Care Home: Abbey Lodge Residential Care Home

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What the care home does well Feedback from the people who use the service comment: `This is a lovely homely home, I am happy here, they are lovely. The staff are so good`. `This is a very homely home, it is comfortable and looks nice. Everything is good and reliable, I know I will be cared for well. The meals are lovely`. Relative comment: `My relative has been a resident for several years. All staff have been very caring, nothing is too much trouble and all of the family are able to relax, safe in the knowledge that our relative is always safe and well looked after`. `We recommend Abbey Lodge to anyone looking for residential care and the owners are to be congratulated on running a great home`. `The home is cheerful and clean, with home cooked food and patient staff`. `They provide very good food and a clean environment`. `Staff are bright, cheerful, kindly, positive and interactive with residents on a personal level, This creates a welcoming, warm, family atmosphere for both residents and visitors`. `Excellent care given to residents. Staff cheerful and welcoming. Genuine desire to satisfy residents needs. Nothing is too much trouble. Home is spotlessly clean. I am so pleased I chose Abbey Lodge for my mother`. Care Managers comment: `They provide a client centered, caring environment. The home provides kindness and compassion in a welcoming, homely environment`. `A lovely residential home. It is clean, warm and well organised. The kitchen is immaculate and very clean`. `Residents are cared for in a homely environment`. Two visitors comment: `I feel the staff are very caring and considerate. They look after the people very well. They try to look after the whole person and if there is a problem they keep relatives and friends well informed`. `The home is clean, warm and welcoming`. Staff comments: `We provide good quality care for the elderly`. `Abbey Lodge is a very friendly home and the staff all get on very well. I enjoy working here`. `We meet the residents needs, make them feel welcome and comfortable. We always make time to chat and do activities with the residents`. `This is a very nice home, very homely, everyone is so kind. I really enjoy working at Abbey Lodge`. `The residents are cared for in a loving way. Their rooms are lovely with a nice sea view and the home is always lovely and clean with a fresh smell`. `This is a very relaxed, homely atmosphere where residents and staff are very comfortable with one another. A high level of care for the residents, always treated as individuals and given choices whilst maintaining their dignity and respect`. What has improved since the last inspection? The extension and refurbishment of the home has been completed. The home is now more spacious and the environment is very well decorated and maintained to a high standard. To assist with the administration and storage of medication a new trolley has been purchased. There is also a new refrigerator for the cold storage of medication if required. New scales have also been purchased. The Registered Manager now has an office on the ground floor. What the care home could do better: Moving and handling risk assessments do not have clear written guidelines of how to move people safely. There are shortfalls in the mandatory training for all staff. The quality assurance programme does not include other stakeholders, for example, health care professionals and other visitors in the home. A staff member comments: `Choice of menus could be a little better. Residents choices could be taken into consideration a bit more`. `The food could be more varied, wider choice on the menu` Key inspection report Care homes for older people Name: Address: Abbey Lodge Residential Care Home 91 Seabrook Road Hythe Kent CT21 5QP     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Penny McMullan     Date: 0 6 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Abbey Lodge Residential Care Home 91 Seabrook Road Hythe Kent CT21 5QP 01303265175 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: mail@abbeyresthome.co.uk www.abbeyresthome.co.uk Abbey Lodge (Residential Home) Ltd care home 25 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 25. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP). Date of last inspection Brief description of the care home Abbey Lodge provides accommodation and personal care for up to 25 Older People. The premises are detached and there is a new extension which was built in 2007, which provides additional facilities and bedrooms. Accommodation is on the ground, first and second floors. There is a shaft lift providing access to all floors, and also a stair lift. Three bathrooms are available for service users use, two of which are assisted. There are communal lounges on two floors allowing service users a choice of where to sit. Care Homes for Older People Page 4 of 27 Over 65 25 0 1 7 0 2 2 0 0 9 Brief description of the care home Staffing numbers are based on the dependency levels of the residents. One of the proprietors, Mrs Elizabeth Bown, manages the home and has gained the NVQ Level 4 qualification in Management and Care. The Home has achieved the Investors in People award. Previous inspection reports are available from the home. Current fee levels range from £344.54 to £575.00 per week. Care Homes for Older People Page 5 of 27 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: three star excellent 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: This key inspection was carried out over a period of time and concluded with a visit to the home on 