Care Home: Alexandra Nursing Home

What the care home does well The Alexandra provides an excellent service for the people who live there. There were some positive comments from residents and their relatives regarding this service. People found it a pleasant and homely place to be, where the atmosphere is good and the welfare and well being of the residents is taken seriously. All of the people that we spoke to during this visit said that they liked the home and the care that it offered its residents. We observed the care staff speaking to people with respect and politeness. A resident commented, "It`s a good place here, they look after me well." One of the visitors to the service also commented, "I know that once I go home she`s looked after properly." The arrangements for meals are good and everyone that we spoke to said that the food is generally good and that people look forward to mealtimes. All of the people who were spoken to during the inspection said that the food was good, and they looked forward to mealtimes. One person said that the food was like "eating in a restaurant." Care staff are recruited properly and there had been regular training events for the staff. This helps to ensure that the carers have the knowledge, skills and ability to care for people properly and professionally. Good recruitment also helps to ensure that the residents are protected from unsuitable staff. There are lots of planned activities available and the home has an activities coordinator to organise and undertake events for the residents. There are also planned activities for those with dementia. A good activities programme means that the residents are mentally and physical stimulated and can do things that they enjoy. Some of the residents had photograph displays that had been developed by the care staff to stimulate memories and conversation. The home is fresh, clean, pleasant and homely. A domestic team were working at the home during our visit and there were regular quality checks by the management team regarding the cleanliness of the home. There were no unpleasant smells and this was commented on by the people who used the service and their visitors. The owner of the home maintains a positive input and regularly visits. He has invested heavily to improve both the fabric and maintenance of the home and by providing positive outcomes for the residents who use this service. What has improved since the last inspection? This service has expanded since our last key inspection: a new dementia unit has been added to the building, meaning that the service can accommodate a total of 75 people. The new unit has been built in an environmentally friendly way, enabling rain water to be recycled for laundry and toilet use. The unit is set out on three floors and has a large, fenced patio area to the front for people to use in good weather. The main part of the home was having en-suite facilities installed in some of the larger bedrooms. We found that people were pleased with the improved facilities that were on offer.The manager had organised a number of training events to improve the skills and knowledge of the care staff. The home has its own dedicated training room where events can be held. Several care staff have achieved a nationally recognised qualification in care (National Vocational Qualification level 2 or 3). What the care home could do better: We found that everyone had a care plan and that these were being properly reviewed on a monthly basis to update information about people`s health requirements. The recording of the reviews were very brief and did not contain outcome statements about changes in their health or, in particular, social needs. The care plans, in general, held little information about interests, hobbies, likes and dislikes. The manager should ensure that this type of information is recorded at assessment stage as a matter of course. Care plans should not be about recording health needs alone; a more complete picture of each person should be developed within the plans and updated and reviewed along with their health needs. We also found that information about the people who worked in the home wasn`t being kept in an organised way. The manager should ensure that this information is kept in separate, bound folders and the information devided into relevant sections. This will make information easier to find. Key inspection report Care homes for older people Name: Address: Alexandra Nursing Home Moorland Road Poulton Le Fylde Blackpool Lancashire FY6 7EU     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Christopher Bond     Date: 2 8 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 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: Alexandra Nursing Home Moorland Road Poulton Le Fylde Blackpool Lancashire FY6 7EU 01253893313 01253899819 info@alexandracarehome.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Alexandra Nursing Home Limited care home 75 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The registered person may provide the following categories of service only. Care home with Nursing - code 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 - Code OP, (maximum number of places: 38) Dementia - Code DE (maximum number of places: 35) Physical disability - Code PD (maximum number of places: 2) The maximum number of service users who can be accommodated is: 75 Date of last inspection Brief description of the care home The Alexandra is a listed building and stands in its own grounds on the outskirts of Poulton-le-Fylde. The main building is most attractive and contains many of its original features, including wall and ceiling paintings, stained glass windows and a broad open staircase leading up from the hallway. The gardens are well managed and there are Care Homes for Older People Page 4 of 28 Over 65 0 38 0 35 0 2 0 5 0 6 2 0 0 9 Brief description of the care home lots of places for residents to sit out in good weather. The main railway station is quite close and bus services run from close by. There are plenty of parking spaces close to the home and within its