed that they were shown around by a staff member who helped them to settle in when they moved in. We also received six Have Your Say... survey forms, which were filled in by people living at Bishops Court. Five people told us that they had received enough information about the home before they moved in. One person said, I came to look round before I moved here. I thought it was lovely and the staff were very friendly. Another person said, My family gathered the information. I was still reluctant to move from my bungalow, but now I know it was the best move to make. The manager reflected in the AQAA that all the staff and Team Leaders had received up to date training in care planning and that the manager is now a Skills for Care accredited trainer in care planning. Staff confirmed this during discussion at the inspection visit. Care Homes for Older People Page 12 of 30 Care Homes for Older People Page 13 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive care that is tailored to their individual needs. Evidence: The manager had told us in the AQAA that improvements to case records were planned, such as the completion of admission and discharge dates, and for a photograph of each person to be placed on file. During the inspection visit we saw that these planned improvements had been achieved. Staff told us that each person and their family are very much involved in the development of their care plan, which is reviewed every month. The care plans of three people were seen during the inspection visit. For one person there was a holistic, individualised and person centred care plan in place, which created a clear picture of them and how they should be cared for. It included instructions and guidance in respect of arrangements for dying and death. These had been completed with the person and their familys input and were signed by Care Homes for Older People Page 14 of 30 Evidence: them. It was noted that discussion with the manager, staff and this person had taken place regarding her health needs and the negative impact her chosen lifestyle may have on her state of health, and prevent her being able to undergo medical treatment. The manager explained that she had ensured that this person was making informed decisions about her own health needs, and an appropriate record had been made of the way in which this issue had been explored. We saw that this person had a review of her care plan within a week of the inspection visit. The care plan of a second person seen had also been developed in a holistic and person centered way. It was individualised, detailed and easy to follow. Risk assessments were seen which had been reviewed within appropriate timescales. One person living at the home said, I can go out when I want and the staff are kind and helpful. They make an appointment for me to see the doctor when Im not well. Another person said, The staff look after me very well here, adding that one of the Team Leaders had been spending time with her that day. She said that she feels very well cared for and staff will come when she needs them. The care plan of another person was seen, who had been admitted in urgent circumstances three days before the inspection visit. Staff had not yet had the opportunity to complete the care planning process, yet the documentation was on file, ready to begin as soon as possible. This would be informed by the assessment that had been completed by the social worker, prior to admission. Staff also showed good knowledge of this persons needs as she had stayed at the home before. At the previous inspection we noted records suggested that one person living at the home had not received a bath or shower for approximately two months, although his care plan stated that he would like a bath each week. Senior staff had stated that they believed that this person had been bathed regularly, but that staff had forgotten to complete the records. Also the person concerned had confirmed that they had received a bath each week and were satisfied with this. In the AQAA, the manager told us that improvements in the completion of bathing records were planned. During this inspection visit the bathing records were seen and found to be appropriately kept. Both the manager and the staff said that arrangements have been made for extra staff to work in the mornings between 7am - 9.30am and at 4pm until 8pm in the evenings, several times a week, and that these arrangements are working well. People spoken with during the visit said that they are able to bathe or shower regularly with staff support. During discussion people said that staff ensure that they have access to health care Care Homes for Older People Page 15 of 30 Evidence: services, such as the GP, optometrists, the dentist and the chiropodist. This was confirmed by what staff said and the records they had made on file on an ongoing basis. At the last key inspection an error were found in the records kept of the disposal of controlled medicines. Records indicated that there should have been 18 tablets in stock, yet the home did not have any controlled medicines, as the person for whom they had been prescribed had been discharged home, and there was no evidence that she had taken the medication with her. The manager confirmed to us in the AQAA, that further medication training has been provided to staff, delivered by The Peoples College and Boots. In addition reviews of medication systems within the home are undertaken by outside professionals. It was also reflected that previous deficits noted