Inspection on 23/01/09 for Keele House

This inspection was carried out on 23rd 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

Keele House 06/02/07

Keele House 13/02/06

Keele House 04/10/05

Keele House 02/02/05

Keele House 24/08/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 27/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Keele House 176 High Street Ramsgate Kent CT11 9TS     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: Christine Grafton     Date: 2 3 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: Keele House 176 High Street Ramsgate Kent CT11 9TS 01843591735 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Soory & Co Ltd Name of registered manager (if applicable) Mrs Margaret Collins 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 31. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP). Date of last inspection Brief description of the care home Keele House is a detached three-storey building with two shaft lifts, providing access to all floors. There are 27 single bedrooms and 2 doubles, the majority with ensuite toilet facilities. Bedrooms are provided with call bells and most have television points. There are 2 main lounges, a dining room and an additional visitors room in the basement. There is an enclosed garden with patio and seating area for residents use, weather permitting. The home is located within easy reach of local shops and all public amenities. Parking is on street in the adjacent road. The home provides care to suit Care Homes for Older People Page 4 of 29 care home 31 Over 65 31 0 Brief description of the care home peoples individual needs and is careful not to admit people with high needs that it is not equipped to meet. The home currently has a local authority contract to provide respite care for up to 4 people at any one time. Information provided by the manager at the time of this inspection indicates that the fees for the home range from £320.00 per week to £424.00 per week. Information on the homes services and CSCI reports for prospective service users will be detailed in the Statement of Purpose and Service Users Guide, which are readily available at the home. 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: This was a key inspection of the service, which means that we reviewed all the information we have received since the last inspection of 6th February 2007, including a visit to the home. An unannounced visit took place on 23rd January 2009 between 09.45 hours and 17.00 hours. The visit included talking to people living in the home, the manager, staff and observing the home routines and staff practices. We looked at some records and looked round communal areas of the home and saw a sample of the bedrooms. The manager sent us some information prior to the visit, in the form of the homes annual quality assurance assessment (AQAA). This gave us the information we asked Care Homes for Older People Page 6 of 29 for and has been used in the planning of the visit and the overall assessment of the service. Information from the last inspection and that received since then has also been considered. At the time of the visit there were 27 people living at the home and their weekly fees were in the range of 320.05 to 425.27 pounds per week. There has been a change in the management of the home since the last inspection and a new manager has been registered with us. There is also a general manager who deals mainly with management administration, but does deputise for the manager in her absence. The two roles are distinct and have strengthened the management structure of the home. What the care home does well: What has improved since the last inspection? They have acted upon the things we raised at the last inspection and made further changes as a result of their own assessment of how they are doing. They have made lots of improvements to their records to make them easier for staff to use and for management to review as part of the homes quality monitoring. One of the things they have done really well is the care plans, which now provide an excellent picture of each person as an individual and tell staff all about them, so they know how to assist them. Care Homes for Older People Page 8 of 29 They have made lots of improvements to the environment to keep the home looking attractive and a pleasant place for people to live in. These are some of the changes they have made. They have redecorated and put new carpets in the hall, lounge and a number of bedrooms, as well as providing some new bedroom furniture and armchairs in lounges. They have altered two toilets to make them more accessible for people with disabilities and those who use wheelchairs. They have created a new shower room that is easy for people to use, as there is plenty of space to move around and you can walk straight into the shower and sit down. They have continued with their staff training programme and they have a good percentage of staff that have achieved a recognised qualification in care. As well as this, a number of staff are currently working towards their qualification and there are lots of opportunities for staff to go on short courses to develop their knowledge and skills. At the last inspection, the providers monthly visit reports were not available at the home. This has been addressed and we saw copies of these that show the provider regularly monitors the performance of the home and reviews the quality of care 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 Care Homes for Older People Page 9 of 29 240 7535. Care Homes for Older People Page 10 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 11 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People considering moving into the home are given the information they need to decide if it is right for them. They have an assessment that tells staff about them and the support they need. This helps make sure that their needs can be met. People who stay for respite or recuperation are helped to go back home if that is their wish. The home does not admit people for specialist intermediate care so standard 6 was judged as not applicable at this inspection. Evidence: People can read about the home in an informative service users guide that tells them all about it, the things included in the fee, and anything they have to provide for Care Homes for Older People Page 12 of 29 Evidence: themselves. A copy of the guide is kept in every bedroom so people can read it at any time when they move in. Since the last inspection, the manager has devised a new form for staff to complete when introducing a new person to the home. This covers all the things they must do when they welcome the new person, helping with the orientation process, so that they feel comfortable in their new surroundings. Copies of the guide and the homes statement of purpose are kept readily available for anyone to read. Both documents have been reviewed and updated since the last inspection and show the changes that have occurred, for example, the change of registered manager. All of this makes sure that people have accurate information