Care Home: Alde House

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What the care home does well Potential service users receive a thorough needs assessment to ensure the home can meet the care needs of the service users. Comments made in returned surveys indicate that people were given good information before they moved into the service. There is a motivated and established staff team who respond to service users in a respectful and appropriate manner. Comments received in returned surveys include, "staff are very kind and always helpful" and "the staff are lovely. They will always do that bit more then they need to and the staff work extremely hard to give me the best possible care and they always meet my needs. I feel completely at home here." The home provides a pleasant and comfortable environment in which people can live. Individuals are encouraged to personalise their own rooms with their own furniture and personal belongings. Comments received about the home in returned surveys tell us, "I chose this home because it is small and personal. Its like being part of a family" and "the home is always clean and there are never any horrible smells. We could do with more storage space because the walking frames make the lounge very cluttered." Communication between people who use the service and staff was observed to be positive and open. There is joint working with the GP surgery and community nurses to the benefit of the service users. Two comments received by healthcare professionals include, "staff are very caring and hard working. They are always helpful when we visit. The manager shows great leadership and this is a delightful residential home" and "Alde house is an assert to Penn, a well managed and caring home." One comment made from a health care professional under the section `what the home could do better` tells us "the provision of out of hours support could be improved from a medical provision. Paramedics have no prior knowledge of the patient and their specific needs and preferences. This could be improved." There is a large garden area where residents are encouraged to sit out and get fresh air. The provision of meals and mealtimes are of a good standard. Comments made about the food include, " the food is lovely and I always eat everything" and "the food is good and the cakes are especially nice". There is an effective complaints procedure with all complaints and concerns being acted upon promptly, within stated time scales. There is a robust recruitment procedure in place that ensures service users are protected from harm. There is a good range of policies and procedures, providing staff with relevant information about all aspects of care and the home/organisation. The evidence seen and comments received indicate that this service meets the diverse needs e.g. religious, racial, cultural, disability of individuals within the limits of its Statement of Purpose. What has improved since the last inspection? The identified care needs of people using the service are recorded in the care plans and these are now more detailed and inform staff how to meet the needs of the individual. The home has put in a place a system that ensures service users plans include guidelines for the administration of all `when required/when needed` medicines. These are detailed and comprehensive. Daily routines in the home have been recorded in care plans and show they are flexible. The home has updated its own safeguarding policy and have also obtained a copy of the local Safeguarding Vulnerable Adults policy. The daily record notes are completed in more detail and are written legibly. Activities for service users are recorded in more detail and show how individuals social care needs will be met. The home has introduced a choice of drinks at meal times and the choice of meals is now recorded on a board in the dining room. This helps service users know what the alternative choice of meal is. Criminal Records Bureau checks dated 2003 and 2004 have been renewed. What the care home could do better: The home should continue to provide a good consistent service to people who use this service and continue with the on-going improvements to the environment. Key inspection report Care homes for older people Name: Address: Alde House Alde House Church Road Penn High Wycombe Buckinghamshire HP10 8NX     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: Barbara Mulligan     Date: 2 7 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Alde House Alde House Church Road Penn High Wycombe Buckinghamshire HP10 8NX 01494813365 01494814154 Noneavailable Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Stumpwell Housing Association Limited care home 15 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 15 The registered person may provide the following category of service: Care home only (PC) to service users of the following gender; Either whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Alde House is a care home for older people situated in Penn, Buckinghamshire and has fifteen bedrooms. The home was opened in 1972 and is managed by Stumpwell Housing Association Limited. The home has been adapted for its present use and comprises the original house and an extension. There is a large and pleasant garden to the rear, with views over the surrounding countryside. The home is on two floors and there is a passenger lift to the first floor for service users with impairment of mobility. Care Homes for Older People Page 4 of 28 Over 65 15 0 3 0 0 4 2 0 0 9 Brief description of the care home The home is mindful of its origins in Penn and priority is given to people who either live in the village, have lived there in the past, or still have family or friends in the area. The home endeavours to meet a range of needs and draws on the resources of health and social care professionals and other services in the local community as required. The fees range from £530 to £695 per week. Services such as hairdressing and chiropody are at additional cost to the service user as are personal items such as toiletries. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection was conducted over the course of one day and covered all the key National Minimum Standards for older people. Prior to the visit, a detailed self-assessment called The Annual Quality Assurance Assessment (AQAA) was sent to the registered manager for completion. The AQAA focuses on how well outcomes are being met for people using the service. This was returned to the Commission by the day it was due and was fully completed, giving us the information we needed. It also gave us some numerical information about the service. Seventeen surveys were sent to the home for staff, healthcare professionals and people using the service to complete. Fifteen of these were returned to the Care Quality Commission and any further completed surveys we receive will be considered as part of our ongoing regulatory responsibilities for registered services. Information received by the Commission since the last inspection was also taken into account. The inspection consisted of discussion with the registered manager of the home, discussion with other staff, opportunities to meet with some people who use the service, examination of Care Homes for Older People Page 6 of 28 some of the homes required records, observation of practice and a tour of the premises. A key theme of the visit was how effectively the service meets needs arising from equality and diversity. Feedback on the inspection findings and areas needing improvement was given to the management of the home at the end of the inspection. The registered manager, the staff and service users are thanked for their cooperation and hospitality during this unannounced visit. Care Homes for Older People Page 7 of 28 What the care home does well: Potential service users receive a thorough needs assessment to ensure the home can meet the care needs of the service users. Comments made in returned surveys indicate that people were given good information before they moved into the service. There is a motivated and established staff team who respond to service users in a respectful and appropriate manner. Comments received in returned surveys include, staff are very kind and always helpful and the staff are lovely. They will always do that bit more then they need to and the staff work extremely hard to give me the best possible care and they always meet my needs. I feel completely at home here. The home provides a pleasant and comfortable environment in which people can live. Individuals are encouraged to personalise their own rooms with their own furniture and personal belongings. Comments received about the home in returned surveys tell us, I chose this home because it is small and personal. Its like being part of a family and the home is always clean and there are never any horrible smells. We could do with more storage space because the walking frames make the lounge very cluttered. Communication between people who use the service and staff was observed to be positive and open. There is joint working with the GP surgery and community nurses to the benefit of the service users. Two comments received by healthcare professionals include, staff are very caring and hard working. They are always helpful when we visit. The manager shows great leadership and this is a delightful residential home and Alde house is an assert to Penn, a well managed and caring home. One comment made from a health care professional under the section what the home could do better tells us the provision of out of hours support could be improved from a medical provision. Paramedics have no prior knowledge of the patient and their specific needs and preferences. This could be improved. There is a large garden area where residents are encouraged to sit out and get fresh air. The provision of meals and mealtimes are of a good standard. Comments made about the food include, the food is lovely and I always eat everything and the food is good and the cakes are especially nice. There is an effective complaints procedure with all complaints and concerns being acted upon promptly, within stated time scales. There is a robust recruitment procedure in place that ensures service users are protected from harm. There is a good range of policies and procedures, providing staff with relevant information about all aspects of care and the home/organisation. The evidence seen and comments received indicate that this service meets the diverse needs e.g. religious, racial, cultural, disability of individuals within the limits of its Care Homes for Older People Page 8 of 28 Statement of Purpose. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 28 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 28 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. The assessment process works well and potential residents and their families have information about the home to help them decide whether their needs can be met, before they decide to move permanently. Evidence: Four completed needs assessments were examined, including those most newly admitted to the home. Each file has a completed needs assessment and shows that all areas and conditions of people using the service were assessed prior to offering them a place in the home. Each assessment contains further information about the persons family and friends, likes, dislikes and preferences. Comments made in returned surveys indicate that people were given good information before they moved into the service. In addition to the initial assessment the home collects a residents personal history Care Homes for Older People Page 11 of 28 Evidence: which provides a more rounded picture of the person. The assessment demonstrates that prospective service users, family members or representatives are included in the assessment process if this is appropriate. The home does not admit service users for intermediate care. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home meets the health, personal and social care needs of the residents, by developing detailed care plans and responding to their changing needs, as appropriate. Evidence: The care of four service users was case tracked and their care plans examined, including those new to the service. At the previous inspection a requirement was issued for the identified care needs of people using the service to be detailed in the care plan. The four files examined during this visit show an improvement in the detail recorded in each file. Each care plan is up to date and contains sufficient detail for staff to learn about residents they support. Specific needs have been identified within the care plans and there is a detailed action plan in place to provide staff with the details of how these needs are to be managed and fully met. Individual preferences, likes and dislikes are recorded in each service user file. The care plans examined provide detailed information for staff to follow. Visual observations of people using this service showed that people were smartly Care Homes for Older People Page 13 of 28 Evidence: dressed including jewelery, make up and nail varnish and people were seen to be wearing the aids needed, for example hearing aids and clean glasses. The care plans show that service users, family members or representatives are included in the care planning process. Daily notes are detailed and informative and inform the carers how the individual has spent their day. There is evidence that care plans are reviewed monthly. Comments received in the surveys about the care provided include, the carers are so helpful and will always help me with anything and staff always ask me if there is anything else they can do for me. Risk assessments are in place covering areas such as falls, moving and handling, wound assessment and nutrition. These are up to date, signed and dated by the person completing the assessment. The inspector was told that all service users except for one person are registered with a local GP practice. Tissue viability assessments are in place for service users and these were seen to be reviewed on a monthly basis and pressure relieving equipment was seen in place for individuals who need it. The registered manager said a domiciliary optical service visits the home and service users receive an annual eye test and referrals for a hearing test go through the service users G.P. Two comments received by healthcare professionals include, staff are very caring and hard working. They are always helpful when we visit. The manager shows great leadership and this is a delightful residential home and Alde house is an asset to Penn, a well managed and caring home. One comment made from a health care professional under the section what the home could do better tells us the provision of out of hours support could be improved from a medical perspective. Paramedics have no prior knowledge of the patient and their specific needs and preferences. This could be improved. Weight monitoring is undertaken on a monthly basis and recorded and this was evident in the four files examined. Chiropody services visit the home every six weeks. Records of health screening was noted in multi disciplinary notes and feedback received in the surveys was positive about how people access medical treatment and health care services. The procedures for the administration of medicines were examined during this visit. At the previous inspection a requirement was issued for the home to implement a system to be put in place that ensures service users plans include guidelines for the administration of all when required/when needed medicines. These guidelines must include when the medicine is to be given and when it is not and include a strategy for when variable doses can be given. At this visit we looked at the medication administration record (MAR) charts, medication supplies and care plans for the four people whose care was being looked at as part of this inspection, and at the MAR charts for all the people using this service. The home works closely with the local Care Homes for Older People Page 14 of 28 Evidence: surgery and pharmacy to ensure an effective and safe medication administration system is operational. The pharmacist visits the home to look at medication administration procedures. The medication is safely stored and there are facilities for the storage of controlled medication. There is a controlled drugs register in place if controlled drugs are used in the home. At the time of the inspection there were no service users who were able to self administer their medication. The home uses a monitored dosage system (MDS) and medicines are stored in a mobile, lockable trolley. Medication administration records (MAR) show no omissions. The home has put guidance in place for when required/when needed medicines and these are detailed and include when the medicine is to be given and a strategy for when variable doses can be given. Training records show that staff have completed medication training and have been deemed competent. Staff training records demonstrate this to be the case. The inspector observed staff assisting people who use the service in a kindly and respectful manner. During lunch it was pleasing to see staff supporting service users with their meals