Inspection on 10/12/08 for Elm Grove Nursing Home

This inspection was carried out on 10th December 2008.

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

Elm Grove Nursing Home 08/01/07

Elm Grove Nursing Home 27/02/06

Elm Grove Nursing Home 24/03/05

Elm Grove Nursing Home 23/07/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Elm Grove Nursing Home 42 Somerford Road Cirencester Gloucestershire GL7 1TX     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Wendy Kirby     Date: 1 0 1 2 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. the things that people have said are important to them: They reflect 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 31 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 31 Information about the care home Name of care home: Address: Elm Grove Nursing Home 42 Somerford Road Cirencester Gloucestershire GL7 1TX 01285653057 01285885798 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: BUPA Care Homes (CFC Homes) Ltd care home 60 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: That a designated person with two years proven experience in dementia care and staff supervision leads the day-to-day care within the Dementia Care Unit. The maximum number of service users who can be accommodated is 60. Date of last inspection Brief description of the care home Elmgrove is part of the BUPA Care Homes Group and provides general nursing and personal care to persons over the age of 65 years. It also has a designated unit where those suffering from dementia can receive personal care. The home is within a residential area of Cirencester Town and is near to several bus routes. There is a communal lounge and dining room in the main home with a designated space for activities. The dementia care unit has two communal areas consisting of lounge and dining areas. All bedrooms throughout the home have en suite facilities and are for single occupancy. The home as a whole has many adaptations designed to make daily living easier for the people living in the home, however the dementia care unit has Care Homes for Older People Page 4 of 31 Over 65 0 38 22 0 Brief description of the care home additional modifications which help the people who are confused. The main home has a large garden and ample parking, as does the dementia care unit, although additional arrangements are in place here to meet the specific needs of this client group. The home has qualified nurses on duty 24 hours of the day and care staff receive specific training in the needs of those with dementia. Current care fees range from 500.00 pounds to 720.00 pounds per week. Care Homes for Older People Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced Key Inspection which included a visit to the home. The visit was completed by one inspector and lasted approximately nine hours. Prior to the inspection we (The Commission) looked at various pieces of information to gather evidence in preparation for our visit, which included the following: The previous inspection report. The homes inspection record, which gives us an account of any information we have received about the home since the last inspection. The Annual Quality Assurance Assessment, known as an AQAA. The home is requested Care Homes for Older People Page 6 of 31 annually to complete and return this assessment to us by a specified time. We received the AQAA on time, which contained information about what the home considers it does well and what plans they have for further improvements in the coming year. During our visit we spoke with some of the people who live in the home, the deputy manager and other staff members who were on duty. We also looked at how effectively staff engage with people in the home and how they were interacting and communicating with each other. We looked at six individuals care files, which included, pre-admission assessments, care plans and risk assessments. We also looked at a number of records and files relating to the day-to-day running and management of the home. We spent time in all communal areas of the home and some of the bedrooms. We gave feedback during the inspection to staff who were part of the inspection and to the deputy manager after the inspection by telephone. We would like to thank everyone who took part in the inspection, their enthusiasm and support was greatly appreciated. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 8 of 31 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 31 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 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are assessed prior to admission to determine the suitability of placement. They can be confident that staff will have the resources and skills to meet their assessed needs. Evidence: We looked at the pre-admission assessments, which were comprehensive covering all activities of daily living, a full health screen and personal history background. The information gathered pre-admission should provide a sound benchmark of the persons ability, state of health prior to admission and subsequent needs when they move into the home. People wishing to live in the home, family and carers are involved in the pre-admission assessment wherever possible and all information is used to determine the suitability of the placement. Where possible the manager also obtains comprehensive Care Homes for Older People Page 11 of 31 Evidence: assessments and care plans from other health and social care professionals involved, for example, social workers and hospital staff. We spoke with the deputy manager who was able to clearly demonstrate the importance of pre-admission assessments in order to ensure that the home can meet individuals identified needs. The home does not provide designated rehabilitation care. Care Homes for Older People Page 12 of 31 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Because