Inspection on 03/04/09 for Rose Martha Care Centre

This inspection was carried out on 3rd April 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rose Martha Care Centre 02/04/08

Rose Martha Care Centre 18/10/07

Rose Martha Care Centre 23/04/07

Rose Martha Care Centre 27/04/06

Rose Martha Care Centre 18/10/05

Rose Martha Care Centre 24/05/05

Rose Martha Care Centre 05/02/05

Rose Martha Care Centre 05/07/04

Rose Martha Care Centre 10/02/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 17/07/2010.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Rose Martha Care Centre 64 Leigh Road Leigh On Sea Essex SS9 1LF     The quality rating for this care home is:   one star adequate 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: Sarah Axam     Date: 0 3 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 31 Information about the care home Name of care home: Address: Rose Martha Care Centre 64 Leigh Road Leigh On Sea Essex SS9 1LF 01702482252 01702716887 rose.martha@ashbourne.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Ashbourne (Eton) Limited care home 76 Number of places (if applicable): Under 65 Over 65 0 76 dementia old age, not falling within any other category Additional conditions: 76 0 The maximum number of service users who can be accommodated is 76. The registered person may provide the following category of service only: Care home only - Code 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 - Code OP Dementia - Code DE Date of last inspection Brief description of the care home Rose Martha Care Centre is a purpose built establishment situated in Leigh on Sea. The home is close to local amenities and access to local bus and train routes is good. The home provides residential care for up to seventy-six older people. The registration category also permits the home to provide care for older people who have dementia. The home also offers `step down`, a scheme whereby arrangements exist with the local hospital where beds are contracted for those patients who are assessed as suitable for residential care. All bedrooms have en-suite facilities for residents. The communal areas consist of two lounge and dining areas on both the ground and first floors. The home also provides a designated smoking area, visitors/hairdressing room Care Homes for Older People Page 4 of 31 Brief description of the care home and an activities room. Access to the first floor is via a passenger lift. The gardens are well maintained. The home offers parking to the front of the property. Inspection reports are readily available for visitors to the care home and are displayed in the main reception area. Upon request, prospective residents and/or their representatives can have a copy of the last report. A copy of the homes Statement of Purpose and Service Users Guide is also readily available and accessible. The range of fees is £379.00 to £421.00 for a social services bed and £525.00 to £700.00 for a private bed. Care Homes for Older People Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The unannounced site visit took nine hours to complete and was carried out as part of the annual inspection programme for this service. This visit was conducted with assistance from the manager and later on the area manager from the organisation. As part of the process a number of records relating to residents, care staff and the general running of the home were examined. The last key inspection was held on the 2nd April 2008. Ten staff, eight residents and one relative were spoken with during the site inspection. We looked at all the information that we have received, or asked for, or what the service has told us about things that have happened in the service since the last Care Homes for Older People Page 6 of 31 inspection. Prior to this site visit, CQC (Care Quality Commission) sent out surveys to all interested parties and twenty were returned to us. All information obtained was triangulated and reviewed against the commissions key lines for regulatory activity. This helps us to use the information to make judgements about the outcomes for the people who use this service in a consistent and fair way. Additionally the manager was sent an (AQAA) Annual Quality Assurance Assessment form by us (CQC) that asked how well the home is meeting the needs of the people who live at Rose Martha Care Centre, unfortunately the latest document had not been received by the home at the time of the site inspection, as a result the current AQAA held on our system was used. What the care home does well: What has improved since the last inspection? What they could do better: The statement of purpose and service user guide needs to include a more in depth description of the support and specific facilities offered to those people who have dementia. The care files need to be further developed into a more person centred approach, by incorporating residents or their representatives views and agreements to the care, which is to be provided. This information needs to be in a format that is understood by the individual. The home needs to provide better information around safeguarding, complaints, Care Homes for Older People Page 8 of 31 concerns and quality assurance feedback and to make this available to all interested parties within the home. The on going redecoration and maintenance of the rooms that are still in need of repair, need to be completed and ready for use before any new residents are admitted. The current manager needs to enrol on her NVQ 4 qualification and to start registration procedures with us. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 31 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A robust assessment process reassures prospective residents that their needs could be met before they move to the home. Evidence: Documentation around the areas of pre-assessments, risk assessments, care plans and consultation with individuals were looked through. Assessments included such issues as diets, weight, nutrition, safety, individual care needs, risks, mental and physical well being. All eight records viewed showed that they all gave sufficient detail about individual needs. Three of the relatives stated to us that they had a sufficient number of visits, prior to any placement being offered. They confirmed that consultation regarding preadmission assessments and the care plan went ahead. They also stated that they had been given sufficient written and verbal information to make a choice that the staff at Care Homes for Older People Page 11 of 31 Evidence: Rose Martha could provide a good quality of care for their relatives. Three of the residents stated to us that their relatives had visited the home for them. They said to us that they did not directly receive any brochures or information from the manager about the home prior to the move, so were reliant on their relatives or social and health workers judgement. Three new residents informed us that they were unaware that significant amounts of people who live at Rose Martha have dementia and that they had only found this out through their own observation of living there. They stated that they would have liked to have this information made available to them. The home has a statement of purpose and service user guide in place. The statement of purpose and service user guide is generally clear in describing the services it can provide, such as, accommodation, facilities, location and what the area offers, the organisation and what staff the home provides, qualifications and admissions processes, as well as, many other useful pieces of information one would want to know before making a decision. Information could also include things such as, structured activities provided, decor layout and signage used, that would all be helpful to people who specifically have dementia and would require a specific type of support. Visits either made by the staff to people, or people visiting the home, were not recorded. Information in peoples individual files also lacked information that a statement of purpose or service users guide had been sent out or provided to them. Additionally no letters of acceptance that the home and staff could cater for the individuals need were found on the eight files looked at. No intermediate care is provided. Care Homes for Older People Page 12 of 31 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can be confident that their personal care and health needs will be met. Evidence: In the eight care plans inspected, there was evidence to show us that a better standard of recording is in place since the last key inspection. In all of the care plans looked at, the information covered areas such as, weight monitoring, peoples fluid in take and nutritional needs, the likelihood of falls and what type of dementia and communication skills people held. Additionally the linking up of the records, such as, the daily notes, professional and health visits and the general recording of the changing needs in care plans and risk assessments is much improved. The care plan is now starting to be used by staff as a working document and better reflects the current care being delivered for all residents. Additionally the manager discussed with us and showed us the new care plan format that they will be using and will be implementing throughout this year. The format to be used will include to a greater extent the residents views, choices and their history. Care Homes for Older People Page 13 of 31 Evidence: All of the ten residents spoken with were very happy with the care they receive from the staff and other outside agencies. Residents stated that they felt the staff treated them with respect and did include them within decisions around their health and personal care, one person stated that, the staff are caring and competent and work hard. We saw recording from GP and DN visits and good detail about general health care for people who were confined to their rooms. The area manager has introduced a new system at night times called the check it system, which is a small scanner used by night staff to record directly into the homes and organisations computer system to record the tasks they have carried out on the night time shift. This enables the manager and area managers to observe each individual staff and the times of the care given to each resident. For example, carers record, fluids given, conversations had, changing of pads and turning of people that are confined to beds, amongst other general tasks. This system helps to ensure that all night staff are giving a consistent approach and that all assessed care and identified risks are monitored appropriately. The manager showed us that she is keen to evaluate all incidents that occur, such as, how many falls people have and where they happen. As a result of being able to analyse this information, she has been able to reduce a significant amount of falls amongst the resident group. For example by looking at such information, the manager had recognised that frequent falls were happening within one of the dinning room areas. The manager observed that this was mainly due to over crowding and people wanting to leave the area after the lunch time period. As a result and through consultation with the residents, this particular dinning room became an activity room and the room now used for the dining area is bigger. Additionally other communal areas throughout the home have been identified for dining purposes, for example, not all people wanted to sit together in the allocated dinning area, so some groups and individuals have a separate table and chairs provided where they choose to eat their meals. This makes the home feel less institutional and caters more to the specific needs of the individual. The residents spoken with stated that they felt that staff were checking with them more about the care they received in the morning and evenings, choices over their meals and they felt in general the staff seemed happier. Most residents stated that waiting times for meals and getting up in the morning had recently and significantly improved. One relative spoken with and three surveys returned, stated that staff informed them on a regular basis of any issues or concerns they may have about their relative. They Care Homes for Older People Page 14 of 31 Evidence: also felt that staff are supportive and easy to speak with. Ten staff spoken with stated to us, that they felt in general they had confidence in the new manager and felt that they could talk with her, raise any concerns and that she would listen and take these on board. They also stated that the training around the health care that had recently received benefited them in acquiring and refreshing knowledge and supported them in their understanding of their