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Care Home: Ainsworth Nursing Home

  • Knowsley Road Ainsworth Bolton Lancashire BL2 5PT
  • Tel: 01617974175
  • Fax: 01617972168

Ainsworth Nursing Home is a care home providing nursing and residential care for older people including older people with mental health and dementia needs. The building is a large, converted former hospital. It is detached and set within its own extensive grounds, with lawned areas and mature trees and shrubs. It is situated at the end of a private access road, in a semi-rural location within the Ainsworth area of Bury. The current fee for this service ranges from 365.83 pounds to 683.80 pounds per week dependent on the level of need and funding arrangements.

  • Latitude: 53.592998504639
    Longitude: -2.3580000400543
  • Manager: Ms Kay Denise Walsh
  • Price p/w: £525
  • UK
  • Total Capacity: 37
  • Type: Care home with nursing
  • Provider: Ainsworth Nursing Home Ltd
  • Ownership: Private
  • Care Home ID: 1441
Residents Needs:
Old age, not falling within any other category, Dementia

Previous Inspections

This may not be the latest inspection for this service as we are having techinical problems updating from CQC - please check directly on the regulators website for the most recent report; bestcarehome hopes to be back to regular updates shortly.

For extracts, read the latest CQC inspection for Ainsworth Nursing Home.

Key inspection report Care homes for older people Name: Address: Ainsworth Nursing Home Knowsley Road Ainsworth Bolton Lancashire BL2 5PT     The quality rating for this care home is:   two star good 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: Elaine Stoddart     Date: 0 9 0 3 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 31 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 31 Information about the care home Name of care home: Address: Ainsworth Nursing Home Knowsley Road Ainsworth Bolton Lancashire BL2 5PT 01617974175 01617972168 d.subbiah@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Ainsworth Nursing Home Ltd care home 37 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The registered person may provide the following categories of service only: Care home with nursing- Code N To people 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- Code OP Dementia- Code DE The maximum number of people who can be accommodated is: 37 Date of last inspection Brief description of the care home Ainsworth Nursing Home is a care home providing nursing and residential care for older people including older people with mental health and dementia needs. The building is a large, converted former hospital. It is detached and set within its own extensive grounds, with lawned areas and mature trees and shrubs. It is situated at the end of a private access road, in a semi-rural location within the Ainsworth area of Bury. The current fee for this service ranges from 365.83 pounds to 683.80 pounds per week dependent on the level of need and funding arrangements. Care Homes for Older People Page 4 of 31 Over 65 0 27 10 0 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: A site visit took part as part of the inspection and this was conducted by one inspector over one day for approximately eight and a half hours. Information for this inspection was gathered in a number of different ways. This included the unannounced site visit where time was spent reading service records, looking at areas of the building and speaking with residents, visitors, staff and management. Case tracking was used as part of the site visit. This involves looking at the support the residents receive from the manager and staff. This also includes looking at the residents care plans to obtain information on how their care needs, medication and finances are managed. Three residents were case tracked, however this was not carried out to the detriment of other residents who also took part in the inspection process. Time was spent meeting with residents, visitors, relatives and staff to gain their views on the overall service. Surveys were sent out to staff and residents to ask them for their comments. Comments from surveys received and people spoken with Care Homes for Older People Page 5 of 31 are contained within this report. All of the key standards and other standards where looked at. The manager and a number of staff were present for the inspection. Feedback was provided to the manager at the end of the visit. An AQAA (annual quality assurance assessment) was completed by the manager in good detail prior to the visit. The AQAA comprises of two self-questionnaires that focus on the outcomes for people. The self-assessment provides information as to how the staff and manager are meeting the needs of the people who live there. The data set gives basic facts and figures about the service, including staffing numbers and training. Some information provided by the AQAA is included in this report. The people accommodated at the home wished to be called residents and this term is used in the report. The last key inspection took place on the 22nd April 2009. Care Homes for Older People Page 6 of 31 What the care home does well: The home provides information on the service in the form of a statement of purpose and service user guide. This information, together with the last inspection report enables prospective residents to make a choice if they wish to live there. Assessments of need are obtained prior to any admission to the home. Other information from social services and other professionals is also obtained. This information enables the home to make a decision if they can meet the individuals needs. Prospective residents and their representatives are able to view the home prior to admission. Care plans contained information on all areas of the care needs of the residents. Actions to be taken by staff to meet those needs are