Inspection on 17/09/08 for Bridge House Care Home

This inspection was carried out on 17th September 2008.

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

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Bridge House Care Home Farnham Road Elstead Surrey GU8 6DB     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: Jane Jewell     Date: 1 7 0 9 2 0 0 8 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: Bridge House Care Home Farnham Road Elstead Surrey GU8 6DB 01132382690 Telephone number: Fax number: Email address: Provider web address: www.mariamallaband.co.uk Name of registered provider(s): Type of registration: Number of places registered: Maria Mallaband Ltd care home 30 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 30. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP). Date of last inspection Brief description of the care home Bridge House is an established care home that has been operating as a residential care home since 1985. The home was purchased in January 2008 by Maria Mellaband care group. This is the first inspection of the home under this new provider. Maria Mallaband are a national company which operate a wide range of registered services across the UK. Bridge House is located in the village of Elstead close to small local amenities. The home is presented across two floors with a shaft lift providing level Care Homes for Older People Page 4 of 29 Over 65 30 0 Brief description of the care home access to most parts of the building. There is a small cottage attached to the main building accessed by a semi-covered passageway, which accommodates three bedrooms. Residents accommodation consists of twenty-nine bedrooms, including two potential double rooms, all bedrooms provide en-suite facilities. Communal space consists of a dining room, conservatory and two lounges. There is a courtyard garden along with a large sloped garden which leads to a stream. The homes literature states that the object of bridge house is to provide care to all service users to a standard of excellence which embraces fundamental principals of good care practices. 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: The information contained in this report has been comprised from an unannounced site visit undertaken over six and half hours and information gathered about the home before and after the site visit. The manager had completed an Annual Quality Assurance Assessment form prior to the inspection and the information contained in this document has been used to inform the site visit of the home. Feedback comment cards were sent to the home in advance of the site visit for the home to distribute and twelve were returned to the Commission. Eight were completed by residents and four by relatives. A summary of their feedback is contained in this report. Pamela Mayre (the registered manager) facilitated the site visit and there were twentyseven residents at the time of the site visit. The site visit involved an in-depth discussion with ten residents and three staff. A tour of the premises was undertaken and examination of the homes records system. A group of ten residents were observed Care Homes for Older People Page 6 of 29 for a short time in their daily routines and in their interactions with staff. This was in order to assess the well-being of residents who are not able to verbally share their experiences of the home. Two relatives were also contacted and interviewed about their experiences at the home following the site visit. What the care home does well: Bridge house has many attractive features including a well maintained homely environment, court yard and gardens. Comments about the environment included: provides a pleasant environment which is comfortable and spotlessly clean always smells fresh. The home demonstrates that it can meet the needs of current residents who are in the main assessed as having low to medium needs. Consistent feedback was received regarding the friendly atmosphere at the home. A sample of residents comments about their experiences at the home included: Very nice here, best bit is not having to do my own housework as they do it all for you; I feel very much at home here and they care how you are. A relative commented: We looked at lots of homes before deciding on the Bridge, where we felt my mothers needs would be met and she would receive the best quality of care. This has proved very true in the 18months she has been there. Her needs have been met. She has had good quality of care, all in a homely and friendly environment. Personal support is offered in ways, which promotes and protect residents privacy and dignity. Residents said Staff always knock on the door and call out before they come in and the best bit about the home is the privacy. A relative fedback that: help is always given in a sensitive and caring way, mindful of her dignity. The health needs of residents are well met with evidence of good health care promotion and regular input from health care professionals. Comments made included: There is a very reliable GP and the matron is also on top of any medical issues and they are very good if you are not feeling very well they get the Dr very quickly. Residents benefit by being supported to maintain relationships with their families and friends with a resident saying: They always make our visitors feel welcome and give them a drink. Residents are helped to exercise some choice and control over their lives with flexible routines being an integral part of daily practice at the home. A resident commented: quite free here to do what I want. The meals are good offering both choice and variety and catering for special dietary needs. A resident commented: you could not fault it at all we all eat very well and if you dont like something they will give you something else. Residents benefit from a stable, well-trained and enthusiastic staff team that know them and who are suitable recruited and employed in sufficient numbers as is necessary to meet their needs. Comments about staff included: The staff are always so kind and considerate to my mother; staff so nice they have time for you and I think there is enough staff around for us to get everything we need. Residents benefit from an experienced and established manager who ensures a clear ethos and values of the home that enables staff to provide good quality care to residents. Comments about the manager included; exceptionally clever person knows everything and welcomes everyone very reasonable can talk to her; Lovely, Care Homes for Older People Page 8 of 29 supportive and encouraged us to take up all the training and is very appreciable. