Inspection on 25/03/09 for The Heathers Nursing Home

This inspection was carried out on 25th March 2009.

CSCI 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

Similar services:

The Lodge Nursing Home

Bracken House

Sunnycroft

Field Farm House

Edgeview Nursing Home

Church Terrace Nursing & Residential Home

The Forbury

The Maples

Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Heathers Nursing Home Gorse Moor Road Heath Hayes Cannock Staffordshire WS12 3HR     The quality rating for this care home is:   two star good 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: Yvonne Allen     Date: 2 5 0 3 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 30 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 30 Information about the care home Name of care home: Address: The Heathers Nursing Home Gorse Moor Road Heath Hayes Cannock Staffordshire WS12 3HR 01543270077 01543274741 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Leyton Healthcare (No 7) Limited Name of registered manager (if applicable) Tracey Jane Burke Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of users who canbe accommodates is 53 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: Mental disorder, excluding learning disability or dementia - Code MD, maximum number of places 53 Date of last inspection Brief description of the care home The Heathers Care Home is a 53 bedded Nursing Home in Heath Hayes. It comprises of a two-storey purpose built building that was opened by the previous Proprietors in 1995 which has now been recently purchased by the above new provider. The home is registered to admit 24 Elderly people with general personal and nursing needs and 29 elderly people with dementia care needs (personal and nursing care). Care Homes for Older People Page 4 of 30 care home 53 Over 65 0 53 Brief description of the care home The current certificate specifies mental health only and will need to be ammended to include the category of OP nursing. The home is set in a rural location close to Cannock Chase. There are 48 bedrooms of which 43 are singles and five are doubles, all except two, have en-suite facilities. People have access to lounge areas, which are bright and airy, and meals are taken in the pleasant dining rooms. Access is available to a garden which has a paved area and some seating. The Philosophy of the home is to provide a personal touch, welcoming people into a caring, comfortable environment where the staff are able to give skilled nursing care, general care and companionship. Fees charged range from 388 to 550 pounds. Care Homes for Older People Page 5 of 30 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: The overall quality rating for this service is 2 STARS. This means that the people using this service experience GOOD quality outcomes. We, the commission, carried out this unannounced Key Inspection visit on 25th March 2009. This inspection took place over one day and was carried out by one inspector. The inspection process was commenced several weeks prior to the visit. All of the key minimum standards were assessed and for each outcome a judgment has been made based on the evidence we gathered. These judgments tell us what life is like for the people who live in the home. Prior to the inspection visit the Providers had completed a self-assessment tool which is known as the Annual Quality Assurance Assessment (AQAA). Completion of the AQAA is a legal requirement and it enables the service to undertake a self-assessment, which focuses on how well outcomes are met for people using the service. It was completed Care Homes for Older People Page 6 of 30 to a good standard and gave detailed information about the services offered. References to the AQAA have been made throughout this report. The ways in which we gathered evidence to make our judgments are as follows - We looked at any information we had received about the service since the last Key Inspection. We spoke to people who live in the home. We spoke with the staff who work in the home. Discussions were held with the Registered Manager of the home. We examined relevant records and documentation in the home. We walked around the home and visited all the units. We observed staff interaction with people they are caring for. At the end of the inspection visit we discussed our findings with the Registered Manager. What the care home does well: What has improved since the last inspection? The requirement to remove the dust from the back of the washers in the laundry has been addressed. The bedroom which was identified as not meeting the minimum requirements for individual space has been changed into a hairdressing salon. This has had the effect that people are no longer sitting along the corridor area under hair driers, which was posing a health and safety risk. Care Homes for Older People Page 8 of 30 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.