during the last inspection relating to the safe disposal of controlled medication, have led to all medication rounds being completed by two trained staff, to reduce the likelihood of errors. During the inspection visit the records and stocks of controlled medicines were examined and found to be in good order. The home sent a notification to CSCI in October 2008, relating to a person who had used the service, who was administered insufficient medication during a respite stay. No adverse problems were encountered, and she did not wish to make a formal complaint. The management of the home took appropriate action in response to this. During this key inspection visit staff confirmed that two trained staff administer medication and make appropriate records, and this was observed. It was noted from the medication records that an error had occurred, in which one person should have been administered paracetamol at 8.30pm in the evening. Discussion took place with the manager and the staff, who explained that a quality assurance audit monitoring system is in place, and that any errors that may occur are identified promptly and dealt with. They added that a pharmacy audit had taken place six days before the inspection visit, with a positive outcome. There had been reminder for two staff to administer medication and to continue to follow national guidance. The manager said that eleven staff are due to attend Safe Handling of Medication training within two weeks of this inspection visit. The manager confirmed that the home has positive working relationships with a range of professionals, such as social workers, occupational therapists, community psychiatric nurses, district nurses, and GPs. Staff also told us that the home enjoys positive working relationships with these professionals and are on first name terms with them. Care Homes for Older People Page 16 of 30 Evidence: It also reflected that management promotes the Dignity Challenge within the home. People spoken with said that staff are friendly and respectful to them and that their privacy and dignity is safeguarded within the home. Care Homes for Older People Page 17 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. People are involved in a range of activities at the home, and they are supported to maintain contact with family and friends and links with the community. Evidence: The manager confirmed in the AQAA that an activities programme is sited on a notice board in the main areas. A massage therapist visits the home to support people with arthritis, and more outings have been arranged in the community. During the inspection visit notice boards showing whats on and lists of activities were seen. This included massage, manicure, bingo, arts and crafts, trips out into the community and a number of others. The walls of the corridors were decorated with photographic displays of the people living at the home engaging in a range of activities. The manager also told us that regular meetings are held with people living at the home, to find out about the activities they most enjoy.. Staff said that meetings take place every six weeks. The minutes of meetings attended by staff and people living at the home were seen. People living at the home filled in some Have Your Say About..... survey forms. Care Homes for Older People Page 18 of 30 Evidence: There were a number of comments made about the activities provided at the home that people can join in. One person said, Would be nice to be offered a few more activities/trips/entertainment. Another person said, I enjoy the sing-along. I also enjoy the fish and chips and the trips to the seaside. People also told us during the inspection visit that they enjoy the activities at the home and can make suggestions to staff who will act upon them. The manager had confirmed to us in the AQAA that a coffee machine had been installed and a Wii machine obtained for use at the home. Also during the visit we saw that each unit within the home has a kitchen where people can prepare snacks and hot and cold drinks. Staff said that they make sure that they buy in the provisions that people ask for and people spoken with confirmed this. People said that staff encourage them to maintain contact with their family and friends. They said that they are supported to live the lifestyle of their choice as far as this is possible. One person spoken with explained how they had been very much involved with the garden re-design, and had really enjoyed the project as they are very creative and practical. The manager informed us in the AQAA that people are consulted on choice of meals, that catering staff welcome people on admission, show them sample menus, and identify their individual food preferences. During the inspection visit staff said that two dishes are always offered to ensure that there is something for everyone. If not soup and a sandwich are prepared for people who want an alternative. During the inspection visit people were observed having lunch. The meals served looked tasty and where needed, staff were offering support to people whilst they were eating. Of the six Have Your Say About... survey forms we received, three people said that they always like the food , two usually like it and one other person sometimes enjoys it. One person viewed the food as Excellent. Another person said, Sometimes prefer the menus to be more varied, with another view expressed as, Apart from we have a lot of baked potatoes and they are nearly always hard. People spoken with during the inspection