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Care Home: Abercarn Residential Home

  • 56 High Street Pensnett Dudley West Midlands DY5 4RS
  • Tel: 01384480059
  • Fax: 01384480059

Abercarn is a located in the heart of Pensnett on a main road between Kingswinford and Dudley, served by a bus route. There is car parking at the front and side of the property. The home provides accommodation for a maximum of 32 people on two floors, accessed by a lift. On the ground floor, there is a communal lounge, and the office is in the corner of the dining room. In the enclosed garden there is a covered area for people who smoke and a laundry building. Bedrooms are on the ground and first floor, have washbasins, and a few of these are double rooms. There are communal toilets located throughout the home and near communal areas, but these cannot accommodate a wheelchair and hoist. There are two assisted bathrooms; a bath on the ground floor and a shower on the first. The home should be contacted directly for current information about fees and charges.

  • Latitude: 52.501998901367
    Longitude: -2.1400001049042
  • Manager: Ms Elaine Margaret Guest
  • UK
  • Total Capacity: 32
  • Type: Care home only
  • Provider: Cotdean Nursing Homes Limited
  • Ownership: Private
  • Care Home ID: 1303
Residents Needs:
mental health, excluding learning disability or dementia, Old age, not falling within any other category, Physical disability

Latest Inspection

This is the latest available inspection report for this service, carried out on 22nd April 2010. CQC found this care home to be providing an Adequate service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

For extracts, read the latest CQC inspection for Abercarn Residential Home.

What the care home does well People`s needs are assessed so that their care and support can be planned properly. They are able to come and visit the home to help them decide if it is the right place for them. Staff treat people in a warm and friendly way and respect their rights to privacy and dignity. They get the support they need to help them stay healthy and well. Routines in the home are flexible, so that people are able to get up and go to bed when they like. They can have visitors to suit them, so that they are able to keep in touch with important people in their lives. They have a varied and balanced diet, so they enjoy their meals and mealtimes. Staff work hard to make sure the home is clean, tidy and fresh so that people can be comfortable in their home. There is low turnover on the staff team, so people are cared for by a familiar group of staff that know them well. Important checks are carried out on staff before they start work at the home. This is to make sure they are fit for their jobs. The Manager and staff team are working hard to make sure that people are well cared for and supported to be safe. What has improved since the last inspection? Clear efforts have been made to meet the requirements we set at the time of the last key inspection. A lot of work has been done to develop people`s care plans. This is so that staff have good guidance about supporting people in the ways they like. Plans have been reviewed so that important information is kept up to date. Bedrails are no longer being used inappropriately in the home. Arrangements for administration, storage and handling of people`s medication have improved so that people get their medines safely and at the right times. New furniture has been provided in some rooms and redecoration and refurbishment of the home is ongoing. This is so that people can enjoy living in a comfortable and safe home environment. Menu planning has been reviewed so that people can enjoy a variety of foods they like. More options are now available for hot snacks in the evenings. Action is now being taken to explore any gaps in employment histories of people applying to work at the home. This helps to ensure that recruitment practice is robust. Some action has been taken to consult with people using the service and their families to see if they are happy with the support they receive. What the care home could do better: Information about what the service provides should be updated. This is so that people who may be thinking about coming to live at the home can be helped to make an informed decision. Develop the use of person-centred approaches in care planning and agree clear goals with people using the service. This is to ensure that they get the support they need in ways that suit them best. Activity options for people need to be improved, particularly on an individual basis. This is to make sure that people get to do the things they value and go to places they like. Develop the ways in which informal complaints are managed, so that people`s opinions are actively sought and their concerns acknowledged and dealt with. Complete redecoration and refurbishment work in the home so that people can enjoy living in comfortable and safe surroundings. Implement a staff training and development plan, to ensure that staff have all the skills and knowledge they need to do their jobs well. Ensure that staff receive regular formal supervision, so they get all the support they need in their work at the home. Monitoring and quality assurance systems should be devised and implemented fully. This is to ensure that the views of people using the service underpin its review and development. The company should ensure that the Manager has the equipment she needs and sufficient time allocated to fulfill all her management duties effectively. This is to ensure that improvements