Care Home: Abbeyfield

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What the care home does well Prospective residents are provided with appropriate information to help them decide whether the home will be able to meet their needs, and residents are assessed prior to being offered a place to establish that their needs can be met by the home. The personal and healthcare needs of residents are recorded within individual care plans to provide staff with the information to support them. The home effectively promotes the health of its residents through its links with external healthcare practitioners. The home has appropriate systems in place to manage the medication on behalf of residents who are unable to do so, and also enables residents to manage their own medication where they can, and wish to do so. Residents are treated as individuals and their privacy and dignity are supported. The social and spiritual needs of residents are provided for by the home, and residents also have opportunities to access events and places of worship in the community. Contact with friends and family is encouraged and supported by the home. Residents are consulted and encouraged to make day-to-day decisions and choices in their lives, and are provided with a varied and appropriate diet. Residents have access to an appropriate complaints procedure, about which information is readily available, in order to raise any specific concerns. The home has an appropriate procedure on safeguarding vulnerable residents. The home provides a well-maintained and homely environment for residents, with appropriate adaptations to meet a range of needs. Standards of hygiene are high and the home has appropriate laundry facilities. The home has sufficient staff, to met the current needs of residents. and their level of NVQ attainment is good. The home`s staff recruitment process is thorough and supported by good records, providing safeguards to the vulnerable residents. The home is managed by a competent and appropriately qualified manager who has attended some recent training to update and maintain her knowledge. The home has systems in place to seek the views of residents and others about the care provided. Service users` finances are protected by the management systems in place, where the home takes on this responsibility. The health, safety and welfare of residents and staff are safeguarded by the systems in place. What has improved since the last inspection? The manager has continued to develop the home`s systems and has addressed all of the recommendations made in the previous inspection report. Key appointments have been made to the senior team to continue the home`s development and the manager has identified some priorities for development. Activities provision has been improved and a new activities coordinator appointed.Additional training has been attended by senior staff on areas relevant to care of the elderly. Plans are about to be actioned to improve the dining space available by replacing the conservatory with an extended dining room. The kitchen has been awarded four stars by the environmental health department. What the care home could do better: The effectiveness of the home`s safeguarding procedure could potentially be compromised by the the failure to provide staff with regular training on safeguarding. There are other gaps in the training provided to staff in key areas, which need to be addressed to ensure that all staff maintain current knowledge in these areas. The establishment of an overall staff training spreadsheet would enable an effective overview of staff training to be maintained. Quality assurance surveys could be sent to additional groups to broaden the range of feedback obtained. management monitoring visits must be carried out in accordance with the legislation. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Abbeyfield 11 Maitland Road Reading Berkshire RG1 6NL     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: Stephen Webb     Date: 2 7 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Abbeyfield 11 Maitland Road Reading Berkshire RG1 6NL 01189572826 01189594867 abbeyfield.reading@btopenworld.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Abbeyfield Reading Society Limited care home 28 Number of places (if applicable): Under 65 Over 65 28 old age, not falling within any other category Additional conditions: 0 The maximum number of service users who can be accommodated is: 28 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 Abbeyfield House provides care and accommodation to residents whose needs are associated with old age. The home is run by a voluntary organisation the Abbeyfield (Reading) Society, through a locally run committee. The Society is a member of the National Abbeyfield Society who provide co-ordination and back-up services. The Abbeyfield Society is a Christian based organisation. The home was opened in 1996 and purpose built. It is situated one mile from Reading town centre. There is a small public park at the rear of the garden. An Anglican church is opposite the house. There are 28 single rooms, each with an en-suite w.c and hand Care Homes for Older People Page 4 of 30 Brief description of the care home basin, built-in wardrobe, TV, and telephone point (if required). Basic furnishings are provided although residents are encouraged to bring some pieces of their own. In addition to the main lounge, there is a quiet lounge and a dining room. There is also a conservatory on the ground floor that leads out to a landscaped garden. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection included an unannounced site visit from 9.45am until 4.00pm on the 27th of April 2009. This report also includes reference to documents completed and supplied by the home, and those examined during the course of the site visit. The report also draws from conversation with the manager, and briefly with some of the staff members on duty during the day, as well as some verbal feedback from residents. The inspector also observed the interactions between residents and staff at various points during the inspection. No inspection surveys had been returned at the time of writing. The inspector examined the majority of the premises, including some of the bedrooms. Care Homes for Older People Page 6 of 30 Feedback from the residents was broadly positive and some of their comments have been included within the report. Any issues raised were communicated to the manager during the inspection for consideration. Current fees range from five hundred and seventy six pounds per week to six hundred and sixty one pounds per week, depending on the level of dependency. What the care home does well: What has improved since the last inspection? The manager has continued to develop the homes systems and has addressed all of the recommendations made in the previous inspection report. Key appointments have been made to the senior team to continue the homes development and the manager has identified some priorities for development. Activities provision has been improved and a new activities coordinator appointed. Care Homes for Older People Page 8 of 30 Additional training has been attended by senior staff on areas relevant to care of the elderly. Plans are about to be actioned to improve the dining space available by replacing the conservatory with an extended dining room. The kitchen has been awarded four stars by the environmental health department. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents are provided with appropriate information to help them decide whether the home will be able to meet their needs. Residents are assessed prior to being offered a place to establish that their needs can be met by the home. Evidence: The home has a Statement of Purpose and a Residents Handbook which provide details about the home and the service provided. The documents were revised in January 2009. Prospective residents also receive an information pack which includes a welcome letter, inviting a visit to the home and informing the reader that the CQC inspection report is available to be read. Also included are a pictorial brochure, details of the names of senior managers, the current fees, and of the complaints procedure, an application form and a consent form for the GP to provide the home with any Care Homes for Older People Page 11 of 30 Evidence: necessary information. The files examined contained copies of appropriately detailed pre-admission assessments which include information about the needs and preferences of the prospective resident, as well as about the areas in which they remain able to look after themselves, to support their dignity. Standard 6 is not applicable as the home does not provide an intermediate care service. Care Homes for Older People Page 12 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The personal and healthcare needs of residents are recorded within individual care plans which provide staff with the information to support them. The home promotes the health of its residents through its links with external healthcare practitioners. The home has appropriate systems in place to manage the medication on behalf of residents who are unable to do so, and also enables residents to manage their own medication where they can, and wish to do so. Residents are treated as individuals and their privacy and dignity are supported. Evidence: The care plan files examined in the course of this inspection generally contained a good level of detail about the residents identified needs, together with information about any known preferences on how the individual likes to be supported, which is recorded within a personal profile. There was room for further development in terms of increasing the level of detail on how staff should provide the identified support, perhaps through the inclusion of more examples of the best individual approach. Care Homes for Older People Page 13 of 30 Evidence: Information was also available on residents communication methods and mobility support. There were details of relevant healthcare contacts, and of whether a bedroom key had been taken or declined. One file contained detailed information on the significant family contacts, friends and neighbours, within a residents support network, including how they are supported to attend their chosen place of worship, indicating a positive approach to resident dignity and spiritual fulfillment. Plans also indicated the residents spiritual needs and any preferences regarding funeral arrangements, where these had been obtained. However, some core information was not recorded in some instances, for example some basic information was not recorded and some consent forms were not yet completed. The care plans are subject to monthly review which is recorded. The manager demonstrated a good understanding of the importance of care plans and has appointed a Principal Senior Carer whose responsibilities include overseeing the residents care plans to ensure they remain upto-date. Healthcare information includes a medical history, a list of prescribed medication, mental and physical health assessments. At present the home does not arrange dental care for any of the residents, and residents families have opted to retain this responsibility. Other healthcare needs are provided for by the home through their links with external healthcare practitioners. GP appointments are recorded on individual sheets which are held within the daily records, and detailed notes are included the daily records. The care plan files also included a standard risk assessment format, which identifies any particular risks and hazards. Risk assessments include those on manual handling, behavioural issues, pressure sores, falls and nutrition. Action plans are included on how staff should address the identified issues. The risk assessments are subject to regular review. The home manages the medication on behalf of most residents, though two currently self-medicate. Each has signed a disclaimer for them to do so, but individual risk assessments should also be completed. Appropriate medication records are maintained where the home manages this, including