Inspection on 05/08/09 for The Oaks Care Home

This inspection was carried out on 5th August 2009.

CQC found this care home to be providing an Good 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

The Oaks Care Home 23/08/07

The Oaks Care Home 28/02/06

The Oaks Care Home 28/10/05

The Oaks Care Home 21/03/05

The Oaks Care Home 27/04/04

The Oaks Care Home 18/12/03

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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 Oaks Care Home 15 - 25 Oaks Drive Lexden Colchester Essex CO3 3PR     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: Louise Bushell     Date: 0 5 0 8 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 32 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 32 Information about the care home Name of care home: Address: The Oaks Care Home 15 - 25 Oaks Drive Lexden Colchester Essex CO3 3PR 01206764469 01206764468 theoaks@new-meronden.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): New Century Care (Colchester) Limited care home 61 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: All new staff to undertake training in palliative care by a recognised authority within three months of appointment. Details of training must be recorded on their individual training and development profile One person, aged 56 years of age, who requires care by reason of a physical disability, whose name was provided to the Commission in August 2006 Persons of either sex, aged 60 years and over, who require nursing care by reason of a physical disability (not to exceed 3 persons) Persons of either sex, aged 65 years and over, only falling within the category of old age (not to exceed 34 persons) Persons of either sex, aged 65 years and over, who require nursing care by reason of a Care Homes for Older People Page 4 of 32 Over 65 34 61 0 4 physical disability (not to exceed 61 persons) The total number of service users accommodated in the home must not exceed 61 persons Date of last inspection Brief description of the care home The Oaks Care Home provides nursing and personal care with accommodation for up to 61 older people, including 3 service users aged 60 years and over with a terminal illness. The Oaks is owned by a private organisation named New Century Care (Colchester) Limited. The home is located in a residential area within walking distance from the centre of Colchester. The home is a single -storey building that was purpose built and has been extended to accommodate a small second storey. There are 57 single en-suite bedrooms on the ground floor and a further 4 single ensuite bedrooms on the second floor that are accessible by stairs and a lift. The home offers large communal areas. The home has surrounding well-maintained gardens that are partially accessible to wheelchairs. The home is accessible by car and the nearest railway station is in Colchester a short bus drive away. Parking is available for staff and visitors in the adjacent car park. Care Homes for Older People Page 5 of 32 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 focus of the inspections undertaken by the Care Quality Commission is based upon outcomes for the people who use the service and their views of the service provided. The primary method of inspection used was case tracking which involved selecting four people and tracking the care they received through looking at their care records, discussion where possible with the people who use the service, the care staff and observation of care practices. The visit was unannounced and planning for the visit included assessment of the notifications of significant events, which had been received from the service to the Care Quality Commission. We looked at the last Inspection Report and information on safeguarding and complaints since the last inspection and we looked at the feedback received from Care Homes for Older People Page 6 of 32 questionnaires circulated to relatives, staff and people who use the service. We also reviewed the recent Annual Quality Assurance Questionnaire (AQAA) that was sent to us from the service. This document outlines how the service believes it meets the National Minimum Standards, what improvements they have made and what areas they feel they need to develop. The AQAA is a legal document that the service must produce annually. The visit took place between 09:15am and 17.:00pm. This enabled us to directly and indirectly observe the care practices and the day to operations of the service. A selected tour of the building was conducted and we spoke with people who use the service, staff, any visitors and the Registered Manager. The fee range for the people who use the service is dependant on the individual needs of the person. Additional costs include personal news papers, chiropody and hair care appointment and any additional personal items as the individual may require. What the care home does well: What has improved since the last inspection? What they could do better: The service must ensure that all medications with an as and when required statement have additional administration guidelines in place, in order for staff to follow to ensure they are being administered as prescribed and recommended by the GP. Care Homes for Older People Page 8 of 32 The fire risk assessment and building plans must identify where oxygen is located. 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 32 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 32 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 who use the service can expect that their assessed needs can be identified. Evidence: The service has developed a Statement of Purpose, which sets out the aims and objectives of the service, and includes a guide, which provides basic information about the service and the specialist care that is available. The documents detail what the current and prospective people using the service can expect and gives a clear account of the specialist services provided, quality of the accommodation, qualifications and experience of staff and how to make a complaint. All people who use the service are given a copy of the guide. When requested the service can provide a copy of the statement of purpose and guide in a format which will meet the capacity of the individual. One person using the service