Inspection on 06/01/09 for Cranmer Court

This inspection was carried out on 6th January 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

Cranmer Court 28/01/08

Cranmer Court 31/05/06

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

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 13/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Cranmer Court Farleigh Road Farleigh Common Warlingham Surrey CR6 9PE     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: Marion Weller     Date: 0 6 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 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Cranmer Court Farleigh Road Farleigh Common Warlingham Surrey CR6 9PE 01883627713 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): manager.cranmercourt@hotmail.co.uk Cranmer Court Ltd Name of registered manager (if applicable) Mrs Norah Davey Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 56. The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) Old age, not falling within any other category (OP). Date of last inspection Brief description of the care home Cranmer Court is a modern purpose built care home for older people and is pleasantly situated in its own landscapped gardens. The home overlooks Farleigh Common and is on the edge of Warlingham village in Surrey. Local and larger shopping facilities are accessible nearby. There is a large car park for visitors at the front of the premises. Service users bedroom accommodation is in single en-suite rooms laid out across two Care Homes for Older People Page 4 of 29 care home 56 Over 65 0 56 56 0 Brief description of the care home floors. The second floor is accessible by two passenger lifts. Communal lounges and dining rooms are available on both floors; there are also fully equipped assisted bathrooms and shower rooms. A dedicated recreational therapy/activities suite is available on the ground floor. There is a dedicated hairdressing salon available to service users. Weekly fee charges ranged between #875 and #1050. Additional charges are payable for private physiotherapy, complimentary therapy, chiropody, hairdressing, guest meals, newspapers and magazines, escorts and telephone calls. 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 last inspection of this service was undertaken over a two day period on the 28th and 30th January 2008. This key unannounced inspection was conducted by Marion Weller, Regulatory Inspector who was in Cranmer Court on 6th January 2009 from 10:30 am until 4:15 pm. During that time the inspector spoke with some residents, some of the residents relatives and friends who were visiting, some members of the nursing and care staff, administrative staff and the Registered Manager. Parts of the home and some records and documents were inspected and care practices were observed. Medication administration practices were also inspected on this visit. Care Homes for Older People Page 6 of 29 Surveys were given to service users, their relatives or representatives, staff and other professionals involved with the home to find out their level of satisfaction, prior to the inspection taking place. The inspector received a number of the survey forms after the inspection had concluded and therefor an indication of the responses and emerging themes were discussed with the manager over the telephone on the 12th January 2009. The inspection report takes into account all the information obtained about the service since the previous site visit. This includes any formal notifications, phone calls and letters received and any complaints or safeguarding allegations notified to the CSCI. The manager was asked to complete the homes Annual Quality Assurance Assessment (AQAA) prior to the inspection. The AQAA is a self assessment that focuses on how well outcomes are being met for people using the service. It also designed to give some numerical information about the service. The majority of survey respondents were very satisfied with the care provided and recognised the changes and improvements that had taken place since the appointment of the homes new manager. Some concerns were raised about inadequate staffing levels in the home at certain times. Survey forms and conversations held with people living in or visiting Cranmer Court included the comments: ....I find it difficult to say anything negative about Cranmer Court and feel very lucky that we are able to be there. ....Over the last 8 months there have been dramatic improvements. Since the new permanent manager took up her post ....There is sometimes a shortage of staff to suit all needs, especially at weekends. ....They should employ more experienced RGNs at night. ....The new manager at Cranmer Court has made a significant difference for the better. ....There have been many changes and noticeable improvement in recent months. ....The home has improved markedly over the last few months with the appointment of the new manager. Other statements made by survey respondents are included throughout the text of the report. No complaints have been made to the CSCI about this home since our last inspection, neither have we been involved in any safeguarding alerts in connection with Cranmer Court. The registered manager and the staff gave their full cooperation throughout the site visit. What the care home does well: What has improved since the last inspection? What they could do better: The homes information documents would benefit from minor review to ensure that people accessing the service have all the information they need prior to moving in and later to use as reference. Despite significant improvements, residents would benefit further from daily records and care planning review systems being further developed. Care Homes for Older People Page 8 of 29 Medication records and medication storage facilities could be improved upon to secure residents safety and welfare. Current staffing levels do not clearly demonstrate that residents needs are consistently being met at all times and a further review is necessary. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.