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Care Home: Amberley House Care Home

  • The Crescent Truro Cornwall TR1 3ES
  • Tel: 01872271921
  • Fax: 01872260137

Amberley House is a Care Home owned by Dove Care Homes Limited. The property is a large house, situated in a quiet residential area on the outskirts of Truro. The City centre is about ten minutes walk away but is not on the level. The home provides nursing and residential care for up to thirty elderly people some of whom may have a physical disability or terminal illness. Accommodation is provided in 16 single bedrooms and 6 shared bedrooms. All bedrooms have a hand washbasin but only one single bedroom has en-suite facilities. There are stair lifts to access the first floor andAnnual Service Review 22009the lower ground floor. There is a large lounge on the ground floor that is also used for dining. The home has a small front garden with limited parking facilities. Suitably qualified nurses and care assistants provide nursing and personal care within a relaxed friendly atmosphere. Information about the home is available in the form of a statement of purpose, residents` guide and welcome pack, which can be supplied to enquirers on request. A copy of the most recent inspection report is available in the home. Fees range from 466 to 700 pounds per week; this information was supplied to the Commission during the inspection. Additional charges are made in respect of private healthcare provision, hairdressing and personal items such as newspapers, confectionary and toiletries.Annual Service Review

  • Latitude: 50.263000488281
    Longitude: -5.0640001296997
  • Manager: Mrs Lindsay Gail Pugh
  • Price p/w: £583
  • UK
  • Total Capacity: 30
  • Type: Care home with nursing
  • Provider: Dove Care Homes Ltd
  • Ownership: Private
  • Care Home ID: 1691
Residents Needs:
Old age, not falling within any other category

Previous Inspections

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

For extracts, read the latest CQC inspection for Amberley House Care Home.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Amberley House Care Home The Crescent Truro Cornwall TR1 3ES     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Diana Penrose     Date: 2 4 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Amberley House Care Home The Crescent Truro Cornwall TR1 3ES 01872271921 01872260137 amberley1@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Dove Care Homes Ltd Name of registered manager (if applicable) Mrs Lindsay Gail Pugh Type of registration: Number of places registered: 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 who can be accommodated is 30 The registered person may provide the following category of service only: Care home with nursing - Code N to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home Amberley House is a Care Home owned by Dove Care Homes Limited. The property is a large house, situated in a quiet residential area on the outskirts of Truro. The City centre is about ten minutes walk away but is not on the level. The home provides nursing and residential care for up to thirty elderly people some of whom may have a physical disability or terminal illness. Accommodation is provided in 16 single bedrooms and 6 shared bedrooms. All bedrooms have a hand washbasin but only one single bedroom has en-suite facilities. Care Homes for Older People Page 4 of 29 care home 30 Over 65 30 0 Brief description of the care home There are stair lifts to access the first floor and the lower ground floor. There is a large lounge on the ground floor that is also used for dining. The home has a small front garden with limited parking facilities. Suitably qualified nurses and care assistants provide nursing and personal care within a relaxed friendly atmosphere. Information about the home is available in the form of a statement of purpose, residents guide and welcome pack, which can be supplied to enquirers on request. A copy of the most recent inspection report is available in the home. Fees range from 466 to 700 pounds per week; this information was supplied to the Commission during the inspection. Additional charges are made in respect of private healthcare provision, hairdressing and personal items such as newspapers, confectionary and toiletries. Care Homes for Older People Page 5 of 29 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: An inspector visited Amberley House Nursing Home on the 24 February 2009 and spent eight and three quarter hours at the home. This was a key inspection and an unannounced visit. The purpose of the inspection was to ensure that peoples needs are properly met, in accordance with good care practices and the laws regulating care homes. The focus was on ensuring that peoples placements in the home result in good outcomes for them. All of the key standards were inspected. On the day of inspection 24 people were living in the home. The methods used to undertake the inspection were to meet with a number of residents, relatives, staff and the registered manager to gain their views on the services offered by the home. Records, policies and procedures were examined and the inspector toured the building. Care Homes for Older People Page 6 of 29 This report summarises the findings of this inspection. The atmosphere in the home was relaxed and friendly, staff were well mannered and caring towards the people living there. Residents and relatives expressed high satisfaction with the care and services provided at the home. What the care home does well: The service provides a well maintained home set in tidy grounds. It is very clean, warm and comfortable and there are no offensive odours. There are very good measures in place for the prevention of infection. The home has a suitable statement of purpose and service user guide that has been kept up to date. The statement of purpose has been produced in large print for