made are sustained and the service is well run for the benefit of the people that use it. Key inspection report Care homes for older people Name: Address: Abercarn Residential Home 56 High Street Pensnett Dudley West Midlands DY5 4RS     The quality rating for this care home is:   one star adequate 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: Gerard Hammond     Date: 2 3 0 4 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 30 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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: Abercarn Residential Home 56 High Street Pensnett Dudley West Midlands DY5 4RS 01384480059 01384480059 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Cotdean Nursing Homes Limited Name of registered manager (if applicable) Type of registration: Number of places registered: care home 32 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 32 The registered person may provide the following category of service only: Care Home Only (Code PC); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Mental disorder, excluding learning disability or dementia (MD) 8, Old age, not falling within any other category (OP) 32, Physical disability (PD) 8, Date of last inspection 2 2 1 0 2 0 0 9 8 0 8 Over 65 0 32 0 Care Homes for Older People Page 4 of 30 Brief description of the care home Abercarn is a located in the heart of Pensnett on a main road between Kingswinford and Dudley, served by a bus route. There is car parking at the front and side of the property. The home provides accommodation for a maximum of 32 people on two floors, accessed by a lift. On the ground floor, there is a communal lounge, and the office is in the corner of the dining room. In the enclosed garden there is a covered area for people who smoke and a laundry building. Bedrooms are on the ground and first floor, have washbasins, and a few of these are double rooms. There are communal toilets located throughout the home and near communal areas, but these cannot accommodate a wheelchair and hoist. There are two assisted bathrooms; a bath on the ground floor and a shower on the first. The home should be contacted directly for current information about fees and charges. 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: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We gathered information from a number of places to inform the judgements we have made in this report. These included the last key inspection and subsequent random inspection reports, and information that the home has sent to us about the service. This inspection was unannounced and took place over two days. We visited the home and spoke with the people who use the service, the Acting Manager and members of staff. We were also able to meet with some peoples relatives and a visiting professional. We looked at records including care plans, personal files, staff records and other documents. We also looked around the home. We were made welcome and well supported throughout the inspection. Care Homes for Older People Page 6 of 30 What the care home does well: What has improved since the last inspection? Clear efforts have been made to meet the requirements we set at the time of the last key inspection. A lot of work has been done to develop peoples care plans. This is so that staff have good guidance about supporting people in the ways they like. Plans have been reviewed so that important information is kept up to date. Bedrails are no longer being used inappropriately in the home. Arrangements for administration, storage and handling of peoples medication have improved so that people get their medines safely and at the right times. New furniture has been provided in some rooms and redecoration and refurbishment of the home is ongoing. This is so that people can enjoy living in a comfortable and safe home environment. Menu planning has been reviewed so that people can enjoy a variety of foods they like. More options are now available for hot snacks in the evenings. Action is now being taken to explore any gaps in employment histories of people applying to work at the home. This helps to ensure that recruitment practice is robust. Some action has been taken to consult with people using the service and their families to see if they are happy with the support they receive. Care Homes for Older People Page 7 of 30 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 8 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 9 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information about what the service provides is in need of some improvement. This is to ensure that people know what they need to, so they can decide if the home is right for them. Peoples needs are assessed, so that their care and support can be planned properly. Evidence: The homes last inspection report shows that written information is available about what the service provides. We saw a copy of the homes Statement of Purpose. It is recommended that this be reviewed in accordance with the guidance provided in Schedule 1 of the Care Homes Regulations 2001. This is to ensure that people who may be thinking about using this service have all the information they need to make a considered decision. We talked to the Manager about this and she said that this is a work in progress. It should be acknowledged that she has had a great deal of work to do in other areas since the last key inspection. This has meant that updating these Care Homes for Older People Page 10 of 30 Evidence: documents has had to be a secondary priority. The Manager told us that the admissions process has been reviewed. We