in an appropriate manner. Staff are obviously aware of the importance of privacy and dignity and were seen to knock on doors before entering and always addressing the individual by their preferred term of address. The homes induction programme includes training regarding privacy and dignity. Care Homes for Older People Page 15 of 28 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. There is a range of activities available to residents who are encouraged and supported to remain in contact with their families and friends and to use local community facilities ensuring people do not become socially isolated. The presentation and standard of food is good and meets the nutritional needs of people who use the service. Evidence: At the previous inspection a requirement was issued for daily routines to be flexible and to be recorded in detail in the care plans. The care plans for four people were examined during this visit. These demonstrate that individual routines of daily living, include bathing, rising and retiring times are recorded in each file. As part of the admission process, the home complete a section called residents personal history which is a life history of the individual and gives staff information about previous leisure pursuits, hobbies and other interests. On the day of the inspection staff were observed to undertake several activities with service users. This included a game called toss the ring and bowls. There is a range of activities organised which is displayed in the home. The range of activities include quizzes, basket weaving, exercise sessions, carpet bowls, tic tac toe, Care Homes for Older People Page 16 of 28 Evidence: toss the ring, connect 4 and ball games. One comment received in a returned survey, under the section what the home could do better tells us, we could try to involve residents families more in outside activities. Examples of involvement in the home by local community groups and individuals are visits by a hairdressers, various visiting entertainers and a church service. Service users are able to receive visitors in the privacy of their own rooms and are able to choose whom they see and do not see. Family and friends are invited to participate in some of the social event organised. Relatives and friends are welcome at any time and two visiting relatives spoken to on the day was able to confirm this. Service users are offered three meals a day. The menu is rotated on a four weekly cycle. Meal times are relaxed, unrushed and well organised. People are well supported by staff and the food is attractively presented. Comments made about the food include, the food is lovely and I always eat everything and the food is good and the cakes are especially nice. Since the previous inspection the home has introduced a choice of drinks and the menu for the day, including an alternative choice, is written on a large board in the dining area. Care Homes for Older People Page 17 of 28 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. There are policies and procedures in place to protect people who use the service from harm and the home has an effective complaints procedure to ensure that people who use the service or their representatives are listened to. Evidence: The inspector examined the homes complaints procedure which illustrates timescales for responding to complaints. This is clear and accessible to service users and was updated on 19th May 2009. A summary of the complaints procedure is included in the Statement of Purpose and Service Users Guide. The registered manager said she welcomes any complaints or concerns and actively encourages residents and relatives to raise any issues they have at the earliest opportunity. The AQAA tells us that the home has received one complaint. This is recorded in the homes complaints log and is well recorded, has a satisfactory outcome and responded to within timescales. At the previous visit a requirement was issued for the home to update its own safeguarding policy and to obtain a copy of the local Safeguarding Vulnerable Adults policy. During this visit the inspector examined the homes safeguarding policy and this was updated in May 2009 and is line with the local authority safeguarding which the home has obtained a copy of. There is a whistle blowing policy which staff have access to Care Homes for Older People Page 18 of 28 Evidence: that provides guidance about responding to suspicions or evidence of abuse or neglect. The AQAA tells us that there have not been any safe guarding referrals since the last inspection. Training records examined show that staff have received safeguarding vulnerable adults training and the home will be extending this training to ancillary staff. Care Homes for Older People Page 19 of 28 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 standard of the environment within the home is good, providing people who use the service with an attractive and homely place to live. Evidence: Alde House is a detached property on the Penn to Beaconsfield Road. It consists of single room accommodation on two floors, some rooms have en-suite facilities and those without are close to shared toilets and bathrooms. Comments received in surveys include, I chose this home because it is small and personal. Its like bing part of a family and the home is always clean and there are never any horrible smells. We could do with more storage space because the walking frames make the lounge very cluttered. There is one small lounge and a larger lounge on the lower floor. One of these lounges is called the sun lounge and looks out onto stunning views of the garden and beyond. There are many personal touches around the home such as pictures, side lamps, books, plants and ornaments. The internal decoration of the