grounds. There are local shops not far from the home as well as places of worship and other amenities. The main building has a lift and some of the bedrooms are en-suite. The service now has a separate dementia unit which is purpose built. This building adjoins the main home and is registered for 35 people who have dementia. This facility has a dedicated staff team. All rooms have en-suite facilities and the rooms are arranged over three floors. Information about this service is available within the Service User Guide and Statement of Purpose that are part of the welcome pack for the home. A colour brochure of the service is also available on request. At the time of this visit (28/09/2009) the information given to the Commission showed that the fees for care at the home are from GBP 496.50 to GBP 624.50 per week for residential and nursing care, with added expenses for hairdressing and chiropody. Fees for the dementia unit are GBP 518.50 per week with added expenses for chiropody and hairdressing. 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: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: As part of the inspection process an unannounced visit took place over a total of 8 hours on the 28th September 2009. The service users personal files and care plans were examined. Care staff records and recruitment records were also looked at. Safety certificates and medication procedures for the service were examined. We spoke at length to the manager of the service during the inspection. A number of people who used this service were also spoken to as part of the inspection process. Several visitors to the service were interviewed and their views have been recorded as part of the inspection process. The Care Quality Commission Inspection also sent out surveys to care staff to gather their views about the service they receive. Two of these were sent back to us and the Care Homes for Older People Page 6 of 28 results have been included in this report. Every year the registered person is asked to provide us with written information about the quality of the service they provide. They are also asked to make an assessment of the quality of the service. This information, in part, has been used to focus our inspection activity and is included in this report. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? This service has expanded since our last key inspection: a new dementia unit has been added to the building, meaning that the service can accommodate a total of 75 people. The new unit has been built in an environmentally friendly way, enabling rain water to be recycled for laundry and toilet use. The unit is set out on three floors and has a large, fenced patio area to the front for people to use in good weather. The main part of the home was having en-suite facilities installed in some of the larger bedrooms. We found that people were pleased with the improved facilities that were on offer. Care Homes for Older People Page 8 of 28 The manager had organised a number of training events to improve the skills and knowledge of the care staff. The home has its own dedicated training room where events can be held. Several care staff have achieved a nationally recognised qualification in care (National Vocational Qualification level 2 or 3). 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. Sufficient information is available for people to make an informed choice regarding the service. Good pre-admission assessment meant that people knew that their needs could be met properly before they came to live at the home. Evidence: The manager of the home ensured that all of the people who were thinking of going to live at the Alexandra Nursing Home had clear and concise information about the purpose and role of the home. The Service User Guide and Statement of Purpose were given to new residents and prospective residents to ensure that they had the information to make an informed decision as to whether the home could meet their needs and was right for them. This had been recently altered and reviewed. We saw a copies of the welcome pack containing this information in vacant rooms, for people to read when they first arrive at the home. A colour brochure was also available with photographs of the service and clear and Care Homes for Older People Page 11 of 28 Evidence: concise information about the services that the home provides. This also contained information about the history of the building. We spoke to several people about the information that was available about the home and all said that this was sufficient. One relative told us, The brochure was very good and told us a lot about the home. Clear information was also held regarding the complaints procedure and how the residents and their families could air their views. There were good pre-admission assessments held on the residents personal files: these were completed before people came to live at the home to ensure that individual needs could be met appropriately by the care staff. The manager described to us the process that she used with regard to admitting people to the service. Two relatives of people who lived at the home confirmed that an assessment had been completed prior to their family member being admitted. Residents also confirmed that they, and their families, had the opportunity to look round the building prior to making a decision about whether the service was right for them. Contracts were available within the residents personal files, which explained the charges and rights of the people who lived there. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are treated with dignity and respect in this home. Health, personal and social care needs are taken seriously and outcomes for residents were excellent. Evidence: All of the residents at this home had a plan of care where their needs were set out clearly so that the care staff could attend to their individual social and health requirements properly and professionally. These plans were added to daily and reviewed regularly to ensure that the information within them was correct and that people received proper care. The plans were clearly laid out and easy to follow. Complex and detailed matters regarding care and support were set out for the care staff to follow: this helped to ensure that people received a consistent level of care. Some of the residents told us that they were very pleased with the way that their healthcare needs were dealt with and that they felt well looked after. We spoke to seven residents during this inspection and they were very positive about the way the care staff went about their duties. One person said that the carers were respectful ; another said that the care was very good and that she was glad that she had chosen Care Homes for Older People Page 13 of 28 Evidence: the Alexandra as a place to live. We also spoke to several visitors whilst we were there. One relative commented, I cannot speak highly enough of them,I know that when I go home shes looked after properly. Another relative told us, Mums come on leaps and bounds because of this place. We observed the carers as they spoke to people, served meals and assisted people to move about the home. It was clear that they were polite, pleasant and professional when carrying out their duties and the residents looked relaxed and confident. The care plans held important information about healthcare needs. There was plenty of information about how the care staff made regular checks regarding pressure area care using a recognised recording tool. The manager was pleased that no one who lived at the home had a pressure sore and there was special equipment available to help prevent these. The plans also held information regarding nutrition, continence, communication, nursing needs, moving and handling, and breathing. There were records to show when the G.P. visited the home and the results of their consultation were recorded clearly on the care plan. Although there was a review process and the care plans were looked at monthly and updated, we found that there were no outcome statements to supplement the reviews. Information regarding health and social care needs with regard to review was limited and needs to improve. We also looked at the medication systems that the service had in place. These were safe, and the residents prescribed medication was stored and administered properly. Some people had been prescribed controlled medication, which was carefully monitored because of its content or strength. The administration and storage of this was being handled correctly by the home. We also looked at the records of when people had their medication: these were in order and there were photographs one each persons records to help ensure that people were given the correct medication. The medication systems were regularly audited by the manager and senior staff to help ensure that this was being administered properly and safely. It was good to see that people looked well dressed and well cared for. The carers were well organised and we observed that the carers were polite, courteous and respectful. There had been training for the carers to help ensure that the residents were assisted to move around the home safely and comfortably and equipment was available to assist with this. The manager confirmed that the service had introduced a care pathway for those Care Homes for Older People Page 14 of 28 Evidence: residents who were nearing the end of their lives. This helped to ensure that the care staff gave the correct kind of care and support for those who required it and helped residents and their relatives to move towards death in a positive and dignified manner. Training had also taken place for the care staff in palliative care which aims to improve the care of people with advanced and progressive illnesses by providing adequate pain relief, and enabling residents to live as actively as possible whilst offering support to families and friends. We also visited the new dementia unit and found that this service was improving after a few teething problems. The care planning system was similar to the main part of the home and health needs were recorded well. There were plenty of care staff on duty and the we saw them speaking respectfully to the people who used this service . There were several visitors to this unit whilst we were there and the people we spoke to were generally pleased with the level of care on offer. One visitor commented that the service had steadily improved since it was opened; they added Were satisfied with the level of care, they give dad a quality of life, they care about what they do. 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. Activities were varied and well planned, which contributed to the well being of the residents. Visitors were welcomed and valued family relationships were encouraged. Evidence: There were plenty of planned activities for the residents to do during the week. One of the care staff had taken on the responsibility of being an activities co-ordinator and helped to ensure that regular events took place both in the main home and the dementia unit. An entertainer visited the home on a regular basis and there were regular seasonal activities available. The menus for the Alexandra were available and lunch was being prepared during the inspection. Meals, it was seen, were well planned and nutritionally balanced. Fresh fruit, vegetables and meat were delivered regularly from local suppliers. The dining area was pleasant and tables were set properly and attractively for the lunchtime meal. The care plans showed that the residents likes and dislikes regarding food were recorded properly. It was also written down when someone had a special diet, or needed specific help with their eating. one person told us, they tend to my diabetes well. We sampled the lunchtime meal and found it to be well cooked and nutritious. Care Homes for Older People Page 16 of 28 Evidence: There were some positive comments made about the food at this home. Almost everyone that we spoke to said that the food was good and that they looked forward to mealtimes. One resident commented, The food is excellent, its like eating in a restaurant! There were several visitors to the home during the inspection. The manger confirmed that relatives and friends were encouraged to visit and were always offered privacy. The visitors that we spoke to said that they were welcomed and offered refreshments during their visit. One relative said, Im always made to feel very welcome, I sometimes stay for lunch. We looked at the care plans and there wasnt much recorded regarding peoples social needs. It would have been good to see more information about what peoples interests were before they came to the home.This information should include what peoples preferences and dislikes were. As much social information should be gathered as possible to assist the carers and to ensure that the people who use the service have their social needs addressed adequately. 