Inspection on 29/07/09 for Portland House

This inspection was carried out on 29th July 2009.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Portland House 31/07/07

Portland House 03/07/06

Portland House 17/11/05

Portland House 11/05/05

Portland House 02/12/04

Portland House 23/04/04

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 15/11/2009.

Key inspection report Care homes for older people Name: Address: Portland House 11 Portland Road Hove East Sussex BN3 5DR     The quality rating for this care home is:   two star good 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: Jennie Williams     Date: 2 9 0 7 2 0 0 9 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) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Portland House 11 Portland Road Hove East Sussex BN3 5DR 01273325705 01273738260 manager.portland@vigcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Beant Kaur Vig,Mr Joginder Singh Vig care home 40 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 who can be accommodated is: 40 The registered person may provide the following category/ies of service only: Care home with nursing - N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - OP Date of last inspection Brief description of the care home Portland House is a care home registered for forty (40) places for people of either gender, aged sixty-five (65) years or over on admission. Nursing care is provided at this service. The home is located in a quiet residential area in Hove. The registered providers own several care homes throughout the South of England, predominantly older people services. The home is a large detached home that provides accommodation over two floors. There is a lounge area on both floors of the home and a communal room in the Care Homes for Older People Page 4 of 29 Over 65 40 0 Brief description of the care home basement that can be used if needed. There is a passenger shaft lift at the home to assist residents accessing all areas of the home. There are ramps or chair lifts in other areas for those unable to mobilise on steps. There are seven rooms for shared occupancy, of which three are provided with en suite facilities and twenty-two rooms for single occupancy, of which ten are provided with en suite facilities. The home generally accommodates only thirty-six people. There are suitable communal toilet facilities. There are two assisted baths and a wheel in shower on the ground floor and an assisted bath on the first floor. Four of the en suites have baths provided, however these are not assisted and are currently not suitable for use by the residents residing in these rooms. Weekly fees range from £314 to £600 per week. There are additional fees; hairdressing, chiropody and newspapers/magazines. This information was provided to us on the 22 April 2009. 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: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: It has been identified that service users prefer to be called people who use services. For the purpose of this report, people who use the service will be referred to as residents. This site visit was facilitated by the Registered Manger. The last key inspection was undertaken on the 31 July 2007 and an Annual Service Review (ASR) was undertaken on 31 July 2008. This unannounced site visit took place over seven hours on the 29 July 2009. Evidence obtained at this site visit, previous information regarding this service and information that we have received since the last key inspection forms this key inspection report. An annual quality assurance assessment (AQAA) was sent to us by the service, completed on the 22 April 2009. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. The AQAA was completed by the Registered Manager and returned when we asked for it. Thirteen residents were involved in the inspection process via discussions with us or Care Homes for Older People Page 6 of 29 through observation. Ten surveys were sent to the home prior to our visit, of which all were returned. We noted three were completed independently by the resident and all others were assisted by a relative/friend. One care plan was viewed and specific areas of care looked at in a further ten care plans. We had discussions with two visitors. Seven staff were involved in the inspection process via discussion with us or through observation. Ten staff surveys were sent to the service prior to our visit. All were returned. Three staff files were inspected. A training matrix and training records were viewed. Medication procedures were looked at. Some individual rooms were viewed, along with communal areas. The quality assurance system, complaint records and quality monitoring checks in place were viewed/discussed. There were 32 residents residing at the home at the time of this site visit. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: Any minor shortfalls noted at the site visit, of which no requirement or recommendation has been made have been highlighted throughout the report. Some areas of improvements are: to ensure it is reflected when the care need of an individual changes, action must be taken to ensure information relating to individuals is kept confidentially at all times, introduce procedures to ensure that pressure relieving mattresses in use are set at the correct settings as per the manufacturers guidelines to ensure effective use and to provide more outings for residents. Care Homes for Older People Page 8 of 29 Written comments from residents on what they thought the home could do better were: more activities and outings, if time permitted a little more conversation with patients and more staff available to talk and socialise with residents. The AQAA identifies that they are committed to making further improvements and ensures the views of residents are included in future plans. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The pre admission process ensures that only residents whose needs can be met at the home are admitted. Evidence: The home has a Statement of Purpose and Service Users Guide that provides prospective residents with information regarding the services and facilities provided at the home. Eight of the resident surveys received identified that they received enough information before they moved in to help them decide if this home was the right place for them. There was evidence of a pre admission assessment having been undertaken prior to a resident being admitted. A resident admitted at the time of the site visit was observed to be supported and reassured by staff. The Registered Manager or a registered nurse will undertake the pre admission assessments of any prospective resident. Care Homes for Older People Page 11 of 29 Evidence: The Registered Manager confirmed that there was no one residing at the home from any minor ethnic community, social/cultural or religious groups with any specific needs or preferences. Where an individual has limited English communication, there are measures in place to assist with communication. Staff are also familiar with this individuals communication method and family members assist with communication needs when medical attention is required. Prospective residents are encouraged to visit the home prior to moving in to meet staff and other residents and to see if the home will meet their expectations. A relative confirmed that they came to visit the home prior to their family member being admitted. The home does not have dedicated accommodation to provide intermediate care. Respite care is available if there is a spare place available. 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 needs are being met at the home with the information contained in care plans. Residents are safeguarded by medication procedures. Evidence: One care plan was viewed in detail and specific areas of needs were observed in a further nine care plans. There was evidence that there is guidance in place for staff on how to meet the assessed needs of individuals and care plans are reviewed on a monthly basis or earlier if the needs change. It was observed on the day of the site visit that care plans are initially devised on the day of admission with involvement from the individual resident. A resident and a visitor confirmed that staff discuss care with them. Eight resident surveys identified that they always receive the care and support they need, two identified they usually receive this support. All staff surveys identified that they are always given up to date information about the needs of residents. A written comment from a relative was good involvement in care planning. It was observed that care plans continue to be kept on an open shelf within the home. This was highlighted at the last site visit. As staff are not always present within this Care Homes for Older People Page 13 of 29 Evidence: area, action must be taken to ensure information relating to individuals is kept confidentially at all times. We were able to access information freely. There was evidence that where a risk had been identified, a care plan was in place to provide guidance for staff on how to reduce the risk to promote the safety of the individual. A Quality Review Nurse from the local purchasing authority undertook a clinical quality review in March 2009, of which the home was happy to share their report with us. These reports advise the home on areas for improvement and provide them with an action plan and timescales within which to comply. The last report from the Quality Review Nurse identified some shortfalls that the home is addressing. The quality review nurse monitors the home to ensure the action plan is complied with and improvements are maintained. Whilst it was observed that care plans are generally being updated as needs change, there was no date to identify when the information was changed. This was particularly noted with wound dressing care plans. The home must implement a procedure to ensure that it is clear when the needs or care for an individual changes. Staff are crossing out previous entries. Action must be taken to ensure that previous information can still be clearly read, as this information may be required at a later date. There was evidence that professional advice is sought from health professionals when the need arises. Eight resident surveys identified that the home always makes sure they get the medical care they need, two identified they usually receive medical care. Evidence was seen of a care plan having been updated following advice from a health professional. The home must introduce procedures to ensure that pressure relieving mattresses in use are set at the correct settings as per the manufacturers guidelines to ensure effective use. There may be a detrimental effect on an individuals well being if this practice continued to go unnoticed. The Registered Manager assured us that this would be addressed immediately. Some written comments from resident surveys relating to care at the home were: there is always someone I can contact, especially if I am not feeling well and this is attended to in very good time, I feel I always get all the help I need and very caring towards residents. When asked what they felt the service does well a relative had written Communication - referrals to GP and other practitioners. Nursing care very Care Homes for Older People Page 14 of 29 Evidence: good. There was evidence that medication procedures in practice safeguard residents. Staff administering medicines have received training for this. Medication Administration Records (MAR) charts identified that medicines are signed for when administered. Hand written prescriptions on MAR charts were seen to double signed by staff that are medicine trained to further safeguard staff and residents from errors being made. There was evidence that accurate records are being maintained of controlled drugs. Written information was provided the day after the site visit that the pharmacist company they use visited the home and confirmed that their controlled drugs cabinet met current regulations. Staff were observed to have a good professional rapport with residents and were heard to be calling them by their preferred term. Of the residents asked, all confirmed that they felt their privacy and dignity are respected. Written comments on staff surveys demonstrated that they were proud of the achieving accreditation for use of the Gold Standard Framework (GSF), which is a framework/tool to deliver a gold standard of care for all people nearing the end of life. The quality review nurse report identified despite having achieved this, the home did not have advance care plans in place for all its residents, however wrote that the home manages end of life care to a very high standard. 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 lifestyle within the home is their own choice and residents are provided with sufficient stimulation to fulfil their interests and needs. Choices and preferences are catered for at meal times. Evidence: There is an activities co-ordinator employed at the home between 15 to 18 hours per week. The activities person also completes social care plans for residents. There is a varied activities programme provided at the home. The activities co-ordinator confirmed that she also arranges people/entertainers to visit the home and has systems in place to ensure individual religious/spiritual needs are met. It was confirmed that individuals who remain in their rooms either by choice or due to medical reasons are visited on a one to one basis. Resident surveys identified that three residents felt that there were always activities provided at the home, five stated usually and one identified sometimes there are activities provided that they can take part in. For a resident spoken with, they could not identify anything else that the home could offer. Care Homes for Older People Page 16 of 29 Evidence: It was reflected in resident surveys and also on discussion with people that more outings could be arranged and more time for staff to spend talking with residents. We were informed that outings are limited due to financial constraint placed on the home from the providers. When asked what the home could do better the surveys identified that people had written More activities and outings. More staff available to talk and socialise with residents, if time permitted a little more conversation with patients and to spend a little more time to talk as staff tend to come in and do whatever is necessary and dash off. This is for the Registered Manager to address within the service to ensure social needs of residents are fully met. Visitors are encouraged to visit the home and there are no visiting restrictions imposed. Residents are able to receive visitors in private if they wish. Visitors spoken with confirmed that they are welcomed at the home and are able to visit at any time. We observed a visitor being warmly welcomed into the home and offered tea/coffee on arrival. Residents were observed to be enjoying their lunch time meal on the day of the site visit and residents were complimentary about the food provided at the home. Some residents confirmed that they are provided with a choice. A staff member was heard to give residents a choice in what they would like to drink. All resident surveys identified that they always/usually liked the meals at the home. Staff were observed to be available to offer discreet assistance to those requiring help with meals. The AQAA identified that variations of meal times have been introduced in order to allow more time for residents to be assisted where needed. This was changed as a result of listening to people who use the service. 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. The majority of residents know how to make a complaint, reassuring those involved that they are being listened to and that action will be taken, if necessary. Safeguarding Adults procedures ensure residents are safeguarded. Evidence: There is a complaints procedure available at the home. Eight resident surveys identified that there is someone they can speak to informally if they are not happy and seven know how to make a formal complaint. A resident confirmed that they would feel comfortable to raise any concerns. The AQAA identifies that there have been four complaints made to the service in the last 12 months of which all were upheld and resolved within 28 days. An additional two complaints had been received between completing the AQAA and this site visit. A copy of all correspondence is kept and there was evidence that the home has investigated complaints in a non biased manner and takes action where necessary to ensure issues are resolved. It was recommended to the Registered Manager that a summary of complaints and outcomes be kept. This will assist him in accumulating information and outcomes for the AQAA when we next