Care Home: Ascot Nursing Home

Similar services:

• 21 High Street
• Vale House
• Chestnut Walk
• The Old Vicarage
• Cherwood House Care Centre
• Ashley House
• Fountain View
• Wardington House Nursing Home

What the care home does well Ascot Nursing Home has a highly committed and caring workforce who aspire to provide quality care to the residents. The staff team are stable and there is minimal turnover of staff which provides a level of continuity for the residents. There were many positive comments about the attributes and qualities of staff including, `highly professional, kind caring and at all times courteous`, `staff are open to change`, `they provide an excellent standard of care` The home is comfortable, clean and attractively decorated and furnished throughout. Residents are encouraged to personalise their own rooms and these are decorated and furnished to a good standard. There are sufficient numbers of staff on duty at all times to meet the needs of residents effectively. The skill mix is appropriate for the size and complexity of the home. People say that staff are `caring, kind and professional` and `they always come when I call`. The staff team are well qualified and highly skilled. They have received the training they need to provide quality care to the residents. Recruitment practices are well carried out and the staff files contain all information needed to ensure the safety of residents. The written care records are well kept and up-to-date and provide staff with the information they need to provide the right care. Visiting professionals said, `The home provides a warm and happy environment for all residents. There is always an atmosphere of respect and caring for the residents who have diverse and challenging needs`, `Relatives are welcomed, involved and supported by staff`. Another professional said, `Ascot Nursing Home looks after those with mental health needs. They do this with a high level of staff skill and sensitivity`. The home offers users a wide range of leisure activities including games, crafts and quizzes as well as the opportunity to see outside entertainers, take trips out and to join in parties and themed events. Residents say that the activity schedule is `good`, `always something to do` and `its never boring`. Food provided by the home offers residents variety and choice and is well presented in pleasant comfortable surroundings. Residents said the food was `good generally` and `on the whole quite nice`. What has improved since the last inspection? Since the last inspection there have been improvements made to the environment including new bedrooms on the top floor, a new games room, a new smoking area outside, decoration and new furniture in various parts of the home. There has also been a new lobby built. What the care home could do better: There are no new requirements or recommendations arising from this inspection. Key inspection report Care homes for older people Name: Address: Ascot Nursing Home Burleigh Road Ascot Berkshire SL5 7LD     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: Julie Willis     Date: 0 8 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 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Ascot Nursing Home Burleigh Road Ascot Berkshire SL5 7LD 01344620656 01344621606 jillchuascot@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Ascot Nursing Home Ltd care home 75 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users to be accommodated is 75. The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) Mental disorder, excluding learning disability or dementia (MD). Date of last inspection Brief description of the care home Ascot Nursing Home is an Edwardian House with a purpose-built extension set in its own grounds close to Ascot Village and Ascot Racecourse. The home is registered to provide nursing care for up to 75 people who have mental health needs, consisting of people who suffer from dementia or a mental disorder either in older age or under 65 years of age. The nursing home is divided into three units each function independently with unit offices, dining rooms, sitting rooms and distinctive staff teams. Care Homes for Older People Page 4 of 30 75 75 Over 65 0 0 Brief description of the care home Unit one cares for residents of all ages who have been diagnosed as suffering from moderate to severe dementia. Unit two cares for older residents who have enduring mental health needs, and may need physical assistance. The Wrens unit cares for residents with enduring mental health needs who are generally able to maintain their own physical care with support and encouragement. The home has an appointed a Head of Care. The registered manager Mrs Jill Chufungleung is responsible for the overall management of the home. The cost of the service varies between 850 and 1300 pounds per week depending on the level of support required. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: This key inspection took place on 8th July at 09:30 and covered all the standards for older people. Prior to the visit a questionnaire was sent to the Manager along with survey and comment cards for residents, relatives and visiting professionals such as doctors and nurses. Any replies were used to help form judgments about the service. Consideration has also been given to other information that has been provided to the Commission since the last inspection. The inspector toured the building, examined records and met most of the residents and one relative that was visiting at the time of the inspection. The inspector also talked to the homes General Practitioner who was carrying out their weekly visit to the home at the time of inspection. Care Homes for Older People Page 6 of 30 The inspector spoke informally to staff in each part of the home and observed how care was being delivered to the residents. The homes approach to equality and diversity was considered throughout. From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals with various religious, racial or cultural needs. The inspector gave feedback about her findings to the homes