roles. Medication training has recently taken place for all staff that administers medication. Stringent audit checks on systems are used and regular in house monitoring of all staff that administers medication by means of observation and in house supervisions are implemented and consistently applied. A Monitored medication dosage system is in place for each resident. Medication is stored in lockable cabinets and trolleys. The administration records were being maintained in accordance with agreed procedures. Record sheets had been signed for with no omissions or gaps. Discussion with staff evidenced they knew procedures well and were aware of individual need. Residents who self-administered some minor medication were supported in a safe and appropriate manner. The manager showed us, that practice issue are picked up on quickly and resolved, so that all residents safety is maintained. Care Homes for Older People Page 15 of 31 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Most residents can be sure that they will be offered appropriate activities, although this may not always be the case for those with more complex issues. Evidence: Speaking with many of the staff team it is apparent that they are listening to residents views, this was seen in general observation of the staffs interaction with people. Observations by the staff of the residents moods, feeling and behaviours were better recorded in all of the eight individual care files viewed. Residents, relatives, staff and other professionals who returned surveys stated to us that, the new activities introduced are very enjoyable, My relative doesnt want to join in group or 1-1 activities very often, so the manager has provided them with sky sports in their room which they love I am happy to work here as it is being managed well by responsible staff, We give the residents a high standard of care and quality of care, There has been lots of change recently which I feel has benefited the residents. Since the last inspection another member of staff has been employed to carry out the activities coordinator role. One coordinator works Monday to Fridays 1 week of the month and Tuesday, Wednesday, Friday, Saturday and Sunday 3 weeks of the month and the other coordinator works 3 hrs per day Monday to Friday. The home provides group Care Homes for Older People Page 16 of 31 Evidence: activities such as, bingo, quizs, snakes & ladders, passing the ball to improve eye and hand coordination, scrabble, arts & crafts, poetry readings, music afternoons, reminiscence, puzzles, hairdressing and nail painting. The second part time activity coordinator carries out 1-1 chats and activities with people in their rooms. Speaking with the activity staff about the residents who have dementia, they showed us that some progress had been made. Some residents that had not previously responded to any type of activity were starting to build a rapport with staff and to show that they still had skills, such as, carrying out painting, making things, talking about their lives, experiences and sharing memories. The care staff in general informed us that they sometimes sit with individuals and chat about their present life and memories of the past. The staff will also read through a magazine or books with people. Touring the home we observed people to have radios, music and televisions available to them both in their bedrooms and communal areas. Some residents informed us that they go to the local shops to buy their choice of newspapers and things that they wanted. Some of the female residents told us that they attend The Ladies Club at St Michaels Church. One person attends the Salvation Army day centre every Wednesday. And one resident attends the Conservative Club most days for a few hours with their son. The activities coordinators arrange lunches at various local restaurants once a week. The manager is presently in the process of buying a minibus for the home. Many of the residents were very excited about this and told us that they felt they would have more opportunities to get outside and down to the sea front. There are a significant percentage of people who live at Rose Martha, that have some degree of dementia and although activities have been developed since the last inspection, this could further be improved in terms of their environment also, such as, it would be an asset for the manager to look at the general decor and signage support that would be helpful to people with dementia and would be good practice in terms of equality, inclusion and fair access to all. A new change is that the conservatory room is now used as the main activities room. This room provides a direct route to the garden and patio area. One activity that is enjoyed by many of the people that live there is the gardening project. There are raised flowerbeds where people are encouraged to plant their own choice of seeds and the wall directly behind this has been painted to depict a garden scene. The area has new seats, tables and garden furniture. This area also gives those with complex needs some type of stimulation by observation, as well as a chance to use the garden area safely and under staff supervision. In December 2008, the Food Hygiene Standards visited the home and graded the quality of food, the hygiene of the kitchen, the records kept and the nutritional value of food as good. Speaking with ten of the residents they all informed us that they had a choice of meals and thought the food was well cooked and tasty. They stated that it was presented well. Many residents notes revealed that they had put on a healthy amount of (sometimes much needed) weight since being admitted to the home. Care Care Homes for Older People Page 17 of 31 Evidence: staff kept good documentation around monitoring of diets, weights and food consumed. The lunchtime meal was observed and seen that it was freshly cooked, smelt nice and looked appealing. The tables used were laid out smartly and all residents had their preferred condiments. The lunchtime period was relaxed and supported people to eat their meals in a sensitive unhurried way. Care Homes for Older People Page 18 of 31 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Rose Martha are protected by staffs knowledge, training and understanding of safe guarding procedures and by the organisations policy and procedures in dealing with complaints. Evidence: During the