they are consulted about their health and social care needs people should be assured that their views and expectations will be considered and that the care received will individualised. Safe systems of practice are in place for receiving, storing, administering and disposing of medications which will help protect and promote the health and well being of people living in the home. People can be confident that staff have a good awareness of their needs and that they will be treated with dignity and respect. Evidence: From the pre-admission assessments the staff are able to develop a set of care plans based on identified needs. During the first months trial period the plans are reviewed weekly and developed accordingly. Care plans were completed with regards to health and social needs including, psychological, emotional, and cultural needs which Care Homes for Older People Page 13 of 31 Evidence: demonstrates that the home takes an holistic approach to the provision of care. The plans that we looked at were fairly detailed and person centered, including personal preferences and likes and dislikes. One plan told us that a person had specific requests when settling down for the night, which included, what time they like to get ready for bed, that they like to have plenty of water made available throughout the night and that they like to use the toilet regularly. This is very good practice and demonstrates that people are involved in deciding how they wish to receive care. The plans showed consistency in assessing, planning and evaluating care as required. Regular care reviews take place for people living in the home, which can include family members and Key Workers wherever possible. This allows the opportunity to discuss and evaluate care and any issues or concerns people might have. Records of General Practitioner (GP) visits and the outcomes were recorded. Specialist referrals and visits from other professional including, Chiropodists, Dentists and Opticians were also seen. Health care needs are monitored and documented in peoples care files. Nutritional assessments are completed on admission and reviewed monthly, people are weighed as part of this review. Care plans are written for people who are nutritionally at risk and how this is to be managed. Specialist health care support is often sought and referrals are made to Community Dieticians and the Speech and language Therapists. The paperwork format for peoples care files is relatively new to the home but they are making good progress. All staff have received training on how to develop them for individuals. The deputy manager regularly audits the care files and gives written feedback and any action required to staff members. We spoke with some staff who demonstrated good relationships with individuals and were knowledgeable about the care needs of those living in the home. Staff agreed that they had up to date information about individuals needs and confirmed that care plans were reviewed at least monthly unless there were any other significant changes. Policies and procedures for receiving, storing, administering and disposing of medications were examined and discussed with the trained nurses. All systems in place are effective, well managed and audited. The home operates a monitored dosage system for the administration of medication, which is supplied at regular intervals by a local pharmacist. Six monthly reviews for people living in the home are completed by GPs. Care Homes for Older People Page 14 of 31 Evidence: Fridge temperatures are recorded daily, the administration charts were legible and continuity of administration was shown with a signature from the person dispensing. The home promotes privacy and dignity to all people who use the home. Staff attend training on induction, which covers aspects such as closing doors and pulling curtains when delivering personal care and knocking on doors and waiting for an invitation to enter before going in to their bedrooms. We saw staff knocking on peoples doors before entering, members of staff spoke respectfully about individuals needs and referred to them in the term of address that they preferred, this information was also recorded in the care files. Care Homes for Older People Page 15 of 31 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. In general people benefit from a varied activities programme, which is both enjoyable, stimulating and meets individuals preferences and expectations. People living in the dementia unit will benefit from extra stimulation, activities, social events and outings tailored to their individual needs. People maintain family contact and the home encourages family and friends to join in with activities, special events and outings. The home actively promotes individuals to exercise choice and control over the lives they choose to live. People receive a varied and wholesome diet that they are able to influence. Evidence: There does not appear to be any unnecessary rules in the home and it was clear that the manager and staff are working towards empowering people and encouraging them to maintain independence, autonomy and choice. Care Homes for Older People Page 16 of 31 Evidence: Daily routines are flexible within the home, people can get up and go to bed when they like, have their meals in their bedrooms, they can go out when they wish and participate in activities they have a particular interest in. This was confirmed through documentation in care files, in discussion with individuals and through observation during our visit. We saw a Map of My Life in peoples care files which contains very useful personal information about people including family history, their favorite things, their dreams, memories, hobbies and personal interests and various photo albums are also in the home. These provide memories and topics of conversation for people where they are