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 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. The home provides both prospective and existing residents, with most of the information about what services are provided and what to expect when living at the home. The way in which prospective residents are assessed ensures that the home admits only those residents whos needs can be met by living at the home. The home is able to identify and meet the needs of the residents. Evidence: There is a range of information about the home and the services it provides, this includes a statement of purpose and service user guide. These are displayed at the home and given to prospective residents, representatives and other interested parties. Minor additions are needed to these documents to ensure that they contain all of the required information in order to help inform prospective residents about the services Care Homes for Older People Page 11 of 29 Evidence: and facilities the home provides. This includes the full terms and conditions of residency at the home and the range of needs the home is able to meet. The manager agreed to add in this information immediately. A relative said that had been given clear helpful information and the previous inspection report to read before making up the mind. The home ensures that prospective residents are accommodated only following an assessment of their needs by the Manager or Social Services. Advice is sought during the assessment process from health care professionals and others who know and understand the needs of the prospective resident. The Majority of residents at the home are assessed as having low to medium needs. There was a range of evidence that the home is able to meet the needs of these residents, as staff were able to demonstrate a clear knowledge and understanding of the needs of each resident and also how those needs are to be consistently met. A sample of residents comments about their experiences at the home included: Very nice here, best bit is not having to do my own housework as they do it all for you I feel very much at home here they care how you are and Like it here as the atmosphere is friendly. A sample of comments from relatives included: We have been very happy with Bridge house, nowhere is perfect - but this place feels more like a guest house than an institution and for that we are grateful and We looked at lots of homes before deciding on the Bridge, where we felt my mothers needs would be met and she would receive the best quality of care. This has proved very true in the 18months she has been there. Her needs have been met. She has had good quality of care, all in a homely and friendly environment. Several residents and their relatives were not clear that the home provided residential care and not nursing care. This situation was exacerbated by the language used at the home, for example Matron staff referred to as nurses and in some of the homes literature and in information sent to the Commission. The manager agreed to ensure that this situation was clarified immediately. Residents and their representatives consulted with spoke of being provided with the opportunity to visit the home in advance to assess the quality, facilities and suitability of the home. Most residents consulted said that it was their families that looked around the home on their behalf. The manager spoke of the first four weeks of occupancy being a trail period, which is Care Homes for Older People Page 12 of 29 Evidence: followed by a review to establish whether the resident wishes to stay at the home permanently Care Homes for Older People Page 13 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. A care planning process is in place which records the needs of each resident. Residents receive the health care intervention they need from a range of health care professional, however not all of the homes medication practices safeguarded residents. Personal support is offered in ways, which promotes and protect residents privacy and dignity. Evidence: Four individual plans of care were inspected, and comprised of much information including risk and needs assessments, basic information, daily notes and a plan of care. The format of the care plans meant that they were not always easy to navigate in order to retrieve and update information. The majority of staff have worked at the home for a number of years and demonstrated a good understanding of the assessed needs of residents and how to meet them in a consistent way. This was however judged to be due to a good handover system rather than regular input into the care Care Homes for Older People Page 14 of 29 Evidence: planning process. The manager is currently reviewing the care planning process and introducing new care planning documentation developed by the new providers. The home has a retained GP, who holds a surgery once a week at the home and visits if needed in-between. Much positive