a photo of the resident, records of the amounts of medication received by the home, details of that administered and of any returns to the pharmacist, providing the required audit trail. The homes medication systems were inspected by both the PCT and the pharmacist in 2008. The manager and deputy have both attended an advanced medication management course, and staff who administer medication have also received training. Residents privacy and dignity are supported through the provision of individual bedrooms with en suite toilets, lockable bedroom doors and drawers. Residents are offered the option of holding these keys. Communal bathrooms and toilets are fitted with appropriate locks, and where appropriate, doors can be opened outwards in an Care Homes for Older People Page 14 of 30 Evidence: emergency. The home has a residents committee and holds residents meetings as well as consulting them annually via a quality assurance survey. One resident is also elected to represent the views of residents on the local Abbeyfield committee. On the day of inspection some of the residents had chosen to attend the funeral of a resident who had recently died, along with representatives from the staff team. The homes activities coordinator is also responsible for pastoral care of residents, and takes the time to see residents individually, especially where they may not have a lot of social contacts. Care Homes for Older People Page 15 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The social and spiritual needs of residents are provided for by the home, and residents also have opportunities to access events and places of worship in the community. Contact with friends and family is encouraged and supported by the home. Residents are consulted and encouraged to make day-to-day decisions and choices in their lives, and are provided with a varied and appropriate diet. Evidence: A new activities coordinator was appointed six weeks before the inspection and works part-time (24 hours over four days). A proprietary tool is used for identifying individual needs/interests and monitoring individual take-up of activities. A series of monthly outings are offered, which residents can opt to attend. Reminiscence items are also loaned from Reading Museum. Records of activities participation are maintained by the activities coordinator. A weekly schedule of planned activities from Monday to Friday is posted in the dining room and in each residents bedroom, to advertise these to everyone. There is also a monthly diary of upcoming events posted. Residents spiritual needs are identified at admission and several residents attend places of worship either with staff or family support. One resident confirmed that they were taken to church by their family. A weekly Holy Communion and weekly Services Care Homes for Older People Page 16 of 30 Evidence: (various denominations), also take place in the home for those wishing to attend. The residents spoken to were happy that a range of activities were offered and that they could opt either to take part or decline to do so. They were also complimentary about the visiting hairdresser. On the afternoon of the inspection there was a film being shown and also two of the residents enjoyed their regular Bridge game with two visitors in the quiet lounge. As noted above, files contain information about residents significant family and other contacts and visitors are encouraged. Friends or family may take residents out perhaps for lunch or to places of worship. Staff understand the importance of maintaining residents existing contacts and of identified spiritual needs being met and will support this if family support is not available. Most of the current residents have some family contact with some being regular visitors or taking residents out. Some family also offer support for group outings. The home offers a good and varied four-weekly menu with two choices at main meals (other standard alternatives are also available daily). Menus are discussed by the residents committee and in residents meetings and the chef also talks informally with individual residents. Residents choose what they would like from the options offered, the day before. Birthday teas are planned individually with residents and the chef makes the cakes. Some residents are provided with soft or diabetic diets, but otherwise there were no specialist needs. Two non-practicing Jewish residents are happy with the homes regular menu. The lunch served on the day of inspection was well presented and tasty, and residents were offered choices where they did not want the menu item, and of sweet and tea or coffee. Some residents also found the portions offered by the temporary cook (the homes cook was off sick), to be too large, but these were changed promptly without fuss to more suitable ones. Where residents required assistance with meals this was offered unobtrusively by the staff, and staff were respectful in their dealings with the residents. Residents were generally complimentary about the meals and choice of menu, though two felt that the service could be rather slow at times. It was noted that staff carried the sweets into the dining room two at a time via the kitchen door rather than via the serving hatch directly into the dining room, from which the main course had been served. Perhaps other options might be considered. Care Homes for Older People Page 17 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents opinions about the service are sought in various ways and they have access to an appropriate complaints procedure, about which information is readily available, in order to raise any specific concerns. The home has an appropriate procedure on safeguarding vulnerable residents though its effectiveness could potentially be compromised by the the failure to provide staff with regular training on safeguarding. Evidence: The home has an appropriate complaints procedure, details of which are included within the information given to prospective residents, and a complaints log is in place. Examination of the complaints