stated, when i moved into the home the manager visited me and told me all about it, my daughter also helped. Care Homes for Older People Page 11 of 32 Evidence: Admissions are not made to the service until a full needs assessment has been undertaken. A skilled and trained person always completes the assessment prior to admission to the service. The assessment format was detailed and appropriate to the policy and procedure in place. The assessment explored areas of diversity including preferences, religious and cultural needs, involvement from family, partners and advocates, race and disability. The assessment process details vital links to further risk assessments, care plans and additional management plans that will be required, based on the completion of the assessment. The assessment is linked and detailed in order for a holistic view of the person to be formed. A health care professional surveyed commented I have placed a number of patients who have chosen The Oaks as their preferred priority of care. I have had good feedback from relatives and patients regarding the care they have received. The service has the capacity to support people who use the service and respond to diverse needs that may have been identified during the assessment process. A total of eleven comment cards were received from a range of people who use the service, work at the service, relatives and health care professionals who have vital links with the service. Many positive comments have been received and include, the home works well in all ways, trying to meet the needs of residents and involving the next of kin throughout. A further health care professional commented very good one to one communication. People who use the service, all determined that they always or usually have enough information to make informed choices about the service. Privately funded people who use the service are provided with a statement of terms and conditions or a contract. This sets out in detail what is included in the fee, the role and responsibility of the provider, and the rights and obligations of the individual. People who are funded receive a social service contract. The Annual Quality Assurance tells us that new residents are only admitted on the basis of a full and comprehensive assessment undertaken by people trained or experienced to do so and to which the prospective resident, hi or her representative and relevant professionals have been party. For individuals referred through Care Management arrangements, the registered person obtains a summary of the care management assessment and a copy of the care plan produced for care management purposes. For individuals who are privately funded and without Care Management assessment the registered person carries out a needs assessment covering all aspects. Careful consideration is given to the assessment before agreement to admission to the home, therefore ensuring staff are qualified and skilled to meet the needs of the resident, a written letter of confirmation is sent to clarify the assessment and its outcome, although Social Care Homes for Older People Page 12 of 32 Evidence: Services complete an assessment the home completes its own to supplement the social services assessment, information is obtained from medical staff as a contribution to the assessment process to provide a clear understanding of the residents needs.This was seen on the day of the inspection, case tracking showed that people had detailed assessments completed held on their files. Care Homes for Older People Page 13 of 32 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 use the service can expect that their medical, health and social care needs will be met. Evidence: A total of four care plans were case tracked fully, it was established that people who use the service receive personal and healthcare support using a person centred approach. Personal healthcare needs including specialist health; nursing and dietary requirements are clearly recorded in each persons care plan. The care plan provides clear information and a comprehensive guide for staff to know how to support the person. The care plan is generated from the pre admission assessment and includes clinical guidelines, risk assessments for the management of falls, bed rails, manual handling and self medication. It was observed that personal support is responsive and tailored to meet the individual choices, needs and preferences. Staff were observed to respect the privacy and Care Homes for Older People Page 14 of 32 Evidence: dignity of all people. The service listens and responds to individual choices and decisions about who delivers their personal care. People are supported and helped to be independent and can take responsibility for their personal care needs. The AQAA tells us that each resident has a care plan generated from comprehensive assessments which are regularly reviewed, these provide good information for the care team to implement high quality care to meet residents needs and provides the basis for the care to be delivered. The residents care plan meets the relevant clinical guidelines produced by the relevant professional bodies concerned with the care of adults, and includes risk assessments. The residents care plan is reviewed by staff within the home at least once a month (or according to changing needs) and is updated to reflect changing needs and current objectives for health and personal care, and actioned. Care files are audited by the home manager and area manager, care plans detail which actions the resident remains capable of performing and encourages independence at all times. Individuals have access to healthcare and remedial services. The health care needs of individuals unable to leave the service are managed by visits from local health care services. Clear evidence was seen in the care plans of specialist health care support services visiting the service and in addition to the care plan there were detailed notes made by the specialist visiting the service for example the General Practitioners. A number of comments were received directly from people that use the service, their relatives and friends. One person commented that, the staff are friendly and if you need anything they always help you out. A number of comments have been