feedback was received about the high standard of medical support and the promptness in receiving medical intervention. Residents commented: they are very good if you are not feeling very well they get the Dr very quickly and Staff have been quick to call in the GP and have followed her instructions. Relatives comments included: There is a very reliable GP and the matron is also on top of any medical issues and They have been very positive in getting the GP out quickly if there are any health worries and really helpful in arrangement transport and staff escort to an out patience appointments and the home were very pro active in getting back dad from hospital rather than a nursing home like the hospital said. Records also showed the home works closely with other health care professionals including District and specialist nurses, chiropodists, opticians and dentists to ensure residents receive a range of good health care intervention. There is an established medication system at the home, which is stored securely and only trained staff are allowed to administer medication. However, the practice of using medication prescribed to named individuals for communal use was observed. This practice is illegal and places residents at risk of receiving medication that has not been prescribed for them that might adversely affect their health and wellbeing. The manager has been required to address this as a matter of priority. The manager agreed to also clarify with the GP why an As required medication was being used permanently. It is recommended that additional instructions are provided for staff on the administration of As required medication, which make clear the individual requirements for when this medications was prescribed. This is necessary for staff to know when to administer these medicines. Staff consulted with showed a good understanding of good practices in preserving residents rights to privacy and dignity. Staff were able to give examples of how they promote these rights in their every day care practices. This was supported by the inspectors own observations of the interactions between staff and residents and the experiences of a visiting relatives. Residents said Staff always knock on the door and call out before they come inand the best bit about the home is the privacy A relative fed back that: help is always given in a sensitive and caring way, mindful of her dignity. Residents clothing was observed to be well-laundered and residents enjoyed the regular input from the visiting hairdresser which further helped to Care Homes for Older People Page 15 of 29 Evidence: promote their dignity. Some bedroom doors and toilet/bathroom doors however, were not fitted with suitable door locks in order to preserve residents privacy. The manager agreed to address promptly. Care Homes for Older People Page 16 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. Residents are helped to exercise choice and control over their lives with flexible routines being an integral part of daily practice at the home. Links with families and friends are valued and supported by the home. Residents lives are enriched by the home providing various opportunities for occupation and leisure. The meals are good offering both choice and variety and catering for special dietary needs. Evidence: There is evidence that residents are treated as individuals. Observation of the daily routines and discussion with residents confirm that staff accommodate residents personal wishes with regard to meal times, going to bed, rising and bathing. During the inspection residents were observed to move around the home choosing which room to be in and what level of company they wanted to enjoy. A resident said very pleasant feel quite free here to do what I want. For a few people living at the home, being able to exercising their choice was difficult due to their level of dementia. However staff were seen to use their acquired knowledge of a person to help them make choices with regard to food drink and occupation. Care Homes for Older People Page 17 of 29 Evidence: Residents views regarding activities varied between those who enjoyed socializing and others who were not so interested. A sample of comments made regarding activities included: Maybe a little more day to day activities for everyone; A little more selection would be nice and The level of activities suit my mother, she enjoys the regular visit of a music man and a retired vicar who gives a small service with Holy communion. These comments were fed back to the manager who was able to evidence that a varied activities programme is offered but said that it can sometimes be difficult to motivate residents to join in. Residents spoke of participating in playing bingo, exercises and quizzes. There was also a mobile library. On the day of the inspection there were several pets either visiting the home or belonging to individual residents, these were clearly being enjoyed by residents. Without exception all residents and visitors commented positively on how welcome they or their visitors were made to feel when visiting. A resident said: They always make our visitors feel welcome and give them a drink. Several residents spoke of the importance of keeping in touch with their friends and relatives and had a private telephone line in their bedroom in order to be able to contact them at any time. A relative spoke of how good the home was at updating them with any changes in their relatives needs. The meal served at inspection was presented well with most residents eating their meals in the pleasantly decorated dinning room. Residents spoke of being given an alternative meal if they did not like what was on the menu and a relative spoke of how helpful the home has been in ensuring that their relative followed a specialized diet. A sample of comments made about food included: good; you could not fault it at all we all eat very well and if you dont like something they will give you something else; food very nice cooked well acceptable we get hot drinks when we want very good on the whole and meals are excellent. 