Inspection on 06/01/09 for James Dixon Court

This inspection was carried out on 6th January 2009.

CSCI found this care home to be providing an Excellent 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

James Dixon Court 09/01/07

James Dixon Court 12/01/06

James Dixon Court 04/10/05

James Dixon Court 23/02/05

James Dixon Court 06/07/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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: James Dixon Court Harrops Croft Netherton Liverpool Merseyside L30 0QY     The quality rating for this care home is:   three star excellent 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: Margaret VanSchaick     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: James Dixon Court Harrops Croft Netherton Liverpool Merseyside L30 0QY 01519315748 01519313708 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Arena Options Ltd Name of registered manager (if applicable) Mrs Christine Cole 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: Service users to include up to 30 OP The service must employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection Brief description of the care home James Dixon Court is a registered care home registered to provide personal care for up to 30 older people of both sexes. Arena Housing Association, who provides a range of services as a registered charity, owns the home. Mrs Christine Cole is the registered manager. Arena also manages a sheltered housing complex, which is adjacent to the care home. The home is situated in a residential area close to local facilities and transport links. The home has been purpose built to accommodate residents of varying abilities with Care Homes for Older People Page 4 of 29 care home 30 Over 65 30 0 Brief description of the care home adaptations fitted throughout. A call bell system is fitted to all bedrooms, bathrooms and public areas. Residents are accommodated in single rooms, all with en-suite facilities. Communal facilities consist of a large lounge, separate large lounge room and dining room. There are also smaller seating areas around the home. The garden grounds are attractive, and easily accessed by residents. There are several sitting out areas with some seating areas covered. There is parking to the front of the building. Weekly fees are 379.90 pounds 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: three star excellent 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: A site visit took place as part of the unannounced key inspection. It was conducted over one day by one inspector and lasted 7.5 hours. 28 residents were accommodated at this time. As part of the inspection process most areas of the service were viewed including some of the residents bedrooms. Care records and other documentation was also viewed. Discussion took place with residents, their relatives, a health professional and staff. The inspection was conducted with the registered manager. During the inspection three of the residents were case tracked (their care files were looked at and their views of the service were obtained). All of the key standards for older people were inspected. Previous requirements and recommendations were discussed. Care Homes for Older People Page 6 of 29 Satisfaction forms Have your say about... were distributed to residents, their relatives and staff. A number of comments included in this report are taken from surveys and interviews. An AQAA (Annual Quality Assurance Assessment) has been completed. The AQAA comprises of two self assessment questionnaires that focus on the outcomes for people. The self assessment provides information as to how the manager and staff are meeting the needs of the current residents and a data set that gives basic facts and figures about the service including numbers and training. What the care home does well: What has improved since the last inspection? Medication audits are now being carried out on a regular basis with records kept. This Care Homes for Older People Page 8 of 29 should improve the overall performance in medication management. All staff who administer medication have a certificate for safe handling of medicines and their competency is checked. The service has improved the activities programme as evidenced through the weekly activities board and following discussion with residents, relatives and staff. The service has improved the staffing levels as evidenced on staff rotas and following. discussion with staff. The service continues to be maintained to a high standard and new furnishings have been provided. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are assessed and visit the service prior to admission. This ensures that their individual care needs are highlighted and the service and prospective resident make an informed decision based on the assessment process. Evidence: There is documented evidence that all three residents case tracked (when all care documentation relating to the residents is looked at) were assessed prior to admission. A written assessment is in place for all three. A copy of the Social Worker assessment is also in evidence. The documentation evidences that health and personal care needs had been highlighted prior to admission and includes many areas such as mobility, communication, continence, specific personal care, and support required by the individual residents. The assessment documentation evidences that sufficient detail has been collected Care Homes for Older People Page 11 of 29 Evidence: during the assessment process to commence care plans. Further information is added to the care plans in the first few weeks of the individual residents stay as staff become more familiar with their needs. The AQAA stated that assessments of new residents are carried out over one day when they can visit for meals and join in with activities. Prospective