those with sight impairment. People are only admitted following a thorough assessment to ensure the home can meet their needs. Prospective residents and their family are invited to visit the home prior to any decisions being made to live there. One relative said I was given really good information before my mother moved in and I came to have a look around. Peoples healthcare needs are met and specialist healthcare professionals visit the home when required. The nurses have their own special interests and link with the specialist teams. Appropriate equipment is provided for pressure relief and moving and handling purposes. There is a suitable system for medications that ensures peoples safety and only qualified nurses administer medicines. Each resident has an individual care plan, designed to meet their specific needs, and it is written in a way that directs staff on what they need to do. Individual risk assessments are undertaken to enhance peoples care and welfare. All of the people spoken with said the care is very good and they are very happy living in the home. They said they are treated with respect and dignity and their privacy is upheld at all times. They also said their individual preferences are respected and they can choose what they do each day. Visitors said they are always made welcome in the home and that they are offered drinks and meals. Social activities take and are organised by the care staff at the moment. Time is spent on one to one sessions when staff and residents get to know each other. There is a nutritious menu and residents said the food is good. Fresh fruit and vegetables are included and drinks and snacks are available at all times. There have been no complaints but there is a system in place that ensures that complaints would be dealt with promptly and records kept. There is a suitable policy for the prevention of abuse and staff have received training in the protection of vulnerable adults and the procedure to be followed. There is a robust recruitment procedure that includes criminal record checks. Training is provided for staff to ensure legal requirements are met and that staff have the necessary skills for their work. Staffing levels are suitable with a skill mix to meet peoples needs, a qualified nurse is on duty at all times. People said the staff are very kind and caring and nothing is too much trouble. One said they go out of their way to help. 74 of care staff have an NVQ qualification in care and the rest are working towards a Care Homes for Older People Page 8 of 29 qualification. The Registered Manager is a qualified nurse and a competent manager; she has managed the home for 15 years. She keeps herself updated and attends courses relevant to her role. Staff and residents spoken with thought highly of her, they said she is very approachable and listens to what they have to say. Staff said she is very supportive and they can talk to her in confidence. There is a quality assurance system in place that allows people to air their views. The management strive to review and continually improve this service. The manager tries to make sure that working practices are safe. Relevant service checks take place as required and are up to date. Accidents are reported as they should be and there are few. What has improved since the last inspection? What they could do better: Care Homes for Older People Page 9 of 29 There is no dining facility that can accommodate all residents if the need should arise; there are plans to build an extension to the lounge and quotes are being sought. The home would benefit greatly from the installation of a shaft lift as not all people can manage the stair lifts. 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 10 of 29 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 11 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information in approprate formats is available for prospective residents enabling them to make an informed choice as to where to live. People are only admitted to the home following an assessment of their needs to ensure the home can provide suitable care. Evidence: The home has a suitable statement of purpose and service user guide that have been kept up to date. A copy of the statement of purpose was seen produced in large print. The manager said she intends to keep a copy in the hall and copies would also be available on request. The home has an admission flow chart. There is a form for initial enquiries where basic information about the prospective resident is recorded. Residents and their relatives said they were encouraged to visit the home before making any decisions. The registered manager said she visits prospective residents to undertake a full Care Homes for Older People Page 12 of 29 Evidence: assessment of needs and this can take a few hours. A nurse does the assessments if she is not available. Assessments were seen for three people using the service and were detailed. Information from the department of adult social care and hospital staff was also seen and some was in depth. The AQAA states that all service users have an initial care plan in place on the day of admission based on the pre-admission assessment. This initial care plan is reviewed after one week and then on a monthly basis unless there are acute problems, which require more frequent review. Care Homes for Older People Page 13 of 29 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. Each person using the service has a detailed written care plan that clearly directs staff to ensure that healthcare needs are met. There is an appropriate system for the use of medicines that safeguards the people using the service. Evidence: The manager said that each person using the service has a written care plan and life histories are being compiled for everyone. Three care files were inspected during this visit. The care plans are person centred and cover health, personal care, social