received that have determined that the care is provided to meet the needs of the people who use the service. One relative commented, in response to what the service does well, stating, see to all individual needs very well. A person using the service commented the staff are absolutely wonderful, some of them are young and I thought that they would not understand my needs, but they do and care really well for us all. The service has an efficient medication policy supported by procedures and practice guidance, which staff understand and follow. Medication records are fully completed, contain required entries, and are signed by appropriate staff. The management of controlled drugs is effective with records being accurate and stock balances being correct. A total of two peoples medication was case tracked in order to ensure compliance with the National Minimum Standards and to access that people were receiving the medication as prescribed. Fridge and room temperatures were being recorded in the medication rooms. Ordering and returns documentation was up to date and accurate. The service works with individuals regarding any refusal to take Care Homes for Older People Page 15 of 32 Evidence: medication. The people using the service are given the support they need to manage their medication. If individuals prefer or where they lack capacity, care staff can manage medication on their behalf. Thought has been given to providing safe but sensitive facilities for keeping medication. The service has a good record of compliance with the receipt, administration, safekeeping, and disposal of controlled drugs. Staff have also completed and passed an appropriate medication course. Some people are prescribed medication which is to be administered on an as and when required basis. Some of the medications viewed did not have additional administration guidelines in place to inform staff of the circumstances where administrating should take place. This was brought to the attention of the manager who agreed to implement new guidelines following the inspection. Care Homes for Older People Page 16 of 32 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. People who use the service encouraged to join in with a variety of activities available. Evidence: The service understands and actively promotes the importance of respecting the human rights of people using the service, with fairness, equality, dignity, respect and autonomy all being seen as central to the care and support being provided. During the inspection staff were indirectly and directly observed offering people equal dignity and respect in a manner of ways. People who use the service are able to enjoy a stimulating lifestyle with a number of options to choose from. The service has sought the views of the individuals and considered their varied interests. In the persons care plan there are individual documents detailing the needs and the preferences of those using the service and these are always taken into account. One person using the service commented the meals are wonderful, them cook them for you, serve you, ask you what you would like, Its like a hotel really. The service employs an activity organiser and is now offering a seven day programme of activities. One person using the service commented the activity lady is so lovely, Care Homes for Older People Page 17 of 32 Evidence: we often see one another. I think there is entertainment this afternoon too, which we all like. A further person commented the activity person comes to talk to me and tries to encourages me to mix with others but I do prefer my own company. I like to use the library and I have a daily paper which is really good. The routines, activities and plans are person centred, individualised and reflect diverse needs of people, including their gender, age, race, religion and disability. They are regularly reviewed, and are very responsive to individuals changing needs, choices and wishes. The AQAA tells us that there is a varied activity programme run by an enthusiastic activity coordinator and activities are flexible and varied to suit residents expectations, preferences and capabilities. Comprehensive life historys provide background information from which to make activity suggestions and allow staff to better understand the needs and or preferences of the residents. Individuality is encouraged throughout the day and staff are available to assist residents as required. All activity session are open to families and friends. Residents are able to express their choice with regard to leisure, social activities and cultural interests, food, meals and mealtimes, routines of daily living, personal and social relationships and religious observance. Activity organisers seek the views of the resident in order to promote a variety of daily activities, these plans are regularly reviewed and can be changed to meet individual needs. Open visiting policy where visitors are welcome at any time and facilities are available for them to have a drink or meal with the resident. Information of community events and activities are displayed throughout the home. The service has strong focus on involving people in all areas of their life, and actively promotes the rights of individuals to make informed choices, providing links to specialist support when needed. This includes developing and maintaining family and personal relationships. Records are maintained where individuals have engaged and or participated in any activity. One person using the service commented they have something going on everyday, whether we chose to attend or not. Outcomes for people are positive, and there is evidence that they are enjoying the life opportunities that they experience. During the insepction it was noted that Radio One was playing in the dinning room. This was brought to the attention of the manager who stated that a more appropraite station could be found if the people wished. Meals are well balanced and nutritional and cater for varying cultural and dietary needs of individuals. For those individuals who need support during mealtimes, Care Homes for Older People Page 18 of 32 Evidence: including those who have difficulty swallowing or chewing, staff give assistance. They are discrete and sensitive to the feelings of both the person