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. Service users and their representatives are provided with the majority of the information they need about the home. They have a full assessment of their needs prior to moving in and know the home are able to meet these needs when a place is offered to them. Evidence: The homes statement of purpose and service user guide gives residents clear and detailed information about the services that the home provides. Both documents have recently been updated to include the new managers details. The manager was advised that the homes information documents would benefit from a further minor review to ensure content is correct and up to date. For example, people are currently informed that staffing levels in the home are set as dictated by the CSCI. It was discussed that the CSCI does not set staffing levels. The ratios of care staff to service users in the Care Homes for Older People Page 11 of 29 Evidence: home must be determined according to the assessed needs of the residents accommodated, and a system operated for calculating staff numbers required, in accordance with guidance recommended by the Department of Health. The statement of purpose uses an out of date title for the Skills for Care training body when referring to staff induction standards used in the home. In addition, the homes complaints procedure, included in the service users guide, would benefit from the inclusion of timescales for the process and the contact details of the local social services and health care authorities. Social services hold statutory powers to investigate complaints and safeguarding issues raised with them about registered homes. The manager visits prospective service users prior to admission to make a decision as the whether the home can meet the persons needs. Information is obtained from other parties, including any relevant health care professionals to assist in assessment decisions. Four pre admission assessments were inspected and were found to be detailed and comprehensive. The manager said she encourages prospective residents, their relatives or representatives to visit the home prior to making any firm decision to move in Some respite care can be provided, but the home does not provide Intermediate Care. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents care and health needs are being met in a dignified and appropriate manner. An improvement to care plan records would better evidence how they are met. Evidence: Four service user care plans were inspected on this site visit. Content was seen to have significantly improved since the last visit and they were found to be much more detailed and comprehensive. Care Plans seen covered the individuals medical, personal, emotional and social care needs. In addition, their preferences, likes and dislikes were being recorded to ensure that staff knew how the person wished to be cared for. The manager said that some people living at Cranmer Court need additional support to communicate their likes and dislikes and in these situations relatives are encouraged to be involved in the assessment of need, care plan development and review. The majority of residents care plans are now being reviewed regularly, with changes made to the main plan where necessary. The manager spoke of her intention over the next 12 months to further develop the involvement of service users and their relatives in the review process. The statutory requirement awarded in the last report Care Homes for Older People Page 13 of 29 Evidence: to review the content of care plans to ensure comprehensiveness has been satisfactorily addressed and will be removed from this report. Service users daily records are being maintained. The amount of detail in some records was found to be inconsistent and dependent on the skill of the staff member completing the record. Daily records when well written help senior staff to audit the care provided and ensure that staff follow the guidelines in the plan of care. It is in the homes interests to be able to illustrate what they have done for the individual and provides evidence on which to base reviews and to record that they are following the assessment of a residents needs. The manager records in her AQAA that the over the last 12 months the homes documentation has become more accurate. She also evidenced clear plans for development in this area, which will involve further care planning training for staff during the next 12 months. Risk assessments are in place for a variety of aspects of care. Attention has been paid to prevention of falls and the moving and handling needs of residents. Health needs are responded to quickly and records indicate that advice is sought from other health care professionals when needed. Pressure relieving equipment was in evidence in the home. Treatment plans for pressure areas were also seen and tissue viability nurses visit the home and provide advice and direction when required. Survey respondents were very positive about the care provided and said staff are hard working and kind. A number of respondents however raised concerns about inadequate staffing levels at times. Concerns appeared to centre around night and weekend staffing rosters. Some respondents were able to record that some improvements had been made in this area since the new manager was appointed in April 2008. One respondent said .... There have been dramatic improvements since the new manager took up post and she has now stabilised the staffing. Another said ....The new manager has made a significant difference for the better !! - the atmosphere in the home has changed for all to see, and the carers seem happier, which reflects positively on the patients. Only the Registered Nurses administer medication to service users. Medication Administration Records (MAR) showed largely safe practice. One minor shortfall was however discussed with the manager. If hand written transcriptions are made by staff on MAR sheets, the directions from the patients original dispensing label should be accurately transcribed, together with any