Care Home: Abbeyfield The Dynes

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What the care home does well The environment is spacious, very clean and homely and there are good infection control measures in place. The home has well maintained, accessible gardens and residents say they have really enjoyed spending time there throughout the summer. The care the home gives is excellent. The home promotes the health and well being of the individual. Good relationships are maintained with local General Practitioners and other health and social care professionals. The residents praised the staff for the way they give care and observation showed that staff respect the privacy and dignity of the residents at all times. There is a well trained and dedicated staff team who work well together. Each resident has a key worker who ensures that care reviews take place and that the views of individual residents are sought and heard. There is a strong, "Friends of the Dynes", volunteer group who support the home in a number of ways such as fund raising, running the trolley shop and helping out with outings and other events. The home is well managed both at a local and organisational level. The views of the residents are actively sought, listened to and acted upon.re is an excellent organisation and management structure so that there is clarity of roles and responsibilities for all staff. Activities in the home are excellent. There is a wide choice of things to do and visitors say they are always made very welcome. The food services at the home are very good. Residents say they enjoy their meals and that there is plenty to eat. What has improved since the last inspection? The home has adopted the Eden Alternative principles, calling it the Pegasus Project. This aims to create a more homely and stimulating environment that involves the residents in all aspects of the home. In line with the Eden principles, staff no longer wear uniform and the home has some pets, including a cat and rabbits. A new manager was appointed and was registered with the Commission last year. The management structures of the home have been changed so that there is more clarity of roles and responsibilities for all staff. The post of care co-ordinator has been created. This have given clearer leadership and direction to improve health, personal care and activities. The variety and frequency of activities in the home have improved significantly. The adoption of the Eden principles has meant that more spontaneous activities take place as well as more outings that are in line with the interests of the residents. Staff training has significantly improved. There is a thorough induction programme and plenty of ongoing training with regular mandatory and specialist training taking place. What the care home could do better: No requirements were placed as a result of this visit. Key inspection report Care homes for older people Name: Address: Abbeyfield The Dynes Nightingale Road Kemsing Sevenoaks Kent TN15 6RU     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: Wendy Mills     Date: 0 1 0 9 2 0 0 9 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 29 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 29 Information about the care home Name of care home: Address: Abbeyfield The Dynes Nightingale Road Kemsing Sevenoaks Kent TN15 6RU 01959523834 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): belinda.watson@abbeyfieldkent.org The Abbeyfield Kent Society Name of registered manager (if applicable) Mrs Nicola Pett Type of registration: Number of places registered: care home 34 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 34. 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 The Dynes is a purpose built home for older people situated in a quiet part of Kemsing village. The home is in close proximity to local shops and there is a bus service to the village connecting with Sevenoaks. the A25 is approximately a mile away and there is good on site parking to the front of the home. Care Homes for Older People Page 4 of 29 Over 65 34 0 Brief description of the care home Residents are accommodated in single bedrooms although it may be possible to provide a double bedroom if requested. All bedrooms have an alarm call system and residents are encouraged to personalise their rooms. A shaft lift provides access to all areas of the home. There are a range of communal areas and a well kept, safe and attractive garden is accessible to residents. Residents have opportunities to take part in a range of activities provided by the home as well as community activities and outings. Staff are well trained and the majority hold the National Vocational Qualification (NVQ) in care. The current weekly fee for the service ranges from £424 to £650 per week. Further information about the home can be obtained by contacting the registered manager at the home. Care Homes for Older People Page 5 of 29 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 visit was unannounced and formed part of the annual inspection process of the Care Quality Commission (CQC). The visit was carried out in accordance with the Care Standards Act. This report takes into account information we have gathered during this visit and information that we have received prior to this visit. This includes information that the home is required to give us such as their Annual Quality Assurance Assessment (AQAA) and notifications about significant events that affect people who use this service; and things that other people have told us about the service such as the comments received from relatives and visiting health and social care professionals. The evidence we have gathered during the inspection process will be used to make a judgement about the quality rating of the home. During this visit important documentation, such as care plans, staff files and policies and procedures, was examined. Three of people who use this service and three of their Care Homes for Older People Page 6 of 29 relatives and