they are helping and also to others present. Mealtimes are flexible and relaxed, staff are patient and helpful, and allow individuals the time they needed to finish their meal comfortably. One person using the service commented I like the sweets, but the pastry is sometimes a bit tough, whilst a further person stated the food is mostly very very good. The AQAA has identified that improvements are planned over the next twelve months and states to explore closer links with local community based organisations in order to expand social activities. Further encourage residents to be involved in outside activities, to further increase all residents in activity sessions. To further involve care staff with activity sessions. Activity coordinator to commence NAPA qualification The AQAA has also identified how the service has improved within the last twelve months and states ensured flexibility of routines, reviewed policies & procedures to empower residents. Mealtime service adapted to better meet the residents need and enjoyment. Encouraged the use of advocates where needed and enabled residents to become independent and return home where possible and in the best interest of that individual. Care Homes for Older People Page 19 of 32 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 use the service can expect that complaints or concerns will be listened to acted upon. Evidence: The service has an open culture that allows people who use the service to express their views and concerns in a safe and understanding environment. People who use the service have commented that they are happy with the service provided; feel safe and well cared for. A number of comments received determined that people who use the service and relatives and friends are aware of what to do if they have any concerns. One person who uses the service stated the manager is always available and on a Monday he has a surgery so we can always talk to him if we have any concerns. I dont contact him every often but when I do he is very pleasant. The manager of the service has identified in the Annual Quality Assurance Assessment that improvements are continuing to be made and it states we have learnt from complaints to ensure the same issues do not occur again. Increased visibility of senior management, continued development of relationships with residents and relatives to encourage open discussion of all matters relating to the welfare and contentment of the resident. Residents have become more confident bringing issues arising to the management and staff team before small issues have grown. Weekly surgeries are held by the Manager to facilitate guaranteed uninterrupted time for visitors, residents, relatives or representatives to discuss any issues, concerns or suggestions not Care Homes for Older People Page 20 of 32 Evidence: discussed at any other time as a matter of urgency. Provided a suggestion box for resident and relatives to use to provide feedback on our service provision. We have improved levels of communication and openness with other authorities and agencies. The service has a complaints procedure that is clearly written and easy to understand. It is available in a number of formats such as different languages on request. The complaints procedure is supplied to everyone living at the service and is displayed in a number of areas within the service. There is a detailed record of all complaints and compliments made and received. It was evident that verbal concerns are also well managed, resolved quickly in the best interest of the person using the service. The AQAA states there is a simple, clear and accessible company complaints procedure which includes stages and timescales for the process displayed near the main entrance and written so as to be easily understandable. Residents and visitors are advised of the various channels of complaint available. Copies of this policy is included in the Statement of Purpose and made available to staff. There have been fourteen complaints made which have both been investigated and responded to within the time scales as required. All of the complaints had been dealt with within the timescales. Five of these complaints were upheld. The service has also received many compliments and these are displayed in the entrance foyer of the service. The policies and procedures for safeguarding adults are available and give clear specific guidance to those using them. Staff commented that they have received training in safeguarding and felt confident in reporting any issues as they occurred. Staff had a clear understanding of the Whistle-blowing policy and when the use of this may be put into practice. The service understands the procedures for safeguarding adults and attends meetings or provides information to external agencies when requested. There has been one referral made in the previous twelve months. This has been fully investigated as required. Care Homes for Older People Page 21 of 32 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 who use the service reside in a safe, homely environment suitable to meet their needs at all times. Evidence: The service provides a physical environment that is appropriate to the specific needs of the people who live there. The environment provides specialist aids and equipment to meet their needs. The service is a pleasant, safe place to live, the bedrooms and communal room provide a personal and homely feel. The layout of the building enables people to move freely with several different seating areas throughout to encourage socialising or enabling the person to have privacy. The Annual Quality Assurance Assessment completed by the service demonstrates that the the location and layout of the home allows independence of movement about the home and good community involvement. We provide a comfortable, clean, safe and homely accommodation in a spacious environment, with personalised bedrooms often personalised prior to admission to minimise disorientation and distress. Provide locks to resident doors to allow privacy, we provide lockable space within each room. Provision of individual door notices to residents bedroom doors requesting privacy or company to respect dignity and privacy. The home offers a good selection of equipment, all staff are trained in the use of this