and religious needs. They show the individual needs for each person and are very specific in the care to be provided. The manager said this can always be improved on. Individual preference as to the care staff who look after them are recorded. The plans are signed by the resident or their representative and are reviewed monthly or more frequently if needed. Relevant risk assessments are included and also reviewed regularly. The daily care records are written by the nurses and care staff and are relevant and informative. People spoken with were aware of their care plans. Care Homes for Older People Page 14 of 29 Evidence: Written consent is now sought from residents or representatives for the use of cotsides, with input from healthcare professionals as appropriate. There is also a good risk assessment undertaken for each resident requiring cotsides. People spoken with said their health needs are met very well and they have access to their GP and other health professionals when required. The manager said that links with specialist healthcare professionals is very good. She said the nurses working in the home have their own special interests and link with external professionals. There is appropriate moving and handling and pressure relieving equipment in the home and hospital style beds are provided. There are suitable wound care plans and records kept; no residents have pressure sores. Care practice was observed to be appropriate during this inspection and carried out in a calm, efficient manner. The Liverpool Care Pathway has been implemented and the manager is hoping to introduce The Gold Standard Framework for palliative care. She said she aims for Amberley to be a home for life and that people should be fully assessed prior to any admission to hospital. There is a suitable policy and system in place for the use of medicines in the home. Medicines are administered from individual pots or packets that are stored safely in individual labelled trays in a tidy trolley downstairs and a cupboard upstairs. Storage of controlled medicines and those requiring refrigeration is satisfactory with appropriate records maintained. No residents are self-administering at the moment. Records are kept of all medicines entering and leaving the home. The medicine charts are typed and checked by two people; there were no gaps observed in the administration records. Two members of staff must always sign handwritten instructions on the charts and the manager said she would ensure this was done. There is a homely remedies policy and a list approved by a doctor. For people prescribed to have medicines administered as required we found that there were no care plans in place about the use of this medicine, or any directions on how to make an assessment if this medicine is required. The manager said that the documentation would be addressed with the nurses. There is some information regarding as required medicines in the policy. People with diabetes have care plans for their management and some information regarding blood glucose monitoring is included. This needs to be more specific and there should be records of the injection sites for those requiring insulin injections so as to avoid using the same site too often. The manager spoke to a nurse about this during this inspection and asked her to pass the information to the night nurse. There are relevant reference books and patient information leaflets are available for staff or residents to refer to. Care staff receive medicines training on induction and during NVQ training. The nurses have no formal medicines training provided by the Care Homes for Older People Page 15 of 29 Evidence: home but do attend external courses if they wish. Peoples privacy was upheld during this inspection. People using the service said they are treated with respect and their privacy is upheld at all times. Shared rooms are provided with appropriate screens. There is a policy for respecting peoples privacy and dignity and there is a section in the statement of purpose. Staff receive training during their induction period. People using the service, visitors and staff all said the care is very good in the home and that people are treated with kindness and respect. Thank you cards and letters praising the care provision in the home were seen on a noticeboard. The Commission has received a letter from a person praising all aspects of the care provided to a relative up to and including his death. Care Homes for Older People Page 16 of 29 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. Staff spend time with people and activities are provided, links with family and friend are encouraged and people are helped to maintain control over their lives and live a life of their preference Evidence: The manager told us that the activities co-ordinator has left and she is advertising for a replacement. In the mean time care staff are providing activities for residents. People told us about the very popular bingo, playing ball, armchair exercises, manicures and one to one time. Staff were seen chatting to residents throughout the day and several female residents had their nails painted. One lady said she had never had her nails painted until she came to Amberley but enjoys having them done. Each month someone comes in to provide music for health for an hour and people said they enjoy this. A minister visits on request and Holy Communion takes place. Records of activities are maintained within the daily records for each resident. The manager said that records will improve again when a new co-ordinator is employed. One person has a befriender who visits and takes him out into the local community. He said he goes to church regularly as well. Care Homes for Older People Page 17 of 29 Evidence: A key worker system has commenced and each carer is responsible for a group of residents. This enables staff to understand peoples personal preferences