Inspection on 16/02/09 for Grosvenor Park Nursing Home

This inspection was carried out on 16th February 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Grosvenor Park Nursing Home 05/03/07

Grosvenor Park Nursing Home 30/11/05

Grosvenor Park Nursing Home 31/05/05

Grosvenor Park Nursing Home 29/11/04

Grosvenor Park Nursing Home 21/05/04

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: Grosvenor Park Nursing Home 26 Brookfield Road Bexhill On Sea East Sussex TN40 1NY     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: Deborah Calveley     Date: 1 6 0 2 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 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 03000 616161 (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 31 Information about the care home Name of care home: Address: Grosvenor Park Nursing Home 26 Brookfield Road Bexhill On Sea East Sussex TN40 1NY 01424-213535 01424732451 smjane@bupa.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): BUPA Care Homes (BNH) Ltd Name of registered manager (if applicable) Jane Lynda Smith Type of registration: Number of places registered: 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 57 The registered person may accommodate the following category of service: 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 category : Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Grosvenor Park is owned and run by BUPA Care Homes, and is registered to provide care for those over 65 years who require personal and nursing care. The home admits residents who are privately funded and also those who are funded by social services. Grosvenor Park admits a number of residents for respite and holidays. The home is purpose built and situated in a residential area enjoying views of the seafront, shops are within walking distance and the home is convenient for public Care Homes for Older People Page 4 of 31 care home 57 Over 65 57 0 Brief description of the care home transport. Residents can enjoy four lounges, a large dining room and a library room. There are attractive gardens, which are accessible to wheelchair users and these are used when weather permits. Grosvenor Park current fees are available from the Manager. Additional charges include Newspapers, hairdressing; toiletries vary depending on personal choice. The homes inspection reports are available for reading at the home. 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: The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term service user to describe those living in care home settings. For the purpose of this report those living at Grosvenor Park will be referred to as residents. This was a key inspection that included an unannounced visit to the home and follow up contact with residents representatives and visiting health and social care professionals. This unannounced inspection was carried out over 6 hours on the 16 February 2009. There were 41 service users living in the home on the day of which six were case Care Homes for Older People Page 6 of 31 tracked and spoken with. During the tour of the premises eight other residents both male and female were also spoken with. The purpose of the inspection was to check that the requirements of previous inspections had been met and inspect all other key standards. A tour of the premises was undertaken and a range of documentation was viewed including the Service Users Guide, Statement of Purpose, care plans, medication records and recruitment files. Four members of care staff, the chef, two registered nurses, the training manager were spoken with in addition to discussion with the registered manager. Telephone contact was made with visiting professionals following the visit and their views and comments are incorporated into the report along with the information received verbally during the site visit. An Annual Quality Assurance Assessment was received from the Manager completed in full prior to this key inspection in December 2008. The fees range from 750 pounds to 1041 pounds per week, daily rates for respite care start at 130 pounds per day. these prices do not include extras such as newspapers, toiletries and hairdressing. Further information regarding the fees are available from the manager. What the care home does well: What has improved since the last inspection? What they could do better: The home needs to confirm in writing to the prospective resident or their representative that with regard to the needs assessment completed the home can meet the needs of the prospective resident. This ensures that decisions around admission to the home are informed. The social histories and social care plans were not completed on all the residents, this does not ensure that the activities provided are suitable for the people living in the home. Care Homes for Older People Page 8 of 31 Some shortfalls were found in the care plan documentation and risk assessments. The home staff need to ensure that the individual care plans reflect the residents changing needs and provides clear guidance for staff to follow. In particular communication, pressure damage and the risk assessments pertaining to call bells and personal oxygen systems. 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 –03000 616161. 