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Inspection on 09/12/08 for Winnie Care (Ashbourne Lodge) Limited

Also see our care home review for Winnie Care (Ashbourne Lodge) Limited for more information

This inspection was carried out on 9th December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The people who live in the home say the staff are kind and helpful. Everybody says that the manager does a good job. The home is a bright and cheerful place with a warm, friendly atmosphere. It is clean and comfortable and family and friends are made welcome. People who use wheelchairs can move around the home easily.

What has improved since the last inspection?

Care plans are better. They tell staff more about what people need and want and how to care for them safely. The way that the staff look after people`s medication has improved. The manager now carries out regular checks to make sure that care plans and other records are completed properly. Lots of work has been done on the building since the last inspection. Rooms have been redecorated and repairs have been carried out. The home has also made some changes that make it easier for people to find their way around and to recognise their own rooms.

What the care home could do better:

All staff must have training on how to deal with complaints and how to protect people from being harmed through abuse or neglect. This is so that people are kept safe and their problems are dealt with quickly. The home must find out about the needs of people who come into the home for short breaks. All the staff working with them them must be told how to care for them. This is to make sure that their needs are met and they are kept safe and well during their stay. The home should employ an activities organiser. This is so that there is someone whose job it is to make sure that people have plenty to do that they enjoy. All staff should have training that tells them about the differences between people and what they can do to treat everyone fairly and with respect.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Winnie Care (Ashbourne Lodge) Limited Ashbourne Lodge Care Home The Green Billingham Stockton on Tees TS23 1EW     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Michaela Griffin     Date: 1 1 1 2 2 0 0 8 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 32 Information about the care home Name of care home: Address: Winnie Care (Ashbourne Lodge) Limited The Green Ashbourne Lodge Care Home Billingham Stockton on Tees TS23 1EW 01642553665 01642558662 ashbournelodge@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Winnie Care (Ashbourne Lodge) Ltd Name of registered manager (if applicable) Mrs Julie Hickey Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Ashbourne Lodge is a care home which can provide personal care and accommodation for up to 55 older people, 32 of whom have a dementia type illness. Nursing care is not provided, however, the support of District Nursing services can be obtained if this is needed. The home is owned by Winnie Care (Ashbourne Lodge) Ltd which is a private organisation. There are 2 floors of accommodation where people live and includes the main kitchen, laundry area and staff rooms. The home has been specifically designed to provide accommodation for older people and has been open for about ten years. There is a level entrance into the home, and good access once inside because of wide corridors. There is a passenger lift which goes to the first floor, where there are two Care Homes for Older People Page 4 of 32 care home 55 Over 65 17 38 0 0 Brief description of the care home parts of the building one which provides accommodation for older people who have dementia, the other for older people who are frail or ill. The home provides single bedrooms, each with their own toilet facilities and there are several lounges and dining areas on each floor. There is a parking area at the back of the home and there is a reception area at the entrance of the home. The home is located in the Billingham Green Area, close to shops, pubs, and community facilities. 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: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The last inspection of this service was completed on 4th February 2008. We have reviewed our practice when making requirements to improve national consistency. Some regulations from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use the services are not being put at risk of harm. In future if a requirement is repeated it is likely that enforcement action will be taken. The manager has completed the Annual Quality Assurance Assessment (AQAA), the services self assessment of how well they think that they are meeting standards. This was received prior to the inspection and some of the information has been reflected within the report to support the judgements made. The AQAA was well completed. Care Homes for Older People Page 6 of 32 Before the inspection, we sent survey forms to people who live in the home and four people completed them. The inspection took place over two days. The inspector met the manager and three staff. She also talked to five people who live in the home and two of their relatives. She looked around the home and checked paperwork in the office and information on the notice boards. She spent some time observing people in the lounge and watching staff helping them. The inspector also contacted professionals who visit the home to ask them what they think about the service. The current weekly charges for the service are 420 to 440 (December 2008) What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 32 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. The home makes sure that it will be able to meet peoples needs, before they move in. Evidence: The inspector checked the files of three people who have moved into the home in the last year. The records showed that the home had got information about peoples care needs from health and social care professionals who know them, and then the manager had