advisory cautions or advice that is included. Evidence was seen that this is not always happening and the omission has the potential to place service users at risk and must be addressed. Residents with proven capacity are able to manage their own medication and this is Care Homes for Older People Page 14 of 29 Evidence: agreed through a clear risk assessment process. Medication is stored securely within the home. One of the homes controlled drugs storage cupboards is currently out of commission. This is putting a strain on the storage capacity of the one small remaining cupboard and makes auditing and accessing CD medicines held by the home difficult. The manager stated her firm intention to resolve the storage issue and the recording shortfall mentioned above. Care plans contained information about how a resident might prefer to be addressed and whether they prefer a male or female carer. Staff was observed to be respectful when speaking to residents and good interaction was seen between staff and residents. Feedback from residents confirms that they feel that staff treat them with respect and maintain their dignity. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have a relaxed, comfortable lifestyle with opportunities to occupy themselves with a range of interests that meet the majority of peoples expectations. Residents enjoy the meals offered and have improved menus to choose from. Evidence: Activities for service users are now being held regularly and the new activities programme was seen to cover every day of the week. Since the last site visit, two activity co coordinators have been recruited. Both individuals have a background in arranging diversionary activities for older people and they intend to provide a broad range of meaningful and stimulating activities and social events. They explained that a group of residents were going to the ballet the next day and all spoke of the event with enthusiasm. The manager records in her AQAA that activities provided are now based on the assessed needs of the people who live in the home. These are better identified through the homes improved care planning procedures. The home has their own mini bus and the manager said this is used to take residents Care Homes for Older People Page 16 of 29 Evidence: out for appointments and social events. A church service is held every month for people living in the home to attend if they wish and a local vicar conducts the service. There are opportunities for residents from all religions to meet their religious and spiritual needs and staff will make individual arrangements where necessary. One survey respondent said ....Activities are now improving, but more trips out in the mini bus would be most welcome. A professional survey respondent said, when asked how the service could improve ...... Better staffing levels to allow carers time to walk clients to lunch, rather than seeing them being pushed in a wheelchair. Residents are encouraged to personalise their rooms with their own possessions if they wish. Some residents had brought small items of furniture and personal effects with them. As rooms are differently shaped and sized this leads to very individual environments. A resident spoken with said they really liked their room and loved the view from the window. Family and friends are welcome in the home at any reasonable time. Relatives spoken with confirmed that they are made to feel very welcome by staff and encouraged to visit regularly. Visitors are offered refreshments and to take meals with their relatives if they so wish. The home has a seasonal four-week menu plan. Residents spoken with were complimentary about the food provided at the home. The two dining rooms are well decorated and maintained and provide a welcoming and attractive environment ,with tables laid with tablecloths and napkins. Adapted equipment is available for those residents with special needs and who wish to maintain their independence. One relative spoke of the service recently reviewing menu choices as a direct result of feedback from residents and their relatives. The manager said the home listens and acts upon suggestions wherever they can. A survey respondent said ....menus were not always suitable for the elderly, the manager has addressed this issue now and more suitable menus have been introduced. Regular residents / relatives meetings are being held with notes of meetings made available to people who live in the home. The new manager has also set up a relatives committee to help and advise on further service developments at Cranmer Court. Care Homes for Older People Page 17 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 are systems in place to ensue that residents are protected from abuse and they can be confident that their concerns and complaints will be acted upon. They will further benefit when staff at all levels understand that complaints and concerns are opportunities to improve the quality of the service they provide. Evidence: The homes complaints procedure is readily available to service users, their relatives and other people visiting the home. Service users and relatives said they felt confident about raising issues of concern and knew they would be listened to and any necessary action would be taken. One visitor said....if there are any problems at all, the manager is very quick to sort things out. A survey respondent said....Help with my concerns has been available when I have needed it. Another respondent said....The manager responds quickly, but I shouldnt have to go to her directly every time. The manager records in her AQAA when asked what the home could do better....ensure staff at junior levels understand the importance of reporting any complaint, however trivial it may appear. The homes complaints procedure, included in the service users guide, would benefit from the inclusion of timescales for the process and the contact details of the local social services dept and health care authorities. Social services hold statutory powers to investigate complaints and safeguarding issues raised with them about