looked at a sample of personal records. The files we saw contained assessments of peoples needs that the home have completed. Some also contained assessments by social workers. Assessments contained information about their background history, care and support needs, personal likes and dislikes, nutrition assessments and information about pressure area care. We saw that these assessments had been reviewed as required. Previous reports show that people are given the opportunity to visit the home before any decisions are made about placement. It is standard practice at the home to review new placements after one month, to ensure that all parties are happy and that peoples needs are being met appropriately. At the last inspection it was recommended that letters be sent to people advising them of the outcomes of assessment. All of the files we looked at contained letters offering placements and written contracts. Care Homes for Older People Page 11 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. Care planning is in need of continued development to make it more person-centred. This is so that people get the support they need in ways that suit them best. Peoples personal and health care needs are generally well met. They get the support they need to ensure they have their medication at the right times and in the right doses. Evidence: We looked at peoples personal records to see how their care is planned and managed. Several statutory requirements and good practice recommendations were made in this area following the last inspection, due to concerns identified at that time. We saw that the home has made positive efforts to address the issues raised since then. It is clear that significant work has been done to develop care planning since the last inspection, and this should be acknowledged. Updated care plans were in place in all Care Homes for Older People Page 12 of 30 Evidence: of the files we looked at. Clear efforts have been made to ensure that plans reflect peoples individual preferences, and to provide staff with clear guidance about how to give support in the ways people like. This included support for personal care, continence promotion, general likes and dislikes,preferred times for getting up and going to bed and so on. We saw evidence that plans have been kept under regular review, so that important information is kept up to date. Plans are supported with risk assessments to ensure that people get the support they need to stay safe. It is recommended that care plans and risk assessments are indexed and cross-referenced, so that important information can be found quickly and easily. Records show that care plans are evaluated regularly. This could be further improved by setting clearer goals with outcomes that can be measured. It is suggested that designated key workers could take responsibilty for this. Goals should be agreed with people individually. Plans will be made more person-centred by focusing clearly on the things that people say are important to them. This should include opportunities for activities on an individual basis (see next section also). Goals should be evaluated regularly so that judgements can be made about what is working and what might need to be changed. Doing this effectively will help to ensure that people are getting the support they want in the ways that suit them best as individuals. Concern was expressed at the last key inspection about the use of bedrails in the home. At a subsequent random inspection it was noted that only one person still had bedrails, and that their use had been appropriately risk assessed with the District Nurse. At this inspection we saw that bedrails were not in use in the home. We also saw a flow chart providing guidance about their use posted in the Managers office. The Manager told us that no-one in the home was currently in need of treatment for pressure area care. We saw individual risk assessments for this on all of the files we looked at. The Manager told us that the home enjoys a good working relationship with the local doctors and District Nurse team, and that their support is sought immediately if any issues arise in this area of care. We saw completed nutritional risk assessments on peoples records, and evidence of regular weight monitoring. One persons file that we looked at is an insulin dependent diabetic. The Distict Nurse administers this each day and monitors her blood sugar levels. We saw information on peoples files relating to individuals identified healthcare needs. These included angina, epilepsy, diabetes, emphysema, and so on. Records showed that people are referred to specialists where this is required. There were also records of routine appointments with GPs, Practice and District Nurses, Dentists, Opticians, Chiropodists, Occupational Therapists and other professionals.We saw records of annual health reviews with peoples doctors. Systems for managing peoples medication were audited at the random inspection and Care Homes for Older People Page 13 of 30 Evidence: found to be satisfactory. The home uses Boots MDS (monitored dosage system)where medicines are generally dispensed in weekly blister packs. We saw the Medication Administration Record had been completed appropriately. The Medication file included peoples photographs, and sample signatures of senior staff responsible for administering medicines. We saw that protocols for PRN (as required) medication were filed with individuals care plans. It is recommended that copies of these are kept with the Medication Administration Record for ease of reference. Controlled drugs are stored