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. The home provides prospective residents and relatives with a good level of information about the home, its facilities, services and the costs involved. The admission procedures allow for the needs of prospective residents to be assessed by a competent person before admission although people are not assured in writing that their needs will be met. The home does not provide intermediate care. Evidence: There is an informative Statement of Purpose and Service Users Guide in place which contains information about the home and the services it provides along with some information regarding the qualifications of staff. In order to reassure prospective residents that the staff have the knowledge and competency to meet their needs, more information regarding the training and updates they receive is available from the manager on request. Care Homes for Older People Page 11 of 31 Evidence: It was confirmed whilst talking to residents that the contract arrangements were clear and understood. There is a copy of the terms and conditions of residency included in the homes information documents. A review of the care documentation confirmed that pre admission assessments are completed by the manager or the deputy manager prior to their admission to the home. The last six admissions to the home were identified and the records relating to the admission procedures followed were reviewed. The care planning system used by BUPA contains an assessment of needs and a scoring system that guides staff into ensuring a care plan is formulated. This confirmed that pre admission assessments are completed and in the main provide a clear assessment of prospective residents care needs. Not all the pre admission documents included written information or details and thus little information was recorded which does not evidence that the home had collated enough information to make a decision whether they could meet the prospective needs at this initial stage. Prospective residents are seen either in their home or hospital before admission and the input from relatives and other professionals is used whenever possible. It was confirmed that the home do not confirm in writing that having regard to the assessment that the home can meet the assessed needs of the prospective resident. This was discussed with the manager who was advised that this should be completed in writing in accordance with the required documentation. The manager was able to verbally demonstrate her knowledge and awareness of the different specialities required in the home and ensures that the staff employed have attended relevant courses to deal with the needs of the elderly and also specialised courses for certain diseases. Trial visits to the home can be arranged. The manager confirmed that residents are invited to a trial period to ensure suitability of the home, this is clearly stated in the Statement of Purpose and in the statement of terms and conditions. One resident said that she had stayed at the home for a short stay before making a decision to move in full time and said the best decision I could have made. Another said I visited the home to see if I liked it, the staff and people in the home were so friendly and I really felt it was home. Intermediate or rehabilitative care is not provided at Grosvenor Park Nursing Home. 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. Although care documentation provides a good framework for the delivery of care, it needs to be developed to provide clear guidance to care staff on all the care needs of the residents along with robust systems for risk assessment to ensure individual person centred care is delivered. The homes practices ensure residents medicines are ordered stored and administered safely thus protecting and promoting the health of the residents. Residents are treated with respect and have their privacy and dignity maintained. Evidence: The care documentation pertaining to six residents were reviewed in depth as part of the inspection process. The residents were found in the main to have care plans specific to their needs and all evidenced regular review, however it was identified that not all care plans had a care plan in place for those with high communication and social care needs and this needs to be developed further. It was also discussed that the wording on the reviews be expanded rather than stating no change. Care Homes for Older People Page 13 of 31 Evidence: Individual risk assessments for health needs are included in the care planning format used by the home and all risk assessments were found to be completed, but not all followed through with an appropriate plan of action when identified as required. This pertains to wound care and the accompanying documentation. One care plan in specific had a care plan in place for a pressure wound but no further information recorded and no evidence of on going review. Short term care plans are used for health related problems that are treated and then resolved, however in one care plan, the daily notes identified a residents swollen hand, but no short term care plan was in place so staff would not know this was an identified problem if they had been off for a few days. Recurrent health problems need to be cross referenced with a plan of action that aims for prevention e.g urinary tract infection. It was also noted that the use of personnal risk assessments for residents safety was limited; for example a personal oxygen system was found left unattended and running and the use of call bells are not documented and no alternative monitoring system in place for those that can not use a call bell. Staff spoken with confirmed that they received a full report on each resident daily and the daily notes seen were informative. It would be beneficial for staff to mention mood and communication in more depth. Two clinical rooms were visited and are well organised and kept clean and tidy. There are suitable storage facilities for medication stocks and dressings. A medicine trolley is stored in the rooms and the staff keep it clean and uncluttered. There are small clinical fridges and temperatures of the rooms and fridges are recorded daily. There are policies and procedures in place for staff to refer to regarding the safe administration storage disposal and recording of medication. There are clear systems for recording and checking controlled drugs. The Medication Administration Charts (MAR) were viewed and no gaps identified. The comparison signatures of staff able to administer medication were available and current. Feedback from a health professional was positive regarding the home and confirmed that advice was sought as and when required. Staff were seen to be respectful and considerate to all residents whilst attending to their needs and the relationships between staff of all nominations and residents was positive and inclusive. Each of the residents were addressed by their preferred term and dressed appropriately in well laundered clothing Care Homes for Older People Page 14 of 31 Evidence: At the last key inspection is was highlighted that further individual information could be discussed with residents and families about the personal contact and action expected by staff at such times of illness and to respect the personal wishes leading to the end of ones life. This will enable staff to offer the personal support respect care and dignity required at this time. This was evident in some of the care plans viewed but not all and this is an area that needs to be developed further. 