registered Care Homes for Older People Page 18 of 29 Evidence: homes. The manager stated her intention to add the information for the further benefit of service users. The manager has a heightened awareness that the quality of the service provided is the responsibility of the provider and all concerns and complaints should be raised with the home in the first instance. The home keeps a record of all complaints received by them. The manager records in her AQAA that there have been 17 complaints received in the last 12 months. evidence shows that all 17 were dealt with quickly, investigated thoroughly and within the timescale of 28 days. 6 complaints received were upheld. The Commission has not received any complaints about the home in the last 12 months. There are procedures for responding to suspicion or evidence of abuse or neglect to ensure the safety and protection of residents. The staff induction and NVQ training have elements of adult protection and there has been POVA training for staff. Safeguarding adults training is ongoing and more update training is planned for January 2009. Those spoken with had a sound understanding of adult safeguarding and protection procedures. The Manager stated any allegation of abuse would be referred to the concerned agencies without delay. There has been one safeguarding referral in the last twelve months. This is now closed. Criminal Record Bureau checks have been obtained for all staff. The registered manager is aware of her obligations with regard to ensuring the safety of residents and protecting them from abuse. Care Homes for Older People Page 19 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users live in a very attractive, well-maintained and homely environment that meets their expectations. Evidence: Cranmer Court is a large purpose built care home with service users accommodation laid out over two floors of the building. The home is situated in attractive landscaped gardens overlooking Farleigh Common and on the edge of Warlingham village in Surrey. All service users bedrooms are designed for single occupancy and have single en-suite shower rooms. There are large communal lounges, two attractive and spacious dining rooms and ample communal bathroom facilities available for people living there. In addition there is a dedicated activities room located on the ground floor. Chairs placed in the entrance hall give the opportunity to sit and watch the homes comings and goings. There is a designated hairdressing room for residents use. Residents bedrooms are bright and airy, warm and comfortable. The design of the building allows for a variety of shapes and sizes of rooms. Bedrooms are very well personalised and have plenty of space to display personal possessions, store clothing, sit and relax and have a comfortable bed. Aids and adaptations are provided where necessary such as lifting hoists, specialist baths, height adjustable beds, pressurerelieving equipment, grab rails and toilet riser seats. A staff call system is available with calls being answered promptly at the time of the inspection. Residents are Care Homes for Older People Page 20 of 29 Evidence: protected from the risks of burns or scalds by safe surface radiators and thermostatically controlled hot water outlets. There is a designated laundry that is suitably equipped with systems in place to reduce the risks of cross infection. The sluicing facilities are also clean and well ordered. Disinfectant gel dispensers are fitted in high-risk areas. A bin was not fitted with a foot pedal for the disposal of used hand towels in the visitors toilet. The manager stated her intention to address this issue to ensure the homes infection control procedures are not compromised. The home was commendably clean and free from any offensive odours throughout. The completed AQAA stated that some raised flowerbeds were to be built in the spring in order to encourage residents to take an active interest in gardening. Residents said they liked their rooms and the home met their expectations. No survey respondents raised any concerns about the homes environment. One respondent said however when asked how the home could improve .....It would be useful to have cabinets in the en-suite bathrooms to hold toiletries. Care Homes for Older People Page 21 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 are hard working, caring and well motivated. Residents can also be confident that all necessary checks have been made to ensure that they are suitable to care for them. Despite significant recent improvements staffing levels do not yet evidence that residents needs are consistently being met at all times and a further review is necessary. Evidence: Following a successful recruitment drive the home is now less dependent on the use agency staff, which allows for greater continuity of care for the resident group. One survey respondent recorded .....not much use is now being made of agency staff which means a much better rapport is possible between staff and residents. A number of survey responses sent to the CSCI raised issues of inadequate staffing levels in the home at specific times. Concerns mainly centered on night and weekend duty rosters. One survey respondent said ....feel they need more qualified staff, especially at nights and weekends. Another professional respondent said .....sometimes not able to meet individual need due to not having enough staff available, but this has improved over the last 6 months. The new manager explained that she had reviewed staffing levels, staff structures and Care Homes for Older People Page 22 of 29 Evidence: the deployment of staff when she took up post in April 2008. There was a clear recognition by people spoken with during this site visit that there has been some improvements in staffing recently. The manager had clear insight into the remaining areas of shortfall and spoke of her plans to further review staffing and to increase the availability of qualified staff during night hours. There is currently only one Registered Nurse deployed across both service floors at night, which