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. There is an effective complaints system with evidence that residents and relatives feel that their views are listened to and acted upon. Staff have the guidance and training necessary to show them what to do if abuse is suspected. Evidence: There is an accessible complaints procedure for residents, their representatives, and staff to follow should they be unhappy with any aspect of the service. All residents and relatives consulted with said that they felt able to share any concerns they had with the manager. A resident said: If you have any worries you can just tell Pam and she would always sort it out for you. Two residents spoke of raising concerns to the manager and the issues were addressed promptly and satisfactorily.A relative said : have raised minor issues in the past and these have been sorted out very quickly The manager reported that there have been no formal complaints to the home since the time of the new providers registered the home. The home has written policies covering safeguarding adults and whistle blowing. These make clear the vulnerability of people in residential care, and the duty of staff to report any concerns they may have to a responsible authority for investigation. The majority of staff have received formal training in safeguarding adults and prevention of abuse and the staff consulted with showed an understanding of their roles and Care Homes for Older People Page 19 of 29 Evidence: responsibilities under safeguarding adults guidelines. The manager stated that staff not yet undertaken or who need refreshers training are due to undertaken this shortly. 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 good 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 clean, well-maintained homely environment, which has been decorated and furnished to a high standard with their bedrooms furnished and decorated according to their individual lifestyles. Evidence: The home is set in its own well-maintained grounds on the outskirts of a small village. The home was decorated and maintained to a high standard with maintenance staff on site. A resident said the handyman is very good at fixing things very quickly, I needed a new light and he came straight away. A relative commented about the environment: provides a pleasant environment which is comfortable. Residents bedrooms are individualized reflecting their tastes and lifestyles, with many residents saying that they were able to bring small items of furniture. All residents consulted with said that their bedrooms provided everything they needed. The occupant of a bedroom, which is below the recommended size stated that they were more than happy with their bedroom. Communal space consists of two lounges, conservatory and dinning room. A relative fed back: You can always find somewhere to sit other than the residents room, that is comfortable and with a degree of privacy (i.e. small groups of chairs and no television blaring.) Much effort has been made to make these areas homely. There is Care Homes for Older People Page 21 of 29 Evidence: an attractive paved courtyard area in the center of the home and a large wellmaintained sloped garden leading to a local river at the bottom, which is accessed, via a path. There is sufficient number of toilets and bathrooms located around the home, including all bedrooms providing en-suite facilities. Though the home does not provide level access throughout, there is evidence that the home ensures residents with mobility needs are in appropriate rooms. From observation and talking with staff it is clear that the home provides a range of adaptations and equipment, including mobility aids, passenger lifts and grab rails. Fitted throughout the home are call points, which enable assistance to be summoned when pressed. Residents commented: I have used the call bell at night and they have come very quickly and You can ring the bell for help any time. All areas inspected were observed to be cleaned to a high standards, comments made about the standard of hygiene included cleaned to a very high standard; room always cleaned daily or after any upset; there are no unpleasant odours to greet you when you enter the home or pass any of the rooms and spotlessly clean always smells fresh. The home employs sufficient domestic staff to ensure that standards of hygiene and cleanliness can be maintained. Systems were in place for the control of infection and staff have been trained in this area and were observed to be working in ways that minimized the risk of infection. 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. Staff make a positive contribution in residents lives as residents benefit from a trained and enthusiastic staff team that know them and who are safely recruited and who are generally employed in sufficient numbers as is necessary to meet their needs. Evidence: Staff, visitors and residents felt that there was usually sufficient numbers of staff on duty for staff to undertake their roles in a timely manner and for residents to receive the support they needed, when they wanted it. There is a core group of staff who have worked at the home for a number of years and showed an in-depth knowledge of individual residents needs and preferences. Staff confirmed that there is some flexibility in staffing levels should residents needs increase suddenly. All staff were found to have a good rapport with residents and visitors which promoted a relaxed atmosphere in