log indicated that there had been no recorded complaints since the last inspection so it was not possible to evaluate the operation of the procedure; however, a number of incidents had been recorded within the complaints log in error by staff. The manager stated that she had already raised this with staff but it appeared that some confusion remains to be addressed. One recent issue, discussed during the inspection, does need to be entered in the complaints log, together with the details of its resolution. No complaints about the service had been raised with the Commission for referral to the home, in the past twelve months. Residents are also consulted and their views sought via the residents committee and Care Homes for Older People Page 18 of 30 Evidence: residents meetings and by means of annual quality assurance surveys, as well as informally by the chef and others. There are also annual family meetings. Residents or their representatives are also directly consulted when completing assessments and care plans. The home also has an appropriate safeguarding procedure in place to protect vulnerable residents. The manager stated there had been no safeguarding issues within the home in the previous twelve months. No safeguarding issues have been notified to the Commission over the same period. The training records supplied during the inspection indicate that no recent safeguarding training has been received by the majority of staff. This issue is addressed within the staffing section later in this report. It is important that all staff maintain an awareness of current best practice around the safeguarding of vulnerable adults and whistle-blowing. Care Homes for Older People Page 19 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent 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 well-maintained and homely environment for residents, with appropriate adaptations to meet a range of needs. Standards of hygiene are high and the home has appropriate laundry facilities. Evidence: The home is purpose built and is decorated and furnished in a homely style. The bedrooms are provided over three floors, including four on the ground floor, which tend to be used for residents with higher level support needs. All are single rooms with ensuite toilets and most are individualised with residents own personal items. There are also communal toilets and bathrooms on each floor and a shower room on the ground floor. The bathrooms and toilets are fitted with appropriate locks to maintain residents privacy and dignity, and there are suitably adapted facilities to meet the needs of residents who may not be able to use a standard bath. Where necessary, toilet doors have been fitted with devices which enable the door to be opened outwards in an emergency. Corridors are wide and provided with handrails to support residents to mobilise independently. There is a main lounge and a separate smaller quiet lounge available as well as the dining room and conservatory, which are both used for dining. There are plans to replace the conservatory with an enlarged dining room, and work is due to start on this in May. The kitchen was appropriate to the Care Homes for Older People Page 20 of 30 Evidence: needs of the home and had been refurbished in the last few years. The home has a part-time handyman who attends to ongoing minor repairs and redecoration as required, and also has a gardener who maintains the outdoor areas. The gardens were attractive and well maintained and privided areas of lawn and planted borders as well as various level paths to enable residents to walk safely within the garden. Seating is also provided. It was notable that there were absolutely no unpleasant odours evident at any time during the inspection and standards of hygiene were high throughout the home. Appropriate laundry facilities were provided including washing machines with appropriate cycles to reduce the risk of cross-infection. Care Homes for Older People Page 21 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has an adequate compliment of staff, to met the current needs of residents. Though levels of NVQ attainment are good, there are some gaps in the training provided to staff in key areas, which need to be addressed to ensure that all staff maintain current knowledge in these areas. The homes recruitment process is thorough and supported by good records, providing safeguards to the vulnerable residents. Evidence: The home had fifteen permanent care staff at the point of inspection, supported by a bank of other staff who work only in the same home, and are used to provide additional cover. Where it is necessary to use agency staff, the manager tries to obtain known individuals who are already familiar with the home to maximise continuity of care. The usual care staffing levels are one senior carer, three carers and a residents assistant in the mornings and one senior and three carers in the afternoons and evenings; supported by the a part-time activities coordinator and the deputy and manager during the daytime. At nights there is one senior and one carer on waking duty. The manager stated that staffing levels are kept under review based on any changes of resident dependency, ill health etc. Observations of staff interactions with residents during the inspection indicated a positive and respectful approach, including the encouragement of individuals to make choices. Care Homes for Older People Page 22 of 30 Evidence: Levels of NVQ attainment based on the training records provided are good with ten staff having either level, two, level three, or both, and one undertaking level 3. The manager and deputy have attained level 4. Examination of a sample of recruitment records indicates that an appropriate recruitment and selection process is undertaken on prospective staff and that appropriate records are maintained of this process. New staff complete a Skills To Care-based induction record which is signed off on completion and a record is maintained. The available training records were listed individually for each staff member and