equipment. The home meets the requirements of the Disability Discrimination Act. There are several comfortable Care Homes for Older People Page 22 of 32 Evidence: communal areas and a large furnished dining area available to residents to ensure that they have a choice to sit quietly, meet with family or engage in activities with others. The people who use the service are encouraged to personalise their bedrooms. All the homes fixtures and fittings meet the needs of individuals and can be changed if their needs change. The decoration of the builing is tasteful and suits the people using the service. One person commented I Like being comfortable and I am comfortable in my own room. The environment promotes the privacy, dignity and autonomy of individuals. The shared areas provide a choice of communal space with opportunities to meet relatives and friends in private. The dining room is laid out to encourage communal dining with a calm relaxed atmosphere. There is a large garden to relax in. The garden has been adapted with time and consideration spent making separate seating areas and areas of interest for all the people who use the service. The home has a robust infection control policy. The service is clean, well lit and in general smells fresh. One person using the service commented my room is very nice I like it here. During the inspection it was noted that the sluice rooms were not locked and could be accessed by people using the service. This was brought to the attention of the manager who agreed to complete a risk assessment tool to determine if any corrective action was required or additional control measures were needed. There was restricted access to high risk areas such as the main kitchen and the laundry areas to reduce the risk of cross infection. Care Homes for Older People Page 23 of 32 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 using the service are supported by suitabely supervised, expereinced, vetted and qualified staff in order to ensure that their needs are met at all times. Evidence: Feedback from the people who use the service shows that they have confidence in the staff who care for them. Staff rotas were seen and displayed adequate numbers of staff on duty to meet the needs of the people using the service. Specific attention was given to the busier periods of the day. In addition to the staffing levels, a manager is availalable and supernumerary to the care staff. This enables staffing levels to be maintained for the safety of all and that record keeping was completed and monitored as required. Staff members undertake external qualifications beyond the basic requirements. Staff are enabled and fully supported to attend traiing. The manager stated that a new member of staff has recently been excepted onto a train the trainers course in manual handling. One staff member working at the service commented I had a full induction which covered fire safety. The training is very good. Managers encourage and enable this and recognise the benefits of a skilled, trained workforce. Accurate job descriptions and specifications clearly define the roles and responsibilities of staff. People who use the service report that staff working with them are very skilled in their role and are consistently able to meet their needs. One person using the service Care Homes for Older People Page 24 of 32 Evidence: commented the staff are so very kind, they are all so very different but very pleasnat and caring at all times. There is a good recruitment procedure that clearly defines the process to be followed. This procedure is followed in practice with the service recognising the importance of effective recruitment procedures in the delivery of good quality services and for the protection of individuals. A total of four staff files were audited and were seen to contain all the required documentation. Three individual staff commented on the strong team culture of the service and felt that following recent recruitment, there are enough staff on duty to meet the needs of the people who use the service. Staff confirmed that the service was clear about what was involved at all stages and was robust in following its procedure. There are clear contingency plans to cover for vacancies and sickness and the use of agency staff was limited. One staff member commenetd the team works very well together, its really nice working here. The manager is really good and will always stay on late if he is needed. Once recruited staff receive an induction and training. The programme is then signed at the end of each stage. The AQAA tells us that we encourage staff to further their education with support from the company. We allow full access to training providers, staff rotas are recorded which demonstrate staff on duty at any time during the 24 hour period. Staff morale is improved and a percentage of care staff hold an NVQ level two or three in Health and Social Care. The AQAA continues to tells us that robust recruitment policies and procedures which ensures completion of an enhanced disclosure as required. Two references and a full employment history. Staff receive supervision at least six times per year and annual appraisals in which they are required to participate. Photographic evidence of identity is obtained for all staff and copies of at least one form of identification is kept on file. Checks are made to ensure that overseas workers are eligible for work. All new staff undertake a homes induction and the common induction standards before commencement of NVQ. The service also has a training and development plan in place for 2009 - 2010. This showed that a number of courses are being provided and included, Fire Safety, Dementia Awareness, Moving and Handling, Infection Control and Safeguarding. Staff confirmed that the senior team provide supervision. Records showed that this was occurring. Staff meetings take place regularly. Notes and action points are taken of meetings and Care Homes for Older People Page 25 of 32 Evidence: sessions, and progress is regularly reviewed by revisiting actions points made at the last meeting to monitor progress and development. Staff reported that they felt supported in their roles and that they were able to discuss issues with a member of the senior team if required. During the