site visit a complaint was made by a visitor to the home. The manager dealt with it quickly, sensitively and professionally. This visitor felt confident in approaching the manager directly. Documentation around complaints showed that there are good systems in place and that outcomes are reached to the satisfaction of all parties. No complaint or safe guarding issues have been made to us or to any other agency since the last key site inspection. Looking at training and speaking with ten of the staff on duty showed us that, they knew procedures well and knew about reporting of any kind of abuse. Ten of the people who live at Rose Martha, stated that they felt confident in raising any complaints and that they would be resolved to their satisfaction. Surveys returned also echoed this. Care Homes for Older People Page 19 of 31 Evidence: The home manager and the area manager stated that there are plans to make the local safe guarding unit contact numbers and names available to all staff and visitors and residents in all communal areas. This would make it easier for people to access this information and will show that the manager and the organisation are seen to be working in a transparent and open manner. Care Homes for Older People Page 20 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean safe environment. Evidence: Towards the front of the home the parking area, the trees and plants have all been tidied up and looks very smart and welcoming when arriving at the Rose Martha Care Centre. Additionally at the back of the house, the manager has arranged for a patio area to be laid and has also had a nice decorative fence erected around this area. There is plenty of seating and tables for residents to use in this part of the garden. This means that in the summer people can use the garden and activities room as they wish and still be kept safe and have staff support. This is a good improvement from the last site inspection. Speaking with many of the residents they enthused about being able to access the garden freely and spend the summer outside. During the tour of the building there were no apparent odours and residents rooms were all clean and well maintained. Two residents stated that, the cleaners are great and my room is kept so clean and nice. All bathrooms, showers and toilet are in good working order, clean and provide plenty of facilities for all residents to use. Care Homes for Older People Page 21 of 31 Evidence: There is a good cleaning programme in place. The management has a good infection control policy and all staff have training to encourage staff to reduce the risk of infection. Individuals rooms were clean and personalised. All residents had the necessary furniture and equipment that they needed, so that they were comfortable and individual rooms were homely. There is a lift in place to access the home fully. The manager stated to us that, the maintenance staff have been decorating bedrooms regularly. We have a few rooms that are in need of repairs, such as, decorating, carpets, curtains and new vanity units surrounding the washing basins. The quotes for this work have been sent and we are awaiting authorisation from head office. These rooms are not occupied. The residents and relatives stated that the rooms were cleaner, well kept and that if there was any kind of a problem it was quickly rectified. The residents told us that they are choosing their own colour schemes for their rooms. The member of staff, who carries out these repairs and the regular upkeep of the home, confirmed to us and showed us, that many issues around the maintenance since the last inspection had been resolved. Clearly with regular on going detail to maintenance, repairs and checks, the residents secure a better quality, safer and more pleasant surrounding both inside and out side of the home. Care Homes for Older People Page 22 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Rose Martha benefit from the care and support they receive from a competent and qualified staff team and are protected by recruitment policy and practices. Evidence: Staff are still covering long shifts according to the rota, but no agency are used on a regular basis and are only used in an emergency situation. The manager informed us that she has three new staff waiting for CRB clearance (Police Checks) and then they will be able to reduce the number of shifts that staff are presently covering. At present the home employs and has in post, 1 manager, 1 deputy, 12 seniors, 23 care staff, 2 chefs, 4 kitchen staff, 8 domestics, 1 maintenance person, 2 activity coordinators and 1 admin staff. The manager stated to us that, we have 5 vacant care positions. We have 2 part time and 1 full time waiting start dates. Despite us being not able to start them yet they are attending all their mandatory training starting next week. Speaking with staff they are aware how important it is to involve residents in every aspect of their lives. The team is starting to think in terms of getting residents to be Care Homes for Older People Page 23 of 31 Evidence: fully involved in being able to make choices, express views and have their unique communication methods understood, however this is at early stages within the team and needs further development. The manager has prioritised training that will benefit residents safety, such as, safe guarding (protection of vulnerable adults) dementia awareness, pressure care, care planning, challenging behaviour, bed rail safety, first aid, fire safety, food hygiene, moving and handling, health and safety, nutrition, medication, communication, infection control and NVQ training. Currently out of 37 care staff and 18 ancillary staff (total 55 staff), 3 senior staff have the NVQ4 qualification, 15 care staff have the NVQ 3 and 29 care and ancillary staff have the NVQ2. A total that 47 of Rose Martha staff hold the NVQ 2, 3 and 4 care qualification. This ensures that residents receive support from a well trained work force. The manager stated to us that, we are conducting Skills for care induction with new starters and this should be completed in 12 weeks. This often exceeds this time scale but they are constantly progressing in their role. Once this is completed we will enrol them on the NVQ 2. Documentation looked at and speaking with the staff confirmed to us that this was the case. Eight staff recruitment records viewed