clearly identified. This enables the staff to have the information available to provide the care required. Care plans are reviewed monthly to reflect changing needs and to enable the staff to monitor residents care. The residents have access to other professionals involved in their care to ensure their health care needs are met. Risk assessments are in place to show all areas of risk to the individual to allow the staff to assist them safely. These are updated monthly or before should needs change. Medication practices and procedures in place ensure that medication is administered safely to the residents. Residents were seen to be treated with dignity and respect at all times throughout the visit by the staff who provide their care. The activity organiser provides a range of activities to suit the residents needs. Visitors were seen to be made welcome at all times of the day and provided positive comments (contained in this report) for the care and support given by the staff. Menus are varied and provide a choice to meet the residents nutritional needs. No complaints have been recorded since the last inspection. There is a complaints policy and procedure and people spoken with were aware of how to use this should they need to. A staff training programme keeps staff up to date with their training needs to ensure they are equipped to carry out their roles in a safe manner. Staff receive the support they need to carry out their roles to meet the needs of the residents. People who use the service are involved in the running of the home. They are able to Care Homes for Older People Page 7 of 31 have their say. What has improved since the last inspection? What they could do better: The AQAA reported that further plans include a new kitchen in September/October 2010. The general lounge is to be re-decorated and made more comfortable and welcoming. The remainder of the wooden windows are to be replaced gradually. Carpets in several corridors are to be replaced. The reception area is to be made more welcoming and spacious. This will improve the general standard of the home for the people who live there. A gate should be fitted at the garden of the dementia unit to provide a safe place for the residents to use. Policies and procedures should be updated annually to meet the needs of the home and ensure staff have access to them. Residents finance records should be available to view at the home at all times as part of the inspection process. Care Homes for Older People Page 8 of 31 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 31 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 31 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 is provided to prospective residents to enable them to make a choice if they wish to live at the home. Residents receive an assessment of their needs prior to admission to enable the home to determine if they can provide the care and support they require. Evidence: The AQAA reported We provide the statement of purpose, philosophy of care and service users guide easy to understand by everybody. We allow relatives/prospective service users to visit the home at any time without appointment. We encourage pre admission visits by prospective service users for a day or short time to suit them. Preadmission assessments are always done by the qualified nurses and any information available from other professionals like social workers and hospital staff and relatives are collected. The statement of purpose and service user guide has recently been updated and is Care Homes for Older People Page 11 of 31 Evidence: available in the entrance for visitors to the home to view. These provide information about the home so that prospective residents can make a choice if they wish to live there. A copy of the most recent inspection report was also available in the reception area for visitors to look at. Discussion with visiting relatives and residents confirmed that they had the opportunity to visit the home at any time prior to admission, to view the home and meet the staff and other residents. A visiting relative spoken with confirmed that she had accessed inspection reports and viewed a number of homes before choosing Ainsworth. The relative commented: I got really good vibes when I came here and the care is very good. All residents are assessed prior to admission to ensure the home can meet their needs. Three assessments were viewed and these contained information on the individual care needs of the residents. Assessments of need from the placing authorities were also available to view. The admission details completed included all areas of the residents care needs. These include medical history, personal care, risk of falls, safety, diet, weight, feeding needs, feet care, hearing, continence, mobility, likes and dislikes, medication, preferred times of bed, mental state and medication. All risk areas in relation to the residents are recorded and reviewed monthly to reflect changing needs. Information is obtained on the residents cultural and religious needs to promote equality and diversity in the home. Standard 6 was not assessed as intermediate care is not provided. Care Homes for Older People Page 12 of 31 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 plans identify individual care needs and actions to be taken by staff to meet those needs. Medication is administered safely to the residents. Evidence: The AQAA reported The care plans indicate what the care needs of the individual service users are and the care practices to be carried out to ensure that their needs are met in a caring and dignified way. Three residents care plans viewed during the visit showed the care plans are formulated using the pre-admission assessments completed by the manager/or nurse. Reports from outside agencies as well as the staffs own observations are used to form the basis of the plan of care. Care plans