supporters were spoken, in private, to to find out what they think about the home. Ten other people were spoken to throughout the day. Four staff members were spoken to, two of them in private, and in-depth discussion was held with the care co-ordinator. A tour of the home was made and direct and indirect observation was used throughout the time spent in the home. As the registered manager was on leave at the time of this visit a telephone conversation was held with her the following week. The people who use this service say that they like to be referred to as residents. Therefore, the term, The residents, will be used throughout this report to refer to the people who use this service. The residents and their relatives all said that they are extremely happy with the care they receive and the life they lead in the home. They made very positive comments about all aspects of the home and the care provided. In particular, they praised the staff and the friendly atmosphere in the home. The quality rating for this home has been assessed as 3 Stars. This means that the residents experience excellent outcomes in all aspects of their care and support whilst living in the home. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? The home has adopted the Eden Alternative principles, calling it the Pegasus Project. This aims to create a more homely and stimulating environment that involves the residents in all aspects of the home. In line with the Eden principles, staff no longer wear uniform and the home has some pets, including a cat and rabbits. A new manager was appointed and was registered with the Commission last year. The management structures of the home have been changed so that there is more clarity of roles and responsibilities for all staff. The post of care co-ordinator has been created. This have given clearer leadership and direction to improve health, personal care and activities. The variety and frequency of activities in the home have improved significantly. The adoption of the Eden principles has meant that more spontaneous activities take place as well as more outings that are in line with the interests of the residents. Staff training has significantly improved. There is a thorough induction programme and plenty of ongoing training with regular mandatory and specialist training taking place. Care Homes for Older People Page 8 of 29 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 29 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 29 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. The home gives prospective service users and their supporters good information about the home so that they can make and informed decision about moving into the home. Thorough pre-admission assessments are made to ensure that the needs of the person applying for a place at the home can be met. Evidence: There is comprehensive information about the home including a statement of purpose, service user guide and guide to the Abbeyfield organisation. There is a large, well maintained notice board in the foyer of the home. The last inspection report and information about the Commission are displayed in a prominent position on the board as well as information about day-to-day activities in the home. There is a large reception area in the foyer of the home. This is manned by a very helpful staff member who was seen to have excellent communication skills and to Care Homes for Older People Page 11 of 29 Evidence: relate very well to residents and their relatives, welcoming them and keeping them well informed. Four care plans were examined, including those of the two most recently admitted residents. There are comprehensive pre-admission assessments in place that record the care needs, wishes, likes and dislikes and cultural and religious needs of the individual. On the day of the visit the care co-ordinator had been out to make a preadmission visit to a prospective service user. Discussion with the co-ordinator later in the day showed that the homes strict pre-admission policies and procedures are adhered to. This means that only those people whose needs can be met and who are suited to the home are offered a place there. The home does not offer intermediate care. Care Homes for Older People Page 12 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home positively promotes the health and well being of the people who use this service in a way that respects their privacy and dignity. Evidence: Four care plans were examined, two were of the most recently admitted residents and two were chosen at random. All care plans were in good order and reflected the care and personal needs of the residents as well as their cultural and religious needs. There is good evidence that the home has been proactive in developing plans for the future. Recently there has been training in the Liverpool Care Pathways for people with terminal illnesses. Staff have also received training in the prevention and management of pressure sores as well and in a number of other specialist areas such as dementia care. Since the last inspection the Abbeyfield homes in Kent have embraced the Eden Alternative principles. They have introduced the concept, called the Pegasus Project, which is based on the Eden Alternative principles. The project is part of an international movement committed to improving the lives of care home residents. This Care Homes for Older People Page 13 of 29 Evidence: is done by creating a homely and stimulating environment where children and pets are welcomed; empowering staff with increased decision making and more flexible roles and enabling them to care for smaller groups of people; and improving resident autonomy by increasing their involvement in the day-to-day running of the home and decision making. Staff have received training in these basic principles and there is ongoing training to develop the concept further. The principles are applied to every aspect of life in the home and more detail will be given to describe how the project