6th January 2010 between 09.30am and 4pm. The last key inspection was carried out on 16th January 2007 and a random inspection on 17th February 2009. Postal surveys were forwarded to the home to distribute to the people who use the service, staff and health care professionals. We sent ten surveys to the people who use the service, ten to the staff and five to health care professionals. Six surveys were received from the people who use the service, five from staff and four from social care professionals. Two visitors to the home also completed a survey. Feedback from all of the surveys and any comments has been included in this report. The care of three people was tracked to help gain evidence as to what it is like to live in the home. A partial tour of the home was made and we also looked at care plans, Care Homes for Older People Page 6 of 27 risk assessments, training records, staff files, quality assurance and complaint records. Three members of staff were also involved in the inspection. The Annual Quality Assurance Assessment (AQAA) that was sent to us by the service was clear and comprehensive. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. The home returned the Annual Quality Assurance Assessment (AQAA) within the required timescale. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? The extension and refurbishment of the home has been completed. The home is now more spacious and the environment is very well decorated and maintained to a high standard. To assist with the administration and storage of medication a new trolley has been purchased. There is also a new refrigerator for the cold storage of medication if required. New scales have also been purchased. The Registered Manager now has an office on the ground floor. Care Homes for Older People Page 8 of 27 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 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 27 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 27 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. All new residents have a full care needs assessment before moving into the home. Intermediate care is not provided in this home. Evidence: We looked at the information provided to people before they decided to move into the home. We spoke to the people living at Abbey Lodge and they told us that they or their family were given information about the home before they moved in. The Registered Manager carries out a thorough care needs assessment to make sure the home can meet the needs of the person. The people are invited to visit the home prior to moving in. In general there is detailed information recorded to make sure that staff have the details they need to care for the individual person. However in some of the assessments seen identified care needs were not always followed through to the care plan. For example, in one persons medical history it was recorded that she had Care Homes for Older People Page 11 of 27 Evidence: hearing loss in her left ear. Although this had been identified this was not followed through and recorded in the summary of care needs. The Registered Manager told us that this information would be added to the plan and we are confident that this will be carried out, therefore no requirement or recommendations will be made at this time. Intermediate care is not provided in this home. Care Homes for Older People Page 12 of 27 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. The health and personal care that a person receives is based on their care plan. Written guidelines for staff will ensure that all staff are consistently moving people safely. Improvements are required when auditing the medication to make sure out of date medication is returned to the Pharmacy Evidence: We looked at three care plans and the information in the care plans clearly records identified care needs and risks. However in some cases the risk assessments lack written guidelines for staff to follow. For example, a moving and handling risk assessment states Use of wheelchair, handrails, stand Mrs X using a handling belt, there are no guidelines for staff to follow to make sure they are moving the person in a consistent safe manner. Staff explained how they move people safely and the majority have received moving and handling training to make sure they have the skills and knowledge to support the people with their mobility. The risk is minimised as the Registered Manager is a moving and handling assessor/trainer and the staff told us that she is always available to demonstrate and assist if problems should arise. The care plan shows how to encourage the people to be as independent as possible by Care Homes for Older People Page 13 of 27 Evidence: identifying what they can do for themselves. There is evidence of reviews including monthly key worker reports. In one case a family member had signed to say that she was involved with her relative when completing the plan. Two people who use the service and one relative told us that they were involved in the care planning process. The people who use the service comment: My care plan covers everything I need. Yes I did go through my care plan and agree with it; I also told them what I dont like. Although there are some shortfalls in the information recorded in the care plans this does not seem to affect the outcomes for the people receiving the service. Staff, relatives and the people who use the service have positively complimented the care being provided. All of the people spoken with at the time of the visit indicated they are happy with the service. For example a relative comments: Personal care is carried out well. My relative has