the home. A sample of comments made about staff included: The staff are always so kind and considerate to my mother; very caring staff; staff always find time for us even when very busy and short staffed; all staff are most helpful; We are short staffed is a frequent response; very good staff; very nice and very helpful I have never had a No from them; I think there is enough staff around for us to get everything we need; super they have time to talk to us which means so much to us older people and staff so nice they have time for you. There were also many recent letters and cards of thanks Care Homes for Older People Page 23 of 29 Evidence: from relatives displayed which all praised the kindness of staff. In response to the comments regarding staff shortages the manager acknowledged that this has occurred recently due to leave and are addressing any shortages by undertaking care shifts themselves and a recruitment drive. The manager has been proactive in ensuring that the majority of staff have undertaken a National Vocational Qualification (NVQ) in Care. Although the majority of staff have completed all of the mandatory training necessary to work safely with residents, new staff needed to undertake this along with some refresher courses for existing staff. The manager had previously identified this and was in the process of working with the new providers to complete this training along with some further specialized training in dementia and Parkinsons. The personal files of the last two appointed staff were inspected and these showed that a robust recruitment process is followed which includes the use of an application form, interviews, Criminal Records Bureau (CRB) checks and written references prior to employment commencing. 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. Residents benefit from an experienced and established manager who ensures a clear ethos and values of the home that enables staff to provide good quality care to residents. A range of regular health and safety checks helps to promote the health and safety of residents and staff. Evidence: The Manager has considerable experience in managing services for older people and have been managing care services for older people since 1984. They have also undertaken the recommended management qualifications and are a trained nurse. The manager also undertakes the same training as care staff in order to keep themselves up to speed on changes in care practices and legislation. Without exception all persons consulted about the home spoke positively about the manager. A sample of comments included: very good always very helpful; Care Homes for Older People Page 25 of 29 Evidence: exceptionally clever person knows everything and welcomes everyone; very reasonable can talk to her; Matron is ok; Lovely, supportive and encouraged us to take up all the training and is very appreciable and brilliant cant fault her she is very supportive. Although several residents and relatives spoke of their initial concerns when they first heard that the home had been sold to new providers they said that they have subsequently felt that there has been no negative impact on residents or on the running of the home during this potentially unsettling period for residents, this is to be commended. There are several mechanisms in place for the home to obtain feedback on the quality of the services provided and whether it is achieving its aims and objectives. Changes in menus and activities have resulted in feedback received from residents. The registered providers representative also visits the home monthly to monitors services and facilities and produces detailed report, which included some residents and staffs views. Residents are encouraged to retain control of their own finances for as long as they are able to do so and if unable then this responsibility is taken on by a relative or another responsible persons external to the home. The manager stated that they do not manage the personal finances for any residents. Staff are in the main supervised by the manager working along side them each shift and all staff consulted with felt well supported. Care staff spoke of receiving occasional formal supervision. Records submitted by the manager prior to the inspection stated that all of the necessary servicing and testing of health and safety equipment has been undertaken. Systems were in place to support fire safety, which included: regular fire alarms and emergency lighting checks, staff training and maintenance of fire equipment and fire drills were reported to have been undertaken. The manager reported that a fire risk assessment had been undertaken by a fire safety expert, which recorded significant findings and the actions taken to ensure adequate fire safety precautions in the home and that recommendations made from this risk assessment have been actioned. Subsequent to the inspection the responsible individual confirmed that all bathing facilities at the home have pre-set valves fitted, of a type unaffected by changes in water pressure and which have fail safe devices to provide hot water within to the recommended safe temperature range. 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 1 9 13 That the prescribed 30/04/2009 instructions for medication is followed at all times and that only medicines are administered to the individual for whom it is prescribed to. That residents are protected by the homes medication practices 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 That additional instructions are provided for staff on the administration of As required medication, which make clear the individual requirements for when this medications was prescribed. 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. 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