separately and distinct records maintained also. We did a sample audit of these and saw that the stock held tallied with the record. We saw evidence of monthly audit checks in the home, and also of regular audits by the local pharmacist. No problems were reported. We saw that temperatures of the medication room and fridge were recorded daily. There is an air conditioning unit for use if recorded temperatures are outside the acceptable limits. We saw that creams and lotions had been labelled with the date of opening, in accordance with recognised good practice. A previous requirement relating to the prescription and storage of oxygen has now been met. We saw that the medication store was clean, tidy and secure. It was recommended at the time of the last key inspection that people should be consulted about having the facility to lock their bedroom doors and secure their possessions. All of the files we looked at included a written record to this effect. Some made a positive choice not to have keys. Some people chose otherwise. We saw that one person likes to have her bedroom locked after 10.30pm. Her care plan and daily records showed that staff respect this. They check on her at that time to ensure she is all right and has her staff call facility to hand. Another recommendation concerned peoples ability to make and receive telephone calls in private. The home has purchased a cordless phone since the last inspection to enable this to happen. We were able to directly observe people and staff interacting during our visits to the home. We saw that staff treated people with gentleness and respect, and it was clear that both are comfortable in each others company. Staff gave support with warmth and friendliness, in a patient manner so that people did not feel pressurised or rushed. One person told us Im very happy here, staff are lovely. We were able to meet with some peoples relatives, visiting during our inspection. One told us Im very happy with mothers care. The staff keep us well informed and refer her to the doctor if there are any problems. A visiting social worker told us that the home had demonstrated a very positive attitude towards supporting one individual with complex needs to explore his options for moving into a more independent living environment. He said I am pleased with support he has been given since moving in. Care Homes for Older People Page 14 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Activity opportunities for people in the home need improvement. This is to ensure that people get the support they need to do the things that they say are important to them, and go to places they like. People are able to keep in touch with their families and friends. They have a varied and balanced diet, so they can enjoy their meals. Evidence: We saw that daily routines around the home are flexible and not fixed. People are able to get up and go to bed at the times they choose. We saw that people are able to receive visitors and to go out whenever they wish. One person regularly goes out to local shops or up to town, and told us that he likes the fact that he still has the freedom to do this. The Manager told us that some people use the local ring and ride service to get out and about. However she told us that others were able to use this service, but opted not to do so. Activity records available in the home were limited, so it is difficult to make a fully informed judgement about this. We saw that some communal activities had been organised. These included a Christmas Party, an Easter Bonnet event, and a fete is Care Homes for Older People Page 15 of 30 Evidence: scheduled for the summer. There is a fortnightly Music and Movement exercise session, and visits have also been made to the home by a local musician and a theatre group. We saw people taking part in a sing along: staff told us that this was popular among some of the residents. We saw people relaxing watching television or reading the paper. We also saw that people made positive choices to go to their rooms for privacy or a nap. Staff said that a number of people liked to do this, particularly in the afternoon after lunch. We saw that peoples records showed that they had been asked about what furniture they wanted in their rooms, to make them homely according to their personal tastes. The Manager told us that it was difficult to motivate this particular group of people to take part in activities. We asked if people were going to take part in the forthcoming elections, and she said that no-one had expressed an interest. In replies to questionnaires that we looked at, one person said Theres very little to do at Abercarn. Another persons relative wrote It would be great if Dad could be involved in activities that are appropriate to his age and interests. Action should be taken to develop the range of activity opportunities available to people in the home, particularly on an individual basis. There should be clear links between peoples activities and their agreed personal goals. Organising this within the home needs to be systematic, with designated people taking responsibility for developing activity opportunities, to ensure positive action is taken. This should be a key part of making peoples care planning truly person-centred, so that they get the support they need to do things they value and go to places they like. It has to be acknowledged that there may be significant challenges in achieving this, and that some people of retiring age make positive choices to lead a less active lifestyle. However, this should not be because they lack the opportunity to