lived at Abbey Lodge for several years and my family has always been pleased with her care. Now that her memory is fading they are being particularly kind. She is always contented as she could be. We visit regularly and would be aware of any changes. Staff comment: I think the care plans are detailed enough. If some of the information is not recorded we know what to do as the Registered Manager is a moving and handling assessor and she shows us how to move people safely. She is a very hands on manager and is always available. The Registered Manager told us that these shortfalls would be addressed and records will be audited to make sure all of the required information is in place. It is evident that the outcomes for the people are good and we are confident that the issues will be addressed therefore no requirement will be made in this report. The people in the home told us that they are supported well with their health care needs. The care plans cover nutrition needs, weight and skin care needs. The staff said they work well with the health care professionals who visit the home. There are regular visits by the chiropodist, dentist or optician if required. One person comments: If any one is not well they will get the doctor straight away. We looked at where the medication is kept. Hand washing facilities are nearby and there is a hand gel wash kept on the medication trolley. There is a medication fridge and separate controlled drugs storage. The home uses a monitored dosage system so Care Homes for Older People Page 14 of 27 Evidence: the medication is kept in blister packs. We saw one of the staff giving out the medication making sure that the people were asked and agreed to take their medication. All of the people living in the home have their medication given to them by staff. One person is able to be supported to self medicate her inhaler and a risk assessment is in place. The recording of the medication was in good order. There was out of date medication in the controlled drugs storage area which was not recorded on the individual medical administration sheet. The Registered Manager told us that this was prescribed as a precaution several years ago and had not been required since. The medication records, including the storage had been audited the day before the inspection and this error was not found at that time. Although there are systems in place to check the medication the system does not seem fully effective. The Registered Manager told us that she would speak to the persons GP and review and dispose of the medication. As immediate action was taken to address this issue no requirement will be made at this time. The control drugs book was in good order, however the home must make sure that the pages in this book are consecutive to make sure that all pages can be accounted for. People said that staff treat them with respect, are sensitive when helping with personal care and always knock before entering their room. Staff were seen to be polite and supporting them with their daily life and the atmosphere in the home was pleasant and calm. When asked if the staff respect their privacy and dignity three service users replied oh yes definitely and always, the staff are very good. Yes, when bathing and doing everything. A person who uses the service comments: The atmosphere of the home is good, I feel comfortable and safe here and I am never frightened to ask for anything. A relative comment: The home treats residents with care and respect. Care Homes for Older People Page 15 of 27 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 excellent 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 are supported well to make some choices about their lifestyle. The people are given the opportunity to participate in appropriate social, cultural and recreational activities of their choice. People enjoy the food and have a varied diet. Evidence: There is a dedicated area for activities to make sure that people can have the option of joining the sessions or sitting quietly in the lounges. Each person has an activity sheet which outlines activities they have participated in, for example, when they go out; personal interests such as looking at photographs, pat the dog sessions, manicures, and cookery. Reminiscence sessions are also held, and board games and bingo are also provided. The people go out to lunch and visit relatives, they are able to go out and come in when they wish with easy access to the kitchen and the home. Daily routines are very flexible and the people living in the home are encouraged to have their say in the daily life in the home. People maintain contact with family, friends and the local community. Some of the people keep in contact with their relatives aboard by using email. When required these emails are printed off in large print. The home has installed wireless internet access so that most of the old rooms will be able to use this facility. All of the new rooms are connected with data lines so Care Homes for Older People Page 16 of 27 Evidence: that individual internet access is available in every room. Family and friends have also used this facility when visiting their relatives. A staff member comments: On a monthly basis Abbey Lodge invites people to sing to the residents and there is also cake making. The residents enjoy this. They are activities several times a week; they go on trips, now and again. They can walk around the home, they go in the lovely garden in the summer and are all happy. A relative comment: There is a good activity programme in place and we can visit at any time, there are no restrictions. People are able to exercise choice