were found to contain individual information for the care needs of the residents. These include information for the residents personal care, diet, risks, skin care, medication, social and mobility. The actions to be taken by the staff were clearly identified to enable the staff to provide the care and support the residents need. All areas of care are reviewed monthly to reflect changing needs. Care Homes for Older People Page 13 of 31 Evidence: A new care plan format has been implemented using the dignity challenge standards to ensure positive outcomes for the people they care for. Each care plan incorporates the residents end of life wishes. This enables the staff to ensure their wishes are met at this time of their life and ensure their dignity and respect is maintained at all times. Residents nursing care needs are identified within their plans of care, such as the use of a pressure relief mattress and bed rails. Staff record any nursing care needs required, such as regular turning to prevent pressure sores and any assistance with feeding. A family visiting expressed their satisfaction with the care and support for their mother who requires regular monitoring and full assistance with all care needs. The resident was found to be comfortable, clean and well attended to at all times. Each resident has a social history Who am I. My story. Things people like about me. What I need support with. This enables staff to have an understanding of the residents background to enable them to meet their care needs. Staff spoken with confirmed this information is very useful to enable them to communicate well with the residents, especially those people with dementia. Daily reports seen showed that residents, care needs are monitored closely and these are reported at the beginning and end of each shift change to report any change in the residents needs during the day or night. Records were seen of daily care given to each resident. These include personal hygiene/bathing/bed changes and toileting. This ensures the residents receive the personal care needed. All areas of risk to the residents are recorded and reviewed monthly to reflect changing needs. These areas include moving residents safely, risk of falls, nutrition and use of bed rails. Monthly observations are completed for residents blood pressure and pulse recordings as part of their health check. All GP and other health care visits are recorded. This shows that residents have access to services to keep them well. Staff were observed to treat the residents with dignity and respect at all times during the visit. They were very responsive to their needs and this was evident in all areas of the home. Staff were seen to be polite and interacted well with the residents and a comfortable, pleasant atmosphere was present. Relatives were seen to visit at all times of the day and provided positive comments on the care and support received. Care Homes for Older People Page 14 of 31 Evidence: Comments from relatives and residents spoken with include: We are very happy with the care. Kay (Manager) is very good. Relative. Marvellous. Very caring. Resident. Very pleased with the care. I have no complaints. Kay is very approachable. Relative. The staff keep me informed of everything. There is nothing I dont know about. I can sleep at night now knowing my Husband is care for. Relative. The home is working towards the Gold Standard Framework, which aims to achieve the best quality of life for the residents. This also includes an end of life care programme to ensure each resident wishes and requests are respected during this time. The home has links with the hospice for end of life care. Contact with a specialist nurse is maintained to assist with those residents who may be at risk of pressure sores. This ensures the residents health care needs are monitored closely. Medication practices and procedures were discussed and observed with two registered nurses. Only qualified nurses are responsible for administering medication. Medication was found to be securely stored. All medication ordered is photocopied and is checked on receipt to ensure there are no shortfalls. Any errors are chased up with the pharmacist. All residents have a current medication administration record (MAR). A copy of their up to date prescriptions are kept to ensure the staff are aware of their current medication. All administrations are recorded and these include inhalers, creams and meal replacements. Staff sample signature are on file to evidence those staff who administer. Counter signatures are obtained for any written entries on MAR records to ensure the correct dosage is given to ensure the residents safety. This was a requirement form the last inspection and has been met. Residents are consulted on How they wish to take their medication. This is recorded within their plan of care. Care Homes for Older People Page 15 of 31 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have a choice of wholesome meals and snacks throughout the day. Visitors are always made welcome. The range of activities provide stimulation to meet the residents needs. Evidence: The AQAA reported The routines within the home are flexible allowing the service users the opportunity to follow a life style of their own choosing. Residents were seen to spend time in the communal areas of the home or within the privacy of their own rooms. Details of their preferences are recorded in their care plans. These include their social history, story of their life, religious beliefs and their likes and dislikes. This enables the staff to have the information available to them to provide the activities and social interests the residents prefer. An activity organiser works with the residents four days a week. Discussion took place with the activity organiser who has worked at the home for 20 years. The programme of activities is informal and can be