make positive choices to do otherwise. We saw that the main meal of the day is served at lunchtime. The home operates a four week menu cycle, prepared in consultation with people using the service. Records of meals taken showed that people enjoy a wide variety of choices at breakfast. We were able to directly observe people having lunch in the dining room. Staff provided support as necessary, people were relaxed and chatty and appeared to enjoy their meal very much. We noted one persons care plan showed that he enjoys a beer with his dinner: we saw that this had been provided for him. We heard people say Its a lovely dinner and It was wonderful. We saw that one person made a positive choice to take her dinner in her room and this was facilitated. She said I like my dinners, not so keen on the teas but I have no real complaints She also said I can do what I like, I have a visit from (relative) once a month: I dont want to go out, Im happy in the home. Records of meals showed that people have variety and choice and enjoy a balanced Care Homes for Older People Page 16 of 30 Evidence: diet. We saw that the home now provides cooked snacks in the evenings at least three times a week. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Improvements are needed to the ways in which people are supported to express their concerns informally. This is so that they can be confident that their concerns are listened to, taken seriously and acted upon. People are generally well protected from abuse, neglect and self-harm Evidence: The last key inspection report shows that the homes complaints policy is on display in the hallway, and that information on making a complaint is included in the Service Users Guide. A recommendation was also made to implement systems for recording informal concerns or complaints, and the action taken to address them in order to demonstrate continued improvement.The Manager was able to show us a book she has prepared for recording these Have your say about us. No complaints have been received about this service since the last key inspection. However, some more work is needed in order to move the action taken to date further forward. The object of the exercise should be to develop a more open complaints culture within the home.People should be actively encouraged to raise any concerns they may have. This is so that the home can take whatever action is needed to address these,learn from the experience and improve the service as a result. We discussed this with the Manager. Open residents meetings may not be the best environment for everyone using the service to raise concerns. The value of holding these regularly (in this particular regard) may be to raise peoples awareness about their rights to make complaints, Care Homes for Older People Page 18 of 30 Evidence: and to reinforce that this is viewed positively. It may be that a more appropriate place to discuss concerns is in the regular discussions people already have with their key workers when care plans are evaluated. This could be a standing item, with a record kept so that (for example) any emerging patterns could be identified easily. We looked at staff records to see if important checks had been done with the Criminal Records Bureau before people started work at the home. The files we saw showed that these checks had taken place as required. Available records also showed that training in the Protection of Vulnerable Adults (safeguarding) has been provided for staff since the last inspection. We spoke to staff about this. They were able to tell us the different forms abuse can take and what action they would take in the event of witnessing or suspecting abuse. Requirements were made at the last inspection relating to the management of peoples money within the home. These have now been met. We saw that records are kept of financial transactions, with receipts kept. These records are audited regularly. We sample checked them and saw that cash balances held tallied with the written account. Full records are now maintained of the residents comfort fund, so that it can be seen that money is expended appropriately. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Work to redecorate, upgrade and refurbish the home should be completed, so that people can fully benefit from living a comfortable safe and homely environment Evidence: We looked around the building in the company of the Manager. Requirements made at the last inspection have now been met. We saw that the clinical waste receptacle at the front of the house was secure. In the garden, paving slabs have been levelled and damaged patio furniture disposed of prior to replacement. We were able to see that work is ongoing to maintain and refurbish the home. We saw that peoples bedrooms are individual in style and reflect the individual personalities of each occupant. We saw that some people had items of furniture they brought with them from home. Personal possessions including televisions and music players, pictures, ornaments and family photographs and so on were very much in evidence. Some rooms are in need of redecoration and renewal of furniture, but it should be acknowledged that this is a work in progress. Overall the home is fitted and furnished to an adequate standard. We could see that some beds have been recently replaced, also new commodes provided and some bedroom furniture. As reported earlier, people have now beenconsulted about their wishes for use of locks and keys. It is clear that staff work very hard to keep the place clean, tidy and fresh and provide Care Homes for Older People Page 20 of 