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 30 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 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People will have their needs assessed by a representative of the home prior to being offered a place here. People are provided with sufficient information about the home in order for them to be able to make an informed decision. Evidence: In their AQAA the Providers tell us, We always welcome enquiries from prospective service users and their families and make time to show them around at any time. They also say, We answer questions honestly and we provide written information in the brochure and service users guide and encourage prospective service users and their relatives to read our most recent inspection report. They tell us, We invite prospective service users and their relatives to spend more time with us or have a meal with us if appropriate. Also they say that they have, A detailed pre-admission Care Homes for Older People Page 11 of 30 Evidence: assessment which is carried out by The Manager or the Nurse-in-Charge of the appropriate Unit. They also say that they, Collect information from other Health Care Professionals involved in the prospective service users care. We discussed the process of pre admission assessments with the registered manager of the service. She explained her role in this and told us that it is mainly herself who goes out to assess the needs of people before they are offered a place at the home. She said that sometimes another nurse will go out to do the assessment or they may even go together. The service has its own pre-admission assessment tool in place which is used to complete the assessment of needs. We saw these completed and contained in individual care plans. We met with some of the people who live in the home and their relatives who were visiting at the time and they told us Oh yes, someone from the home came out to see me before I came in. Tracy came out to see mum before she came was given a place at the home and we came for a look around the home. We had to wait for mum to come in here, because we wanted her to come to this particular home. The manager explained that the service does take emergency admissions but not without a full assessment of needs has been carried out. We saw new contracts in place at the home devised by the new Company. We saw copies of the Service User Guide and Statement Of Purpose which have been changed to reflect the new Company structure, policies and procedures. Care Homes for Older People Page 12 of 30 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 who live in the home can be assured that their personal, nursing and health care needs will be monitored and met at the home. Care will be delivered with dignity and respect. Evidence: In their AQAA the Providers tell us, We have an extensive care plan document which sets out our service users health, personal and social care needs and a plan of how we will meet these needs. They also say that Staff form good relationships with Service Users and their families which helps positive interaction. Also We provide a good support network for our Service Users and their families and we liaise closely with Community Health Care Professionals. We looked at a number of individual care plans and discussed these with some of the people who live in the home. People are pleased with the care they receive and tell us Care Homes for Older People Page 13 of 30 Evidence: that, You are treated like a Queen here and Everybody is very good here. Everybody who lives in the home has an individual care plan based on an initial assessment of their needs and people are involved in their plan of care. We noted that one of the relatives assists staff with her husbands hygiene needs and as this is documented in his care plan. Peoples personal choices and preferences are documented and people told us that these are upheld. You can have a lie in if you want to. Peoples health care needs are assessed and monitored and people have access to health care professionals such as the General Practitioner, Chiropodist, Optician, Practice Nurse, Community Matron, Continence Nurse and Tissue Viability Nurse Specialist. We spoke to a person who lives in the home about her medical and nursing care and she told us that all her needs are monitored and met by the staff at the home. I am diabetic and they test my blood sugar levels and make sure that I am alright. We saw records of this diabetic monitoring in this persons care plan. We also met a person who is nursed in bed on an alternating pressure mattress and her care plan reflected this need for pressure relief. The manager also explained that the service has good support from the Tissue Viability Nurse Specialist, who will come out to see people living in the home and give advice and treatment as needed. We also saw evidence contained in care plans of assessment and monitoring of nutritional needs. The assessment tool used for this was a little outdated and we discussed the use of the nutritional assessment MUST tool which is a more effective assessment tool. We met a person who lives in the home and has poor communication skills. The staff have assessed this persons communication needs and have devised an alphabet board which contains key words for communication. In this way the person is able to communicate his wishes and express himself. Another person is registered blind and deaf and her care plan reflects her specific needs in this area. The care of people with dementia care needs is good and care plans are specific to their particular mental health needs. One of the people we met had received a specific assessment for Alzheimers and a plan of care was drawn up with the involvement of Care Homes for Older People Page 14 of 30 Evidence: the persons representative to help to meet his needs. The Community Psychiatric Nurse (CPN) is involved in this persons care. All care staff working with people on the dementia care unit have had training in managing challenging behavior. Also a member of staff from St Georges, hospital is coming in to the home to give staff more specific training in managing the particular needs of individuals who live in the home. This will help to ensure that specific individual needs are met. We looked at the receipt, storage, administration and disposal of medication in the home. This was satisfactory apart from a recommendation to avoid handwritten prescribing on Medication Administration Record (MAR) charts. Wherever possible this should be avoided and the instructions should be printed on by the prescribing