adapted depending on the residents wishes. This includes music, dancing, chair exercises, hand massage and film shows. Individual activities, such as shopping and walks down the lane are provided and this was Care Homes for Older People Page 16 of 31 Evidence: observed to take place at the visit. One resident expressed she had really enjoyed the fresh air. The organiser divides her time between the units and staff assist her in her role. Those residents who are bedfast are provided with individual support from the organiser in their own rooms. The service plans to provide more trips for the residents in the future. The home is divided into two units each with a dining area and lounges. Since the last visit to the service large televisions have been purchased for the communal areas. A dining area has been established in the conservatory on the general side of the home and a new conservatory/dining area has been built on the dementia unit. Both areas were seen to be used by the residents and their visitors during all times off the day. A pleasant, relaxed, friendly atmosphere was present as staff, residents and visitors chatted together in the communal areas. Visitors were seen to call at all times of the day from early morning to late afternoon. Staff were seen to make them welcome at all times and were available to discuss any issues with them. Visitors spoken with provided positive comments on the homely feel and good vibes when they visited. Residents are involved in devising the menus. Menus are four weekly and displayed on a board for residents to view. Staff consult with each resident daily on their choice of menu for the day. All residents birthdays are celebrated. Some time was spent with the cook and kitchen assistant to discuss the meals provided. The cook is made aware of any specific needs, such as diabetes, soft diets and their likes and dislikes. Both are qualified in food hygiene. The main meal is served at lunch and the residents have a choice of meals. The cook commented They can have anything they wish and alternatives were seen to be provided. Food stores were plentiful in supply. The cook commented that she never gets any complaints about the food. Drinks and snacks were seen to be served throughout the day. The kitchen is in need of refurbishment to improve the standard. The manager confirmed this is in improvement plan for September/October 2010. This is also discussed in section 5 of this report. The last Environmental Health report was seen and was satisfactory. Fridge and freezer temperatures are made daily to record that food is correctly stored. Residents have the right to access to postal votes to enable them to have their say in the election process. Residents finances were unable to be viewed at this time as the manager had taken Care Homes for Older People Page 17 of 31 Evidence: the details home to audit them. Policies and procedures are in place and the manager confirmed that only residents personal allowances are managed by the home and receipts kept for all transactions. The manager is not appointee for any residents. The manager is to forward copies of the financial records to the Commission and agreed that these should be made available for inspection. A recommendation is made in the report that these records should be available to view. Residents are encouraged to bring their personal items with them and this was seen when viewing private rooms, which were found to be very personalised. Residents are able to bring in small pets, such as a cat. The home has a fish tank, cat and a budgie for the residents to enjoy. Care Homes for Older People Page 18 of 31 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. Information is available on how to make a complaint should people who use the service wish to do so. The staff are trained to safeguard the people they care for from abuse. Evidence: The AQAA reported There are arrangements in place to ensure that the service users and their families are listened to and appropriate action would be taken to ensure their safety and protection. The AQAA reported that no complaints have been made since the last inspection. Discussion with the manager confirmed that any comments are dealt with immediatly to avoid further complaints. Discussion with relatives confirmed this and comments made include: Kay is very approachable. I had one grumble but it was all sorted out. I have no complaints regarding my Mums care. A copy of the complaints procedure is available in the entrance and contained in the service user guide. Policies and procedures are in place to deal with complaints. This information is available should people need to make a complaint. Staff receive training in the local safeguarding procedures this is also included at their Care Homes for Older People Page 19 of 31 Evidence: induction. The AQAA reported that no safeguarding referrals have been made since the last visit. Staff spoken with were aware of what to do should any concerns arise. A copy of the local safeguarding procedures were seen and accessible to staff. Senior staff have completed training in the Deprivation of Liberty and the Mental Capacity Act. Two applications have been made on behalf of two residents and these have been approved. These applications are made on behalf of people who are unable to make certain decisions regarding their safety. Care Homes for Older People Page 20 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a comfortable and clean place for the residents to live. Evidence: The AQAA reported On going redecoration and refurbishment is being undertaken. We are aware that further work needs to be completed to ensure a good standard of environment. Hygiene standards are good and the home is clean and tidy there are no malodours. Staff hand washing facilities are provided as well as protected clothing. There are designated staff in place to carry