30 Evidence: a homely environment for people to live in. There are ample toilets and bathrooms situated on both floors, to meet the needs of people using the service. The first floor can be accessed by stairways or a passenger lift. A suitable range of equipment is available to assist people who may have reduced mobility. These include portable hoists, raised toilet seats, handrails etc. Arrangements to replace one of the hoists (which was showing signs of wear and tear) were made during the inspection visit. The laundry is situated in an outbuilding. Though there is no independent source of heating, appropriate equipment is provided to ensure that adequate standards of infection control are maintained. In the garden there is a separate facility used by the people who smoke. At the last inspection concerns were raised about the ventilation and cleaning of this. On this occasion, we saw that the extractor fan was working correctly and that windows and doors provide additional options for ventilation. The outbuilding was in need of cleaning, and this was brought to the Managers attention. We saw that the main kitchen was well organised, clean and appropriately equipped. Regular checks have been carried out on fridge and freezer temperatures to ensure efficient working. These were in order. Since the last inspection the rating for the homes kitchen has been upgraded from one to three stars in the scores on the doors system operated by the Local Authoritys Department of the Urban Environment. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are enough staff working at the home so that people get the care and attention they need. The staff team is generally well qualified, but training support needs developing to ensure that staff have all the knowledge and skills they need to do their jobs well. Evidence: We looked at staff records to see how recruitment is managed. Files we saw contained completed applications and work histories. We noted that where there were gaps that these had been explored. Files also contained two written references and evidence that checks had been carried out with the Criminal Records Bureau. We also saw job descriptions, declarations relating to medical health and convictions, and workbooks for induction training. These things show that the service takes positive action to ensure that people employed to work at the home are fit for their jobs. We saw that there were sufficient staff on each shift to meet the needs of people living in the home. It should be acknowledged that there are currently a number of resident vacancies following the suspension of admissions after the last key inspection. There has been low turnover of staff at the home, and this helps to promote continuity of care. We saw that staff and residents appeared to get on well together. Previous reports show that most of the staff team hold qualifications at NVQ level 2 or Care Homes for Older People Page 22 of 30 Evidence: above. Senior care staff either hold qualifications at NVQ level 3, or are working towards this. The Manager told us that staff training is organised alongside the companys sister home. Records show that updates for statutory training have been provided recently. However, it was not possible to fully verify this during the inspection. It is recommended that a staff training and development plan be produced. This should show, for each member of staff, all training undertaken and qualifications gained, with dates. It should highlight when refreshers are due and when this training is scheduled. It is recommended that this be presented in spreadsheet or chart format. Doing it in this way provides the Manager with an instant overview of staff training and development needs, and should be a useful tool for future planning. In addition to statutory training, the home should clearly identify specific training for staff relating to the assessed needs of the people that use the service. This should seek to take account of new legislation and developing best practice. This might include, for instance, training on the Mental Capacity Act and Deprivation of Liberties Safeguards, and common conditions affecting elderly people (such as prevention of pressure sores, diabetes, dementia, etc.). Some staff have done additional training, but this needs to be organised more systematically, in the interests of improving staff knowledge and skills beyond minimum requirements. We also noted that arrangements for staff to receive formal supervision are in need of improvement (see next section also). It should be acknowledged that staff we spoke to were generally very positive about working at the home. They said that they felt part of a strong team and generally supported each other well. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Improvements made since the last inspection need to be continued and sustained. This will ensure that the home is well run for the benefit of the people using the service. Evidence: The Manager told us that she is qualified to NVQ level 4 and has fourteen years of care management experience. At the time of the inspection visits we had not received an application to register her as the manager for the home, as previously requested. We subsequently received a telephone call from a company senior manager advising that this has now been submitted. Staff told us that the Manager is open and approachable, and that they are comfortable raising any matters of concern with her. During the inspection we saw clear evidence of the hard work the Manager has done to address concerns we raised in past inspections: in