Care Home: Alfriston Court Luxury Care Home

Similar services:

• The Shelley
• Springfield House
• Sutton Lodge Nursing Home
• St Helier`s Residential Hotel
• St Joseph`s
• Ridgemount
• Wingham Court
• Old Hastings House

What the care home does well The care and support is tailored to individual preferences and is delivered to a high quality. The atmosphere at the home is relaxed and friendly but conveys the environment and facilities of a high standard hotel. The quality and standard of the food in the home is very good with resident satisfaction being maintained, and choices responded to. Alfriston Court Luxury Care Home provides a high quality environment that is fitted and furnished to a high specification and is suitable to meet the needs of residents. Visitors are made to feel welcome and are able to stay and enjoy the homes atmosphere and facilities. The quality of the service is being closely monitored with the intention to improve as necessary in all areas to secure and maintain an `excellent` home. This is done in consultation with staff and residents who feel that they are `listened to`. Residents were very positive about the care provided and comments received included,`There is no other home that is so keen to meet your individual needs` `they take time to find out what you need, or want` `the home gives understanding and care, from bright and helpful staff` `every endeavor is taken to make me comfortable`. What has improved since the last inspection? The care documentation has been extended to reflect and promote a person centered approach to care. The homes management have worked hard to improve this area recording in the AQAA that the home had `moved forward into person centered care and as we have been open a year now we are understanding of our residents needs`. Further risk assessment processes have been established and are now linked to individual care plans for specific care needs, providing both long and short term guidance for staff to follow. The systems for handling and storing all medicines, including controlled drugs have been improved to ensure medicines are stored appropriately. Suitable hand washing facilities have been established at all communal areas to enable people to wash their hands effectively, therefore reducing any possibility of cross infection. The recruitment practice is now full and robust and ensures all the required checks are completed before staff are deployed to work in the home. This ensures residents are safeguarded. Management arrangements have been stabalised and now support staff in adhering to the homes policies and procedures that promote and maintain high standards of care, and safety for residents. Any money held by the home on behalf of residents are held securely with accurate records being held in respect of these. What the care home could do better: Although no requirements have been made following this inspection the appointed manager has agreed to action a number of shortfalls to ensure the home is run in accordance with the Care Home Regulations 2001. These are documented within this report. Areas to be addressed include ensuring all documentation providing information about the service, or how the home is to be conducted, is full, accurate and up to date. In addition a thorough admission procedure must be followed on all occasions, and the appointed manager of the home must apply for her registration with the Care Quality Commission. Key inspection report Care homes for older people Name: Address: Alfriston Court Luxury Care Home Sloe Lane Alfriston East Sussex BN26 5UR     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: Melanie Freeman     Date: 0 6 0 7 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: Alfriston Court Luxury Care Home Sloe Lane Alfriston East Sussex BN26 5UR 01323874140 01323871609 enquiries@chanctonbury-care.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Chanctonbury Healthcare Limited care home 27 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 27. The registered person may provide the following category/ies of service only: 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 categories: Old age, not falling within any other category (OP). Date of last inspection Brief description of the care home Alfriston Court Luxury Care Home is a converted Hotel that has been fitted and furnished to a high standard for the purpose of providing a quality living environment. It is registered to provide support and care for up to twenty-seven (27) residents in the category `older people. The home is owned and managed by Chanctonbury Healthcare Ltd. The home benefits from a village location overlooking the South Downs, which is well suited to the purpose of providing country house hotel type living for those who wish for, and can afford, a degree of luxury in old age. The community facilities in the village, including tearooms, restaurants, pubs, post office, church, general stores and craft shops, are all within easy walking distance, down the homes Care Homes for Older People Page 4 of 28 Over 65 27 0 Brief description of the care home private driveway. Residents accommodation is found on the ground, first and second floors. All rooms have en-suite facilities and disabled access is available throughout the home with the provision of ramping and a passenger lift. Varied communal space is available along with outside space for walking and sitting. The homes fees as of the Jul 2009 vary according to what room is to be occupied and start at £750 rising to £900 per person per week. All fees are clearly recorded in the homes brochure and additional charges are made for some services including hairdressing, chiropody, carer accompaniment for hospital visits and telephone rental and call costs. Some activities and entertainment are included in the fees. 