residents are invited along with their relatives to visit the home and spend some time getting to know what kind of service, accommodation and facilities are offered. Prospective residents are invited to meals and to join in on the daily activities so that this gives them time to meet with other residents and staff. The manager told us that the visit gives prospective residents an opportunity to find out what is on offer and if the service is suitable for them. The manager told us that she is also able to further assess prospective residents during this visit. Residents canvassed for their views about the admission process stated, My social worker visited James Dixon Court as I wanted to live in this area as my friends live around me, I am happy and I came to visit and stayed for lunch. Relatives interviewed stated, I chose here for ...., he spent the day here before coming in, he has made new friends and is happy here and Mum came in for the day to visit and the assessment was carried out. I was happy with the pre admission assessment. I was impressed with how much time was spent. Prior to admission a bedroom check is carried out to ensure that all areas are safe for the resident. Risk assessments are also in place prior to admission to ensure any areas highlighted are well managed. Standard 6 is not applicable. 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 are provided with a care plan that identifies their planned and agreed care with health professional and other support that they individually need recorded also. Evidence: Information is collated prior to the admission date by the pre admission assessment process. The manager assesses all prospective residents prior to admission and also collates further information during their visit to the service when they come to see what it has to offer. This information is then used to set up care plans for the individual residents. They are commenced on the day of or very next day following admission to the service as evidenced in care documentation. The care plan evidences that care and support needs have been recorded. Where needed additional treatment or advice from other health professionals such as chiropodists, dentists, opticians, district nurses or medical doctors are also recorded. Preferred support such as checks at night are discussed and agreed on. Other areas of need at night are also recorded such as additional care staff for mobility support. One Care Homes for Older People Page 13 of 29 Evidence: of the residents interviewed stated, I know about my care plan, I have read it. There is also evidence that care plans have been reviewed on a regular basis and includes discussion with the residents, their family and key worker where agreed. Information recorded following a review is well detailed. There is also documented evidence that social workers carry out reviews of care also. One staff commented, All care plans are checked and updated when needed and are reviewed six monthly. Family support is recorded and where restrictions are placed on some visitors this is discussed with the resident and their advocate and recorded in the care documentation. Residents are also consulted with regard to their preferred name as evidenced on care documentation. There is documented evidence that residents agree and sign their care plans. One staff interviewed stated, We participate in setting up the care plan and get the family and residents to read and sign. Staff interviewed were confident that care needs of residents were known to them and stated, We have a regular report and handover day and night. The Commission canvassed relatives for their views and comments included, My brother in law is looked after extremely well and we are very pleased. Residents canvassed for their views stated, I am very well looked after, staff are very helpful and make you feel at home, they are great and The care is good. Treatment cards and dressing notes evidence visits from the district nurses, doctors and other health professionals. Where there are changes care plans reflect these. Residents preferred routines are recorded dependent on their individual needs and preferences. Risk assessments are in place with regard to the individual residents needs. Where needed manual handling assessments are in place with regular reviews. Where residents are capable of managing some of their own care needs this is recorded on care plans also. Relatives interviewed were complimentary about the care provided and stated, The care is brilliant, you wouldnt believe the difference in him since he came here, staff contact me to discuss his condition and support and My relative told me it couldnt be any better than it is, it is absolutely brilliant, Im putting my name down. A health professional interviewed was complimentary about the service and stated, Its a fantastic place, its lovely here, I visit twice a day. Any health professional or other visits to the residents are carried out in their individual bedrooms. All residents have their own bedrooms and en suite facility therefore this ensures residents privacy is promoted. Care Homes for Older People Page 14 of 29 Evidence: The service have a medication store room and trolley, which is used each day for the medication round. The trolley and cupboard were well organised. Both were locked when not in use. Despite regular stock checks, some expired medication was still in stock therefore this needs to be returned to pharmacy. The returns book was viewed and this evidences medication returns are carried out regularly with signatures and dates recorded. Medication records were viewed. Photos of residents are in place for easier identification. Staff who administer medication have received training as evidenced in staff files and interviews. One residents interviewed about their