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. Social activities and meals continue to be creative and provide daily variation and interest for people living in the home. Residents are able to make a range of choices about their lives as well as maintaining links with friends and relatives. Evidence: Grosvenor Park employ an activities organiser to arrange activities within the home. A programme of planned events for February was displayed in the entrance area of the home and throughout the building, the programme also evidenced that activities are provided six days a week. Residents can choose to join in or not as they wish. Residents spoken with spoke highly of the range of activities and of the fun they have attending various functions. The home were celebrating red heart week for the British Heart Foundation and areas of the home had been beautifully decorated. The activities on the day of the inspection was an afternoon quiz, which was seen to be well attended and enjoyed by residents. Comments included I paint in the basement most days, which I really enjoy, the quiz sessions are really very good, they keep my brain going. There are various areas of the home that are used by the residents for meeting their Care Homes for Older People Page 16 of 31 Evidence: friends, reading the papers, having a drink and watching television. These include the lounge and entrance area library and dining area. Residents confirmed that activities are offered but the choice is theirs, whether they attend or not. There was talk of going for walks along the sea front when the weather improves and of inviting their friends to lunch. The care plans viewed did detail some residents social and activity preferences, however some of the frailer residents that do not have the mental or physical capacity to join in activities, had no social care plan in place and no evidence of social interaction. This was discussed in full and needs to be developed. It was confirmed that Religious Services are arranged in the home and residents are supported to attend. During discussion with the staff it was evident that residents religious choices are important and that they will arrange for ministers from different denominations to visit. Residents are supported and enabled to have choice in areas as times of getting up and going to bed, when to have their bath or shower, where they would like to eat and what they would like to do with their day. Residents are also encouraged to bring personal possessions in with them and many have their own bits of furniture paintings and ornaments around them. The kitchen was visited and the chef was available for discussion regarding the dietary provision for the residents. There are cleaning schedules in place and the kitchen was clean, well organised and has the cooking equipment needed to cater for the people who live in the home. The chef completes the safer cooking better business book. The chef confirmed that menus are prepared in advance following consultation with the residents and residents choose what they want from the menu on the day. The only notice required is for hot breakfast or special items that are not on everyday selection. There are two main courses available each day with a starter, along with a wide selection of alternative snacks and light meals. Residents are able to choose a pudding from the sweet trolley and are offered a choice of juices or a glass of wine with dinner after dinner coffee and cheese and biscuits if they should so choose. The home offer a hotel silver service in the dining room with dedicated kitchen and waiting staff. The dining area is well used by many residents and is attractively decorated with lovely sea views and natural light. Residents wishing to eat in their rooms are supported to do so with full care staff support, food is delivered to each floor on heated trolleys and served by the care staff. The residents were complimentary regarding the quality and choice of food, and the comments included: high standard, always a choice l like to be able to choose and have a glass of wine, unfortunately I have to pay for that! there is always a good choice and its presented very nicely. Care Homes for Older People Page 17 of 31 Evidence: There are some frail residents that require special diets and the chef has a good knowledge of the dietary needs of residents in the home. He evidenced a sound knowledge of diabetic diets, soft and pureed diets and would be able to provide food for differing cultures. He confirmed that he is informed by care staff and kitchen staff when food is not eaten and there is a need to fortify diets. Care Homes for Older People Page 18 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. Practice in the home ensures that complaints are responded to with residents and representatives being confident that they are listened to. Practice in the home ensures that adult protection issues are responded to when identified. Evidence: The complaint policy and procedure is clear and uncomplicated and a copy of this is readily available in the home and the Service Users Guide. A system of recording complaints was demonstrated to the inspector during her visit to the home. The home has not received any complaints since