out the laundry and domestic tasks. A full tour of the premises was made. Since the last visit improvement have been made in the following. The conservatory has been repainted along with a number bedrooms and corridors. New flooring has been acquired in several bedrooms and new carpets in the corridors on the dementia unit. Doors have been repainted and residents toilet doors have been painted in bright yellow to make easy identification. The grounds of the home have been improved and maintained. A conservatory has been built to add more communal area to the dementia unit and therefore improving dining facilities. The dementia lounge has been re-decorated. A number of windows have been replaced with UPVC. Staff surveys received provided the following comment. Continue to improve the standard. Care Homes for Older People Page 21 of 31 Evidence: The AQAA reported that further plans include a new kitchen in September/October 2010. This was observed to be needed at the visit and the refurbishment confirmed with the manager. A recommendation is made in this report for this to take place. A memorial garden at the rear of the dementia unit is in the process of being provided. The general lounge is to be re-decorated and made more comfortable and welcoming. The remainder of the wooden windows are to be replaced gradually. Carpets in several corridors are to be replaced. The reception area is to be made more welcoming and spacious. This will improve the general standard of the home for the people who live there. A number of private rooms viewed showed that they provide, comfortable, homely and clean surroundings for the people to live. They contained many personal possessions, which the residents had been able to bring from their own homes. Some furnishings in rooms were in need of replacement and the manager confirmed this will be undertaken along with redecoration when the rooms are vacant. Residents spoken with were satisfied with their rooms and their surroundings. Some rooms have pleasant views across the countryside and the residents said they enjoyed watching the sheep and young lambs. The grounds are spacious and accessible to the residents, some who require support. A small garden area is available to the rear of the dementia unit and this is yet to be secured by a gate for the residents safety. This was discussed with the manager and agreed and recommended in this report. There are sufficient communal areas to meet the residents needs and provide a place for them to sit with their relatives if they wish. A designated smoking room is available for residents who smoke. A call bell system is available throughout for the residents to call for assistance. There are two bedrooms with en suite and sufficient toilets and bathrooms for other residents to use. Equipment is available for those residents with mobility needs. Handrails are in place for residents use to aid mobility. All rooms are ground floor with the exception of two rooms, which are presently used for residents who are mobile. The dementia unit has secure access and exits to ensure the safety of the residents. The AQAA reported that all certificates for services such as gas are in date. Gas certificates were viewed to confirm this. Thus providing a safe place for the residents to live. Fire risk assessments are in place. Emergency lighting checks, fire checks and water temperature checks are regularly made to provide a safe environment. There are two laundrys available for the residents washing. There is also an ironing Care Homes for Older People Page 22 of 31 Evidence: room. The laundry assistant who has worked at the home for eleven years was spoken with and a tour of the laundry took place. Handwashing facilities and equipment were found to help avoid cross infection. There are sufficient domestic staff on duty to maintain a clean environment. Care Homes for Older People Page 23 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are recruited following the correct procedures to safeguard the residents. Staff are trained to carry out their roles. Evidence: The AQAA reported Sufficient staff is provided throughout the day, staff are appropriately recruited and offered ongoing training and development. We work in partnership with Bury Adult Learning to provide ongoing training. Six staff surveys were received their comments include: The home gives good support to the residents and their families. We look after the needs of the residents in caring environment. We work well as a team with good communication. The home has made alot of improvements over the last 12 months. The home is happy and the residents and staff are happy. Since the last visit a training matrix has been developed to show training needs and the training planned for the staff. This ensures the staff are equipped with the skills to carry out the care in a safe manner. Training is provided in all statutory areas, such as moving and handling. The manager ensures that this training is kept up to date and those staff who require updates future training planned was seen to show this. Additional training to meet the specific needs of the people they care for is also given Care Homes for Older People Page 24 of 31 Evidence: these include diabetes, person centred care, safeguarding, challenging behaviour, equality and diversity and stroke awareness. All staff have completed or are registering on National Vocational Qualifications (NVQ) Level 2 and two staff have shown interest in training to NVQ level 3. Staff training needs are also discussed at regular supervision sessions with all the staff. Staff records viewed and staff spoken with confirmed this. The home has been invited to work towards the Gold Standard Framework Quality Award. This will involve all staff to attend training on end of life, dignity, communication skills, advanced care planning using the integrated care pathway and