able to reminisce and tell stories about their lives. We saw some very good life style plans which were very person centered. We spent time with the full time activity coordinator who has been in post for nine years, she was very enthusiastic about her role and showed great commitment to the people living there. There is also a newly recruited assistant who works sixteen hours per week, both members have attended courses relevant to their roles, which will help them to implement new initiatives for the people living in the home. The home also has some regular volunteers who help out when they can. The coordinator told us that she meets with people who move into the home within the first two days to introduce herself, explains what the home offers in way of activities, trips and events and gets a general idea of any special requests and needs for each individual. She documents this in her own format and reviews them on a monthly basis. There is always a varied programme on offer to people living in the home on a weekly basis, this information is made available to everyone and peoples wishes are respected if they do not wish to join in. The people living in the dementia unit are also invited to join any activity and event in the main house, however a lot of the people have found this confusing and unsettling and the extra people and noise can be intimidating. We discussed this with the deputy manager who confirmed that the staff from the dementia unit had said that this was the case and separate activities and events are going to be organised in the very near future. Members form the Alzheimers Society have visited the home and are giving some guidance on specific stimulation for those people in the unit. We visited the home near Christmas time and could see that lots of activities and events had been organised. A Christmas bizarre had taken place days before our visit, which had proved very popular, a traveling theater group were visiting to provide entertainment and a Christmas Card competition had previously taken place. The cards Care Homes for Older People Page 17 of 31 Evidence: were judged and the winners card was published at a local printers, these cards were sent to various people to wish everyone a Merry Christmas including family and friends. People continue to enjoy trips out in the local community, including shopping, coffee shops, pubs, restaurants and the local organic farm. Children from local schools also visit the home to see the people, entertain them and have a talk with them over morning coffee or afternoon tea. People are supported to satisfy their religious preferences. Several denominations visit the home for individuals and they are also taken to local places of worship when they wish to go, one person told us, I always enjoy the service and the different hymns we sing. Lounges in the home provide good entertainment systems including televisions, videos, DVD players and musical systems. The home operates an open door policy for visitors and people are able to see visitors in the privacy of their own rooms and there are several semi-private seating areas around the home and in the gardens. The home has a receptionist to greet visitors on arrival to the home and assist with general enquiries and this is often the first point of contact for visitors to the home. We saw the receptionist greet people in a warm friendly professional manner throughout our visit. The size and layout of the dining rooms makes it possible for everyone to enjoy the social advantages of dining together. The dining rooms are light and spacious with the tables attractively laid. Staff members supported people that required assistance with eating their meals in a respectful sensitive manner. Staff sat at the same level and assisted them without rushing. When we were in the dining room at lunch time we saw jugs of juices, beakers and glasses and these were being handed to people whilst waiting for lunch. Later when we visited people in their rooms we saw that jugs of fluid had also been provided for individual use. The kitchen was well organised and seemed to run efficiently and effectively. The chef was able to demonstrate an awareness of individual requirements and needs including special dietary requirements and personal preferences. The chef told us that he had attended a course on Planning Healthy Nutritional Meals, which had been useful and Care Homes for Older People Page 18 of 31 Evidence: interesting The food is home cooked offering various choices of hot and cold alternatives and fresh fruit is available at all times. The menu rota displays traditional meals and menus are reviewed to reflect seasonal trends and availability of produce. Extras are ordered on request for birthdays and special occasions. Any visitors to the home are welcome to stay for lunch. The kitchen was well equipped and spacious, in general it was fairly clean, although the cooker and its surrounding area needed a deep clean, there is a thick film of grease in many areas which is collecting dust. Many parts of the hob were missing and not in working order, we were told that a new cooker and hob was going to be provided. The cooker and hob had been recently serviced and was deemed safe to use. Stores exhibited a good range of foods. Food hygiene training was up to date for staff. Documentation was provided to show that the required temperature checks were being carried out on fridges and freezers and that food was also being probed after being cooked. People told us that they usually liked the food offered to them and that they ask for something else if they didnt like what was on the menu. Care Homes for Older People Page 19 of 31 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good policies and procedures in place to manage complaints and people can be confident that their concerns will be listened to and acted