carried out her own assessment. This was so that people could be sure that the home could meet their needs before they moved in. The home now sends people a letter to confirm that it can meet their needs, before offering them a place. The inspector also talked to someone who came to stay in the home for a trial period and has now decided she wants to stay. She described how the manager had visited her and asked her about the help she needs and the way she likes to be helped. Her relatives had visited the home and got all the information they wanted about it. She Care Homes for Older People Page 11 of 32 Evidence: had spent some time there before she decided to move in. After six weeks she had been asked if she wanted a permanent place. She explained how she had made her her decision and how she had plenty of opportunities to ask questions and discuss any worries she had, before and after she first came to stay. The home must also ensure that people who come in for a temporary stay only are not offered a place until the home has enough information to be sure that it can meet their needs. The questions on assessment forms remind staff to ask people about their spiritual needs and beliefs and to find out how they express their sexuality. These can be very important aspects of an individuals identity and lifestyle and so asking the relevant questions can provide guidance for staff on how they can support people to make choices and lead their lives the way they want to. The questions should be be revised to remind staff that not everyone who may need to live in a care home is from a Christian tradition or from the white British majority community. Also guidance to staff should remind them that some individuals are not heterosexual and some may want to express their sexuality in ways other than dressing in traditional male or female clothing. Care Homes for Older People Page 12 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. Peoples health and social care needs are explained in care plans. People who use the service are protected by the homes policies and procedures for managing medication. Evidence: The inspector checked the care plans and records of four people who live in the home. She also talked to four people about the care and support they get. She interviewed the manager and three members of the care staff. This included the senior carer, with responsibility for the safe management of medication, and a new starter. The inspector also talked to other professionals who have visited the home and she observed staff giving out medication and generally helping people in the living rooms, dining rooms and corridors. The manager has improved the care plans and introduced records that say more about the whole person, their likes and dislikes, their backgrounds and what is important to them. Next she plans to introduce on-going Life- Story books for each person, to remind people about their pasts and significant memories and to help staff to Care Homes for Older People Page 13 of 32 Evidence: understand them as whole individuals. Care plans also have more detail about health related matters. They let staff know about peoples needs and the way they like to be cared for. They also help staff to check on peoples health and well-being and to keep records, for example of peoples weight. The manager promotes peoples well-being in the general management of their care and by keeping up to date with good practice, for example she has obtained the latest advice on fall prevention from the health trust. The manager has recently introduced body maps to remind staff to check and record the condition of peoples skin. These records provide important information for the manager and health professionals and enable them to decide if any action needs to be taken to promote each persons health and welfare. The people who live in the home had some very good things to say about the care they get. One person said I can do a lot for myself, but its good to know that if I am poorly during the night or just need a bit more help than usual I can call on the staff at any time. Another person who lives in the home explained that the staff take her for physiotherapy every week and in between help her carry out exercises, as they have been trained to do by her physiotherapist. A social care professional who attends reviews at the home described how senior staff know each person well. She said that she finds it reassuring that they can always talk about the individuals health and personal care needs without having to check the written records. She also said that the senior staff work well with health and social care professionals and make sure that information is passed on. The staff understand the care needs of the people who live in the home and know how they like them to be met. But sometimes people come in for a short break and staff do not have time to get to know them well, before they are responsible for caring for them and ensuring that all their needs are met. The home must make sure that when people come into the home for short breaks only, all staff who have contact with them have information about their needs and clear written guidance about how their care and support must be given. The home has a policy and procedures that give staff clear guidelines on what they must do to keep people safe and to promote their comfort and well-being. All staff who help administer medication have special training and show that they know what to do, before they are allowed to take on the important responsibility. The home also has a policy and procedures to enable people who want to to look after their own medication, but none of the people who currently use the service have chosen to. Care Homes for Older People Page 14 of 32 Evidence: Following the last inspection, the manager has introduced significant changes in the way that the home manages medication. This ensures that people are protected from mistakes in the way medication is stored or handled. Evidence held on record showed that a senior carer