visit said that they enjoy the food and that there is always a choice. They said that if they prefer something different they can tell staff, who will sort it out for them. Care Homes for Older People Page 19 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. People are confident in the homes response to complaints and they feel safe and protected from abuse. Evidence: The manager confirmed to us in the AQAA that the complaints procedure is explained to people when they move into the home, and that complaints leaflets are available in the home, as well as in each persons bedroom. The Comments, Suggestions and Complaints Procedure leaflet was seen during the inspection visit. This had been produced in an accessible format, with information in Large Print, in English and in community languages, such as Urdu, Hindi, Gujarati and Punjabi, as well as Makaton. Before the inspection visit took place the manager had told us that complaints records kept at the home have been further improved, and are now recorded on a separate page in the complaints book. The manager also confirmed that complaints are dealt with immediately, and that a record of complaints and compliments is also kept by the departments Customer Relations Department. During the inspection visit the corporate complaints forms were seen, as well as leaflets containing a guide to independent advocacy. Care Homes for Older People Page 20 of 30 Evidence: Six people who filled in the Have Your Say About... surveys forms, told us that they know how to make a complaint. Five people said that they usually know who to speak to if they are unhappy about something. One person said, No complaints, and another added, I like to make do and manage, thats how Ive been brought up. There is nothing to complain about. People spoken with during the inspection visit said that they know how to complain, and are confident that if they are not happy about something, this will be resolved by staff. The home notified us about an incident where it had been alleged some money had gone missing. This was properly resolved by the home. Later in November 2008 we received information that a complaint had been made to the local authority about a persons experience of a respite stay at the home. Staff confirmed that the concerns had been referred to the Safeguarding Team and an investigation was underway, with an outcome awaited. This showed us that appropriate action had been taken. During the inspection visit the records of two complaints were seen to be appropriately kept. Discussion took place with the manager in relation to these concerns which had been responded to promptly and both parties were satisfied with the outcome. The manager told us in the AQAA that a safeguarding procedure is in place, and that staff at the home have received refresher safeguarding training. During discussion with the manager she said that she had attended training facilitated by Nottinghamshire County Council Adult Social Care Service. Policies and procedures were seen in place, including the Nottinghamshire County Council Safeguarding Adults, Policy, Procedure and Guidance for Alerters - October 2007. Staff spoken with during the inspection confirmed that they had received training and they demonstrated that they understand their responsibilities in relation to making a safeguarding alert if they suspected abuse. All staff spoken with said that they would approach management first and then the Safeguarding Team. People living at the home said they feel safe and comfortable. Care Homes for Older People Page 21 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides clean, well maintained and comfortable accommodation for the people who live there. Evidence: The accommodation is purpose built and divided into five units. The home is well maintained, comfortably furnished and decorated. A tour was provided by staff and we saw that the environment was clean, tidy and in good order. Four people told us in the Have Your Say About... surveys, that the home is always kept fresh and clean, with two others saying it is usually maintained well. One person said: The home is always being cleaned and my washing is done. During the inspection visit people said that staff keep the home clean and fresh. The manager told us in the AQAA that there were plans to replace worn furniture as needed. New furniture had been bought, including lounge chairs, commodes and wheelchairs. This was pointed out by staff during the tour. The manager and the staff said that two maserators are now available for use on site to manage and reduce the level of clinical waste, and that deep cleaning of all bedrooms is undertaken on a weekly basis, to help prevent the spread of infection. Care Homes for Older People Page 22 of 30 Evidence: Staff said that everyone has a key to their bedroom, so as to safeguard their privacy and the safety of their belongings. A number of people spoken with during the inspection confirmed this. The manager informed us that people are encouraged to personalise their bedrooms, and that some bedrooms have now been fully refurbished and redecorated with new carpets. In addition all the lounges and some of the corridors and bathrooms have been redecorated and re-carpeted. This was seen during the tour of the building. A number of peoples bedrooms were seen. They were very personalised with personal belongings and an array of photographs of family and friends on the walls. Before the inspection visit the manager told us that the garden area had been