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: The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term service user to describe those living in care home settings. For the purpose of this report those living at Alfriston Court Luxury Care Home will be referred to as residents. This was a key inspection that included an unannounced visit to the home on Monday 6 July 2009. The allocated inspector spent approximately six hours in the home and was able to discuss matters with the appointed manager of the local sister home who had been allocated a management overview of the home in the appointed managers absence. In addition the inspector spoke to the appointed manager on her return from annual leave. All communal areas in the home were seen with the bathing facilities, along with a selection of bedrooms. A range of documentation was reviewed including the homes Care Homes for Older People Page 6 of 28 service users guide, pre-admission assessment procedures, the systems in place for handling complaints and protecting residents from harm. Staff recruitment files, staff training records and quality assurance systems. The care documentation pertaining to two residents were reviewed in depth and the inspector ate a midday meal with a group of residents in the dining room. The required Annual Quality Assurance Assessment (AQAA) was completed by the appointed manager and returned when requested and was used to inform this inspection report. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? The care documentation has been extended to reflect and promote a person centered approach to care. The homes management have worked hard to improve this area recording in the AQAA that the home had moved forward into person centered care and as we have been open a year now we are understanding of our residents needs. Further risk assessment processes have been established and are now linked to individual care plans for specific care needs, providing both long and short term guidance for staff to follow. The systems for handling and storing all medicines, including controlled drugs have been improved to ensure medicines are stored appropriately. Suitable hand washing facilities have been established at all communal areas to enable people to wash their hands effectively, therefore reducing any possibility of cross infection. The recruitment practice is now full and robust and ensures all the required checks are completed before staff are deployed to work in the home. This ensures residents are safeguarded. Management arrangements have been stabalised and now support staff in adhering to the homes policies and procedures that promote and maintain high standards of care, and safety for residents. Any money held by the home on behalf of residents are held securely with accurate records being held in respect of these. Care Homes for Older People Page 8 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides prospective residents and relatives, with a good level of information about the home, its facilities, services and the costs involved. The admission procedures do not always ensure that all prospective residents are fully assessed by a competent person before admission, and are assured that their needs can be met by the home. Intermediate care is not provided at Alfriston Court Luxury Care Home. Evidence: The statement of purpose was available at request at the reception area. The home has a brochure and a separate service users guide is supplied to residents. These documents need total review and update as they recorded the current manager as the previous manager, who left the home over 10 months ago, and that there was a Care Homes for Older People Page 11 of 28 Evidence: quality manager in post, when this is not the case. The complaints procedure within the service users guide was different to the one displayed, and it refereed to an individual inspector. There was no record of service users views and it did not clearly record where the last inspection report could be located. Contact with the appointed manager following the inspection visit confirmed that she had not fully reviewed these documents and would do so, and ensure all the required information is available and accurate. The last two admissions were identified and it was clear that both were assessed before admission to the home. Initially they were admitted for respite care and were later admitted on a long term basis. The records examined confirmed that confirmation is sent to each prospective resident following assessment, confirming that the home is able to meet their assessed needs. In this way people are not admitted to the home unless they know that the home can meet their needs. Later discussions identified that a resident was being admitted directly from hospital to the home later that week. It was however noted that the only assessment of need was completed at her home before her admission to hospital, and before any operation had been completed. Clearly this does not give a picture of the specific individual needs on admission, or take into account any care that may be required as a result of the operation. This shortfall was raised with the appointed manager of the local sister home, who had been allocated a management responsibility in the appointed managers absence. For her to address and to ensure a suitable assessment was completed, before an admission to the home was progressed. When this matter was discussed with the appointed manager on her return from annual leave she said that this was an oversight and that normal practice would be to complete a further assessment at the hospital, when discharge arrangements could be finalised. The management arrangements must ensure that all residents are fully assessed prior to admission so they, and the home, are confident that all their care needs can be met. It was clear from the AQAA and discussions with residents that the assessment process allows residents to make choices about their admission, and are aware that the admission is subject to a months trial. Alfriston Court is being used for respite care by the local community and allows residents to enjoy hotel like services, in addition to personal care and support. 