Manager and Head of Care at the end of inspection. There were no outstanding requirements from previous inspections and no new legal requirements were made as a result of this inspection The Commission has received no information about any complaints about this home since the last inspection. Care Homes for Older People Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 8 of 30 following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are fully assessed prior to admission to ensure their needs can be met effectively by the home. Evidence: The home has developed a comprehensive Statement of Purpose which includes a philosophy of care and mission statement for the home. It is provided to anyone who makes an enquiry about the home along with the Service User Guide which has been produced in a user-friendly booklet format. It details what the resident can expect from the home and includes details of the complaint procedure, a copy of the contract and terms and conditions of residency. The AQAA (Annual Quality Assurance Assessment) details the homes plans to put a video of the home on its website and take a CD of the home on each preadmission assessment so that prospective residents may see the home for themselves. It is evident from the records that the home adheres strictly to its policy on Care Homes for Older People Page 11 of 30 Evidence: admissions. People are fully assessed to ensure that their needs can be met effectively by the home. The assessment is undertaken by the Registered Manager or Head of Care in the persons own residence or in hospital. The assessment is holistic and thorough. Sufficient time and effort is given to ensuring peoples transition to the home goes smoothly. The resident and their family are involved fully in the admission process from the outset. Relatives confirmed that people are respected as individuals and their right to make choices and express their individuality are considered paramount. It is clear from the records and discussion with management that admissions to the home only take place if the service is confident that the staff team have the skills, ability and qualifications to meet the assessed needs of the prospective resident. The home employs nursing professionals with a mental health background on each of its units to effectively support residents with mental health needs. The documentation for 5 people was examined and residents were case tracked from their preadmission assessment to date. The records evidenced that all necessary information about the residents health and personal care needs were sought prior to admission. The use of clinical tools to assess the residents nutrition, communication, mobility, risk of falls, continence and mental state were well developed. The preadmission assessment takes into account the ethnicity and diversity needs of the individual and their specific needs, wishes and requests are incorporated into the draft care plan. Several of the records examined included Mental Capacity Act (MCA) and Deprivation of Liberty (DOLS) assessments. The home has devised a new assessment tool and in future all residents will be assessed using the tool to identify those people who may need referral for professional assessment under MCA & DOLs protocols. Records indicate that all staff have received the training they need to identify when someone may need a Mental Capacity Act or Deprivation of Liberty assessment undertaken. There was evidence in the records that all residents are admitted for a trial period. This is usually four to six weeks after which a multi-disciplinary review is held to consider if the resident should be admitted permanently. The resident is central to the process and their wishes and feelings are considered throughout. The inspector had the opportunity to meet residents some of whom were being case tracked. One resident said, Its alright here, plenty of food, its warm and its Care Homes for Older People Page 12 of 30 Evidence: comfortable another said, I cant complain, the staff are kind. Care Homes for Older People Page 13 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Clear information is in place to enable staff to meet the health & personal care needs of residents. People are encouraged to participate in the care planning and review process from the outset. The systems for the administration of medication are good with clear and comprehensive arrangements in place to ensure the safety of residents Evidence: The home has a strong belief that residents should be fully involved in planning their care. The AQAA states that the assessment of residents is carried out in a holistic way which determines peoples need and formulates care plans based on relationship centred evidence based care. All care plans seen were centred on the specific needs of the individual and took into account their diverse needs and personal preferences. Examination of the care plans of five people living in the home evidenced that each residents care plan has been agreed with them and is individualised and person centred. The plans consider all aspects of a persons lifestyle including their personal, Care Homes for Older People Page 14 of 30 Evidence: health and social care needs. They contain a detailed record of the residents mood, affect and behaviour. Care plans are regularly reviewed and updated and any changes to the plan are discussed and agreed with the resident and their family. The care plans are a working tool and staff when questioned were knowledgeable about their content. Residents confirm that they are provided with access to health and social care professionals for advice and support as necessary. They regularly see the GP who visits the home weekly and the psychiatrist who visits the home twice a week. People are referred to hospital when necessary for further advice, support and treatment. Routine screening and preventative treatments are provided to all residents of the home by the local surgery. The home provides care and comfort to people who have a terminal illness. The home is in liaison with the local surgery and