upon which to base any decisions about moving into the home. Each person admitted to the home has their needs assessed before they move in. Where a person has been referred by social services, a copy of the care management assessment is obtained first. Next, the manager, or another senior member of the care staff team, go out and meet the person to assess their needs and complete the homes own assessment document. This pre admission visit is also used to give them information about the home and tell them what to expect upon moving in. Sometimes at this point, the decision might be made not to admit the person, if it is felt that the home cannot meet their needs. We looked at some recently completed assessment documentation and saw that the home had gathered enough information to satisfy itself that it could provide the right care for the person. There was evidence that risks had been considered and a care plan had been drawn up covering a wide range of needs, including things like the risk of falls and what staff should do to reduce risk. We also looked at the care records for two more people and saw that assessments and care plans look at people as individuals. They show that a whole range of diverse needs are considered from the outset, including, religious observance, beliefs, age and disability. The home has a contract with the local authority to provide respite care for up to three people at any one time and there are dedicated rooms for this purpose. We spoke to those people staying for respite periods. They described how it had been for them when they first moved into the home and each person spoke about it as a positive experience. They each praised the home, saying how much they had improved since moving in. Care Homes for Older People Page 13 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from having their own individual plan of care that has all the information necessary to make sure they get the right personal care and good health care. People can be confident that their medication will be dealt with safely, that staff understand their needs and their dignity will be respected. Evidence: People living in the home have a plan of care that looks at each one of them as an individual. The plans contain details of the personal things that staff need to know in order to support them in the right way and help with their care. Because the care plans were judged as good at the last inspection we looked at just two care plans and saw that the good standard evident at the last inspection has continued and been developed. A new typed care plan format has been introduced for each person that is clear and easy to follow through. The plans contain detailed guidance for staff on how to help people with their daily living needs. They identify personal preferences and cover Care Homes for Older People Page 14 of 29 Evidence: things such as, how to assist with washing and bathing and how to look after a persons skin to prevent dryness, or pressure damage from occurring. Other things include, how to help people with moving around, how to make sure that a persons nutritional needs are met and they also cover a whole range of other diverse needs. The plans clearly show what the person can do for themselves, what they need help with and if they need two carers to assist them. Care plans are reviewed each month by the care staff and in addition, the manager has started to do her own monthly reviews as part of the homes quality monitoring process. This helps to make sure that changes do not get missed and any follow up action is monitored. One of the things discussed at the last inspection was the development of the risk assessments where high risks had been identified. This has been done and in addition, the manager has introduced new procedures and risk assessments for care staff to follow, which she goes through with them in their induction training. We saw a good example in one of the care plans of how a mobility and health care need was being met. The care plan contained informative guidance about the medical condition that was the cause of the mobility problem. There was a detailed risk assessment around falling, what to do to prevent falls and what action to take if a fall occurs. As well as this, the mobility care plan shows how to help the person with moving around and any specific handling requirements. All the components of the care plan link together, including the medications and the daily records, providing a good overall picture of the person and their needs. All of this indicates that the home has achieved an excellent level of care planning. We saw that peoples general health is regularly monitored and health care professionals are accessed as needed, such as doctors and community nurses. People are weighed regularly so that weight gain or loss can be picked up and acted upon. Care plans cover peoples mental health and wellbeing and identify if preventive and restorative care is needed. They also cover the persons wishes in the event of death and specify what staff should do to comply with their wishes. We looked at the way medications are managed and saw that things are in order. Medicines are stored safely in a dedicated room and a medication trolley is used to administer peoples medicines to them. We observed the lunchtime medications being given and saw that this was done in a safe way. Two staff do this together and administration records are signed. Care staff do not administer medications unless they have been trained and assessed as competent. The manager carries out regular audits of the medication records and the AQAA states their future plan to access Care Homes for Older People Page 15 of 29 Evidence: external audits on medications. This will add a further check so that things can be picked up and any improvements made where necessary. Conversations with two carers, daily records of care and observation all confirm that people are treated with respect and their dignity is upheld. The people living in the home that we spoke to confirmed that their care needs are being met and they said that they get good care. One person said, I thought it was lovely from the start. They treated me very well. The staff are very good. Care Homes for Older People Page 16 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from living in a stimulating and friendly environment where they have opportunities to take part in a variety of activities. They will know that their relatives and friends will be welcomed and they will receive a nourishing and balanced diet in attractive and sociable surroundings. Evidence: There is a weekly programme of activities that people can choose to participate in. These include, exercise to music sessions, a weekly visit from an entertainer that people refer to as the music man, weekly bingo sessions, film afternoons, quizzes and board games. People spoke about their favourite activities and of choosing whether to join in, or just watch. When talking about taking part in the various activities, they expressed their enjoyment experienced from the occasions. The entertainer is