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 was found to be meeting residents health and general needs with assessed additional community support when needed. The homes practice ensures residents medicines are administered safely and that the care and support is delivered in such a way that promotes and protects the residents privacy, dignity and individuality. Evidence: The care documentation pertaining to two residents were reviewed in depth as part of the inspection process and each of these residents was met with during the inspection visit to the home. These confirmed that the care needs of each resident are fully assessed and the needs identified are reflected in plans of care. These plans were person centered and reflected individual preferences and specific needs, providing guidelines for staff to follow. They were updated regularly and there was evidence that residents were involved with this process, showing that they were in agreement with the level of care provided. A record of monthly dietary needs and choices is also recorded, allowing people to change their prefaces and discuss their diets with staff. Care Homes for Older People Page 13 of 28 Evidence: The AQAA identified that the home is keen to maintain peoples independence and this was reflected within the care documentation and in the way that support and care was being delivered. The home is also suitably adapted to promote this, and additional equipment would be accessed as necessary. Care plans contain risk assessments for a range of areas and it is generally possible to track the level of risk and the controls in place to minimise these, and included nutritional, pressure area and moving assessments. The care documentation demonstrated that the home works closely with local community professionals promoting a multi-disciplinary approach to care and support. Daily records are maintained and these confirmed a good understanding of individual needs and that these were responded to. One residents in conversation said I have a daily shower when I want. Observation in the home confirmed that staff were meeting residents needs in a flexible way allowing residents to direct the care and support that they need. All feedback from residents was very positive, and comments from residents included There is no other home that is so keen to meet your individual needs they take time to find out what you need, or want the home gives understanding and care, from bright and helpful staff every endeavor is taken to make me comfortable. The home has reviewed the medicine storage facilities since the last inspection and have changed the medicines room. Records seen were clear and accurate and confirmed that residents are receiving their prescribed medicines. The home has a separate controlled drug cupboard to ensure all drugs are stored securely, however a suitable register needs to be available so that appropriate records are maintained as soon as any controlled drug is brought into the home. Records held confirmed the signatures of staff trained to administer medicines and a photograph of each resident on the medicine charts promote safe medicine administration. Risk assessments are completed if residents choose to retain their own medicines and written guidelines are provided to staff for those medicines that are prescribed on an as required basis. Although the home has good generic policies and procedures for the safe administration of medicines the home has changed where all their medicines are supplied, and need to amend their specific procedures accordingly. Residents are clearly happy with the services and care at the home and had a high input into the care and services, being consulted regularly about all aspects. Care Homes for Older People Page 14 of 28 Evidence: Privacy is well respected and residents rooms are seen as there own space. Al staff knock on doors before entering and are mindful of respecting private conversations and private time. Some residents are given keys to these when requested. It was suggested that this is offered routinely to all residents. 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. Residents are able to live their life in accordance with their own expectations and preferences maintaining strong links with family and friends. Residents choices are well respected and the food provided is both appetising and wholesome and served in a way and in an environment to meet hotel standards. Evidence: Residents living in the home are very able to direct there own days activity and their choices with regard to this are respected. There are no set routines in the home and this allows the care and services to be flexible. The home employs an Activities person who spends individual time with each resident and arranges outings and some activity in the home that include quizzes. These tend to be based around the residents preferences take into account the kind of entertainment that the residents have been accustomed to. One residents said how much the residents were all looking forward to a meal arranged at a local restaurant. A garden party is also being