Care Home: Aldwick House

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What the care home does well The residents are cared for in a respectful manner in well-maintained and comfortable surroundings. Residents were relaxed and all stated that they are treated with care and respect. Activities provided in the home are varied and suit the individual needs of the residents. The residents stated that they enjoy these activities and have choice on whether to join in. Staff said they are well supported and that their training provides a good knowledge base to meet residents needs appropriately. The quality of the documentation in the home is in good order, up to date and readily available. The home has a dedicated cleaning staff, which ensures the home is clean throughout. All comment cards received from residents stated that they enjoy the meals, which are produced to a good standard. What has improved since the last inspection? Since the last inspection, several aspects of the home have been improved upon; Care plan documents contain more comprehensive information about the residents needs and preferences. Additional information relating to Capacity and Deprivation of Liberty is being implemented as part of the pre-admission assessment process. The manager holds an `open door clinic` one afternoon a week which dedicates times to any resident, relative or staff member to discuss issues relating to the home. What the care home could do better: The home needs to continue to develop on identified areas of improvement, outlined in their AQAA. The refurbishment plans to replace the downstairs carpets in the home should be undertaken to ensure the home is free from odours. A requirement was made to ensure the risk assessments are specific to individuals, and in line with risks identified in health professionals assessments. A requirement has been made to ensure daily recording includes details of residents daily nutritional intake and is monitored as part of the care planning process. Key inspection report Care homes for older people Name: Address: Aldwick House Nyewood Lane Bognor Regis West Sussex PO21 2SJ     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: Beth Tye     Date: 0 6 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) 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 30 Information about the care home Name of care home: Address: Aldwick House Nyewood Lane Bognor Regis West Sussex PO21 2SJ 01243842244 01243838041 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: New Century Care (Bognor Regis) Ltd care home 32 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 32. The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) Dementia (DE) Mental disorder, excluding learning disability or dementia (MD). Date of last inspection Brief description of the care home Aldwick House is a care home with nursing. The property is a large detached house, situated in a residential area, within walking distance of the shops and seafront at Aldwick, on the outskirts of Bognor Regis. Residents are accommodated on the ground and first floors in thirty single and one double room. All floors are serviced by a Care Homes for Older People Page 4 of 30 Over 65 0 0 32 32 32 0 Brief description of the care home passenger lift. There is a large communal dining room and dayroom on the ground floor, which opens on to an attractive garden area. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This service has been rated as two stars, which is a Good quality rating. The site visit was undertaken by Ms Beth Tye, as part of the inspection process. It took place on 6th August 2009 between 10.30 and 4pm. The registered manager was present on the day of the visit and assisted the inspector to access information, when needed. An Annual Quality Assurance Assessment had been completed by the manager and forwarded to the Commission prior to the visit. All documents required on the day were made available. Three comment cards were received from residents, all filled out with the aid of relatives who added their own comments. Two were received from professionals. Three by staff working at the home. These comments were all positive. Comments from residents, families and professionals elicited by the homes own quality assurance Care Homes for Older People Page 6 of 30 systems were seen in the home and these were also positive. We looked at four residents care plans, daily recording, health charts, risk assessments and medicine administration charts. We spoke to a relative and three residents, all spoke well of the home and the care offered, which they said was delivered in a respectful manner. They also stated that the activities were appropriate and they were given choices. The atmosphere in the home was very relaxed and sociable. Many of the residents were sitting in the lounge socialising. Others were seen in their rooms listening to music, reading, watching television or with visitors. This report is compiled using information as described above and also information held on file at the Commission. Care Homes for Older People Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: The home needs to continue to develop on identified areas of improvement, outlined in their AQAA. The refurbishment plans to replace the downstairs carpets in the home should be undertaken to ensure the home is free from odours. A requirement was made to ensure the risk assessments are specific to individuals, and in line with risks identified in health professionals assessments. A requirement has been made to ensure daily recording includes details of residents daily nutritional intake and is monitored as part of the care planning process. Care Homes for Older People Page 8 of 30 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 30 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. To ensure