is making a difference in the home under each outcome area. There was good evidence that the people who use this service and their families have increased their input into care planning and the decisions that are made about their health care. One relative said, They are very good, they always ask mum about her care and keep me informed if theres anything I should know about. The home communicates well with the local general practitioners (GPs) and the staff that work within their practices. The registered manager told us that there are very good working relationships with local health care services. The home has allocated a room for visiting health and social care professionals and a district nurses visit the home on a regular basis. The people who use this service are encouraged to make choices about their own health and personal care. All can choose whether to bath or shower and at which time they bathe. Where possible they can choose the general practitioner with whom they resister although this can be restricted by the number of GPs that are close enough to the home. Choices can me made as to whether to self medicate and some people have chosen to take responsibility for some medication such as creams and painkillers whilst others say they prefer the home to look after their medicines. One person said, It is marvelous that they do this for me then I dont have to worry if I have forgotten to take my tablet. There is close working with the GPs and other health care professionals to ensure that the medicines the people who use this service are taking are kept to the minimum needed so that they are not suffering too many side effects of medication. The management and administration of medicines in the home is very good. There is a room set aside for medication. The storage was inspected. It was found to be safe and secure. Medicines are stored at the correct temperature, which is checked daily. They are kept in a locked cabinet in a locked room with controlled drugs being stored in an approved locked cabinet. There are sound systems for the ordering and returns of medicines. These were described fully by the care co-ordinator. The Medicines Administration Records (MARs)were examined and found to be in good order. These are scrutinised by the care co-ordinator to ensure there are no errors. Care Homes for Older People Page 14 of 29 Evidence: All staff who administer medicines have received thorough training. Training records of three staff members were examined. These records showed that the appropriate training has been undertaken. Care Homes for Older People Page 15 of 29 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 activities in the home are person centred, varied and enhance the lives of the people who use this service. This helps them to continue to lead interesting and meaningful lives whilst maintaining as much independence as possible. Evidence: Four care plans were chosen at random and examined to check that the wishes of the people who use this service are recorded in respect of daily life and activities. The records show that the likes and dislikes, religious and cultural needs, previous experiences and interests and other pertinent information has been detailed. The records also indicate how these needs should be met. As previously mentioned, the home has adopted the Eden Alternative principles to care, calling the introduction of these principles, The Pegasus project. Activities in the home have always been varied and included outings but since the beginning of the project, the home has worked even harder to ensure that activities are person centred, varied and stimulating. the project encourages more person centred, spontaneous and innovative activities. The presence of pets in the home is encouraged. The home has a cat, two pet rabbits Care Homes for Older People Page 16 of 29 Evidence: and a tropical fish tank. Some of the residents said that they enjoyed being able to stroke the rabbits and watch their progress whilst others take more interest in the fish tank. The staff spoken to said that the training they have received as part of the Pegasus project has made them much more aware of the importance of activity. They also said that they are trying to encourage different sorts of activities and spontaneity. One member of staff said, For example, say I was chatting to a resident and they said they used to like something, like crochet, knitting, making their own cards, then I would try use that moment to get them interested in doing that activity. There is a local group of volunteers who visit the home. They run a mobile shop so residents can purchase items such as toiletries and sweets. One of the volunteers was spoken to. She said that she really enjoys visiting the home and is always made welcome. She told us that she works hard to ensure that the items in the shop are at the best prices and that all monies are carefully accounted for. The residents said that they find the shop useful and enjoy making purchases. There have been several outings since the last inspection. There have been trips to garden centres, picnics and theatre trips. Another theatre trip is planned for next month to see the musical, Annie. Relatives spoke enthusiastically about the way the home involves them in these trips. One relative said, They always tell us what theyre planning and give us the chance to go along. Its nice because we can still enjoy things as a family. They also invite us to things going on in the home, garden parties, barbecues, things like that. There are also several activities that go on in the home. Recently a donation to the home funded the purchase of a flat screen television that, after consultation with the residents, has been installed in the dining room to give a, cinema atmosphere, when popular films and programmes are on. This television has become very popular with the gentlemen in the home as it means they can have a, Male domain, and watch sport without, Disturbing the ladies. Visitors