there was no overall spreadsheet available to enable easy monitoring of this across the team as a whole. It is recommended that an overall training spreadsheet is established to enable an overview to be maintained. The home uses a mix of external accredited trainers, local authority training course and some in house training. The training records supplied during the inspection indicate that no recent safeguarding training has been received by the majority of staff. There also appeared to be shortfalls in other mandatory training and some staff had not had recent updates in some of the mandatory areas. The manager should review training across the whole staff team to identify and address any identified shortfalls in mandatory training or updates so that arrangements can be made to address these. The manager and deputy had attended training on the Mental Capacity Act and related new legislation, and there were plans for staff to attend local authority training on this in due course. Care Homes for Older People Page 23 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed by a competent and appropriately qualified manager who has attended some recent training to update and maintain her knowledge, though additional refresher courses in some areas should be attended. The home has systems in place to seek the views of residents and other stakeholders on the care provided, though the range of stakeholders surveyed could be broadened, and management monitoring visits must be carried out in accordance with the legislation. Service users finances are protected by the management systems in place, where the home takes on this responsibility. The health, safety and welfare of residents and staff are safeguarded by the systems in place. Evidence: The home is managed by an apropriately qualified and experienced manager who has attained NVQ level 4 and the Registered Managers Award, and has had seven years Care Homes for Older People Page 24 of 30 Evidence: experience as a manager. The manager has attended some recent training to keep upto-date with changing legislation, though she has not attended recent updates on safeguarding or moving and handling. The home has a quality assurance system which includes surveys to residents, relatives, friends, GPs and district nurses, though at present the views of staff and care managers are not sought through this process. Surveys were done in February 2007 and 2008, and the 2009 survey was due. Residents are also consulted via the residents committee and residents meetings, and also by the chef and activities coordinator to establish their wishes. The home also holds an annual meeting with residents relatives to seek their views. These had been held in March 2007 and 2008 and the minutes act as a summary of the outcome. An annual development plan was in place in the form of a business plan for 2008/9. Although the required regulation 26 monthly management monitoring visits were undertaken for most of the months over the last year, no reports were available for four months, and the February 2009 report had yet to arrive. Regulation 26 visits must be undertaken monthly and the resulting reports copied to the manager for action and filing for inspection. The home looks after the funds on behalf of some residents. Where this is the case an individual file is set up which includes a log of monies in and out and a running balance, which is checked monthly by management. The records are copied to next of kin where requested when providing top-up, together with copies of receipts for any expenditure. Examination of a sample of health and safety-related service certification indicated appropriate service intervals. The home was visited by a fire officer in July 2008, from which no issues reportedly arose. The homes fire risk assessment was written in July 2007 and reviewed July 2008. The latest fire drill took place in August 2008 and all staff are reported to receive regular fire training, via a computer-based hazard perception course. Seniors also attend a fire safety course. The home has a zone by zone evacuation plan approved by the fire authority and also holds a key to a local church hall, should an evacuation be necessary in an emergency. Examination of recent accident records indicated they were still held in the tear-off accident book. The manager agreed to set up a collective record for accident monitoring and for copies of completed forms to be filed on individual files. The records indicated that one resident had begun to have a number of falls and the home had responded appropriately by arranging a hospital appointment at the falls clinic. Care Homes for Older People Page 25 of 30 Care Homes for Older People Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 26 18 The manager must ensure that any staff training shortfalls are identified and steps taken to ensure that all staff receive the training they require. In order to ensure that staff maintain current knowledge in all key areas. 11/07/2009 2 33 26 The provider must ensure 12/06/2009 that management monitoring visits are undertaken monthly in accordance with regulations, and the resulting reports must be provided promptly to the manager for action and filing within the home. In order to maintain a consistent and thorough overview of the operation of the home. Recommendations These recommendations are taken from the best practice described in the National Care Homes for Older People Page 28 of 30 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 26 It is recommended that a training spreadsheet for all staff is established to enable management to maintain an overview of staff training. The manager should ensure that she attends regular updates to all key training to maintain current knowledge in these areas. The range of stakeholders surveyed could be broadened to include staff and care managers in order to maximise the breadth of feedback available. 2 31 3 33 Care Homes for Older People Page 29 of 30 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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