and they get to know each other better. There is a record of visitors to the home and there were several visitors in the home during this inspection. People said they could receive visitors in private and at any time. Visitors spoken with said they are always made welcome in the home and can call in when they like. They said they are always offered a drink or even a meal while they are there. Visitors were relaxed and spoke openly to staff and the manager. People said they choose when they get up and go to bed. They said they choose what clothes to wear and how they spend their day. They said they can stay in their room or go to the lounge. Everyone was suitably dressed in clean clothes. The bedrooms were homely and personalised with peoples belongings and furniture. Nutritional assessments were seen and the manager said that special diets are catered for. The manager said the menu is being written weekly at the moment due to her computer breaking down, various forms and information has been lost. There are choices on the menu and staff said other things are also available if people do not want what is on the menu. Fresh vegetables and fruit are included. Care staff were seen asking people what they would like for their meal. The manager said carers do this as they know the residents very well and can understand those who have difficulty communicating. Snacks and drinks are available between meals and water or juice was provided all day during this inspection for all residents. Staff were seen prompting people to drink. Everyone said the food is good and they have plenty to eat. The lunchtime meal was served in the lounge but several people ate in their bedrooms; it was their choice. The meal was unhurried and appropriate assistance was given. Care Homes for Older People Page 18 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are suitable policies and processes in place for complaints and adult protection to ensure that people using the service are safeguarded. Evidence: There is a suitable complaints policy in the home and a method for recording complaints, the action taken and the outcome. Residents and relatives said they could approach the staff or manager if there was a problem. There have been no complaints to the home or the Commission. Thank you letters and cards are kept and there are many, several were seen displayed on a noticeboard. The manager and staff have attended the local No Secrets course provided by the department for adult social care. The manager has undertaken the trainers course and provides in house training. She said all new staff receive training regarding abuse. There is a copy of the local inter-agency procedures in the home and the home has a suitable policy. There have been no abuse issues at the home. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean, well maintained, decorated and furnished to a reasonable standard, there are no unpleasant odours, making it a pleasant place to live and work in. Evidence: The home is warm, homely, comfortable and clean with no offensive odours. The manager said that maintenance and refurbishment is ongoing in a place like Amberley. She is aware that some areas are in need of painting and said the maintenance person will be able to do this when he does not have to work so many hours helping in the kitchen. It was evident that some redecoration has taken place and new furniture has been provided since the last inspection. The home would benefit greatly from the installation of a shaft lift as not all residents can manage the stair lifts this has been an issue for several years. People can access the communal areas and the grounds. There have been no changes to communal space since the last inspection. There is no dining facility that can accommodate all residents if the need should arise. Planning permission has been granted to provide an extension to the lounge and quotes are being sought. The laundry facilities are adequate with two washers and two driers. People are happy with the laundry service. Protective clothing is supplied for staff and they were seen Care Homes for Older People Page 20 of 29 Evidence: wearing aprons and gloves. Hand washing facilities for staff are suitable and alcohol hand cleansing gel is provided. There are relevant policies in place for infection control. Care Homes for Older People Page 21 of 29 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. There are suitable staffing levels for the number of residents and evidence that staff hold nursing and NVQ qualifications. Recruitment procedures are robust and staff receive regular training this helps to safeguard people using the service and ensures staff have the knowledge and skills to care for them. Evidence: The registered manager said there is a vacancy for an activities co-ordinator. She said that when staff are on annual leave or sick leave agency staff are sometimes employed. There was a list on the board for staff to cover deficit hours with overtime if they wish. Staff said the manager is very fair and allows them to request days off; she also helps them to work hours to fit with childcare. There is a registered nurse on duty at all times. As a minimum there are 5 care assistants on duty in the mornings, 4 in the afternoons and 2 at night. There are designated housekeeping and catering staff. Staff said that staffing levels are flexible and changed according to the needs of residents. Generally everyone spoken with thought there were enough staff. Everyone said the staff are very kind and caring. One person said they go out of their way to help. There is a recruitment policy and the home operates an equal opportunities policy. The manager said that staff are all treated equally. Three staff files were inspected and Care Homes for Older People Page 22 of 29 Evidence: contained the relevant checks and documents required by legislation. Interview records were seen and show that there is equality in the recruitment process. Terms and conditions of employment and relevant job descriptions were seen in the files. 