arranged for the summer, and residents spoken with said that they had been involved in its planning. Care Homes for Older People Page 16 of 28 Evidence: Another resident said that the home has a visiting physiotherapist that helped with exercises and mobility, and that a beautician provided treatments like facials and massages. The local priest now also visits the home on a regular basis. Visitors are very welcome and the home has an open visiting policy, with the AQAA confirming that a large number of visitors come to the home, and can take advantage of the beautifully setting of the home and excellent standard of cuisine. Most residents deal with their own financial affairs or are supported by a relative and all have complete control over their lives making decisions and maintaining their own autonomy. The registered manager works well with residents and staff to ensure that this freedom and protection of individuals rights is maintained. Residents spoken with said they were free to do as they wish, but help was available if needed. Feedback received from residents about the food was very positive and the meal eaten with three residents in the communal dining room was of a high quality. Choices were available and individual preferences were also responded to. The environment and presentation was of a high quality hotel. The chef responds to residents individually and incorporates their ideas and requests in the menu, and responds to any comments positively. Residents felt that their views about the food were responded to and that the standard continues to improve all the time meeting residents specific likes. 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. Residents benefit from an open culture where they are able to express their views and are confident that any complaint made would be listened to and responded to appropriately. The appointed managers overview of the home would ensure that any safeguarding issue raised would be responded to quickly and appropriately, although supporting procedures need to be accurate. Evidence: The home has a complaints procedure which is held within the the service users guide, that is given to each resident. This needs to be amended to reflect the correct contact address for the CQC. The record of complaints held in the home demonstrated that complaints are taken seriously and that they are investigated and responded to. It was recommended that a complaints record is maintained and in this way they can be audited easily with any themes being identified. Everyone spoken to as part of the inspection process confirmed that they would feel comfortable in raising any concern with the appointed manager, and were sure that she would deal with any matter in an effective way. Although the home has a Safeguarding Vulnerable Adults procedure a review of this indicated that this procedure needs to be updated, to clearly record that social services must be notified of any allegation or suspicion of abuse, before an investigation is undertaken by the Care Homes for Older People Page 18 of 28 Evidence: home. Discussion with the appointed manager confirmed a good understanding of safeguarding matters and she agreed to update the procedure accordingly. Staff training has been provided in the past and the training matrix demonstrated that further staff training has been organised to ensure all staff are suitably trained on safeguarding matters. Criminal Record Bureau (CRB) checks and Protection of Vulnerable Adult (POVA) checks are carried out on all new 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment and facilities are excellent, and the home is clean and hygienic throughout. Evidence: Alfriston Court Luxury Care Home is a converted hotel benefiting from a village location overlooking the South Downs. The conversion has been completed to a very high specification with the decoration and furnishings being of a high standard for the purpose of providing a quality living environment for all residents and visitors to the home. The environment is well maintained and decorated to provide a beautiful hotel like home. The whole environment is both very attractive and appropriate to meet the needs of older people who need personal care and support. The home is set in extensive grounds and provides off road parking. There is an attractive patio area with seating and a rose garden. There is a large garden that would benefit from further landscaping to provide further seating and walking areas. Residents accommodation is found on three floors and a passenger lift ensures that disabled access is provided throughout the home for residents. Care Homes for Older People Page 20 of 28 Evidence: The home was found to be clean and fresh throughout. The home does not have a laundry so all sheets and towels are laundered by an outside contractor, and residents personal laundry is sent to a sister care home. These arrangements currently provide a quick and on the whole a good service, although residents identified that there had been occasions when small garments went missing and a jumper had been shrunk. The appointed manager was aware of these matters, and the residents have been told that once the occupancy of the home improves the laundry facilities will be changed, and allow an individual service. 