ask for it. All staff surveys identified that they knew what to do if someone raises concerns about the home. Care Homes for Older People Page 18 of 29 Evidence: Staff receive training in Safeguarding Adults and it was confirmed that this includes whistle blowing. There are plans to have a representative for the registered providers to be accredited for this training. The AQAA identifies that there has been three Safeguarding Adults investigations within the last 12 months. We have information that there have been four. Information identified that the home raised the alerts, evidencing that they are committed to ensuring residents are safeguarded. Two allegations were unsubstantiated and one was inconclusive. One alert was not related to practices within the home but an alert raised by them, this was substantiated. The ASR undertaken last year identified that information was shared with us from social services advising that they had received information raising 44 separate issues within the home, of which some fell within the remit of Safeguarding Adults. Social services had referred these concerns to the provider to investigate. We were told that the overall outcome was inconclusive; however recommendations were made to the home following a case conference of which the Registered Manager confirmed that all had been addressed. 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. Residents live in a homely environment and are provided with comfortable indoor communal facilities and their private accommodation personalised to suit their taste. Evidence: The last inspection report identified that the outcome for residents within the environment was good. The AQAA identified that there have not been any major changes made to the environment since the last inspection. Whilst walking around the home, it was noted that the home continues to be well maintained. The AQAA identifies that some improvements they have made in the last 12 months are: all room doors have magnetic fire closures, carpets in rooms have been changed when necessary, dining rooms have been made more appealing and items such as bedside lights, cutlery and crockery have been replaced and updated. Their plans for the next 12 months are to continue to redecorate interior and exterior areas of the home. Some residents were happy for us to visit their individual rooms and these were seen to be personalised to reflect the individuals choice and character. The AQAA identifies that all staff have received training in prevention and control of infection and they have an action plan to deliver best practice in prevention and Care Homes for Older People Page 20 of 29 Evidence: control of infection. There is alcohol gel located at the entrance and throughout the home for people to use to assist in promoting infection control. All of the residents surveys received identified that they always/usually find the home fresh and clean. Some written comments received were: good hygiene standards on the whole, good laundry service, and rooms and all public areas are clean and free from any offensive odours. The cleaner confirmed that there is enough equipment provided for them to undertake their duties and are provided with training relevant to their role. 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. Residents needs are being met with the skill mix of staff on duty. Residents are safeguarded by recruitment procedures. Evidence: The last inspection report identified that the outcome for residents was good in relation to staffing. The AQAA identifies that three care staff/registered nurses have left employment in the last 12 months. This low turnover of staff assists in promoting continuity of care. We observed a relaxed atmosphere within the home when visiting. The AQAA identifies that 15 care shifts have been covered by temporary staff or staff from an agency in the past three months. Eight staff surveys identified that there is always enough staff on duty to meet the needs of residents, two thought usually there is enough staff. Six resident surveys identified that staff are always available when needed, three felt they are usually available and one identified sometimes they are available. Nine of the resident surveys identified that staff always/usually listen and act on what they say. Some written comments regarding staff at the home were: very caring towards residents, welcoming and will listen to requests and act upon these well when asked for by relatives, most of the staff are friendly and staff are under a lot of pressure., but they are always pleasant and ready with a smile. We received other positive Care Homes for Older People Page 22 of 29 Evidence: comments from residents and visitors regarding the staff throughout the site visit. The AQAA identifies that changes have been made in shift times/patterns so that there are more staff on duty at peak times. The Registered Manager confirmed that staffing numbers are calculated on a needs basis and are regularly reviewed. As identified earlier in the report, some people have commented that more time for staff to spend talking with residents could be an area for improvement. These comments were shared with the Registered Manager who will look into ways of improving this. The AQAA identifies that all people who have started work in the home in the last 12 months have satisfactory pre-employment checks. Staff surveys identified that their employer carried out employment checks prior to them starting. Three staff files viewed evidenced that robust recruitment procedures are in place to safeguard residents. All recruitment checks were