the last inspection and the manager confirmed that the open door policy has enabled residents and visitors to raise their grumbles and deal with them before they become complaints. Relatives and residents spoken with confirmed that they were confident that any complaints or concerns that they had would be listened to and responded to effectively. I am confident that any problem would be acted on immediately no complaints The home has relevant guidelines on the protection of vulnerable adults and staff have received appropriate training. Care Homes for Older People Page 19 of 31 Evidence: The management team has a clear understanding of adult protection guidelines and are aware of how to initiate an investigation if required. There have been no safeguarding referrals made in the past year. Care Homes for Older People Page 20 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 provides a comfortable, clean and safe environment for those living in the home and visiting. Residents are enabled and encouraged to personalise their room and rooms are homely and reflect the residents personalities and interests. Evidence: Grosvenor Park is a purpose built home and is situated overlooking the sea front of Bexhill on Sea. There are lovely views to the front of the home over the sea front and residents can enjoy the views from the dining room lounges and library. The rear of the building over looks attractive gardens. The home has wide corridors and high ceilings and gives the whole home a light and airy environment with good sized communal rooms and bedrooms. It is furnished and decorated to a good standard. There are adequate communal bathrooms and shower rooms in the home with specialist equipment which enables frail residents and those with a physical disability to enjoy the facilities available. Specialised equipment to encourage independence is provided, e.g handrails in bathrooms, hoists, wheelchairs and lifts to all areas of the home. Call bells are provided in all areas of the home. The lighting in the home is of domestic quality and there are above bed lights as well as the main ceiling lights. Water temperatures are controlled and monitored monthly and a record kept. Random temperatures were taken and were of the recommended level. Care Homes for Older People Page 21 of 31 Evidence: There are systems in place for monitoring safety issues such as fire checks, fire drills, PAT testing, electrical tests and gas and boiler checks and all the rooms are routinely checked for safety and maintenance issues. The records in the home confirmed they were up to date. The tour of the home confirmed that staff are aware of the fire safety policies however one door was found inappropriately wedged open. This was discussed with the manager. Grosvenor Park is registered for 57 beds, at present the top floor is not being used at it is being refurbished and upgraded with a view to caring for terminally ill people in the future. The second floor was refurbished over a year ago- 2007 to allow for further nursing care beds with a new clinical room nurse station and sluicing facility installed. The rooms were not fully functional at the last inspection but are now up and running successfully. It was confirmed that fire doors and windows on balconied rooms are now risk assessed to promote personal safety and security to individuals living in the home. The home is clean and free from any offensive odours. Good practice by ancilliary staff was observed. Good practice in infection control measures by staff was observed during the day and there were gloves and aprons freely available in the home. It was discussed that the practice of leaving commodes in corridors be reviewed and also of the use of communal commodes. Sluice and laundry areas were found clean and safe. The home provides a good laundry service which is appreciated by the people who use the service. Care Homes for Older People Page 22 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. Robust recruitment procedures are in place to protect residents and staff training ensures they are aware of their roles and are able to provide the support and care the residents need. Evidence: At the time of the inspection visit 41 residents were living in the home. The staffing rota was viewed and the staffing levels were seen to be sufficient to meet the needs of the residents at this time. The manager confirmed that the staffing arrangements are flexible and respond to residents dependency. Staff spoken to said that there was enough staff to look after the residents to a good standard. Comments received included: I never have to wait for assistance I think they are short staffed sometimes Feedback received from residents relatives and visiting care professionals as part of this inspection was very positive about the staff and comments received included: Very friendly and knowledgeable staff, couldnt wish for better people to care for me I am very well cared for and staff are nice I can not speak too highly of the staff. The staffing levels at night need to reviewed regularly as some negative comments were made regarding there not being enough staff to ensure the safety of all the residents. A selection of staff recruitment files were viewed and demonstrate that a robust Care Homes for Older People Page 23 of 31 Evidence: recruitment process has been maintained to protect residents and contained all the relevant information required. There was evidence of health questionnaires, Criminal Record Bureau checks, two references, a resume of previous employment and work permits where necessary. All the paperwork is kept within a locked room. Staff training is well established and records indicated that this is well organised with new staff starting a comprehensive induction programme. The induction programme is devised by the organisation and is in line with the Skills for Care guidelines and has been introduced for all staff. New staff are required to complete an initial induction programme and undertake mandatory training