pharmacist in order to help prevent errors in drug administration. We observed and heard staff talking to people in a polite and respectful manner. Staff told us about how they promote dignity and respect at the home. Care Homes for Older People Page 15 of 30 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. Lifestyles in this home are flexible and varied and people can be assured that their personal choices and preferences will be upheld wherever possible. People can be assured that the home will help to meet their diverse needs. Evidence: In their AQAA the Providers tell us that they provide the people who live in the home With social interaction appropriate to each individual person. They say that they Provide a variety of entertainment and a good choice of outings. These include Visits from entertainers, school and nursery groups, religious groups and therapy animals. They also Provide a choice of meals and drinks. We met people who live in the home and talked to them about what life is like there, the choices available to them and the meals on offer in the home. They were all very positive about life in the home. We received the following comments from a person who lives in the home I can please myself where I have my meals. We have very good Cooks here with me Care Homes for Older People Page 16 of 30 Evidence: being diabetic they know what I can have. There is always a choice and alternatives. When we looked in care plans we saw likes and dislikes documented including such things as preferred retiring and rising times. Also preferred hobbies and interests are documented in Social Assessments and a Map Of Life is completed which takes into account the persons previous occupation and lifestyle. We met one of the people who live at the home who is registered blind and who enjoys playing the keyboard in the home. This was documented in this persons Social Assessment together with the fact the he likes to walk outside with someone holding his hand. We also met another person who is both registered blind and hard of hearing. It was documented in this persons care plan how staff need to address this including sitting and holding this persons hand and reassuring her. Another person told us that he does not really get involved with activities but prefers to stay in his room and watch his television. The activities coordinator assesses peoples abilities and preferences for activities and we saw these assessments contained in peoples care plans. Good records are maintained which evidence peoples participation in activities and entertainment. The activities coordinator has completed a training course in social and therapeutic activities for older people at the local university. This helps her to understand and meet the social needs of people living in the home. Peoples spiritual and religious needs are assessed and people told told us that representatives from the following Churches visit the home regularly, the Catholic Church, the Church Of England and the Salvation Army. One person is a Jehovahs Witness and is assisted to take a taxi to her Church (Kingdom). People living in the home enjoy regular trips out. These have included visits to Shugborough Hall, The Monkey Sanctuary at Trentham Gardens, the Sea Life at Birmingham and two canal boat trips are planned for this year. Special events and days are celebrated including a recent Burns Night celebration. There are plenty of photographs around the home of trips out and activities which people have taken part in. Care Homes for Older People Page 17 of 30 Evidence: Entertainers also visit the home including Pat Dog and Donkey therapy. The service provides a budget for activities which helps to fund some of the entertainment. New flat screen televisions have been installed in the lounges for the benefit of people who live in the home. Health and Social Care students come to work at the home for their work experience and assist the activities coordinator in delivering the programme of activities and entertainment. Beauty students also work at the home and deliver beauty therapy to people. People go out to do shopping individually with a carer. A person who lives in the home told us that she enjoys this. The Mobile Museum Bus comes around and visits the home from time to time. We observed lunch being served on both units. This was relaxed and appeared an enjoyable event. Staff help people who are unable to feed themselves plus assist others with theirs. People were observed eating different meals and alternatives to the main menu plus some people were having the soft diet menu. On the dementia care unit we were shown the new pictorial menu booklet which has been devised to help people with reduced capacity to choose which meal they would like. We noted that there were no tablecloths on the tables on the dementia care unit and it is recommended that these be put on to help make the dining experience more homely and conducive to dining. We spoke with the Cook who explained how the kitchen staff ensure that people are served the meals they prefer and how special diets are catered for. Care Homes for Older People Page 18 of 30 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 who live in this home can be assured that any concerns they might have about the home will be listened to and taken seriously. The systems in place at the home help to ensure that people are kept safe. Evidence: In their AQAA the Providers tell us that Verbal complaints are dealt with quickly and we welcome an open relationship with our Service Users and Visitors so that they feel able to talk to us about any issues, no matter how small. They say that Written complaints are dealt with as per the Complaints Procedure. We, the Care Quality Commission, have received one