residents needs can be met appropriately by the home, the manager undertakes a full assessment prior to admission. Each resident is provided with a written contract of terms and conditions, which is signed by all involved parties, so residents are clear about their rights within the home. Evidence: The manager assesses individuals prior to admission. During the visit, pre-admission assessments were examined for four residents. These identified relevant areas of need including, mobility, communication, health and social needs. Files seen contained correspondence from external health professionals such as social services and health. Records demonstrated the information collated prior to admission is then translated into care plans and reviewed on a regular basis by the manager. All records are kept in a locked office only accessible by care staff to ensure confidentiality. Care Homes for Older People Page 11 of 30 Evidence: Residents spoken with confirmed they are given up to date information about the home prior to admission, including a service users guide and complaints procedure. Copies of these were seen in some residents bedrooms during the visit. Pre admission visits and printed literature helps residents (and their families) to make an informed decision about moving to the home and what to expect. All residents have received a copy of their Terms and Conditions for the home, which they or their families had signed following admission. This informs residents of their rights and what to expect of the home. Care Homes for Older People Page 12 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is Good Staff have appropriate training and information to ensure they are able to meet residents health needs. Risk assessments and daily recording specific to individual need would promote the welfare and well being of residents. Medication is dispensed in line with the homes policies and procedures. Current care practices ensure residents feel they are treated with respect and their right to privacy has been upheld. This judgement has been made using available evidence including a visit to this service. Evidence: During the visit we looked at four care plans. Each care plan contains relevant details relating to the residents health needs and social well-being, they also detailed aspects of health, personal and social care and the actions staff needed to take to meet these needs. Care Homes for Older People Page 13 of 30 Evidence: Information seen on care files was up to date and easily accessible. There was evidence to demonstrate that the manager undertakes regular care reviews for residents, and up date the care plans as changes occur. During the visit the manager showed us a document that he is in the final stages of implementing. This is a detailed pre admission assessment which relates specifically to capacity and deprivation of liberty issues. He is currently waiting for final feedback from the mental health team. Once implemented this document will be part of the care planning process and reviewed in line with all aspects of care. It includes input from residents (where possible) family members and/or involved health professionals. Health and social care records demonstrated that the care provided was relevant to individuals assessed needs and links are established with community health professionals to provide this. These include a weekly visit to the home by a GP, regular visits by the chiropodist (six weekly) dentist (six monthly) and optician (annually). The home has good links with social workers, PCT, continence advisor and the local mental health team who offer advice and resources as required. Records of visits and correspondence from community agencies were seen on residents files. Daily records and a monthly observation sheets are kept for each resident. Records seen were up to date and in good order. It was noted that some of the daily records contained general information about residents and the manager agreed the daily recording needed to be more specific to the individual and contain more detail (see requirement under daily life and activities) Risk assessments are in place for some residents but most did not contain details about specific risk areas for individuals or appropriate action to be taken by staff. For example, On one care plan a resident has requested that her door be locked at night but there was no risk assessment relating to this or confirmation that this had been actioned or reviewed. Other residents (some of which had complex health needs) had undergone assessments prior to admission by mental health professionals which highlighted risk areas, but these had not been translated into risk assessments or action plans by the home. Implementation of more detailed risk assessments and appropriate action plans for staff will promote a better understanding of need and responses in addition to supporting residents to maintain independence safely where possible. A requirement has been made in respect of this. Records demonstrated that staff complete a full induction which covers all aspects of the mandatory training programme. More than half of staff have undertaken the National Vocational Qualification Level 1, 2 and/or 3 in Care Skills. This provides staff Care Homes for Older People Page 14 of 30 Evidence: with the skills and knowledge base to respond appropriately to residents health care needs. Feedback and discussion with the residents and their relatives confirmed good practice is maintained in the home and residents are treated with dignity and respect. We observed staff directly and indirectly and noted that they were friendly, caring and professional with the residents and the residents were at ease with the staff. One residents whose daughter was visiting said the home is very good I have no complaints at all about the care here Other