over their lives. People spoken to confirm that they can get up and go to bed as they wish. It is evident from speaking to the people and staff in the home that choice and preferences are promoted. A person living in the home comments: I have a very nice bedroom and I am able to come and go as I please. There are no rules and regulations, we just ask and they will always try and do it or get it for you. They are very kind. The lunch served at the time of the visit looked appetising with good portions. The people told us that the meals are good and there are always two choices. Their likes and dislikes are known by the staff and when required special diets are provided. One person was being supported to eat their meal in a sensitive caring manner. The menu and standard of food is discussed at the residents meetings and changed in line with their choices and suggestions. One relative had commented in a postal survey that the home could provide better quality of food. The Registered Manager closely monitors the standard of food and there have been no complaints with regard to the quality and no negative comments were received at the time of the visit. The kitchen is always accessible to the residents who are able to make tea or have a snack if they wish. There are also facilities for making tea on the first floor by the library. The people who use the service comment: I would recommend this home and the food is good. You can not fault the food; you could not find a better home. The Manager and her deputy are brilliant. You can get a snack if your need it but the food is ample. Care Homes for Older People Page 17 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service are confident complaints will be listened to and dealt with appropriately. People who use the service are protected from abuse. Evidence: The people told us that they are confident that any concerns raised would be listened to and resolved. A complaints procedure is displayed in the front hall and all complaints logged had been recorded with action taken to resolve the issues. The Registered Manager talks with the people on a daily basis so that they have the opportunity to raise any concerns. There are safeguarding polices and procedures in place to make sure that the people using the service are protected. Staff have received safeguarding training and told us what they would do if they had any concerns. The home has been involved in a safeguarding alert since the last inspection and this was investigated by the local social services safeguarding team. The outcome from the investigation was that the alleged abuse was not upheld. The home has a robust recruitment procedure and checks are made on new members of staff to make sure that they are safe to work in the home. Care Homes for Older People Page 18 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has improved the environment to provide people with an excellent, comfortable, homely and safe place to live. The residents benefit from a clean and very well maintained environment. Evidence: The planned refurbishment of the home is now complete. The home has a new courtyard garden which is accessible on one level for the people to walk from the new dining room into the garden. There has been an extension to the ramped area at the front with a patio area so again residents can walk safely and sit out the front. New rockeries, a rock pool, lighting & seating have been provided. There is seating at strategic points so the people can rest and enjoy the view. The garden is protected by a gate and fencing and there are also raised flowerbeds with seating, a raised pond, and a pegola. There are more spacious areas in the home to improve privacy to make sure that there is effective social interaction with other residents, their families and friends. The people in the home have more choice of where they would like to sit and can find areas where they can be alone if they wish, rather than sitting in their bedroom. The new refurbishment has included wider doorways to improve the space for wheelchair users and more space for activities to take place. There is level access in and out of the building enabling all resident to move freely and wander safely. Care Homes for Older People Page 19 of 27 Evidence: The recordation of the home is now complete, the decor is excellent making the home a comfortable place to live. The laundry and sluice room have appropriate facilities with good systems in place to reduce the risk of infection. The sluice room was also in good order. The whole of the home was very clean and tidy, very well maintained with a pleasant smell throughout. Bedrooms are personalised to individual choice and the people have the aids and equipment to support them with their mobility. Care Homes for Older People Page 20 of 27 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. The people living in the home are protected by the recruitment procedures and have confidence in the staff who care for them. Improvements in the training programme is required to make sure that all staff receive relevant training that is focused on improving outcomes for the people living in the home. Evidence: We looked at the staff rota to make sure that there was enough staff on duty to support the people living in the home. Care staffing numbers are sufficient to meet the needs of the people. The staff group is very stable and know the people in the home well. There is always a manager to call upon should the staff have any concerns. The people who live in the home told us that the staff were always available and very kind. A person who uses the service comments: The staff