contained application forms, two references obtained, criminal records bureau checks undertaken and contracts of conditions of service and job descriptions were issued to new staff. Recently the manager has created a senior room downstairs as well as the one on the first floor. This allows all residents and staff working on the different units to have better access to seniors and provides better safety through the home for all people that live there. Staff spoken with informed us that there were verbal updates among the team, handovers, meetings, appraisals, supervisions and regular observations of staff practice. Documentation looked at within fifteen of the staff files looked at supported this. Care Homes for Older People Page 24 of 31 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well run home that ensures that their best interests are met. Evidence: Evidence was available to confirm that the service has insurance cover for the registered managers legal liabilities to employees, people using the service and third parties and this is placed along side the registration certificate within the front lobby of the home. Additionally the staff regularly practice fire drills. The manager informed us that the fire officer is due in the next couple of weeks and staff will have re-training around this. At present there is an issue with some residents who were spoken with, who do not want any type of fire guards (these keep fire doors open and are triggered to close when the fire alarm sounds) or door closures attached to their bedroom doors. (Door Care Homes for Older People Page 25 of 31 Evidence: closures would make the door very hard to use) The reason is due to issues such as, poor mobility ( the fire guards have a switch that you operate with your foot to close them if wanted) and with door closures the ability to open and access bedrooms. (door closures make the door feel very heavy) Therefore the manager will seek advice around the general mobility and safety of all residents within the home and their specific issues and regarding the type of door closures to be used for individuals. After this has been carried out, the manager will then risk assess everyone individually so that their safety is maintained if there was a fire outbreak within the home. The home has a system where all residents finance are checked and accounted for every month and an independent audit check goes ahead annually. The residents finances are well recorded and kept securely. The admin member of staff showed us on the computer system how this is accounted for and recorded. The systems in place ensure that all residents monies are protected against financial abuse. Quality assurance does go ahead annually within the home, although discussion with the manager and area manager may mean that this could change in the future. Ideas at the moment are that quality assurance and feedback forms will be made available in all communal areas and be easy to access by all residents, visitors and staff to use anonymously. This is so the service can develop a holistic approach to measuring how they are performing in terms of the quality of service they offer. At present surveys have gone out to all interested parties and this information will be collated and the outcomes recorded. A report will then be produced and made available to all. Documentation looked at in general by us and specifically related to the residents showed us that, a different style of good practice in terms of recording information, is starting to develop among the team. This was seen in residents daily notes, care files and health records. The present manager of Rose Martha has been in post since October 2008. Previous to this she has ten years experience within Rose Martha as the former deputy manager. The manager is applying for and will soon be studying the NVQ4 and RMA. (Registered managers award). She is presently qualified to a NVQ 2 & 3 in Health & Social care. The current manager also needs to be registered with us and will start to apply for this status. The manager evidenced that she has a lot of good ideas and ways in which she wants the team and herself develop the service. A large part of those plans would be a move towards residents involvement into moulding the service more than is presently the Care Homes for Older People Page 26 of 31 Evidence: case. Care Homes for Older People Page 27 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 28 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 38 4 The registered person shall ensure that - a) all parts of the home to which the service users have access are so far as reasonably practicable free from hazards to their safety; c) unnecessary risks to the health and safety of service users are identified and so far as possible eliminated. That all residents are risk assessed regarding fire evacuation procedures. This includes looking at mobility, type of door closures, general health issues and staff support needed to evacuate in the case of such an emergency occurring. 06/07/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 29 of 31 1 2 2 4 That a Statement and service user guide is to be given to all new prospective residents. When assessment is carried out that all new residents are sent a letter of offer stating that the staff have the skill, mix and experience to cater for that individuals specific needs. That when new residents are visited either by staff or they or their relatives visits the home that this is recorded within their care files. Care files to incorporate further residents views. Care plans should be written in a format appropriate to the needs and abilities of the people using the service so that they are actively able to contribute. To ensure that residents care plans evidence residents involvement and views have been sought and that a person centred approach is used. That the current manager registers with CQC and enrols on the NVQ4 in care and RMA qualification. Quality Assurance monitoring information of residents, relative and other professionals views need to be collated. The action plans with outcomes to be kept on the premises and made available for inspection and to all other interested parties. 3 5 4 7 5 6 31 33 Care Homes for Older People Page 30 of 31 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 31 of 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!