complaint about the home prior to this inspection visit. This was regarding the pre admission assessment process and meeting of needs. We have looked at the issues raised during this visit and are satisfied that the assessment process and meeting of needs in the home is good. We saw the complaints procedure displayed prominently in the home and this is also contained in the Service User Guide. We spoke to people in the home and they told us, If I had any complaints I would speak to Tracy and I know that she would sort it out and I dont have any complaints Care Homes for Older People Page 19 of 30 Evidence: but I could go to Amy of the girls or Tracy. We saw the log of complaints which is maintained by the manager It was documented that on 17/10/08 the responsible individual of the service investigated a complaint with a satisfactory outcome given back to the complainant. An anonymous complaint about staff was received on 20/10/08 and the manager Tracy met with staff and talked to them about it. Again a full report investigation was completed and sent to the complainant. The service has policies and procedures relating to Safeguarding people who live in the home. The manager Tracy confirmed that she had recently instigated a Protection Of Vulnerable Adults (POVA) incident about a nurse who worked for the service. The outcome was that the nurse was dismissed and the incident referred to Nursing and Midwifery Council (NMC). The service also has a robust recruitment procedure where staff are carefully selcted to work at the home. This helps to protect people who live in the home from harm or abuse. We spoke with staff about the Safeguarding and Whistle blowing policies and staff are aware of these and know what to do in the event of abuse or poor practice. Staff are given training in this area and we saw records of this. Care Homes for Older People Page 20 of 30 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 well presented and adapted to meet the needs of people who live there. Evidence: In their AQAA the Providers tell us, We provide a homely and relaxed atmosphere and upkeep and repairs are carried out promptly. Also Interior decoration and garden areas are maintained. We walked around the home and found the environment to be clean, well presented and homely. Bedrooms have been personalized and adapted to meet the needs of the people living in the home. We spoke to a lady whose bedroom is very personalized with lots of her own items such as books and DVDs. We also met a person who is registered blind and his bedroom is very much adapted to meet his needs. We met another person who is blind and deaf and at risk of falling out of bed. Her bedroom is completely adapted to her needs with cushion flooring and a low bed. The service has an ongoing programme of redecoration and refurbishment and we saw that some of the bedroom furniture has been replaced. There is still a need to continue this refurbishment programme as other bedroom furniture we saw is looking worn and Care Homes for Older People Page 21 of 30 Evidence: and in need of updating. On the second floor dementia care unit one of the window seals had gone on the double glazed window in the lounge and this was misted up. This glass should be replaced to enable people to be able to see clearly out of the window. The service has had an independent bed and mattress audit carried out with replacement of these as required. We saw a person who is nursed in bed. Her room is very pleasant with lovely wallpaper chosen by her family and hanging decorative mobiles. The lounge on the dementia care unit has been attractively redecorated since the last inspection. The service has infection control policies and guidance in place and undergoes inspections from Environmental Health department. Staff confirmed to us that they had received training in infection control and we saw the records of this training. The service also has access to the advice and guidance from the Health Protection Agency Nurse. Care Homes for Older People Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in this home are cared for by a skilled and competent staff team who are trained to meet their needs. Evidence: In their AQAA the Providers tell us Our Home is staffed above the minimum required levels and we provide flexibility to our employees. They tell us that We staff our Units separately to maintain consistency and we only use agency staff during sickness, and then only rarely as our own staff will change shifts or pick up extra to cover wherever possible. We select and recruit appropriate staff for their role. We discussed the staffing arrangements for the home with the registered manager and were shown copies of the staff duty rota. This appeared satisfactory for the occupancy and dependency levels in the home at the time of the visit and the manager stated that she adjusted staffing levels accordingly as needed. There is a good skill mix of staff provided at the home and nurses in charge of each floor. On the dementia care unit a Registered Mental health Nurse (RMN) was in charge and she was supported by four care staff. On the general elderly care nursing unit on the ground floor there was a State Enrolled Nurse (SEN) on duty supported by four care staff. The registered manager was also on duty to give support and advice to Care Homes for Older People Page 23 of 30 Evidence: staff. There is a full time activities coordinator who works between both floors. There is a team of domestic staff who keep the home clean and staff the laundry, washing peoples clothes and general washing.. There is a Cook and team of kitchen assistants who cook all the meals. There is a maintenance person who is responsible for the general maintenance of the the home including