comments on feedback forms included The home does really well looking after its residents and we have always found staff pleasant and co-operative Staff were observed communicating with residents in a caring and respectful manner. All residents spoken to said they were very well looked after. The medication administration procedures were discussed and policies and procedures are in place to ensure safe medication administration. A random selection of medication was checked and found to be in order. Medication administration charts are completed correctly, which indicated that residents are receiving their medication as prescribed. Photographs of residents are displayed on records as an extra safeguard towards safe administration. Medicine Administration Records seen were in good order and up to date, demonstrating staff, follow appropriate procedures. We found that there were no risk assessments in place for residents who refuse medication, although the home does report this to the GP on his weekly visit. As the majority of residents have complex mental health needs, some behaviours may occur as a direct result of not receiving regular medication. The manager acknowledged risk assessments and action plans for staff in this area would better promote the health and welfare of residents and staff. A requirement has been made for this to be implemented. At present the care plans in the home do not include residents final wishes in respect of palliative and end of life care. The manager stated he is in the process of working with families and residents to gain information about this and include relevant information in the care plans. Care Homes for Older People Page 15 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are able to make decisions and choices in their lives. A range of activities is offered to residents. Residents are encouraged to maintain contact with family and friends and links with the local community are maintained. Residents are offered a varied diet of good home cooked food. Evidence: The AQAA for the home said There is a varied activity programme run by an enthusiastic activities coordinators. Activities are flexible and varied to suit residents expectations, preferences and capabilities; comprehensive life historys provide background information from which to make activity suggestions and allow staff to better understand the needs and/or preferences of the residents; individuality is encouraged throughout the day and staff are available to assist residents as required; all activity session are open to families and friends. Residents are able to express their choice with regard to leisure, social activities and cultural interests, food, meals and mealtimes, routines of daily living, personal and social relationships and religious observance. Activity organisers seek the views of the resident in order to promote a variety of daily activities, these plans are regularly reviewed and can be changed to meet individual needs. Care Homes for Older People Page 16 of 30 Evidence: An activities plan is on display in the home to enable residents to plan their time. However on the whole, routines are flexible to meet residents needs. Residents confirmed that they can choose what they want to do as far as social events, routines and also what times they go to bed and get up in the morning. Flexibility enables individuals to have choice and express a preference in their daily lives. We spoke with a resident who spoke about his love of art and making model planes. He said one of the workers at the home regularly take him to the local model shop. Later when we saw his room it was full of model planes he had constructed and there was a collection of drawings and paintings he had done, displayed on the walls. This demonstrates the home encourages individuals to pursue areas of interest and promotes choice in the activities on offer. Residents and relatives confirmed that the visiting arrangements for the home are open and visitors can come and go as they please and are made welcome by the staff. Feedback forms confirmed relatives felt welcomed and involved by the home. The manager holds an open door clinic one afternoon per week for residents families, staff or other involved parties to discuss any issues or aspect of the home. This practice, alongside regular meetings, demonstrates that staff, residents and their families are encouraged to participate in decision-making about the care the home provides. During the visit staff were observed interacting with the residents. Staff were seen throughout the day being respectful, kind and sensitive to residents needs. The activities co-ordinator was observed working with the residents, she used gentle prompts and encouragement to engage residents and maintain their focus on the activity they were undertaking. The menu offered at the home takes in to account the preferences of residents and specialist dietary needs, which are recorded on care plans. This promotes choice for the residents and provides an opportunity for them to eat what they prefer. An alternative meal is on offer at lunchtime and teatimes. Residents spoken with said they really enjoyed the food and it was always very good Records seen during the visit showed that most residents had gained weight since admission to the home and weight and dietary needs are recorded on monthly observations sheets. However, daily nutritional intake is not being fully recorded on daily record charts. For example some records stated that residents had eaten in the Care Homes for Older People Page 17 of 30 Evidence: day but it did not say what or how much. This means the home is not able to demonstrate the residents were receiving the nutrition they needed. The manager agreed he would review this with the staff and ensure records were more specific to individuals daily lives. A