pain and symptom control. This will ensure that each resident has their wishes and requests respected during this time. Staff from all areas of employment in the home were spoken with. All were very knowledgeable regarding their roles and responsibilities and the care needs of the residents. All staff spoke highly of the direction and support received form the manager. Staff were observed to interact well with residents, visitors and each other at all times creating a pleasant, friendly and supportive atmosphere. Visitors spoken with also provided positive comments on the staff. Their comments include: They always let me know whats going on. They are always there to listen. Sufficient staff were found to be on duty to meet the residents needs throughout the day and these included the manager, nurses, care staff, cook, laundry, domestics and handyman. There is administrative support two days a week for the manager. The activity organiser is employed for four days to provide a range of activities for the people who live there. Staff are recruited correctly and staff records viewed confirmed this. Records showed that criminal record checks and references are obtained prior to employments to safeguard the residents. Agency staff are used when there is a need to cover staff short falls to ensure the residents care needs are met. Care Homes for Older People Page 25 of 31 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed. People who use the service are able to have their say on the running of the home. Evidence: The AQAA reported The homes team, families and residents are actively involved in the future plans of the home. Audits are recorded and evidenced were action has been identified and followed up with the relevant action taken. The manager is now registered with the Commission and has many years experience in the care of the client group she is responsible for. The manager has made progress since the last visit and has met all the requirements made at the last visit. Improvements have been made in the recording systems. The manager is motivating the staff team who aim to achieve the Gold Standard Framework Award. The manager has an open door approach and welcomes any comments regarding the running of the home. Staff, residents and visitors provided positive comments on the manager. Their comments include: Care Homes for Older People Page 26 of 31 Evidence: Always approachable. Relative. Very supportive. Staff. The home is 100 better with the new manager. Staff. Residents finances were unable to be viewed at this time as the manager had taken the details home to audit them. Policies and procedures are in place and the manager confirmed that only residents personal allowances are managed by the home and receipts kept for all transactions. The manager is not appointee for any residents. The manager is to forward copies of the financial records to CQC and agreed that these should be made available for inspection. A recommendation has been made in this report under Standard 14. To monitor the quality of care and standards of the home weekly audits are conducted on accidents, complaints, incidents and staff competency. Medication audits take place every six months to ensure a safe system is in place. Care plans are audited monthly to ensure residents receive the care they need. Monthly visits take place by the provider to monitor the homes progress and highlight any areas which are in need of improvement. Surveys are sent out annually to relatives and residents to obtain their views on the care provided. Comments from a recent survey conducted in January 2010 include: The support and friendliness of the staff given to my family is of the highest standard. The manager and staff have been nominated by Bury Council for the Adult Care Awards, which is a special award for people in the caring sector. To provide a safe place for the residents to live regular fire, water checks, emergency lighting checks are made. All accidents and incidents are all recorded and are contained in residents files to view. Actions are taken to avoid further incidents were possible. The AQAA reported that all certificate for services are up to date. Thus providing a safe environment. The AQAA reported that policies and procedures were last reviewed in 2008. This was discussed with manager who agreed to up date them annually to meet the needs of the home and ensure staff have access to them. A recommendation for this is made in this report and was agreed with manager during the visit. The manager provides regular staff support via supervision sessions and staff meetings. She is also in daily contact with the staff while on duty and was observed to Care Homes for Older People Page 27 of 31 Evidence: be supportive to their needs. All records viewed during the visit were easy to access and well organised. Care Homes for Older People Page 28 of 31 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 29 of 31 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 2 14 19 Residents finance records should be available to view at the home at all times for inspection. The ongoing maintenance programme should continue to include the fitting of a new kitchen, redecoration of rooms, new carpets in areas identified, a new reception area, new furniture in rooms in need of up grading and the replacement of wooden windows. A gate should be fitted at the garden of the dementia unit to provide a safe place for the residents to use. Policies and procedures should be updated annually to meet the needs of the home and ensure staff have access to them. 3 4 19 38 Care Homes for Older People Page 30 of 31 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. 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. Care Homes for Older People Page 31 of 31 - 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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