maintaining equipment used at the home. There are administration staff who are responsible for secretarial and administration duties. We looked at how staff are recruited by talking to staff about this process and looking at their recruitment files. The recruitment process is robust and staff undergo checks to ensure that they are safe to work at the home. These checks include Criminal Records Bureau (CRB) checks and Protection Of Vulnerable Adults (POVA) checks. Two written references are also obtained and employment history is examined. Staff also have to have the necessary qualities to be selected to work at the home. People who live at the home think that the staff are very good The care is wonderful here, you are treated like a queen. We have very good cooking staff. The staff are great and all very caring. The service has an effective staff training and development programme in place. Staff training is based around meeting the needs of the people living in the home. This training includes subjects such as, Managing Challenging Behaviors and Dementia Care. Also Diabetes Care, Equality and Diversity, Palliative Care and on going NVQ training in Care and also Customer Service. We spoke to staff about their training and they told us This is a good home to work for and We are very well supported and there is always plenty of training. We looked at staff training records and they confirmed the above. Care Homes for Older People Page 24 of 30 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. This is a very well managed home and people have a voice and are listened to. The home is run in the best interests of the people who live there. Evidence: In their AQAA the Providers tell us that, The Manager continues to have a good rapport with staff, service users and visitors. They say that Staff, service users and visitors are encouraged to discuss any issues with the Home Managementand that Facilities, procedures and documentation are in place to ensure the safe keeping of Service Users monies and other valuables. We discussed the management of the home with Tracy the Registered Manager. Tracy has been manager of this home for many years now and is well respected by people who live in the home and the staff who work there. There is a history of good management of the home and, even though there has been a change in Providers recently, the management of the home has not faltered. Care Homes for Older People Page 25 of 30 Evidence: The manager is supported by a Deputy Manager and a team of nurses. She is well qualified for the job and keeps herself updated. The manager says that she runs an open door policy and this was confirmed when we spoke to people who live in the home and staff who work there. They all feel supported by the manager and able to approach her about any concerns. The manager is very effective at record keeping and her records of complaints and the management of these, including the outcomes, is good. People feel that they are listened to and that any suggestions they have are taken seriously. We saw evidence of this contained in minutes of residents and relatives meetings. We also saw where the views of people who live in the home have been obtained and improvements made as a result of suggestions by people. The service runs an effective Quality Assurance programme. Each month the home is visited by a representative of the Company, (usually the Regional Manager) who completes a short inspection report about the home as per the requirement under Regulation 26 of the Care Standards Act. We saw these reports maintained in the home. Regular audits are undertaken by the registered manger and the regional manager. These include audits of personal allowances, medication, care plans, and an external audit of beds and mattresses. The service also obtains peoples views about the home by sending out questionnaires and we saw this together with actions taken. We looked at the maintenance of personal allowances and found this to be safe and transparent. Receipts are kept and signatures for expenditure are in place. The service has a Health and Safety Statement in place with many relating policies and procedures. People have individual risk assessments carried out and there are also generic risk assessments in place for people to refer to. We looked at the records of servicing and maintenance of equipment. We also looked at staff mandatory training records and these are well maintained. The service is inspected by the Fire safety officer and Environmental Health Officer and there are no outstanding issues from their last visits. Care Homes for Older People Page 26 of 30 Care Homes for Older People Page 27 of 30 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 30 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 8 Another assessment tool should be used for the assessment of nutritional needs such as the MUST tool. This will help to ensure that nutritional needs are more easily identified, monitored and met. Wherever possible handwritten prescribing on MAR charts should be avoided and the instructions should be printed on by the prescribing pharmacist in order to help prevent errors in drug administration. It is recommended that table clothes be put on to the tables in the dementia care unit to help make the dining experience more homely and conducive to dining. That the glass in the window in the lounge on the second floor unit is replaced. The seal has gone on the double glazed unit and people are unable to see out. To continue with replacement of bedroom furniture as some of this is now in need of updating. 2 9 3 15 4 19 5 19 Care Homes for Older People Page 29 of 30 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. 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