including fire and health and safety. This leads into foundation training in preparation of National Vocational Qualification (NVQ) training. At present 37 per cent, 13/32 of staff have an NVQ qualification with further staff enrolled on a course, the AQAA states that they are working to increase the amount of staff with an NVQ. The provider facilitates regular training sessions and recent ones have included safe cleaning, food hygiene, nutrition, infection control and moving and handling. There is a training matrix with a rolling programme of training, which will ensure that staff receive the training necessary to meet the residents needs. Staff spoken with said that training opportunities at the home are good and they are well supported by the senior staff, the training manager and the manager of the home. Care Homes for Older People Page 24 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. The home is managed in an open and friendly manner with suitable quality monitoring systems. Residents financial interests are safeguarded. The health safety and welfare of residents and staff are generally well promoted and protected. Evidence: The manager was registered by the CSCI in November 2007. She has 40 years experience in the caring profession, but this is her first management post. She is a Registered Nurse and has completed the Registered Managers Award. She has the necessary experience and knowledge to run the home efficiently and in the best interests of the residents. During the inspection visits there was no doubt that the manager had a good working relationship with everyone in the home and everyone spoken to said that she was approachable and responded to issues raised quickly. There is a clear management structure in the home with staff having designated Care Homes for Older People Page 25 of 31 Evidence: responsibilities. The quality assurance systems in the home include questionnaires sent out to residents and relatives following admission to the home. The formal quality assurance and quality monitoring systems has enabled the management to objectively evaluate the service and ensure it is run in the residents best interests. The quality assurance results are audited and action taken to address any suggestions of improvement and the results are then published to the residents, copies are available in the reception area of the home. Further quality assurance measures include 3 monthly resident and relative meetings, which are minuted, and any issues raised are then dealt with. There is also a regular newsletter which keeps residents and visitors informed of interesting and important happenings. The home does manage the personal monies for a number of their residents. Resident monies are held in a separate interest bearing account as per the BUPA policies and procedures. It was confirmed that the system used provides an audit trail of how transactions are managed on behalf of residents. Staff supervision for some staff is in place and up to date, however the home admit to being behind with the night staff supervision but new arrangements will address this and therefore a requirement will not be made at this time but will be reviewed in depth at the next inspection. Grosvenor Park looked well maintained and systems are in place to report any problems to the maintenance team that are in need of attention. Certificates relating to Health and Safety in the home were reviewed and found on the whole to be full. Environmental risk assessments are in place and are reviewed on a regular basis, there are fire risk assessments in place and these were seen. The accident book was viewed along with the actions taken to prevent a reoccurrence and evidenced that the accident book was completed competently and evidenced required follow up. There are first aid boxes spread out throughout the home and assessable to all staff and all staff recieve first aid training. Good practice was observed throughout the inspection in respect of promoting the safety and well being of the residents. Care Homes for Older People Page 26 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 27 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 1 3 14 That the registered person 24/04/2009 confirms in writing that having regard to the assessment made on any prospective service user that the home can meet those needs. That the prospective service user is assured that the home can meet their needs before admission to the home. 2 7 15 That the registered person ensures that care plans accurately reflect the needs of the service users in respect of their short term health needs, communication and social needs. to promote the health and social needs of all the service users. 24/04/2009 3 8 12 That the registered person ensures that suitable risk assessments are completed 24/04/2009 Care Homes for Older People Page 28 of 31 in all areas of risk and cover the use of pressure damage, call bells and personal oxygen systems. That appropriate risk assessments are in place with an action plan for those residents that do not have the capacity to ring the call bell. To protect and promote the health of the residents. 4 12 16 That the registered person 24/04/2009 ensures that all service users have a social care plan that is designed to meet their interests and preferences. That service users isolated in their bedrooms have a plan of care to ensure that they receive interaction and stimulation. To promote the social needs of all the service users living in the home. 5 27 18 That the Registered Person ensures that there are sufficient staff on duty to meet the needs of the service users at all times. To ensure that the needs of the service users are met by sufficient amount of staff at all times. 24/04/2009 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 Care Homes for Older People Page 29 of 31 improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 30 of 31 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. 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!