medication stated, Staff give me my medicines on time. Residents who wish to self medicate do so following a risk assessment. One resident who does self medicate has a medication sheet evidencing the daily prescription of medication but there is no record to confirm that they have taken their medication therefore this needs addressing. One medication has been recorded again on the medication sheet when it was already on record. There were no changes, it was the same medication to be given at the same time and same dose. Following discussion with the manager and senior staff they could not account for the error as it was confusing. The resident was not given the same medication twice. The manager assured us that this would be discussed with the staff member to ensure they understood their error. One prescribed medication has the dose changed regularly depending on blood tests and the service have this medication record very clearly set out and easy to follow. Recommendations made at the last inspection have been carried out and there were no missing signatures on medication sheets. With the permission of Gps and the residents, one or two medications are given earlier in the evening to suit the individual residents sleep pattern. None of the residents share bedrooms and each has their own en suite facility, which promotes privacy of the individual residents. Some of the residents have their own private telephone lines and others have mobile phones. For the residents who wish to, they can use the service phone that can be plugged into their bedroom for privacy. Residents were noted to be treated well by staff who interacted with them in a respectful and friendly manner. Residents looked well cared for and well groomed. Residents clothing was neatly folded or hung in their bedroom storage accommodation. 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 are encouraged to live their lives as they please with support provided to enable them to do so. Evidence: Documentation shows that where possible residents are encouraged to live their lives as they wish with support and care provided by staff where needed. The care documentation evidences that residents are asked about their daily routines and care needs prior to admission. Care plans evidence how this is managed and these are kept under review and changed to reflect the individual residents needs. Residents interviewed confirmed that they had choices about how they spend their time and one stated, I get up when I want and go to bed when I want to ,I have communion every Sundayand My two daughters and son visit me when they wish and have a cup of tea when they want. Residents who live in the service have a positive view of their lives since admission. Some of the residents have improved their daily lives since they decided to take up residency. For many of the residents their physical health has improved and they are happier because of it. Relatives interviewed were complimentary about how their family has settled into a routine that they enjoyed and took comfort from. Care Homes for Older People Page 16 of 29 Evidence: Relatives interviewed were happy with the support provided to their relatives and stated, Staff are always asking people to join in to play cards, board games or listen to visiting entertainers and I was happy that mum could keep the same hairdresser, continuity for mum. Residents are offered various activities and those residents who wish to, join in. Residents who prefer their own company or not to participate are accommodated. Activities arranged include, passing the ball, local church visits, musical days, beauty days, films, gardening , playing cards, board games, sing a longs and bingo. The activities are planned so that one takes place daily on a rota. The activities are displayed for residents to see. The service also have outside entertainers and groups visiting regularly throughout the year including local schoolchildren and community policemen. One staff interviewed confirmed that regular activities take place and stated, The residents play cards, bingo, dominoes, scrabble and we had a Xmas party and entertainment including school choirs. We have enough time to care. We have quiet times and we sit with the residents around the table and chat with them in the afternoon. Residents have been able to personalise their bedrooms with their own items as seen during the visit to the service. Residents have the use of a pleasant dining room for mealtimes. Residents who wish to can take their meals in their rooms if wished. The menu offers residents a varied and nutritious diet with choices on offer at each mealtime. The cook meets up with new residents when they first arrive so that she can find out their preferences with regard to their diet. One staff interviewed about the meals stated, The food is excellent, the residents have scones, sponges and birthday cakes also. Residents canvassed for their views stated, We have a good variety of meals and The meals are wonderful and you always get a choice, we have lots of activities, we enjoy bingo and playing dominoes. A relative commented. The food and standard of cleanliness is excellent. 