are made very welcome to the home. There is a large foyer with a reception desk and comfortable seating ad well as plenty of information about the home and magazines. A receptionist greets visitors. Relatives spoken to said that they are made welcome. One said, They always make us feel part of the home, always offer a cup of tea or coffee, chat to us - theyre all really friendly - the staff are lovely. The Abbeyfield Society is a Christian based organisation and has its own ministry to Care Homes for Older People Page 17 of 29 Evidence: the home that includes church services. However, the home is not exclusively for those of the Christian faith. Religious and cultural needs are recorded in the care plans and arrangements are made for those who wish to attend their places of worship or for their religious leaders to visit. The residents said that the food in the home is very good and that they nearly alway enjoy their meals. One resident did mention that some meat had been rather tough recently and the home is looking into this to make sure meat is tender in the future. The residents told us that there is always a choice and plenty to eat. The chef plans the menu in conjunction with the manager and the residents views are taken into account. The chef has control of the budget for food and is responsible for ordering produce. There is a choice of two meals at lunchtime, when the main meal is taken and a selection of hot and cold light meals at teatime. The menu choice is offered on the morning of the meal. Special diets are catered for and the staff showed a good understanding of the importance of good nutrition and nutritional monitoring. Care Homes for Older People Page 18 of 29 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 home has sound policies and procedures for managing complaints, concerns and safeguarding. This helps to protect the service users from harm. Evidence: The home has sound policies and procedures for the management of concerns, complaints and safeguarding. These are displayed on the notice board in the foyer of the home, in the Statement of Purpose and the Service User Guide. All complaints and concerns, however minor, are recorded. These records were examined and discussed with the care co-ordinator. Records show that all concerns and complaints were responded to in within the stated timescales. There was good evidence to show that, where complaints were upheld, action had been taken to rectify them and that the home has put in further safeguards. The home is commended for the way it records all concerns, follows them up and learns by the issues raised. Staff spoken to were clear about their responsibilities for making a complaint on behalf of a resident is indicated. The people who use this service and their relatives said that they know how to complain and fell comfortable in making any concerns known to the registered manager. One relative said, I have no con plaints at all, they are really good here, they involve us (family) in mums care when they need to. Another said, We know we can speak to the manager about anything that worries us, having said Care Homes for Older People Page 19 of 29 Evidence: that, there has been nothing, so far, that we have had any worries about. Staff receive training in the safeguarding of vulnerable people and those spoken to were clear about the reporting procedures for serious concerns. The staff spoken to said they would have no hesitation in reporting concerns to the manager or the care co-ordinator. Care Homes for Older People Page 20 of 29 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 environment is very clean, safe and well maintained. This gives the residents a pleasant and homely place in which to live. Evidence: The home is situated in a quiet area on the edge of the village of Kemsing, about seven miles from the town of Sevenoaks. The accommodation is arranged over two floor and there are wide stairs and a shaft lift between the two floors. The home has a friendly and welcoming atmosphere and residents were observed to choose where they spent their time. There is plenty of communal space including several small sitting areas, a conservatory, a main lounge and a light and airy dining room. Some of the residents showed us their rooms. The small sitting areas give a very homely feel and residents can meet with friends in relative privacy in these areas, if they choose not to use their rooms for this purpose. The communal areas are all well decorated and fabrics have been used to good advantage to make the areas more attractive and homely. In addition, there are interesting pictures in each area. All private accommodation for residents is in single rooms. The residents said that they have been able to personalise their rooms with items from home. One said, Its been nice to be able to make it look like a bit of home. Care Homes for Older People Page 21 of 29 Evidence: Outside there is a well maintained garden with patio areas, lawns and borders to the rear of the home. Some of the borders have been raised so those who want to take part in gardening activities can do this more easily. There is plenty of car parking at the front of the premises. All certificates for the maintenance and review of safety, such as electrical testing and fire safety were in place nd up-to-date. A tour of the home was made. All areas were very clean and pleasant smelling. There are sound infection control measures in place throughout the home. Infection control equipment such as disposable gloves and aprons are stored discretely and there were plenty available on the day of this visit. The laundry was inspected and the laundry assistant spoken with. The laundry was very well organised and the assistant is clear about infection control and has received training in this topic. The kitchen is kept very clean and is well managed. There is plenty of room and storage is well managed. No health and safety hazards were noted during a tour of the home. Care Homes for Older People