may have the potential to place some people at risk. In line with a statutory requirement awarded at the last site visit there have been improvements in staffs access to mandatory and specialist training. The home has comprehensive and well-maintained training records. There is an electronic staff training matrix/ database, which provides a clear overview of staff, training completed, staff training planned and when training updates are due. The home has a comprehensive induction programme for new staff, which meets the standards required by Skills for Care. Mandatory training for staff is largely up to date. Where shortfalls were seen, staff had been booked on necessary courses. The manager records on the AQAA ....E- learning has ensured that all staff have completed their mandatory training. She explains that the home has a computer based training programme for staff to complete. The manager also records her plans over the next 12 months to increase NVQ training for care staff in order to ensure the home meets the standard of 50 of NVQ qualified care staff. Currently of 26 care staff employed, 8 staff have attained the qualification. CRB and POVA checks for staff were clearly in evidence and the home follows a robust recruitment process designed to protect residents from any potential for harm. In line with a requirement issued at the last inspection, the manager ensures that suitable references are sought and any gaps in the employment history of staff are thoroughly investigated and explanations recorded to evidence a robust recruitment policy. Residents spoken with said they liked the staff, felt they worked hard and were very caring. One survey respondent recorded ....I am most appreciative of the staff. Another said .....staff here are always caring and very friendly. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has gone through a period of change and significant improvement since the last inspection. Residents living at Crammer Court now benefit from the permanent appointment of an experienced and competent manager who communicates a clear sense of leadership and provides an excellent role model. Evidence: In line with a statutory requirement awarded at the last inspection the Registered Provider has appointed a permananent manager to run Crammer Court. The new manager has been registered with the CSCI before at another home also owned by the provider organisation. Mrs Davey transferred to Crammer Court in April 2008 and applied to the CSCI for registration, completing the fit person process in December 2008. Mrs Davey is a qualified registered nurse (RN) with 16 years experience of managing older peoples services in both residential and nursing home settings. In Care Homes for Older People Page 24 of 29 Evidence: addition, Mrs Davey holds the Registered Managers Award. There was overwhelming praise for the new manager both in survey responses and conversations held with residents and their relatives or representatives on the day of the inspection. Comments included .....Absolutely first class manager who takes a very personal interest in getting it right. And.....There have simply been dramatic improvements since the new manager took up office. And .....I simply cannot speak highly enough of her professionalism and leadership skills. Another relative records ..... I feel the new manager is superb within her role of motivating and leading the staff team. A member of staff said .....everything is so much better now and its all because of the new manager. The home has a policy on quality assurance and uses annual surveys to obtain feedback from all stakeholders in the service. The manager arranges regular residents / relatives meetings and a relatives committee has recently been set up to inform future service developments and the homes business plan. A representative of the provider organisation undertakes regular Regulation 26 visits. Records of visits and any actions taken as a result to secure the welfare of service users are available in the home to see. The manager understands the principles of equal opportunity and diversity and applies the concept to her practice with residents and staff. She was able to evidence a high level of commitment to ensuring the health, welfare and safety of the people living and working at Cranmer Court. The home had received a visit from the HSE Inspector In July 2008. The manager was able to evidence that shortfalls identified during that inspection had since been addressed to secure service users welfare and best interests. There are records of fire systems checks and fire drills / training and staff spoken with have a sound understanding of emergency procedures. The Manager said all records of maintenance and safety checks are up to date. These were not inspected on this occasion. All records seen are kept in a manner that preserve confidentiality. General record keeping is good and well ordered. The home assists some residents with the day- today management of their monies. Records are kept of transactions with receipts held detailing any expenditure on the residents behalf. These are checked by the organisation as part of their audit process. The residents spoken with say they have no worries regarding their finances and feel they are supported in managing their affairs efficiently. The manager completed the homes Annual Quality Assurance Assessment (AQAA) when we asked for it and within timescale given. The document provided a reasonable Care Homes for Older People Page 25 of 29 Evidence: but somewhat limited picture of what had been happening in the home since the last inspection and some of the data section was incomplete. The manager was however able to provide a detailed explanation of the developments in the home during the site visit and to provide other information needed. It was discussed with the manager that future assessments need further development to best evidence the homes ongoing good practice and further development. Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. 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