very popular and people spoke about their pleasure from joining in with the singing. Several people spoke of the bingo as a favourite activity and others expressed their sense of achievement and well being from doing the exercises. A small group of people spoke of enjoying socialising together in one of the lounges, where the seating is laid out in groups, which lends itself well to this sort of thing. Care Homes for Older People Page 17 of 29 Evidence: Others were seen doing individual activities, such as crosswords, reading and crocheting. People say they have lots of visitors to the home and that their relatives and friends are always welcomed. They are supported to celebrate their faith in the way that they want. Some people receive visits from clergymen or lay preachers, to fulfil their religious needs. People are also supported to go to church, if they wish. Care plans contain details of personal preferences and show that people have lots of choices, for example, in their daily routines, staying in their bedrooms when they want to during the day. Bedtime preferences are recorded and the daily records show that these are respected. A hairdresser comes each week and was at the home during our visit. People were having their hair done, which helps them to keep up their appearance. People say they enjoy good food and have plenty to eat. Two people commented that the food is excellent with the others saying it is good. One person said, The food is smashing and you can always have more. The menu is displayed each day in the dining room and home cooked meals with fresh vegetables are provided. The dining room is pleasantly decorated and arranged to provide a very congenial setting. The lunchtime meal was a leisurely affair with people socialising with each other. Care Homes for Older People Page 18 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home can be confident that any complaints will be listened to and acted upon, and that staff practices will keep them safe. Evidence: People say that all the staff are very approachable and listen to them if they have anything they need to talk about. They are confident to approach the manager and the general manager, who they talk of in first name terms. They also say they have no concerns at the moment and praised the home. The complaints procedure is displayed and the service users guide that each person has in their bedroom tells people what to do if they have a complaint. It clearly states that comments, suggestions and complaints are welcomed and details the complaints procedure well. The manager keeps a complaints record file that shows things are properly recorded and what has been done to resolve the issue. The provider visits the home at least once a month and always looks at the complaints record. The staff training matrix indicates that all except two staff have done training on the protection of vulnerable adults, with places booked for those two to undertake within the next three months. The manager also spoke of her plans to arrange regular updates for all staff in the coming year plus training on the mental capacity act and deprivation of liberties. Care Homes for Older People Page 19 of 29 Evidence: We spoke to two carers who confirmed they had done this training and knew what to do if they suspected that some form of abuse might have occurred. Staff know who to talk to if they are concerned and have the telephone numbers for both managers and the provider. They commented, that they know the provider, who they call by his first name, would come to the home if necessary, as he is committed to the residents. The home has made one referral during the past twelve months to social services under their protection procedures. This had been investigated and the alert closed. Care Homes for Older People Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are benefiting from the ongoing investment in the environment that continues to improve the decoration and furnishing, as well as provide the specialist equipment and adaptations to enhance peoples independence and safety. This makes sure that people continue to live in a homely, comfortable and pleasing environment that suits their individual and collective needs. People are protected by the practices followed by staff to maintain hygiene and prevent the spread of infection in the home. Evidence: The provider has an ongoing development plan for the home, which is reviewed and updated annually. Improvements are discussed within the management team and agreed according to identified need. People living in the home are consulted about any planned changes and kept informed when work is being carried out. Previous inspections have shown a consistently good standard of environment. In the past twelve months, the provider has continued to invest in the property making a number of improvements. These include, new hall carpeting and new colour coordinated decor, making it look attractive and welcoming. A new wet room has been created, with new shower and shower chair, toilet frame, tiled walls, coved non slip Care Homes for Older People Page 21 of 29 Evidence: flooring, liquid soap and paper towel dispenser. It is clean, attractive and functional. Two new toilets have been created to make it easier for people with disabilities to use, with wide opening doors and space for wheelchairs to turn. They have replaced two smaller toilets, which have been extended and new sanitary ware provided with tiling, grab rails and new flooring. Good hand washing facilities are provided with a foot operated clinical waste bin. This means that people are safeguarded from the spread of infection. There are two attractive comfortably furnished lounges. The front lounge has been redecorated with new carpet and there are a lot of new armchairs. Management records show that these have been purchased for both lounges over the course of the year to spread the cost. A number of bedrooms have been redecorated, some with new furniture and carpets. We looked at several bedrooms that were all clean and homely, with attractive bedding and curtaining. Bedrooms are personalised and arranged to suit peoples individual needs. Several people commented that they like their rooms. We also saw that various mobility aids are provided, including grab rails in corridors and a new electric hoist. We looked round all the communal areas and a selection of bedrooms. Good standards of hygiene were seen at the last inspection and have been sustained. All areas seen were clean and there were no odours. There are effective systems in place to keep the home fresh smelling. There is a well equipped laundry in the basement and a small sluicing facility on the ground floor. We discussed with the manager that the refurbishment of the sluice facility could be considered within the homes future development plans. Safe infection control practices were observed. The staff training matrix indicates that eight staff have completed their infection control training, with five more currently in the process of completing the course. Care Homes for Older People Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home can be confident that there will be enough competent and qualified staff on duty at all times to meet their needs. They are protected by the homes good recruitment practices and commitment to staff training. Evidence: We looked at the numbers of staff on duty and compared it with copies of worked and planned rotas. These are planned to provide four carers on duty during the day where possible, with a minimum of three, and additional staff for cooking and cleaning. The manager keeps a close watch on care staffing levels and tries to adjust them according to peoples needs. They have employed an extra full time staff member to help cover staff sickness and absences, including cover needed for training. There is a nucleus of long standing staff, but there have been some changes in the past twelve months. The two staff spoken to say that the new staff have fitted well into the team. The manager says that staff turnover has improved and feels that in some cases staff have left because they cannot keep up to the high standards expected of them at the home. A full time senior carer had recently left and the gap in the rota means that currently, four carers per shift may not always be achievable. Care staff spoke of sometimes Care Homes for Older People Page 23 of 29 Evidence: feeling a bit pushed when there are only three on duty and one said, It would be excellent if we had four carers each shift They went on to say it would give them that bit of extra quality time with residents. People say they like the staff and that that staff give them the assistance they need. Staff spoke enthusiastically about working in the home, saying that they have a good team spirit and they feel well supported by the management. We talked to the manager about the use of the Residential Forum Guidance recommended by the Department of Health to calculate staffing numbers. Although she has not been using this, she has her own system that seems to work well. However, this cannot be validated, as it does not show peoples dependencies, for example, how many with high needs, medium needs and low needs, or how staff numbers have been determined to take account of this. The manager said she would refer to the guidance when working out future staffing levels. This is a way of making sure they get the right numbers of care staff to match the needs of the people living in the home at any one time. Staff are encouraged and supported to achieve their National Vocational Qualification (NVQ) in care, level two or above. Ten staff have already achieved it and four more staff are currently working towards their NVQ qualification. Staff spoke about their training with enthusiasm, saying it helps give them the confidence to do their job well for the benefit of the people living in the home. We saw that new staff complete a thorough induction programme when they start working at the home. The home carries out a number of security checks on new staff before they start work to make sure they are trustworthy and safe to be around the people living in the home. We looked at two staff files and saw that the checks specified in the National Minimum Standards and legislation had been done, including two references and criminal records bureau (CRB) checks. The manager has devised a check list to show the dates the security checks have been completed and it is being added to the files. We discussed that files could be better organised and that papers should be securely held together. Interview records are not currently kept and this is an area for development. 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 home is well managed in a way that safeguards the best interests of the people living there, promoting and protecting their health, safety and welfare. People can be confident that the management regularly monitors the quality of service it provides and will listen to their views. It continually strives to improve its service and makes changes as a result of listening to people. Evidence: A new manager has been appointed since the last inspection and was registered with us in June 2008. This means that we think she has the necessary skills to manage the home. She has the formal management and care qualifications that the National Minimum Standards specify. She is supported in her role by a general manager who had previously managed the home for many years. The registered provider adds a third management strand and between the three of them, they have set up excellent management practices with good financial planning and budgetary control. Care Homes for Older People Page 25 of 29 Evidence: The provider and management team have a clear vision for the home to provide a high quality service. They have created an open culture where peoples views are sought in a variety of ways to make sure that what they plan to achieve is what people want. They do this by holding regular residents meetings, staff meetings, one to one meetings with staff, day to day contact with people living in the home, contact with their relatives and care managers, and sending out surveys. They have regular management meetings and the provider visits the home monthly to carry out a formal visit, where he writes a report as part of the homes quality monitoring process. Copies of the reports are now kept available at the home to comply with the requirement set at the last inspection. Survey results have been analysed and where an issue was identified, a letter was sent to people with information showing them that their views had been listened to and taken seriously. We saw evidence of financial planning with regard to environmental improvements, staffing levels and training. The manager does her own budgeting and she commented that the provider never restricts her expenditure. At the last inspection we saw that the home follows a good system for safeguarding peoples financial interests. Information in the AQAA and discussion with the manager indicates that this is being maintained. The AQAA was well completed and clearly shows the things they do well, where they have improved and what their future plans are. From the records seen and discussions with staff and people living in the home, we saw that what has been stated in the AQAA matches what we found. Everything we have seen shows the management commitment to developing and improving the service. Where things were done well at the last inspection, they have sustained the good standards and developed the service so that the overall outcomes for people living in the home are excellent. The AQAA indicates that the homes equipment has been serviced at appropriate intervals and no safety hazards were observed. The staff training matrix and discussion with the manager indicates that staff training on safety things such as fire safety, first aid, food hygiene and moving and handling is given high priority so they keep people safe. Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. 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 29 of 29 - 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!