requirement has been made in respect of this. Care Homes for Older People Page 18 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good Residents who use this service or their representatives are able to express concerns, and have an access to an effective complaints procedure. Residents are protected from abuse and have their rights protected. This judgement has been made using available evidence including a visit to this service. Evidence: The home has a complaint procedure, which is outlined in the statement of purpose and displayed in the home. Complaints are recorded and investigated with feedback to complainant within 28 days with the actions taken. All residents and visitors spoken with said they knew who to complain to and that they would do so if they thought it appropriate. Staff induction and training records indicated that all staff receive training in safeguarding vulnerable adults. Staff spoken to, did know what to do if they suspected abuse. Staff personnel files seen during the visit, were in very good order and held all Care Homes for Older People Page 19 of 30 Evidence: appropriate checks and references. This ensures residents are safeguarded from risk of harm. Regular staff meetings within the home encourage feedback about how the home is run and could be improved upon. Information on advocacy services is available if needed. Care Homes for Older People Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good The home provides a homely environment to the people who live there. All areas are clean, tidy, well maintained. Some downstairs carpets which currently omit odours are due to be replaced at the end of August 2009. The bathing facilities are able to meet the needs of all residents. Equipment and safety checks necessary to ensure the welfare of the residents are in place. This judgement has been made using available evidence including a visit to this service. Evidence: The AQAA for the home states The location and layout of the home allows independence of movement about the home and good community involvement, we provide a comfortable, clean, safe and homely accommodation in a spacious environment, with personalised bedrooms often personalised prior to admission to minimise disorientation and distress, provide locks to resident doors to allow privacy, we provide lockable space within each room, provision of individual door notices to residents bedroom doors requesting privacy or company to respect dignity and privacy, home offers a good selection of equipment, all staff are trained in the use of this equipment, the home meets the requirements of the Disability Discrimination Act, there are several comfortable communal areas and a large furnished dining area available to residents to ensure that they have a choice to sit quietly, meet with family Care Homes for Older People Page 21 of 30 Evidence: or engage in activities with others It was noted on arrival to the home that the hall and downstairs lounge had a strong unpleasant odour. We spoke to the manager about this who confirmed it was due to the old carpets, despite being cleaned weekly. However the home is due for a complete refurbishment at the end of August 2009. This will include new carpets throughout and redecoration of communal areas and bedrooms. It was noted during the inspection that the house was very clean throughout and furnishings were comfortable and homely. There is a maintenance man and ancillary staff employed to maintain the home and gardens. Records seen demonstrated that the home has all relevant health and safety checks in place, which are up to date and in good order. This means the residents environment is kept safe and well maintained at all times. Residents are encouraged to personalise their own bedrooms to give them a sense of ownership. All bedrooms seen during the visit were clean and tidy. Communal areas provide a large space for residents to sit and participate in daily routines. Reminisce posters/collages were displayed in the lounge. In the past year the old hairdresser room and smoking lounge have been redecorated to provide a designated activities room. There are hoists, bath aids and specialist equipment to promote the independence of those who require assistance with personal care and nursing needs. Anti bacterial soap was evidenced at shared sinks. Laundry and sluice facilities are provided. Policies and procedures are in place for infection control, and all of the staff have attended relevant training for infection control and health and safety procedures. This promotes good practice in the area of safety and welfare for the residents and reduces the risk of infection spreading within the home. There is a passenger lift for residents with limited mobility to access all floors of the house. All radiators throughout the home have been covered. Records of the hot water temperatures throughout the home are recorded and monitored. A call bell system is provided in every room so staff can attend an emergency situation swiftly, should it arise. Care Homes for Older People Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are protected by the homes recruitment policies and procedures and by an induction and training programme. People who use this service experience good outcomes because their needs are met by suitably recruited and trained staff. This judgement has been made using available evidence including a visit to this service. Evidence: Staff rotas, observation and feedback reflected that there are enough skilled staff on duty in the home to meet residents assessed needs. Both staff and residents fed back how this had helped to allow more time for one to one care. In addition, the home has dedicated catering and house keeping staff which enables care staff to focus on their roles and responsibilities providing care for residents. Following