upon. There are good arrangements in place for staff training and awareness of protecting vulnerable adults so that people living in the home are further protected from abuse. Evidence: The complaints policy and procedure is detailed and contains all the required information, this can be found in the service user guide and welcome pack which is given to people on admission, it is also displayed on notice boards throughout the home. People told us that they knew who to speak to if they were not happy comments included, All staff are very good and kind, I would speak to any staff member here and The trained nurses always have time to listen to me. There are policies and procedures as well as a range of guidance information on the topic of protecting vulnerable adults from abuse. The availability of this information should increase staff awareness and their role of protecting people in the home. We were told that the home actively promotes staff training in this area on induction Care Homes for Older People Page 20 of 31 Evidence: and on an annual basis staff receive an annual update. A number of staff are also enrolled on the National Vocational Qualification (NVQ) in Care Award and a component of the award addresses issues about protecting vulnerable people. Records showed us that many of the staff had attended the training and future dates books for those who hadnt. Care Homes for Older People Page 21 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean, comfortable, well decorated and furnished. It provides a safe, peaceful and well-maintained environment for everyone. The bedrooms, communal rooms and facilities are suitable and well presented for their purpose and meet the needs of people living in the home. Evidence: The home is fully accessible and has a number of aids and adaptations throughout the premises to enable physically disabled people to maximise their independence. This includes wide corridors and pathways, passenger lifts, specialised bathing facilities, grab rails and assisted toilet facilities. We walked around the inside of the home and viewed some of the bedrooms and the communal areas including the dining rooms, lounges and bathrooms. Room sizes are spacious for their stated purposes, particularly the lounges and bedrooms. Bedrooms have en suite facilities provided and communal bathing areas, showers and toilet facilities are located throughout the home. All areas of the home were tastefully decorated, clean and well maintained. Attention has been given to ensure that all areas are homely. People had been supported to Care Homes for Older People Page 22 of 31 Evidence: personalise their bedrooms with pictures and ornaments and they are able to bring items of furniture should they wish. Rooms are lockable so that they can maintain their privacy and keep their personal possessions secure. All rooms had profiling or divan beds dependent on need, and good quality matching bedroom suites, lounge chairs and a small table. Various lounge areas allow for people to be seated together enjoying the entertainment systems on offer. The laundry room is large and well equipped. Staff were wearing gloves and aprons whilst working and told us about effective infection control procedures in place when handling soiled linen. The home was very clean. People told us that the home was always clean and smelled fresh and pleasant throughout. Care Homes for Older People Page 23 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home promotes staffing levels and skill mix of staff in order to help ensure that people needs can be met. The recruitment policies and procedures set up in the home should help ensure that people living in the home are supported and protected. The training provided to staff should help ensure that staff have the skills and resources to meet peoples needs. Evidence: The deputy manager told us that staffing levels are indicative of the needs and levels of care required by the people living in the home and confirmed that levels of staff rise should dependency levels increase. Additional staff are also asked to come into the home to assist with other duties including training, updating and reviewing care files and policies and procedures. During our visit there were three trained nurses on duty instead of the usual two. The additional trained nurse had come on duty to audit medications and update some care files. This is good practice and demonstrates that the staffing levels to care for people are not compromised by other duties required by trained staff. Care Homes for Older People Page 24 of 31 Evidence: We asked some people living in the home if staff were always available when they were needed them. Comments included, They do everything for me when I ask, they are lovely and I am well looked after, They always come to me when I ask, if they are busy they explain and come back when they have finished and I would say in general they are available when I need them. We spoke with several people who expressed very positive views about staff and the care they receive one person said, I am so lucky to be here all of the staff are caring and kind, I am well looked after, oh I am very happy here I dont know what I would do without them all and I havent been here very long but it is all going very well so far and I have everything I need. The recruitment records were examined and showed that the home follows good recruitment procedures. Records contained application forms with an employment history, two written references, and a CRB (Criminal Records Bureau) disclosure. This will help ensure that the right people are employed to work at the home and people living in the home will be further protected. There is an induction programme, which covers all mandatory training, including Fire, Manual Handling, Health and Safety and the Protection of Vulnerable adults. The home has