undertaken prior to an individual commencing employment. There was evidence in staff files of training being provided. Six staff surveys identified that they are provided with training that is relevant to their role, helps them to understand and meet the individual needs of residents, keeps them up to date with new ways of working and gives them enough knowledge about health care and medication. Four staff did not answer this question in full. The majority of staff surveys identified that staff felt they always/usually have enough support, experience and knowledge to meet the different needs of people who live at the home. Following advice from the Quality Review Nurse, the Registered Manager has developed a training matrix to assist in ensuring all staff are kept up to date with all mandatory training. The AQAA identifies that there are ten permanent care workers of which all have undertaken induction training as recommended by Skills for Care. Seven permanent care staff have National Vocation Qualification level 2 or above. Care Homes for Older People Page 23 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from the home being run by an experienced and dedicated Registered Manager who ensures that the home is run safely and in the best interest of residents. Evidence: The Registered Manager has worked at Portland House since March 2003. He has the relevant knowledge, qualification and experience to manage the service. He is a registered nurse with current registration with the Nursing and Midwifery Council (NMC) and has completed the Registered Manager Award course. The Registered Manager confirmed that he keeps himself up to date with changes in practice via prep required for continual registration with the NMC, magazines, attending courses and viewing information via the internet. Eight staff surveys identified that the manager meets with them regularly to give support and discuss their work. Two identified he often meets with them. It was observed at the site visit that staff are aware of roles and responsibilities within the Care Homes for Older People Page 24 of 29 Evidence: service and an allocation of work rota was observed to be kept near the care staff station that clearly identified areas of responsibilities. A written comment on a resident survey showed We commend the manager for his running of a caring, well ordered establishment and readiness to deal promptly with any concerns that may arise. There is information available at the home regarding Deprivation of Liberty Safeguard (DOLS) to ensure staff are familiar with new legislation. The Registered Manager and senior staff attend training sessions and cascade the information to other staff. There was currently no application for authorisation being processed. The AQAA identified that there are numerous procedures implemented within the home to provide an opportunity for residents to have their say about the service. Some examples of changes made as a result of listening to people who use their service are: to have menus correspond with the white boards in the lounges, choice of foods at supper time, variations of meal times in order to allow more time for residents to be assisted, reviewing seating arrangement in the lounges and typing up minutes of meetings to give to resident/relatives. Surveys are given to residents, relatives and stakeholders at least annually and this information is analysed and used in future planning for the home. Resident/relative and staff meetings are held quarterly to obtain feedback and discuss ways of improving the service. Recent results are available for viewing at the entrance of the home and these were seen to show that residents/relatives are overall satisfied with the care provided at the home. The home has just implemented surveys for staff. These results were currently being analysed. The home has various internal monitoring systems in place and monthly visits are now undertaken by a representative for the registered providers to assist in ensuring the home is meeting its aims and objectives. The AQAA contained the information we needed. It identifies areas in what they could do better, how they have improved in the last 12 months and their plans for improvements in the next 12 months to ensure outcomes for residents are maintained and improved upon. The home is currently holding personal allowance for one individual. Records were unable to be viewed as the Registered Manager did not have the key at the home. He offered to go and collect it, however we had no cause for concern that accurate records are not maintained, so did not require him to leave the service to collect the key. Care Homes for Older People Page 25 of 29 Evidence: It was confirmed that regular health and safety checks are undertaken and the AQAA identifies that equipment in use has been serviced or tested as recommended by the manufacturer or other regulatory body. The homes fire risk assessment has recently been reviewed. The AQAA identifies that they have written assessments on hazardous substances, Control of Substances Hazardous to Health (COSHH). The fire alarm went off unexpectedly and it was observed that staff are familiar with the safety procedures to take in the event of the fire alarm sounding. This was observed to be managed calmly and all fire doors we were near were observed to automatically close. 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: 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. Copyright © (2009) Care Quality Commission (CQC). 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. 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