redesigned. The garden was seen. It provides a pleasant space for people to sit out in good weather. One person described his enjoyment and sense of achievement as he was actively involved in the project. Evidence was seen that the homes infection control policies and procedures and related risk assessments are in place to be followed by staff. The manager and staff said that the home has good joint working arrangements with the PCT (Primary Care Trust) on continence promotion. Care Homes for Older People Page 23 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. Adequate staffing levels are maintained at the home. Recruitment practices are in line with the policy in place. Staff usually have the training that is relevant to their work. Evidence: Before the inspection visit the manager told us that the recruitment process could be quicker, and that delays happen because of the necessary checks which must be done, which can sometimes result in people seeking work elsewhere. Staff said that the home has three vacancies and that these have been advertised. In the meantime agency staff are being used to cover hours, with the same ones being used for continuity of care. Two staff files were examined and the recruitment records seen were kept in god order. They contained all the necessary paperwork, including proof of identity, satisfactory references and a CRB (Criminal Records Bureau) Enhanced Disclosure. We also saw that there was evidence that staff had an induction soon after starting work. The manager said that CRB checks are being re-done for all staff this year. Staff said that there are enough staff employed to provide care and complete the daily Care Homes for Older People Page 24 of 30 Evidence: records. The manager expressed her commitment to staff training and personal development. It was confirmed that out of 39 staff 83 had achieved an NVQ (National Vocational Qualification) Level 2, with the remaining staff at varying stages of completing this training. NVQ studies followed by staff cover the fields of care, cleaning and buildings, and catering and hospitality. The manager and staff said that eleven people were attending training in the Safe Handling of Medication within two weeks following the inspection visit. In addition the manager and the Team Leaders are attending Deprivation of Liberty training in March 2009. The training records at the home were seen. We found that some staff had received the mandatory and specialist training which is relevant to their work. However not all staff had received updates to training in fire safety, food hygiene, infection control and first aid. In the AQAA the manager shared her commitment to the regular and effective supervision of staff. The organisations leaflet, Supervision For You was seen during the key inspection visit. This is a useful question and answer booklet explaining the process and benefits of supervision, as well as Supervision Skills training available for managers. All staff spoken with said that they receive regular supervision, and that their training needs are raised in these meetings. Staff spoken with also said that team meetings are held regularly and that minutes are produced for them to read. We saw that the last team meeting took place five days before the inspection visit. Staff said that they are a good team and that they support one another. Some have worked for the home for a number of years and they said that they have seen many changes and improvements at the home. Care Homes for Older People Page 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is experienced and well qualified and the home is run in the best interests of the people who live there. Evidence: The manager is well qualified and experienced. She has developed an individual business plan for the home, reflecting views and comments made by people who have completed survey forms, including visitors to the home and people living there. Staff and people living at the home said that the manager is approachable and encourages their views on the direction and running of the home. The minutes of some of the meetings attended by them were seen. There was evidence that people are consulted and kept informed of matters relating to the running of the home. The records of the personal finances of three people were seen and found to be well maintained. Care Homes for Older People Page 26 of 30 Evidence: The paperwork known as the AQAA was completed and returned to us by the manager within the required timescale. It contained all the information we had asked for. Discussion with the manager and information shared with us in the AQAA, showed us that she is aware of any changes that need to be made and is committed to making improvements within the service. Notifications of significant incidents or occurrences at the home have been made to us without delay. 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 30 18 Staff must be provided with 31/07/2009 the mandatory and specialist training that is relevant to their work. This will help them to provide the best possible care to the people living at the home. 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 The quality assurance and audit monitoring arrangements for the receipt, administration, recording and disposal of medication should continue, to ensure good medication management within the home. 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. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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