Inspection on 15/04/10 for Mount Olivet Nursing Home

This inspection was carried out on 15th April 2010.

CQC 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

Mount Olivet Nursing Home 18/04/07

Mount Olivet Nursing Home 08/11/05

Mount Olivet Nursing Home 07/06/05

Mount Olivet Nursing Home 02/12/04

Mount Olivet Nursing Home 15/06/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 29/06/2010.

Key inspection report Care homes for older people Name: Address: Mount Olivet Nursing Home 2 Great Headland Road Paignton Devon TQ3 2DY     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Michelle Finniear     Date: 1 5 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Mount Olivet Nursing Home 2 Great Headland Road Paignton Devon TQ3 2DY 01803522148 01803696573 monh@grayareas.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Robert Hugh Gray Name of registered manager (if applicable) Mrs Alison Homer Type of registration: Number of places registered: care home 30 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home Mount Olivet is situated in the Preston area of Paignton and is easily accessible by public transport. It is set in private grounds with a pleasant sheltered garden. The home overlooks the sea at Paignton and is approached from a driveway, parking is available for several cars to the right of the building. The home occupies a position that overlooks Torbay with panoramic views across to Brixham. The home is registered to provide accommodation to a maximum of 30 people of either gender, over the age of 65 years requiring nursing andor personal care because of physical frailty, illness or disability. A registered nurse is on duty at all times supported by a team of Health Care Assistants. The home has a range of equipment and adaptations to cater for the needs of the residents. Information about the home and the latest inspection report was Care Homes for Older People Page 4 of 29 Over 65 30 0 0 30 Brief description of the care home found in the entrance hall, people can also receive information by visiting their website. Information given to the Commission by the provider indicates the current range of fees is from GBP 558.70 to GBP 764.60 per week. Additional charges are made for podiatry, hairdressing, newspapersmagazines and aromatherapy. 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: We sent the service an Annual Quality Assurance Assessment or AQAA. This is a document for them to complete to tell us about the way they operate, what they have improved in the last year since we visited and what they plan to do in the coming 12 months; We looked at the last Key Inspection report and a random inspection we have carried out since then; We looked at the information we have received about the service; We looked at the notifications the home has sent us. These are a legal requirement and tell us about incidents that have happened at the home, for example a serious injury to a person who lives there; Care Homes for Older People Page 6 of 29 We carried out a site visit over one day without telling the home when we were coming; We spoke to the people who live at the home, visitors, staff who work there and the management looking at how well the home meets peoples needs; We sampled care plans, policies and records the home keeps and we toured the premises looking at areas such as cleanliness and equipment provided; We sent questionnaires to the people who use the service, staff who work there and professionals who visit the home such as community nurses and general practitioners; These all help to give us a rounded picture of what the home is like. Care Homes for Older People Page 7 of 29 What the care home does well: The home is in a residential area with attractive views out over Torbay from many of the rooms; many other rooms have access to an enclosed garden with patio doors; People tell us that the nursing care is of a high standard; The home is pro-active in joining in local initiatives to improve care, such as palliative care forums and infection control audits; Visitors we spoke to told us that they were kept involved in their relations care and were welcome at any time; People spoke very highly of the matron, her skills and kindness; Staff are committed and have developed some initiatives to meet peoples needs, such as providing a visiting service and developing discussion and debating groups on local and national issues; There is a good level of activities at the home. A programme is on display in the hallway for the coming week so that people can plan in advance. Sessions include exercises, trips out, cultural activities as well as games and quizzes. This helps make sure there is something for everyone; Staff have access to a training programme and people told us they have lots of training; People told us: I have always had very positive experiences when dealing with Mount Olivet nursing home This is the best home I provide a service to The staff are knowledgeable, caring and good to work with. And the Matron is brilliant Always make sure staff know about the patients when we contact them. Everything is fine for my needs Nursing care is of a high standard This is the nearest to Hospice care one could hope for Mount Olivet is a very good nursing home. The overall care and welfare of clients is upmost to all the staff. The home provides a safe and comfortable environment for my mum. I could not wish for better care. High standard of care. Staff very attentive helpful and always available. Home always Care Homes for Older People Page 8 of 29 very clean, and residents always very well cared for. Food very good. I am very happy here This is an excellent home in every aspect of care and nursing. The staff have a lot of patience taking into account the number of clients they have to attend to The staff are caring, knowledgeable and good to work with The staff are always courteous and smiling and they create a good atmosphere Staff very attentive, helpful and always available The staff are always very friendly and smart. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home makes sure people receive a full assessment before a decision was made about an admission. Further discussion is needed on the intermediate care currently being offered. Evidence: Mount Olivet has a statement of purpose and service user guide available to help people make a decision about whether the home is the right place for them. The guide is available in a larger print type and discussion was held on making it available in other formats to meet individual needs. The guide needs some updating as indicated below. We looked at the way in which the home decides whether they can meet the needs of people seeking admission. We looked at the files for the two most recently admitted people. These showed a full assessment had been undertaken. In one case this had involved visiting the person at their previous placement, looking at the records of their Care Homes for Older People Page 11 of 29 Evidence: previous care and talking to their carers and relatives. The person had themselves been involved in the process as far as they were able. Another person had been admitted from abroad, and their care needs were identified in discussions with relatives and in documentation which was then translated. The assessment information may benefit from being collated in a more structured way. The assessment documentation also contained a copy of the homes contract. This sets out the terms and conditions of residency of the home and also what people can expect to receive for the fees paid. People are given opportunities to visit the home and see accommodation available and records were available to detail enquiries and visits made. The home told us they have recently started to provide Intermediate care. This is an intensive programme of rehabilitation with a view to returning people to their own homes. However this was not detailed in the statement of purpose, service user guide and there was no evidence to show that the home had complied with the national minimum standards on intermediate care. These require the home to have specific staff training in rehabilitation, provide equipment to promote activities of daily living and dedicated space made available for this style of care. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Nursing and care are of a high standard. Medication is being managed well. Evidence: We looked at the care plans for four people in detail on the inspection to sample a range of need. Most people at the home have significant and multiple health concerns, some of which require regular, urgent or unpredictable support and treatment. Some people come to the home for short term respite, convalescent or palliative care, but the majority live there long term. Assessments in care plans showed the home reviews peoples nutritional and care needs, communication, tissue viability, falls, visits of medical practitioners and records attendance at hospitals. Risk assessments are undertaken for areas where there is a concern. Risk assessments are a way of identifying and minimising wherever possible the potential harm in the least restrictive way. Discussion was held on capacity assessments and instances where the staff have to make decisions on behalf of people at the home who are no longer able to make them themselves. The home are advised to revisit the Mental Capacity Act training to make Care Homes for Older People Page 13 of 29 Evidence: sure more significant decisions made on peoples behalf are appropriately recorded. The care plans showed us that the home regularly re-assesses peoples needs and plans care and support to meet them. This includes protocols for the clear management of unpredictable concerns which might need urgent treatment such as unstable Epilepsy or diabetes.The home has good contacts with local community services such as speech and language therapists, physiotherapists, dietitians, palliative care teams and general practitioners. Evidence of the contacts and support received were detailed in the care plans. Visiting professionals who completed questionnaires for us told us I have always had very positive experiences when dealing with Mount Olivet nursing home This is the best home I provide a service to The staff are knowledgeable, caring and good to work with. And the Matron is brilliant Always make sure staff know about the patients when we contact them. Care plans would benefit from being more person centred and including more social information wherever possible, however it is acknowledged that many of the people at the home would be too frail to give much of that information themselves, or may not wish to. Discussion was held on resources to support this. We looked at ways the home manages medication. Currently no people at the home manage their own medication, but systems are in place to support them to do so, and risk assessments are undertaken to make sure this would be safe. The home keeps clear records for all medications administered or destroyed in the home. We spoke to the deputy matron who showed us how medication is stored and given to people, and this was being managed well. The balance for controlled drugs was checked at random and found to balance. Controlled drugs are those that because of their strength or effects need special precautions in the way they are managed. People who live at Mount Olivet or their relatives who completed questionnaires for us or who we spoke to on the visit told us that they were very happy with the level of care and support they received. They said Care Homes for Older People Page 14 of 29 Evidence: Everything is fine for my needs Nursing care is of a high standard This is the nearest to Hospice care one could hope for Mount Olivet is a very good nursing home. The overall care and welfare of clients is upmost to all the staff. The home provides a safe and comfortable environment for my mum. I could not wish for better care. High standard of care. Staff very attentive helpful and always available. Home always very clean, and residents always very well cared for. Food very good. I am very happy here This is an excellent home in every aspect of care and nursing. The home is pro-active in working with local Palliative care forums and is up to date with best practice in this area. The home has purchased some new equipment since the last inspection including a nebuliser for vapourising some medications, and a syringe driver for delivering pain relief medication 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to be as active and involved as they possibly can be. Visitors are welcome at any time. Food is well presented and of a good quality. Evidence: During the site visit we spent some time looking at how people spend their time and the lifestyle they can experience whilst resident at Mount Olivet nursing home. The home has told us that they practice a person centred approach to care, which ensures that people are treated as individuals and are encouraged to make choices about the lifestyle they wish to follow. They have told us they try and offer flexible routines of daily living to suit expectations, preference and choice and control of their lives. Many people at the nursing home have multiple frailties and these impact considerably upon their ability to do if they wish. However as far as possible people