a mentor system where all new staff are linked with and shadow a senior staff member during each shift to enable continuity and continued training throughout the induction process. Since the last inspection the Deputy Manager has become the lead for coordinating training within the home, she also takes responsibility to train staff in some areas that she has specialised in.Three staff have completed a level 3 certificate in Mental Health and two of these nurses are the homes Dementia Link Nurses. They have accessed training resources within the community and attend seminars relating to dementia awareness. It is their responsibility to cascade their acquired knowledge to the staff in the home through training sessions. All staff attend basic training in dementia awareness provided by the home, a work booklet is completed following the training. If any shortfalls are identified the staff member will have additional support and training until they feel competent and confident. Other related training is accessed through outside trainers including the Alzheimers Society. Staff in the dementia unit told us that they had found all the training very useful in assisting them to understand and identify the needs that people in their care require. The home is conscientious about attending training relevant to the care needs of Care Homes for Older People Page 25 of 31 Evidence: people living in the home. We looked at staff training records and saw certificates of attendance and that all annual updates had been completed.All staff confirmed that they receive training relevant to their roles and responsibilities in order to understand peoples needs and to keep up to date with current practice. Staff comments included, The menu Management Course was very useful, We have attended a course in the Provision of Activities in a Care Setting and All the training has been relevant and useful to my role. The home continues to support staff in the NVQ in Care Award and staff have recently commenced this. We also asked staff if they felt that they had the right support, experience and knowledge to meet the different needs of individuals. Information we received was constructive and demonstrated that staff take their roles and responsibilities seriously. We spent some time throughout the day observing staff carrying out their duties and assisting people. Staff were respectful, warm in manner, good humoured and sensitive toward people within a relaxed, calm environment. All staff demonstrated a very caring, committed attitude to their roles and responsibilities in ensuring they provide quality of care. Care Homes for Older People Page 26 of 31 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs and best interests are central to the management approach in the home. Good accounting methods are adopted and policies and procedures are followed correctly when handling peoples personal money so they can be sure their finances will be managed correctly. Staff feel that they receive supervision and support that is appropriate to their roles and responsibilities in the home. The health and safety of people who use this service is protected. Evidence: The manager was not at the home on the day of our visit, but we spent time during our visit with the deputy manager and nurses on duty.The team demonstrates good, Care Homes for Older People Page 27 of 31 Evidence: effective leadership and management skills that relate to the aims and purposes of the home. The deputy manager shared various new initiatives in order to further develop the care, standards and services that the home provides to the people living there. The staff are a stable team that supports a commitment to providing quality care for the benefit of the people living in the home. People we spoke with told us that they were happy in the home and with the services provided, comments included, Im very happy and made the right decision to move here and I am well looked after, everyone does the best they can for me. The home continues to monitor and assess the quality of services provided, by giving people questionnaires to complete and holding meetings for people living in the home and their relatives , families and friends. As mentioned in the report audits are also carried out in the home with regards to care documentation, medication and other procedures in the home. The policy and procedure for holding peoples personal money was looked at. Although peoples personal money is not kept in the home they are able to set up an account with the head office. We looked at the statements of four individual accounts and saw that good accounting methods are maintained and receipts for sundries were available. There is an annual appraisal process, which ties in with the supervision arrangements. The management have established a formal recorded supervision procedure for all staff. A plan is devised for discussion relating to the residents, work issues, staff issues, personal development and training. Staff felt that the sessions were useful and confirmed that they received them approximately every eight weeks. We spoke with the maintenance operative who told us about his role. Documentation showed that relevant checks were maintained correctly and at the required intervals including all fire alarms and equipment and emergency lighting. The homes records showed all necessary service contracts were up to date including, gas and electrical services and passenger lifts. The fire logbook evidenced compliance to the weekly, monthly and annual checks. Care Homes for Older People Page 28 of 31 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 29 of 31 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 30 of 31 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. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 31 of 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!