are lovely they always come quickly. People receive care from staff that is qualified. There are thirteen members of staff who have achieved National Vocational Qualification (NVQ) level 2 or above. This is above the recommended 50 for good practice. People are protected by the recruitment procedures. All of the staff have been checked Care Homes for Older People Page 21 of 27 Evidence: to make sure that they are safe to provide care to the people living in the home. This includes criminal record checks, proof of identity and two written satisfactory references. A programme of staff training is in place and the Registered Manager is a trainer in moving and handling and Mental Capacity. Not all staff have completed the full mandatory training and there are gaps in most of the subjects. For example, only five members of staff have received health and safety training. The Registered Manager has already identified these shortfalls in the AQAA and has introduced an incentive for staff to take advantage of the training provided. Four members of staff have signed to complete a health and safety course and two are currently completing their first aid training. As the Registered Manager had already identified this issue and is taking action to address these shortfalls, no requirement will be made at this time. Some specialist training has been provided for small numbers of staff, for example four staff have received dementia training, eight staff in The Mental Capacity Act and one in diet and nutrition. The Registered Manager told us that she will also be booking additonal courses to cover specialist needs. The AQAA states that the induction training is going well and training workshops are provided to enable new staff one to one time with managers. This is to make sure that the induction training is completed within the three month period. The induction training work book can be used as evidence for parts of the NVQ 2 assessments. Care Homes for Older People Page 22 of 27 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 excellent 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 in the best interest of the people who live there. The health, safety and welfare of the people living in the home is promoted. Evidence: The Registered Manager has the qualifications and experience to make sure that the people who live in the home receive a high standard of care. She is the owner/manager and speaks to the people of a daily basis to make sure the home is running well. The Registered Manager is aware of what needs to be improved in the home and has a business plan in place to address any issues. The people who live in the home, staff and care management made complimentary comments about her commitment to the service. She is consistently in the home supporting the staff and knows the people who live there well, encouraging and supporting them to have their say in how the home is run. Last year the home achieved the Investors in People Award. People who use the service comment: The Manager is always here to help me. Care Homes for Older People Page 23 of 27 Evidence: Relative comment: This is a family run business; the management team are a good role model for the staff. Care Manager comment: The manager and staff are welcoming and kind. A staff member comments: I always feel supported by the Manager, she knows what is going on in the home, everything is brilliant here. The people in the home are aware that their views and suggestions will be taken into consideration in the day to day running of the home. They told us that there are regular meetings so that they have a chance to discuss any issues. Minutes from the last meeting were seen and they made suggestions about the menu and meals in the home. Questionnaires are also sent to the people to monitor the standard of care being provided. The programme does not currently include other stakeholders, for example relatives and health care professionals who visit the home. The Registered Manager told us that they will be included in the next quality assurance. Relatives spoken with at the time of the visit told us that the Registered Manager includes their views and suggestions however this is not formally recorded. The AQAA states that new staff comment that they like the fact that they have hands on managers who work closely with them. The Registered Manager and Deputy carry out audits of the records in care planning and medication to monitor the service. Staff meetings are held on a regular basis to give them the opportunity raise any concerns. Staff are receiving supervision on a regular basis so they have the opportunity to discuss their development and identify any training needs. The people living in the home are supported with their finances. There are systems in place to safeguard peoples finances. Records seen were in good order and showed that the people are encouraged to sign for their monies. All receipts of any transactions are also on file to make sure that a clear audit trail is in place. The AQAA states that all servicing and maintenance checks are carried out to make sure the building is maintained safely. The owner is responsible for the maintenance of the home, which is in excellent order. There is a fire risk assessment in place and the fire checks have been carried out at regular intervals. The Registered Manager has identified the shortfalls in the mandatory training and is taking action to address these issues. Care Homes for Older People Page 24 of 27 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 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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