Page 22 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels, staff training and recruitment procedures are all excellent. There is good team working and staff morale is high. This means that the residents are cared for by a well qualified, carefully vetted and cheerful staff team. Evidence: Since the last inspection there has been a reorganisation of staffing structures. There is now a care co-ordinator who oversees the health and personal care that the home gives. There are three care teams, each with a team leader. The team leaders report to the care co-ordinator. This new structure makes staff roles and responsibilities much clearer. It also ensures that there are well defined lines for reporting any concerns. There are good staffing levels in the home. As well as care staff the home employs a chef, kitchen assistant, laundry assistant, cleaners and gardening and maintenance personnel. There are four care staff on each morning shift, three on in the afternoons and two wake night staff. The residents and their relatives spoke very highly of the staff. Comments such as, The staff really look after us well. We can have a good laugh with them - its lovely here; We get out a lot, the staff take us on picnics, cream teas - lots of things theatre and that - theres plenty to do here, (in the home), if you want to - the staff Care Homes for Older People Page 23 of 29 Evidence: are always there to help you have a game of cards, whatever; and, They look after mum really well, I dont think the staff could do any better than they do, were received. The staff spoken to said that they really enjoy working in the home. One said, Its a lovely home, really good atmosphere and everybody works together for the people here. Since the last inspection there has been a significant improvement in staff training. Three staff files were selected at random for inspection. There was good evidence that staff have attended recent statutory training such a manual handling and fire safety, and specialist training, such as dementia care, the Mental Capacity Act and diabetes. Three members of staff were spoken to. They confirmed that they receive a wide range of training opportunities and that the home encourages them to embark on the National Vocational Qualification (NVQ) programmes. There was good evidence in the staff files and other recruitment documentation that all necessary pre-employment checks are carried out before employment at the home is offered. Check lists showed that Criminal records Bureau (CRB) and Safeguarding (POVA First) checks have been carried out and at least two written references were seen sought. There is an induction period and a thorough induction programme. In addition there is close staff supervision, performance and absence monitoring. Care Homes for Older People Page 24 of 29 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 managed and run in the best interests of the people who use this service. Evidence: The registered provider for the home is the Abbeyfield Society. This is a Christian based organisation that runs a number of homes for older people in Kent. The Society is a not for profit organisation that has a sound reputation for ethical service provision in the region. The registered manager has been in post since October 2008. She has over eleven years experience in working in care setting and has worked for the Abbeyfield Society for over none years, previously she was deputy manager at another Abbeyfield home in Kent. She holds the National Vocational Qualification (NVQ) at level three in care and is currently working toward the NVQ at level four in leadership and management. Since the last inspection there has been some change in the organisational structure Care Homes for Older People Page 25 of 29 Evidence: within the home. The post of assistant manager has been replaced with a post of care co-ordinator and three new teams with team leaders have been set up. This means that individual job roles and responsibilities are much clearer and that there are sound structures for staff supervision. The role of care co-ordinator now means that there is greater overview of care practice in the home and improved health care input. In depth discussion with the care co-ordinator and a later telephone conversation with the registered manager confirmed that there are good working relationships throughout the home. Regular one-to-one supervision takes place and is recorded in an agreed format. The recent restructuring means that there is a much tighter procedure for staff supervision and that staff performance management has improved. The Annual Quality Assurance Assessment (AQAA) confirmed that the home has sound quality assurance systems and that the views of the people who use this service and their supported are sought on a regular basis. The people who use this service and their supporters spoke highly of the way the home is managed and said that they know that any concerns will be dealt with quickly and that the home keeps them informed of what is going on. they also said that their views are sought on a regular basis. one said, we are given a questionnaire to fill in every so often, they ask us about all sorts of things, the food, the environment and activities. They are always asking us if we think there is any activity that would be different or that the residents would enjoy. Documentation in the home is well organised, well maintained and up-to-date. the care co-ordinator was able to quickly find all documentation requested at this visit. There are sound health and safety policies and procedures in place and the AQAA told us that regular health and safety checks are made and that all required safety certificates are in place and in date. Care Homes for Older People Page 26 of 29 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 29 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 28 of 29 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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