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. Residents are protected by the policies and procedures in the service . Evidence: Residents have access to a clear and easy to follow complaints procedure. Copies of which, are in their bedrooms. One minor complaint was raised with the service approximately a year ago and this was resolved immediately. The complaints log was viewed and evidences the complaint and investigation and outcome. There have been no complaints or adult protection issues raised with the Commission. The AQAA stated that the service promote an open culture where residents are encouraged to raise any concerns they have with staff. Residents interviewed confirmed they are able to do this. The Commission canvassed relatives for their views about any concerns they may have had and relatives commented, I could not find any fault whatsoever and No concerns, and judging from the care my aunt has received since she has been at James Dixon, I am sure a complaint will not be necessary. One resident interviewed stated, I have no worries, its very good here. The service has a copy of the Sefton Adult Protection Procedure. All staff have attended training in this area. Senior staff interviewed were familiar with the procedure. Where needed staff have sought advice on behalf of residents. The local Care Homes for Older People Page 18 of 29 Evidence: advocacy service contact details are available for residents and staff have assisted residents who needed the service. Residents are supported to use their voting right by visiting the polling station or posting their votes. Residents have a lockable facility for storage of valuables. The service does not hold any monies on residents behalf. 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. Residents are provided with a well maintained service which is decorated and furnished to a high standard. This ensures residents live in confortable and safe surroundings. Evidence: The service provides a pleasant and well maintained environment for the residents. All bedrooms and public areas are placed at ground floor level giving residents easy access throughout the service and garden grounds. Residents bedrooms have been personalised with their own items. Relatives canvassed for their views commented, My aunt is happy here and feels quite at home, her room facilities are fine. Residents canvassed for their views stated, My room is cleaned every day, everywhere is lovely and clean. One residents interviewed stated, I have a nice bedroom. Each bedroom has an en-suite facility with twelve also including a shower. This promotes residents privacy and dignity. Bedrooms viewed were decorated to a high standard and all areas including public rooms were clean and tidy. The service is equipped to suit the needs of the residents including adaptations fitted to the Care Homes for Older People Page 20 of 29 Evidence: bathrooms. A call bell system is in use and this was tested during the visit and was working. Public rooms and hallways were decorated to a high standard and provided spacious areas for residents to use. There are two sitting rooms and a dining room for residents use. These are pleasantly and comfortably furnished in a domestic style. The service also has other seating areas throughout the building for residents use. The external grounds provides residents and their visitors with spacious seating areas. Suitable outdoor furniture is in place. The grounds are well maintained with mature shrubs and other planting. CCTV has been fitted externally to provide additional security. A programme of routine maintenance is in place as evidenced in service documentation. Refurbishment takes place on a regular basis as evidenced during a tour of the service. The kitchen was very clean, tidy and well organised. The cook on duty was very knowledgeable about the residents nutritional needs and her responsibilities in the kitchen. The laundry is situated well away from the kitchen. The laundry was clean, organised and had sufficient equipment to care for residents personal laundry and service laundry. Hand washing facilities and protective clothing is provided for staff. 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. The service is managed by a well trained team of staff. This ensures residents health and welfare are well cared for. Evidence: The AQAA stated that the service have increased staffing levels since the last inspection and this has ensured that staff have more time to spend with residents providing support and care. This was evidenced on the staffing rota and through discussions with residents and staff. The service employ sufficient domestic staff also as evidenced in the clean bedrooms and public areas. The registered manager is supernumerary and there is also a manager from head office on call, out of hours. Most of the staff are qualified to NVQ Level 2 and 3 with two seniors qualified to Level 4. One senior is working towards the Registered Managers Award. The service have exceeded the standard in this area. Staff interviewed were very complimentary about the training provided and stated, I have my NVQ 2 and 3 and I think I have enough training to do the job properly. I have attended training here and at College and I have done an induction and other training including infection control, health and safety, manual handling, first aid, whistle blowing, equality and diversity and abuse. Care Homes for Older People Page 22 of 29 Evidence: Three staff files and training records were looked at during the visit. Staff files evidence enhanced police checks have been carried out prior to employment. Not all of the files contained an application form. The manager told us they were at head office. Staff files need to evidence the application form has been completed. Two written references are in place for two staff but the third file has evidence of only one. Therefore this needs addressing. Brief employment history, previous experience and qualifications are on record. A record of staff induction, evidences it commences on the first week of employment and continues over several weeks. Staff are issued with an induction pack. The induction is signed and dated by the employee. Following the induction process staff are then enrolled in the NVQ training programme. There is recorded evidence that staff have regular supervision and appraisals. The service provide staff with a good training programme that includes mandatory training. Staff training is