inspection positive manual handling practices were indirectly observed where by a person was being hoisted from a chair to their wheelchair. Throughout the process the care workers were talking to the person and making them fell at ease. Care Homes for Older People Page 26 of 32 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. People who use the service can be assured that the service is managed well and in the best interest of the individual. Evidence: The Registered Manager has the required qualifications and experience and is competent to run the service. The Registered Manager and the senior team have a clear understanding of the key principles and focus of the service, based on organisational values and priorities. They work to continuously improve the service. Feedback received on the day of the inspection from staff and as part of the feedback questionnaires received determines that the management are effective and approachable. One staff member comeneted the management team are brilliant, everyone helps each other out, the team is great. The care planning format encourages and enables staff and the people who use the service to focus on person centred thinking, with the people who use the service becoming increasingly more involved. The format reviews the persons entire needs. Care Homes for Older People Page 27 of 32 Evidence: The Registered Manager and senior team lead and support a stable staff team who have been recruited and trained to the required levels. The manager promotes equal opportunities, has good people skills and understands the importance of person centred care and effective outcomes for people who use the service. This is reflective in the managers leadership style, his ability to work with the team and ensure that the service is run in the best possible interests of the individual. The service has sound policies and procedures, which are corporately and internally reviewed and updated, in line with current thinking and practice. The manager ensures that staff follow the policies and procedures of the service, through close monitoring, supervision and training. The staff team are positive in translating policy into practice and showed good knowledge of care principles, health and safety and safeguarding issues. This includes the management of finances within the service. Staff meetings take place regularly and minutes of the meetings are available on each unit, this increasing effective communication throughout the teams. The service works to a clear health and safety policy. Safeguarding is given high priority and provides a range of policies and guidance to underpin good practice. Recent training has occurred regarding safeguarding issues. Through discussions with the management team and it was determined that priority is given to ensure that all staff are in receipt of training, including in a full complete induction programme. Individual training plans have been developed. The AQAA tells us that the manager ensures the approach of the home remains open, positive with an inclusive atmosphere. A commitment is made to equal opportunities. Methods of running the home are transparent. Management planning and practice encourages innovation, creativity and development. The manager develops good relationships with residents and their representatives and ensures that their opinions are considered when reviewing the services offered. The manager promotes a working environment where the skills and knowledge of the staff are valued and considered at every opportunity. The manager promotes good communication with other authorities and manages the home in an open and transparent manner. It was directly observed during the inspection that the staff team are well managed and supported as required. Health and safety is well managed and records were directly observed to be up to date and in order. The service has a detailed fire risk assessment in place. In the foyer area of the service, plans of the service are clearly displayed next to the fire panel. The fire Care Homes for Older People Page 28 of 32 Evidence: risk assessment is detailed and has been reviewed. The service currently stores and uses oxygen to support a number of people who use the service, the location and storage of the oxygen was not displayed on the service map or detailed in the fire risk assessment. Signs were being used throughout the building identify where oxygen is located however the signs are not visible if engulfed in smoke. This was brought to the attention of the manager and the area manager during feedback. The service has a robust quality assurance system and thrives on ensuring that the needs of the people using the service are listened to and that systems are used in their best interest at all times. The service has recently completed an annual quality assurance survey for the staff and the people using the service. The manager stated that the results obtained were very pleasing and would be sued to further develop the service. This is further supported by the completed AQAA which states for the manager to continue to delegate some of his duties to ensure the deputies competence of acting up in managers absence. Provide the questionnaires in various formats dependant on need e.g. large print, braille or audio etc. to further improve relationships and communication with other agencies. The manager of the service also completes a weekly report which informs the company of the significant events, improvements and a progress up date of the service. This is sent to the operations manager who reviews this as part of their monthly visit to the service. Care Homes for Older People Page 29 of 32 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 30 of 32 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 13 The fire risk assessment and 01/11/2009 plans must identify the location oxygen. To ensure that information regarding the location of combustible products are clearly identified. 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 2 26 38 Access to the sluicing rooms should be reviewed. Signs used to show where oxygen is stored should be aluminas. Care Homes for Older People Page 31 of 32 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. 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