particular, to revise and update peoples care plans. We noted that these documents are handwritten. The Manager told us that she does not have access to a computer or printer within the home. Care Care Homes for Older People Page 24 of 30 Evidence: plans and other documents relating to peoples care are constantly evolving and in need of updating. It is recommended that the company makes equipment available within the home so that this, and other tasks relating to managing the home, can be done efficiently. Updating records by hand is time-consuming and labour intensive. The Manager told us that she has been working supernumerary since the last inspection. She was unable to confirm that this practice will continue in the future. It is important that the Manager has sufficient time allocated to fulfill all her management responsibilities effectively. It is therefore strongly recommended that the Managers position continues to be supernumerary, to ensure that she can continue the good work she has already done and sustain improvements made. Quality assurance within the home continues to be in need of development. We noted that this is a recurring theme from past inspection reports. We were able to see that some activity has occurred in this area. We noted that reports required under Regulation 26 (Care Homes Regulations 2001) have been completed each month. We saw that some questionnaires have been completed by some people using the service and their relatives. Consultation with people using the service and other interested parties needs to be done more systematically. Information gained from activity relating to service quality should be collated and analysed, and a report made of the findings. The object of the exercise should be to learn from peoples views so that the information gained can be used to develop and improve the service. Reports on quality assurance of the service should be made available to all interested parties. Sampling of staff records showed that arrangements for formal staff supervision currently fall below national minimum standards. The Manager acknowledged this and told us that she is trying to address this issue. Staff files that we looked at showed that recent efforts have been made to do this, and that it is a work in progress. We suggested that consideration be given to delegating some of the responsibility for supervision to senior members of staff. Good supervision practice should also include an annual appraisal of individuals performance and training and development needs. We sample checked records in the home relating to health and safety issues and safe working practices. These were generally satisfactory and showed that essential equipment has been serviced regularly and that checks are carried out routinely. We noted that the fire risk assessment has been reviewed as previously required. Although there are still areas for continued improvement in the management and administration of the home, the efforts made by the Manager since the last inspection should be acknowledged. It is important that the good work she has done to date be Care Homes for Older People Page 25 of 30 Evidence: continued, and that she gets the support she needs from the company to sustain this. 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 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 1 Update the homes Statement of Purpose and Service Users Guide in line with National Minimum Standards and the Care Homes Regulations guidance. This is to ensure that people have all the information they need to decide if the service provides what they are looking for. Index and cross reference care plans and risk assessments. This is so that important information can be found quickly and easily. Develop the use of person centred practices in care planning and management. Agree clear goals that have measurable outcomes with individuals, and evaluate these regularly. This is to ensure that people get the support they want in ways that suit them best. Develop the ways in which peoples activity opportunities are planned and managed, particularly on an individual basis. Ensure that opportunities are clearly linked to peoples agreed individual goals. This is so that people get the support they need to do things they value and go to places they like. Build on work already done to develop a more open Page 28 of 30 2 7 3 7 4 12 5 16 Care Homes for Older People 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 complaints culture in the home. This is so that all people using the service can be confident that their views are actively sought, listened to and acted upon. 6 19 Complete refurbishment programme so that all people using the service can enjoy the benefit of living in a homely environment. Make arrangements for the smoking shelter to be cleaned regularly. Produce a staff training and development plan and extend training support for all staff beyond minimum requirements. This is to ensure that staff have all the knowledge and skills they need to do their jobs well Ensure that the Manager has sufficient time allocated to fulfill all her management responsibilities effectively. Develop quality assurance systems in the home in order to demonstrate clearly how the views of people using the service underpin its review and development Ensure that staff receive regular formal supervision so that they get all the support they need to do their jobs well. 7 8 20 30 9 10 31 33 11 36 Care Homes for Older People Page 29 of 30 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!

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