evidenced in the staff files to include first aid, risk assessment, policies and procedures, fire, continence, infection control, basic food hygiene, health and safety, manual handling, medication, supervision, palliative care, MRSA, NVQ, equality and diversity and Dementia. The Commission canvassed relatives for their views on how the service was run and comments included, The loving care and attention that my dad gets from all the staff is excellent, nothing is too much trouble to them and From what I have seen and you can call into James Dixon at anytime, every single member of staff has been so nice (above what I expected) at all times. I never feel that they are being nice just when I or other relatives are here. One relative interviewed about the staff was complimentary and stated, I know all the staff by their first names and the main carer, they are brilliant. Residents canvassed stated, The staff are always there when needed, I am very happy here and The staff always help me in anything I need and are always there to listen to me. The Commission canvassed staff for their views on how the service was managed and comments received were positive. Comments included: The training is very good, it keeps me up to date. The service provides an excellent standard of care. It is also a really good environment to work in. All aspects of the work environment to both residents and staff are of a very high standard. Care Homes for Older People Page 23 of 29 Evidence: I was not allowed to start work until my police checks and references were checked out. My induction was excellent. My manager is very supportive, I have no problems talking to her. I like working here, the staff are nice. Care Homes for Older People Page 24 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is managed to an excellent standard in the best interests of the residents. Evidence: It is apparent through discussion with the registered manager that she is knowledgeable about the various care needs and conditions that can affect the older person. The manager has many years experience in her post. The manager is qualified to Level 5 NVQ in management and holds the Registered Managers Award. The manager also holds many other certificates that includes all of the mandatory training necessary to her post. Residents, relatives, health professionals and staff were very complimentary about how the service is managed. Through discussion with the residents and staff it is evident that the service provides a very good standard of care and support. One relative interviewed stated, The manager has been excellent with any concerns. Care Homes for Older People Page 25 of 29 Evidence: The service have been awarded a five star external quality assurance award in 2008. The service also ensure that residents, staff, relatives and other visitors to the service are canvassed for their views throughout the year. The results of which are open to inspection. The results of the survey were positive and complimentary. The service also hold regular meetings for residents and staff. Minutes of the meetings held are published and these were viewed during the visit. The service is audited monthly by head office and the manager also carries out frequent audits of all areas throughout the year as evidenced on care documentation. Areas of audit cover many aspects of health and safety, staff training, residents meetings, menus, equipment and the building. Policies and procedures are reviewed on an annual basis as evidenced in care documentation. None of the residents monies are dealt with by the service. Where needed residents get support from their families and one resident has made use of the local advocacy service. Advocacy contact details are available for those residents who may wish to use it. Each resident has a safe in their bedroom and a lockable drawer. All bedroom doors have keys and risk assessments are carried out before agreement is reached with the resident in regard to residents holding their own keys. Some of the residents do hold their own key. This is documented. Various certificates and documents were viewed including health and safety checks with regard to the premises, equipment used and all servicing of equipment. This verified and confirmed that everything is in date including servicing of appliances and boilers. Fire safety equipment is in place and a fire risk assessment of the building has been carried out. All fire checks are carried out regularly with records kept. Mandatory training and employee induction is in place for all staff and staff files evidence the training attended. Staff interviewed also confirmed that they had an induction on commencement of employment and attended mandatory training throughout the year. 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 1 9 It is recommended that medication audits should be carried out regularly so that any out of date stock is picked up and returned to pharmacy. The audit will also pick up any errors on the medication sheets. Staff should also be assessed to ensure their competency with medication. It is recommended that where a resident self medicates, the medication record should evidence that they have taken their daily prescribed medication. This will ensure that residents have their prescribed medication to maintain their health. It is recommended that all staff files should evidence the employee application form. This ensures that the service is able to gather sufficient information about the employee prior to commencement of work. It is strongly recommended that two written references should be evidenced in staff files. This ensures that prior to commencement of employment all checks are carried out thoroughly. 2 9 3 29 4 29 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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