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. Good safeguarding procedures help to ensure that people remain safe in this home. The complaints procedure is clear and accessible meaning that residents and their representatives can voice their opinions easily. Evidence: All of the staff that were spoken to said that they knew what to do if someone was unhappy about the service. The complaints procedure was displayed in the home and was part of the Service User Guide. Everyone was given a copy of this when they first arrived at the home; timescales were given for the handling of complaints and the manager confirmed that all complaints and concerns were handled properly and seriously. The manager was aware of the homes role regarding the complaints procedure and how complaints can be used as a quality tool to ensure that the home is run in the best interests of the residents. It was clear that the manager and the owner of the home took safeguarding procedures very seriously. There were policy documents for the staff to read about how to ensure that people were safeguarded from harm. All of the staff that we spoke to said that they had a good awareness of this important issue and knew what to do if they were not happy about something they had seen. The manager was aware of her responsibilities and knew whom to contact should there be any question regarding how the residents were being supported and safeguarded. Recent training had taken place regarding safeguarding adults and some of the carers that we spoke to said that Care Homes for Older People Page 18 of 28 Evidence: they were taught about safeguarding people as part of their National Vocational Qualification training. It is important that all of the care staff that work at the home have access to this information as it helps to ensure that people are safeguarded from harm. Copies of all the homes policies and procedures were available in the main office for the staff to read to help them in their roles as carers. There was also a whistle blowing policy for staff to report incidents that they are not sure of, and assurances were given within this policy that any such reports would be taken seriously and acted upon. There had been four complaints about this service since our last key inspection. The manager had acted accordingly and had investigated each one properly and professionally within given timescales. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents live in a clean, pleasant and well -maintained environment. This is a service that was homely. Evidence: The property itself was a grade two listed building, set in its own grounds with views of the surrounding countryside from some of the bedrooms. The manager of the service showed us round the home and we viewed most of the bedrooms and the communal areas. The bedrooms were connected by wide corridors and all the rooms were quite large and well furnished. Work was being undertaken to fit en-suite facilities to 14 of the larger bedrooms in the main home, which improved the facilities. Several of the residents told us that they were pleased with this. One resident told us, Its much better having my own toilet in my room, Im very pleased with it. Most of the rooms that we looked in had been personalised and had individual possessions around to help make them more homely. New light fitments had been fitted in some ares which made them brighter. There had been some redecoration work undertaken and new flooring fitted. The main part of the home had a traditional feel and some of the people who used the service commented on this. One person commented, Its very grand in the main areas, it makes you feel special, and the care is just as good. Care Homes for Older People Page 20 of 28 Evidence: There were two lounges on the ground floor and a conservatory area to the side of the building. Many residents were relaxing, and looked content; there was a feeling of well- being, and quite a lot of relatives and friends were visiting. Some of the visitors told us that they were pleased with the layout and facilities of the service. One person said, Its very comfortable and were pleased that mum is here. The dementia unit had recently been built and was more modern and open plan in design. There was a large lounge area with a large flat screen television and areas around the edge of the room where activities took place. The rooms were set out on three floors and all had en-suite facilities. The corridors had been painted in bright colours to help people to find their way around. We found that some visitors and relatives we spoke to didnt like the open plan design and would have preferred more quiet rooms where people could relax away from the main areas. Overall, however, there were some positive comments regarding this part of the service. One relative told us, Its a safe and pleasant place. The care is very good and I couldnt think of a better place for Dad to be. There were toilets that lead off the main dining area which had been seen as a problem when they were being used during meal times. This had been identified by the manager and another toilet was used during meals. There was a large patio area to the front of the unit where people could sit out safely in good weather Overall the service was very clean and pleasant. We found that all areas of the home smelled fresh, and any continence issues were dealt with properly and promptly so that unpleasant smells did not linger. The laundry area was well- organised and clean. Issues regarding lost property were being addressed by the manager. 