74 of care staff are qualified to at least NVQ level 2 in care. One person is working through the induction standards and one has recently completed them. The remainder of the care staff are enrolled on NVQ courses. The induction programme for new employees is in line with the skills for care induction standards and a completed induction book was seen. It was very detailed. A training matrix for statutory training was seen. Fire training and moving and handling were almost up to date. The manager said other training is in hand and the AQAA states that there will be a new programme of training to cover all mandatory training plus, Dementia care, Parkinsons Disease, Stroke Awareness and Pressure area care in 2009. We were told that palliative care and PEG training have been undertaken by some staff and that one nurse has venepuncture training. Posters advertising courses were seen. The manager is a moving and handling trainer and keeps herself updated she has also undertaken a fire wardens course. She hopes to extend this to other staff so that a fire warden is on duty at all times. Staff said there is plenty of training available to them and there are opportunities to attend external courses if they wish. A nurse said she is attending syringe driver training soon. Care Homes for Older People Page 23 of 29 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 registered manager is competent in running the home and systems are in place to monitor and improve the service for residents and staff. An appropriate system is in place for managing peoples monies and training and safety checks are undertaken to ensure the health, safety and welfare of residents, staff and visitors. Evidence: The registered manager is a registered general nurse. She had hoped to attain the Registered Managers Award by the end of 2008 but the company went bankrupt after only one visit. The operations manager is exploring the possibility of her enrolment with another company to start the Leadership and Management for Care Services Award. She has competently managed this home for fifteen years and was the deputy for two years prior to that. She said she keeps up to date by using the Internet and reading the nursing press. Recent training includes two courses on the Mental Capacity Act and the moving and handling trainers 4 day update. She is attending further moving and handling training soon and Deprivation of Liberties training. Care Homes for Older People Page 24 of 29 Evidence: Everyone spoken with said she manages the home well and is very approachable. A visitor said she finds time to listen and knows all of the residents very well. People using the service said the home is well run and the manager has everything under control. Staff said she is a good leader and always finds time for them, they said they can talk to her in confidence and she listens. The manager said an annual quality assurance survey is undertaken with questionnaires sent to residents and relatives. It has not been done recently, a new format was seen which is easier to complete. Various audits take place and include medicines, accidents, pressure area care and continence. The operations manager undertakes a monthly home audit and she visits each month to undertake an inspection followed by a written report, in line with regulation 26. These reports were seen in a file. The manager completed her Annual Quality Assurance Assessment (AQAA) in detail and returned it to the Commission within the allotted timescale. Staff meetings take place but there are no resident or relatives meetings at present. There is a policy in place for the safekeeping of residents money, which needs to be updated. Key holding for the safe and access to money out of office hours needs to be included. The manager said that people could control their money for as long as possible but there was no one controlling their own at present. Most of them control their money with their relatives. Some small amounts of money are held for a few people just in case they need it but has not been used at all. Money is handled for two people one of whom has money regularly. He signs a receipt when he receives his money; the book was shown to us. The other person is very frail and dependent her money is used as necessary for clothes and toiletries and so on. The manager is seeking advice regarding appointeeship or other means of managing this persons money. Her savings are held in a post office account. Money is held individually and suitable records are maintained with transactions signed. The manager agreed to get the accounts checked regularly with a signature. Receipts are kept but are minimal. The manager endeavours to ensure that working practices are safe. Relevant service checks take place and certificates are held. Staff receive statutory training regularly and kitchen staff have all received basic food hygiene training and one at intermediate level. The environmental health officers report was seen and an upgrade of the kitchen was recommended. Accident reporting complies with data protection and the manager audits accidents in the home. There are very few accidents normally but there have been problems with one resident that are being sorted; there were 6 in January and 8 in February. Health and safety and fire risk assessments have been undertaken. Care Homes for Older People Page 25 of 29 Evidence: Care Homes for Older People Page 26 of 29 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 29 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 22 It is strongly recommended that a shaft lift is installed in the home to access the first floor Care Homes for Older People Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!

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