carries out regular checks of the medication stocks and records. The manager also carries out spot checks. The inspector checked the records and found that they were accurate and up to date. Individual care plans have information about the medication each person takes, how it should be given to them and what the possible side- effects could be . This information should also be kept on individuals medication administration records, to remind staff what they must look out for and record. People said that staff and kind and respectful. One person said They are all good. Care Homes for Older People Page 15 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home offers a lifestyle that matches the basic needs and expectations of most people. It also provides a specially designed activity programme for the people who live in the home who have dementia. Evidence: The inspector talked to four people who live in the home and two relatives about the lifestyle the home offers. She talked to the manager, a carer and a professional who visits the home. She observed five people in the lounge of the dementia care unit and the way that staff worked with them. The home does not have a planned programme of activities for every day in each of the three units. There is an activity file on each unit, which includes a record of the activities organised and who joined in. Social events are provided on one evening a month and family and friends are invited. The home does not employ its own activities organiser, but pays an independent service to come in one afternoon a month and to involve people in activities and games. In between, staff ask people what they would like to do each day. Activities taking place during the inspection were communal singing to well known songs, bingo and watching a popular film. Care Homes for Older People Page 16 of 32 Evidence: Staff, relatives and members of the local community raise money to fund events and buy games. There was a raffle going on during the inspection with lots of prizes donated by families. This will raise money to buy a set of carpet bowls. A professional commented that when one person had asked to play dominoes, the home had bought a set and encouraged other people to join in. One relative said that There is plenty going on. We come to the pie and peas suppers. But some of the men would like a snooker or pool table. One person who lives in the home said that the staff always ask her what she wants to do and will spend time chatting. But she said that she would like to have more opportunities to go out with staff and on trips. The home organised one trip to the coast this year and people who went enjoyed it. The manager said that the home now has the use of a mini-bus, so she hopes to be able to take people on more trips next year. During the two days of the inspection, relatives and friends visited to the home freely. Some just popped in and others stayed for longer. It was clear that they felt welcome and at ease. Some staff came to see the manager and called her by her first name, this showed that they find her approachable and easy to talk to. The home has brought in specialist advisers to train staff who work with people who have dementia and provide guidance on appropriate activities. The inspector observed care staff working with people and using their knowledge and specially designed equipment to encourage people to talk and take an interest in activities. People responded well to this. All staff should have this training. The home should appoint someone to take a lead role in organising and developing activities and fund-raising events. One way the home enables people to make choices is by providing a pleasant, ventilated smoking lounge. It has glass doors for staff to provide supervision if required, where people can smoke in comfort and safety, without endangering other people who live or work in the home. People who live in the home enjoy and varied and balanced diet, with choices at every meal. They have pleasant dining rooms to eat in, or can eat in their rooms. The food offered is based on what people say they prefer. Individual menus are developed for people who choose or need alternative diets and the staff get expert or specialist Care Homes for Older People Page 17 of 32 Evidence: advice as required. None of the people who currently live in the home are from a minority ethnic community or religious tradition. The manager recognises that meeting the needs and choices of someone who was not from the majority community or Christian religion would oblige her to seek additional advice and information, so that she could ensure that the food and lifestyle offered supports their choices and beliefs. Care Homes for Older People Page 18 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can feel confident that the manager will listen to and act on their complaints and concerns. People are protected by the homes policy and procedures for safeguarding adults. But some staff need more training on complaints and protection issues. Evidence: The home has a complaints policy and procedure that explains how people can make a complaint and how the home will deal with it in a fair and thorough way. Information about the complaints policy and procedure is displayed on the notice board in the public area. All the people who returned surveys said that they would know how to make a complaint. However, not all the staff have been clear about how to respond to complaints. This means that when a complaint was made while the manager was on holiday, the person who made it did not get the quick and respectful response that she should have. The manager investigated the complaint when she returned from holiday and provided a response in a timely way. She found that the staff had made mistakes and has introduced changes to the way that they work to try to ensure that the same problems do not arise in future. All staff should have training on how to respond to complaints and the manager should Care Homes for Older People Page 19 of 32 Evidence: introduce