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. Residents benefit from being supported by a kind and dedicated team of staff and are protected by the recruitment systems in place. Evidence: At the time of this assessment visit eight permanent residents were residing at Alfriston Court. A review of the duty rota and discussion with the staff indicated that staffing levels provide a minimum of two care staff across the waking day. The manager works in a supernumerary capacity. At night, the home is staffed by one waking staff member and one sleep in carer. In addition to care staff the home employs adequate numbers of cooking and domestic staff. Feedback from staff and residents confirmed that there was enough staff to meet the needs of residents. As the appointed manager was on holiday the senior carer on nights was working on days to cover the management duties. The duty rota had not been amended to record this and needs to be an accurate record of staff working in the home. This was discussed with the appointed manager on her return from leave who agreed to ensure an accurate record at all times. Care Homes for Older People Page 22 of 28 Evidence: All feedback about the staff and the staffing arrangements were positive. Comments received included the staff have a caring approach and are attentivethe home provides a good friendly service the staff have the right attitude and professionalism for the job Staff surveys indicated that staff liked working at Alfriston Court liking the atmosphere and the team spitit between staff. They also recorded that on the whole they felt well supported by the homes management, the home has a lovely atmosphere good friendly service. One staff member recorded the home gives the loveliest example of good habitation with the class and dignity for the elders. Of the six carers working in the home two have completed an National Vocational Qualification in care at level 2. The other four carers working in the home have been recruited from the Philippines and are qualified nurses in this country and are working on a student visa, while completing a BSc in health and social care. Staff records indicated that staff complete a full induction programme and the training matrix displayed in the managers office confirmed ongoing planning. The AQAA recorded that the training provided was responsive to individuals needs and covered all mandatory areas, to ensure all residents are well cared for. The recruitment files pertaining to two staff were reviewed as part of the inspection process and and on the whole were found to be comprehensive. They included an application form, evidence of two references and the required Criminal Records Bureau (CRB) and POVA checks on all staff. It was however noted that not all staff had a photograph on file, the appointed manager said that this would be addressed. The recruitment file relating to the appointed manager was incomplete and this was left with the appointed manager at the sister home for her to address, as she was the regional manager at the time of this appointment. 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. Residents benefit from a well motivated and trained appointed manager who promotes an inclusive atmosphere and clear leadership for the home. Quality monitoring processes are well developed and take into account residents views, the financial interest of resident s are safeguarded. Systems are in place to protect the health, safety and welfare of residents and staff. Evidence: The appointed manager was not working as she was on annual leave. The senior night carer was the acting manager in her absence, and was available for advice during the inspection visit. It was however noted that she was included in the carer and housekeeper numbers, and there was no management time allocated for her. The appointed manager of the nearby sister home also attended to facilitate the inspection process, and received the Care Homes for Older People Page 24 of 28 Evidence: feedback at the inspection visit conclusion. She confirmed that she had been allocated a management overview in the absence of the appointed manager. The appointed manager has been in post for approx 9 months. She is not registered and discussion with her following the inspection visit confirmed that she had completed her application for registration and would be submitting it to the Commission this week. She has sixteen years experience in the care industry having managed other services and completed the registered managers award. The management structure provides clear lines of accountability and monthly management meeting for the three homes within the Organisation are held. Where information can be shared and advice given in a supportive and proactive way. Residents and staff were positive about the management arrangements with staff saying that they felt supported, and residents felt they were listened to. The home uses a variety of quality auditing systems which include audits completed by other home managers in the Organisation, the required regulation 26 visits and reports. Health and safety audits and regular feedback from residents and staff within meetings and questionnaires. Residents spoken with referred to the regular meetings held with the manager which they felt were constructive and used to respond to their views. The last AQAA was well completed and used as an audit and quality improvement tool. The home does not take any responsibility for any of the residents finances and most residents look after their own affairs or have an allocated person to do so. Some money is held by the home for safe keeping and the amounts seen and checked against the records held were found to be accurate. The procedure is rather general and needs to be specific on what records are to be held. The appointed manager confirmed that this procedure would be reviewed and expanded on. Systems have been put in place in relation to the Health and safety of residents and full environmental risk assessments are completed and responded to. 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. 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!