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. Good recruitment procedures at this home help to protect the residents from unsuitable staff. Training for the staff was good, which helps to ensure that the care staff have the skills to do their jobs properly. Evidence: Each of the care staff had an individual training file that helped to set out their training needs and documented the courses, training and qualifications that they had undertaken and achieved. We looked at several of these and spoke to the carers about them. It was confirmed that the service takes the training of its staff seriously; several courses and training events had taken place since the last key inspection. These included training in catheter care, nutrition, dementia awareness, palliative care, and safeguarding people. Mandatory safety training had also taken place. Over 70 of the carers held a nationally recognised qualification in care (National Vocational Qualification level 2 or 3 in care). A well -trained staff team helps to ensure that they have the knowledge, skills and ability to provide a better standard of care. This service has a training facility within the home where instruction of the staff takes place. We looked at six care staff files during our visit. Staff files were not separately bound and information was hard to find. Each file, however, held a photograph and the correct information on each person. This helped to ensure that the people who used this service remained safe and secure. Evidence was available that Criminal Records Care Homes for Older People Page 22 of 28 Evidence: Bureau disclosures had been obtained, and checks had been requested from the Protection of Vulnerable Adult Scheme prior to employment. There were enough trained staff and care staff on duty to help ensure that the assessed needs of the residents were addressed properly. There were some positive comments made about the care staff who worked at this service. One resident told us, There always seems to be plenty of staff and theyre pretty good at their job.. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is being run in the best interests of the residents and their welfare is promoted and protected. Good quality control systems help ensure the service runs well. The manager is well respected and runs the service well. Evidence: The manager of the home is a registered nurse and holds the Registered Managers Award. The owner of the service has an office within the building and visits the service on a regular basis. The management team is trained, prepared and qualified to manage the home properly, which helps to ensure that the people who live there receive a good service. The care staff, residents and visitors told us that the manager was pleasant, organised and well thought of. One resident told us, she walks the home every day and tries to speak to everyone individually; she cares about what she does. There were quality monitoring systems in process to measure how well the service Care Homes for Older People Page 24 of 28 Evidence: was progressing. The manager undertakes a daily quality walk round, checking the bedrooms and communal areas. The residents were surveyed as to their views about the home on a regular basis and the results collated and assessed. The owner of the home undertook regular monthly quality visits and completed a report on his findings. The care staff received regular training in areas of safety around the home: this included fire safety, food hygiene, first aid, infection control, and moving and handling training. There was equipment available to help ensure that the residents of the home were helped to move around the home safely and comfortably. The staff had received training in using this. There were records to show that major appliances within the home had been serviced properly and that safety equipment had been examined by suitably qualified persons to ensure that the health, safety and welfare of the residents was being properly addressed. The gas system, electrical installation and lift had been serviced on a regular basis and there were certificates to show that this had taken place. The home was also properly insured to help protect the residents. Risk assessments had been completed for areas where the residents might need extra protection. The manager told us that there were regular staff meetings for both day and night care staff and there were minutes available to confirm this. There were also minutes held for residents meetings where people were encouraged to talk about the service that they received and what changes could be made to improve their lives. As part of the inspection process the manager provided the commission with an Annual Quality Assurance Assessment that told us about the home and how it was progressing. This was completed well and outlined in detail how the service was improving outcomes for the residents and meeting their specific needs. 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 1 7 The review process within the care plans should contain more information and outcome statements. This is to help ensure that the care staff record both social needs and care needs in a planned and consistent way. 2 12 A record of social preferences should be kept within the care plan. This is to help ensure that people can continue their hobbies and interests. 3 27 The care staff files should be individually bound and well organised. This is to ensure that important information regarding each staff member can be easily found. 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. 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 28 of 28 - 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. 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