home is in good repair. Recent repairs to the home since the previous inspection include new boilers, carpets have been replaced downstairs in corridors, new windows have been installed in some areas of the home Care Homes for Older People Page 20 of 28 Evidence: and a new door on the entrance side of the home and kitchen worktops have been replaced. The laundry room doubles as the hairdressers and the home need to ensure there is no risk of cross infection in this area. The standard of cleanliness in the home is good and the home is odour free. Adaptations are in place to enable service users to use toilets and baths and there is a shower suitable for people with disabilities to use. The garden is well maintained and provides a restful outlook from the lounge, dining room and bedrooms. There is seating and tables on the patio and an awning that can be opened to shade both the patio and the sun lounge. There is parking at the side and rear of the Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staffing numbers and skill mix is satisfactory and staff training is sufficient and up to date to ensure that people who use the service benefit from staff who are competent to do their job. Recruitment procedures are undertaken to ensure staff have the right skills and competencies to support the people who live there. Evidence: The homes staff rota demonstrates that there are adequate numbers and skill mix of staff on duty at all times. The registered manager confirmed that there were additional staff on duty at busy times of the day. The manager is supernumerary on the roster, allowing for flexibility during peak and holiday periods. The homes staff team are supported by full time housekeeping and catering staff. Comments received in returned surveys tell us, staff are very kind and always helpful and the staff are lovely. They will always do that bit more then they need to. The staff work extremely hard to give me the best possible care and they always meet my needs. I feel completely at home here. The home continues to support care staff on NVQ training and the AQAA tells us that eight of the ten permanent staff have obtained NVQ level 2 or above. The recruitment files for four staff were examined, including those for people new to the service. These contain the necessary documentation as detailed in schedule 2 of the older persons regulations. Staff files are kept in lockable filing cabinets in the managers office. It was recommended at the previous inspection that Criminal Records Bureau checks dated 2003 and 2004 are updated and it is pleasing Care Homes for Older People Page 22 of 28 Evidence: to see this has been acted upon. All staff complete an induction programme that covers the common induction standards for social care and this was seen in the four files examined. During the initial induction to the home staff are extra to the numbers on the staff rota and work alongside more experienced staff. Training records show that staff are up to date with their mandatory training. There is specialist training available for staff, and an example of this is oral health care, palliative care and equality and diversity training. Care Homes for Older People Page 23 of 28 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 by a stable experienced management team and service users are protected by safe working practices ensuring the health and safety of people using the service. Evidence: The registered manager is Vi Bassam. She started working in the home as a deputy in 1994 and then became the manager in 2000. The registered manager said she has a City and Guilds qualification in care of the elderly. Further training in the previous twelve months includes all mandatory training, safeguarding vulnerable adults and distance learning courses. Comments made in returned surveys include the manager shows great leadership and this is a delightful residential home and we can talk to the manager about anything. She is very supportive. The organisation & home has a clear and accountable management structure and the Care Homes for Older People Page 24 of 28 Evidence: manager is supported by the organisation. The inspector noted good teamwork in progress. The organisations management system includes a quality assurance module which includes a satisfaction survey. These have been sent out by the home and the registered manager collates the questionnaires and provides a summary of the results. An action plan is then drawn up to address any improvements needed. Regular residents meetings are held and minutes are kept of these. The organisation also undertake regular monitoring visits. Reports of these visits are kept at the home and are open to scrutiny. Service users are encouraged to look after their own financial affairs where at all possible. If this is not practicable then families will undertake this role. There are secure facilities available for the safe-keeping of money and valuables and record and receipts are kept of possessions left for safe keeping. There is a comprehensive health and safety policy in place and health and safety training is completed and up to date for all staff. Records were seen for fire safety. These cover the homes fire procedures, practice fire drills, fire prevention, fire alarm testing and emergency lighting testing. Testing of the homes fire alarm system is undertaken on a weekly basis and evidence was seen of this. There is a fire based risk assessment that is reviewed annually. Service reports are in place for PAT testing, gas appliances and electrical installation. Care Homes for Older People Page 25 of 28 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 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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