examination of staff records it was concluded that, recruitment procedures in the home are good and in line with the homes recruitment policies. All staff files seen were found to contain the necessary documentation required by Schedule 2 of the Care Regulations. Training records of four staff files were looked at during the visit. They showed that Care Homes for Older People Page 23 of 30 Evidence: staff have received induction training which includes all aspects of care in the home, health and safety and best practice guidance. The staff induction pack includes reference to appropriate policies and procedures and a checklist covering all aspects of the home which is overseen by the manager. The mandatory training for staff covers fire safety, manual handling, health and safety, adult protection and infection control. In addition the home has provided some specialist training to meet assessed needs of the residents. This includes; Dementia, Nutrition, Catheter Care and Equality and Diversity. The staff who have completed these will then cascade information to other team members. The manager has a staff training programme in place which identifies training needs and timetables refresher updates. There are plans for the home to provide more specialist training to staff such as the Mental Capacity Act. The majority of the staff employed by the home have completed the National Vocational Qualification in Level 1, 2 and/or 3. Examination of training records, observation and feedback from surveys and during the visit highlighted that staff are skilled and competent in their roles. Staff spoke with during the visit were clear about their roles and responsibilities and how to respond appropriately to residents needs. Comments made about the staff by the residents and their families included staff treat the residents as individuals, staff are compassionate, pleasant and cooperative and the staff are very good at offering choices. This was supported by observation of care practice and examination of care records during the visit. Care Homes for Older People Page 24 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The quality of this outcome area is Good Residents and staff benefit from the leadership and management approach within the home. Overall the residents welfare is a priority within the home, and this is supported by administration systems, policies and procedures. This judgement was made from available evidence including a visit to the service Evidence: The AQAA states The manager has the appropriate qualifications and several years experience to run the home and meet the aims and objectives and purpose; health, safety and welfare of residents and staff is prompted through the companys policies & procedures which the manager ensures are implemented; there are clear lines of communication and accountability with external management; the manager ensures the approach of the home remains open, positive with an inclusive atmosphere; a commitment is made to equal opportunities; methods of running the home are transparent; management planning and practice encourages innovation, creativity and development Care Homes for Older People Page 25 of 30 Evidence: Aldwick House has a full time manager in post, who is registered with the Commission. Simon Hollis is a registered Nurse with a several years nursing and management experience. He has completed the Registered Managers Award. Staff feedback reflected that the management provides good leadership and direction. Staff spoken to stated if there are problems the manager is always around to deal with it. And that the manager is supportive. This enables staff to seek guidance when needed to ensure residents needs are met appropriately. The home has very clear and up to date administrative procedures in place to support care practice within the home. All care records and documentation seen was in good order and information was easily accessible. Staff in the home receive regular supervison and annual appraisals with the manager. They also undertake a comprehensive induction, training relevant to their role and attend regular staff meetings. This promotes good practice in the home, helps identify learning needs and gives them the opportunity to contribute to the way the home is run. Aldwick House has a quality assurance process in place which is used to inform the annual business plan. Questionnaires are sent out annually and the results once published, are available to any involved parties. Residents are encouraged to manage their own finances or if this is not viable a representative of the resident will take on the responsibilities for this. No residents financial accounts are dealt with by the home Health and safety is maintained through record keeping, training and servicing of necessary equipment. All equipment checks and servicing is carried out within the safe guidelines. Policies and procedures are in place and reviewed on a regular basis. Care Homes for Older People Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 13 The registered person shall 31/10/2009 make suitable arrangements to prevent unnecessary risks. That these are identified and where possible eliminated. The manager must implement risk assessments relevant to individuals assessed need in order to reduce risk and promote safety and independence of the resident concerned. 2 15 17 The registered person must 31/10/2009 ensure staff maintain suitable daily records relevant to individual need Nutritional records are not kept up to date. The record should be kept up to date and recorded in the care plan so that staff know what each residents nutritional needs are. Care Homes for Older People Page 28 of 30 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 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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