a system for checking that people who have a complaint are happy with the way it has been dealt with. They must be given clear information about how to make a further complaint to someone senior to the manager, if they are not satisfied. The home has policies and procedures that tell staff what they must do to keep people safe. But not all staff have had training on how to recognise the signs that someone has been hurt through abuse or neglect and how to follow these safeguarding procedures. All new staff must have this training during their induction, which is when they are first learning about the job and what it expected of them. Experienced staff must also have regular refresher training to remind them about what they need to know to keep people safe and report any concerns and to keep them up to date with changes. Care Homes for Older People Page 20 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. The home provides a safe and comfortable environment for people to live and enjoy as much independence and choice as possible. Evidence: The inspector looked around the home and asked about the repairs and improvements that have been carried out since the last inspection. She checked maintenance records and asked people what they think about the accommodation. The home was purpose built ten years ago and is on two floors. It has a level entrance, wide corridors and a through floor lift. This means that people who use wheelchairs can stay in the home or visit people who live there. The home is separated into three units, each with its own sitting rooms and dining rooms with a pleasant, homely feel. The overall impression the home gives is that it is a clean, comfortable, bright and cheerful place to live and work. The ground floor dining room and larger lounges are big enough for social events and activities. There are smaller sitting areas, where people can sit peacefully alone , or with company, and watch the activity along the corridors. The communal rooms are furnished and equipped with good quality, attractive furniture and fittings. The home has undergone a programme of repairs and improvements this year and bathrooms Care Homes for Older People Page 21 of 32 Evidence: and communal areas have been redecorated and any worn or shabby fittings have been replaced. The manager has been introducing changes to the communal areas of the unit for people with dementia, based on advice about the best practice for providing a supportive environment that will help promote peoples independence, for example by changing the signs, using photographs and symbols that are easier for people to recognise and understand. The home is also making changes that will personalise the doors to the bedrooms in all the units, to help people identify their own rooms easily. For example, one lady who is blind has a rustling, fabric dream-catcher ornament hanging on her door. She can recognise it by the way it feels and the rustling noise it makes when she touches it. The manager has asked relatives to bring in old photographs of people who live in the home. They will be used, alongside recent photographs, to help people identify their own rooms. They will also remind others of the long and full lives that these people have led and the contributions each person has made to society. Each person has their own room with en suite toilet. They can personalise their rooms with family portraits, ornaments and small pieces of furniture. There are several bathrooms on each floor, with suitable equipment to enable people to care for their own bathing needs safely, or get assistance from staff in a dignified way. The home has gardens and patio areas for people to sit outside and it has an interesting outlook over the village green. It is close to community facilities, has its own car park and and is close to local bus routes. One person who lives in the home said: It is a pleasant place and its nice outside. I like to walk around the garden Another one said I like my room.I like to sit and watch the village green. The records show that suitably qualified and registered contractors are called in to ensure that all services and equipment are routinely checked and maintained in a safe and effective condition. The home is inspected by the Fire Prevention Authority and all precautions and fire safety equipment and procedures have recently been reviewed to ensure that they are up to date. Some of the rooms have automatic door closures that are connected to the fire alarm system. This means that people can sit in their own rooms, with their doors propped open to see what is going on outside their rooms without having to actively be involved when they do not feel they want to. The home should fit automatic closures to all the bedrooms, so that everyone can choose to have their door open when they want to without risking any danger in the event of a fire. Care Homes for Older People Page 22 of 32 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 who use this service experience good outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. The home has enough trained staff to meet peoples needs and they are protected by its recruitment procedures. Evidence: The inspector checked four staff files, including records of how people were recruited and the training they have received. She checked the numbers on duty in each unit for each shift. She interviewed the manager and a new member of staff and spoke to a social care professional. The inspector also asked people who live in the home if they thought that there are enough staff to care for them and if they know how to meet their needs. They all said that they only had to ask staff were there to help them and that they knew what to do for them. There are never less than two care staff on duty in each of the three units of the home and there are three staff on every morning in the largest unit. There are four staff on duty at night, one based in each unit and one moving between as needed. the home also employs 5 domestic staff and 4 kitchen staff, which