can follow activities of their choosing, and the home has an open visiting policy. While we were at the home there were many visitors, several of whom we spoke to. They told us they were always welcomed to visit the home and were kept in contact with their relatives well-being. One person told that at their request they are contacted at any Care Homes for Older People Page 16 of 29 Evidence: time throughout the day or night if there is a change to their relatives condition and that they can visit immediately. they also said thay wre consulted on their relatives care and had an input on their behalf into the care planning system. People are encouraged to bring personal and valued possessions with them into the home which helps them settle and feel at home. There are a number of areas throughout the building where people can choose to spend time, and on this visit people were in their rooms, reading quietly in the conservatory, or watching television in the lounge. The manager told us that two members of staff have started a residents discussion group which is held once a month. A small group of residents meet in the conservatory to discuss local national and global issues. Another member of staff has taken on a role as a visitor who twice a week visits people who do not have their own visitors, reading, writing letters or cards on their behalf, making things and chatting. Stop some of the information gathered is then used to compile the social Plans. Care plans contain some information about peoples lifestyle choices, hobbies and interests and past social history. Regular residents meetings are held where people have opportunities to discuss the way the home is run and provide suggestions for activities or development. Equipment is available to support communication with people with visual or hearing impairments. As an example large magnified sheets have been provided to help people read print in newspapers. The home has information about the forthcoming weeks activities on display in the hallwayand this is also advertised in the homes regular newsletter. There is a visiting aromatherapist and in-house entertainment is organised frequently. Outings are also provided following discussion with people living at the home about what they would enjoy. There are plans to offer more general entertainment in the afternoons including jigsaws, bingo and quizzes. Regular activities include exercise classes, reminiscing, discussion groups, animal lectures, and music. For people who spend most of their time in bed the home try to ensure that individual time is also spent with them and they also plan to provide entertainment outside so that people who are bedbound in the lower ground floor rooms would be able to hear. One person who completed a questionnaire for us said they would like to have someone to talk to a bit more. People told us the food served to them was of a very high standard. This was confirmed in questionnaires received. The meal on the day that we visited was Gammon and vegetables with egg custard or ice cream for dessert. The evening meal Care Homes for Older People Page 17 of 29 Evidence: was lentil soup, sausage rolls, sandwiches, jelly and cream cake and yoghurts. Some people need to have their meals pureed, and a relative who spoke us to confirmed that this is well presented and made to look as appetising as possible. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People should be protected by the homes policies and procedures for the management of complaints and adult protection. Evidence: Mount Olivet has a complaints procedure which is given to each person in the service users guide, as well as being on display in the hallway and the homes office. The home had not received any complaints in the last year and told us that they try hard to nip any concerns in the bud before they develop into larger issues. However just after the site visit we received some concerns about the operation of the home. These related to weekend staffing levels, medication and staff deployment. These were sent to the manager and provider for investigation and their response indicated that issues were being managed satisfactorily. The senior staff have received training in the Mental Capacity Act and Deprivation of Liberty safeguards. They hope to support all staff to attend this training as well. This legislation helps to protect peoples rights and to ensure their capacity to make decisions is supported. Staff also attend training in the safeguarding process and protection of potentially vulnerable adults. This should help ensure that staff know what to do if they are concerned about potential abuse. Staff who completed questionnaires for us told us that they knew what to do if someone had concerns over their care or the home. 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 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 being well maintained and offers a comfortable environmnt that meets nursing needs. Evidence: During the site visit we looked round the home, looking in most bedrooms and talking to people living at the home, visitors and staff. We also looked at the clinical areas, and service areas such as the kitchen and laundry. All of the areas we saw on this visit were clean, warm and comfortable. Handwashing facilities were available throughout the home along with protective equipment to ensure that infection control practices are managed. Cleaning materials were locked away, and data sheets were available in case of accidental misuse. The home is set in a residential area of Preston, Paignton, and is elevated so has good views out over Torbay from some rooms. Some other rooms have patio doors to the garden level.The home has three floors with a passenger lift to access all floors. There are twenty five single and five shared rooms available at the home, some of which have en-suite facilities. Specialist bathing equipment is available to support people, along with hoists to support with moving and transferring people in safety. These are regularly serviced. Care Homes for Older People Page 20 of 29 Evidence: Pressure relieving equipment such as matresses, profiling beds and cushions are provided. The fire precautions have recently been upgraded and fire tests are regularly carried oiut. Some fire exits are through residents rooms. The home has a lounge on the ground floor and a conservatory with views out over the bay leading to a decked area. There is no dining room, so people eat meals in their rooms or on tables in the lounges. The laundry was clean and clear from obstruction. The staff we spoke to told us that although busy, they managed to keep organised with the laundry. Sheets and bed linen are dealt with by a contractor outside of the home. Arrangements are in place to deal with clinical waste. The home has a part time handyman who ensures that day to day maintenance can be undertaken without delay. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staffing arrangements support people well and make sure their needs are met. Evidence: Mount Olivet provided us with information about the staffing arrangements prior to the inspection, and staff completed questionnaires for us about what it is like to work at the home. On the site visit we looked at the ways in which the home recruits, trains and supports the staff who work there. We looked at the staff files for four people employed by the home. These showed that the home follows a full recruitment procedure including taking up references and criminal records bureau checks. These help to ensure that people are being cared for by staff who are suitable to be working with potentially vulnerable people. The system also ensures equality and diversity are respected, and the home has anti discriminatory policies in place. As a care home with nursing, Mount Olivet is required to have a qualified nurse on duty 24 hours a day to meet peoples needs, which may be unpredictable or complex. The staffing compliment shows the staff have a range of skill and qualifications, with trained nurses, and care staff, over half of whom have NVQ level 2 or 3. NVQs are national vocational qualifications, which are a nationally recognised award reflecting the individuals competency in their workplace. Care Homes for Older People Page 22 of 29 Evidence: The staff that we met on duty were skilled and clear about their role. People we spoke to or who completed questionnaires told us: The staff have a lot of patience taking into account the number of clients they have to attend to The staff are caring, knowledgable and good to work with Sometimes there is a shortage of staff, but this is very rare and things are always done but it just means it takes a little longer The staff are always courteous and smiling and they create a good atmosphere Staff very attentive, helpful and always available The staff are always very friendly and smart. We looked at the training that staff recieve and the home showed us their training records and matrix to demonstrate the training undertaken. Staff certificates are on display or kept in folders. Some training is in house and registered nurses are also responsible for their own professional develoment and competency. They also have individual areas of responsibility within the home. Along with nursing and care staff the home employs an administrator, cleaning and laundry staff, kitchen staff and cooks and maintenance staff. Staff recieve a full induction programme which startes the day they commence work and continues for several weeks. Staff who completed questionnaires for us told us: I think that Mount Olivet is a credit to Torbay. Very good at moving and handling. Dealing with complex illnesses and the registered nurses pick up on when someone is not well and deal with it straight away. Pleanty of training which makes work more interesting. We look after our patients very well. Whatever they ask for we are there to help and support. I love working at the home. Matron and RGNs are very helpful and support you at all Care Homes for Older People Page 23 of 29 Evidence: times. We have activities and some of the residents go out on trips. The food at the home is good and nutritional. The home has in house training (Grayareas Ltd) and a manual handling trainer works at the home. We get to go on loads of courses. Discussion was held on mentoring systems and staff support. Regular staff meetings and trained staff meetings are held, the minutes of which were seen. 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 being well managed. Evidence: The matron/manager of the home is a registered nurse and has run the home for over 6 years. She is experienced in care home management and had a clear understanding of her responsibilities. People we spoke to or who completed questionnaires for us told us about how good she was. People said Matron is lovely- you only have to ask and it is done and The matron is brilliant. The home has a quality assurance system which includes a series of feedback questionnaires which are collated by the owner. Time is also spent talking to individuals and there are regular residents meetings where people can raise issues or suggestions. The home also has a series of internal and external audits for example on maintenance of rooms. It is understood these are collaated to form an annual development plan for the business, looking at what is working well and what can be improved, however this was not seen on this occasion. Care Homes for Older People Page 25 of 29 Evidence: Staff receive supervision at least six times a year. Supervision is a system combining professional development and performance management and should help ensure staff are working to their full potential and in a consistent fashion to support people. Records were available to detail progress made. We looked at the health and safety arrangements at the home, which help to ensure people living and working at the home are kept safe or risks are minimised. We sampled systems such as for the detection and management of fire, which were found to be satisfactory. As an example the home has individual notifications on evacuation needs of people, regular fire tests of the detection and fighting systems, and fire training for staff. Equipment is serviced on a contract, and emergency evacuation accommodation is pre-arranged. Risk assessments were sampled for some areas of the environment and safe working practices. The home should have a first aid risk assessment to determine the level of training and equipment needed. Manntenance contracts were seen for lifts hoists and electrical equipment and chemicals in use were stored in a locked area. The systems for managing monies kept in trust by the home were also seen. Some people have a small float of cash left with the administrator so that they can settle bills etc without holding money in their rooms. This was checked and found to balance in the samples seen. reciepts are kept for any items purchased. 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 6 The home should ensure that their documentation identifies all the services being provided and that the home is assured to meet the National minimum standards for intermediate care. A first aid risk assessment should be provided. 2 38 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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