means carers can concentrate Care Homes for Older People Page 24 of 32 Evidence: on caring for people. The home has a recruitment procedure that tries to ensure that people who apply for jobs are treated fairly. It also includes carrying out checks to make sure that people are not employed who have something in their backgrounds that means they are not suitable to work in a care setting. The home employs thirty five people, including two people who are not from the majority white British community. They have brought their experience and interests to their work and the people who live in the home appreciate this. The manager explained how she has supported one carer whose first language is not English, but can communicate clearly in conversation, to develop her writing and recording skills. This is one way that the home can ensure that it has a team of staff with the right attitudes and skills to care for people. It also means that people are not deterred from applying to live or work in the home because they know it welcomes and supports people from different ethnic backgrounds, communities and cultural traditions. Three of the staff are men and ages range from nineteen to sixty years. One carer has worked in the home since it opened in 1998 and nineteen have worked there for more than 2 years. This means that the people who live in the home benfit from having a stable staff team who they can get to know well. All staff should have training on equality and diversity issues, so that they recognise and respect the differences between people, including those related to sexual orientation and identity, lifestyle choice and belief, as well as those related to ethnicity and cultural heritage. The home has an annual training programme, which ensures that all staff have the basic training they need to care for people safely. Some of the staff who support people with dementia have had additional specialist training and the home is currently developing a programme of health care related and specialist training, with the support of a trainer from the parent company Winnie Care. There are thirty one care staff. Fifteen of the current carers already have achieved the recommended National Vocational Qualification in Care at level two and fifteen are working towards it. New staff are encouraged to work for this award, once they have completed their basic induction training. Care Homes for Older People Page 25 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. The home is well run and the manager continues to introduce improvements in the quality of the service. Evidence: All the people who provided information for this inspection said that this service is run well. The home has a new manager. She is working hard to make changes to the way the service is run to make it better for the people who live there. She has had the training and experience required to run a care home, including qualifications in management and care. The home has a basic quality assurance system, which is based on asking people who live in and visit the home for their views on the service. It also includes monthly visits and reports by one of the directors and regular audits of care plans and daily recording by the manager. A new carer commented on how the manager listens to what people say and is always keen to hear suggestions for improving the service or helping Care Homes for Older People Page 26 of 32 Evidence: individuals who live in the home more effectively. The home enables people to keep their own money where it is safe for them to do so. Careful records are kept of any money that the home looks after in each persons name. There are polices and systems in place to protect the health and welfare of people who live and work in the home, and the arrangements for the storage of hazardous substances have been improved since the last inspection. Care Homes for Older People Page 27 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 28 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 3 14 The home must ensure that 02/04/2009 people who come in for a temporary stay only are not offered a place until the home has enough information to be sure that it can meet their needs. This is to protect the health and well-being of people who stay in the home temporarily and to reassure their regular carers that they are in safe hands. 2 10 13 Individual care plans have information about the medication each person takes, how it should be given to them and what the possible side- effects could be . This information should also be kept on individuals medication administration records. 02/04/2009 Care Homes for Older People Page 29 of 32 This is to keep people safe by reminding staff what they must look out for and record. 3 16 22 All staff should have training 02/04/2009 on how to respond to complaints and the manager should introduce a system for checking that people who have a complaint are happy with the way it has been dealt with. This is to ensure that people know that the managers and staff will take their complaints seriously and try to resolve them quickly and properly. 4 18 13 All new staff must have this training during their induction, which when they are first learning about the job and what it expected of them. Experienced staff must also have regular refresher training. this is to ensure that all staff know what to do to keep people safe and are kept up to date with any changes in policies and guidance. 04/06/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 12 The home should appoint someone to take a lead role in organising and developing activities and fund-raising Page 30 of 32 Care Homes for Older People events. 2 23 The home should fit automatic closures to all the bedrooms, so that everyone can choose to have their door open when they want to without risking any danger in the event of a fire. Care Homes for Older People Page 31 of 32 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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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