follows the Liverpool Care Pathways for palliative care. The Head of Care is a member of a local group looking into palliative care issues and is keen to cascade knowledge and best practice to the staff of the home. The use of clinical tools to identify risks to residents in relation to tissue viability, nutrition, dependency rating, environmental risks, bathing and falls were fully developed. Care plans treatment plans and appropriate equipment were in place to reduce the risks identified. The home refers residents to various specialist resources for further advice and support. In the case of one resident referrals to a dietitian and Speech and Language therapist had been made in order to improve their nutrition and to address the residents recent weight loss. Examination of the daily records clearly evidenced that care was being delivered in accordance with the individuals care plan and that residents are involved in ongoing review. All care plans contain daily statements which identify how care has been delivered and care plans are fully evaluated monthly along with the individual risk assessments. Observation of practice concluded that staff are mindful of the need to respect the privacy and dignity of residents when delivering personal care. Staff make every effort to enable residents to choose who delivers their care and respect their preferences. Recruitment of staff takes into consideration the need to employ a varied, balanced and skilled staff group. Staff were observed throughout the course of inspection to provide personal care in a discreet and sensitive manner. Residents were addressed courteously and staff knocked on service users bedroom Care Homes for Older People Page 15 of 30 Evidence: doors and waited to be invited in before entering. The inspector spoke at length to two residents and to others in small groups in various parts of the home. The inspector also had a discussion with a relative that was visiting at the time of inspection. The residents and the relative were generally complimentary about the qualities and caring attitudes of the staff. One resident said, the staff are good they know me well, when Im not feeling well I see the doctor another said, they care for you well here, I have everything I need, I cant complain. From examination of the medication administration system and discussion with senior staff it is clear that the home follows best practice guidance in relation to medication. The storage systems for medication are effective and disposal systems are safe. The home is audited at regular intervals by BOOTS pharmacists. The most recent audit took place on 14th May 2009. The home has an appropriate contract with a registered disposal company. The registered Manager is currently undertaking an NCFE distance learning course in all aspects of medication to update her knowledge and skills and to identify any changes in legislation. She intends to cascade the training to other staff of the home on completion. Care Homes for Older People Page 16 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A range of activities is offered that provide opportunity for mental and physical stimulation. Residents are encouraged to maintain contact with their family and friends and are able to have visitors at any time. The home provides a varied and nutritious menu designed to meet the needs of its residents. Evidence: From discussion with the management, staff and residents it is clear that residents are offered the opportunity to participate in a range of activities suited to their needs. There is a full time Activity Organiser and five part time activity coordinators in the home who are responsible for arranging the daily activities. They liaise with the Manager to purchase new activities equipment and arrange festivities, celebrations and fund raising events. The activity schedule includes activities such as board games, skittles, baking, table football, pool, exercises, jewelry making, pottery, relaxation and hand massage and playing musical instruments. At the time of inspection residents of the Wrens unit were enjoying a karaoke session. The home has recently renovated what was a Care Homes for Older People Page 17 of 30 Evidence: smokers room on the Wrens unit. It has been converted into a games room with exercise equipment, pool table, table tennis and table football game. There is a dedicated activity room on the ground floor which is used daily for activities. It incorporates a tuck shop where residents can purchase sweets, crisps and ice cream. A summer party has been arranged for the end of July which will include a cream tea and entertainment. The summer party is open to anyone and encourages community contact and involvement. Two residents said that they were particularly looking forward to this activity. In addition to in house activities the home arranges for external entertainments to visit. At the time of inspection residents were enjoying the Music for Health entertainment in one of the lounges. This activity has been very popular and a number of volunteers come to help the residents each fortnight. Many of the volunteers have had relatives that lived at the home and like to keep in contact with the staff and residents that they had known previously. The inspector had the opportunity to talk to one of the volunteers who said, this is a lovely home, they are really caring people that work here, you cant fault the care. The activity schedule also includes trips out in the house vehicle to Hayling Island, Runnymede, Frensham Ponds, Virginia water, Saville Gardens, the Christmas lights in Oxford Street and theatre trips. These trips are particularly popular with residents. The home has also arranged a holiday to the New Forest for four of the residents who will be supported by trained staff and volunteers. The home also provides residents with an opportunity to visit their relatives. One resident is taken home each Saturday to stay the night and is collected from their home on Sunday. The central quadrangle is popular with residents. It has been covered in parts by canopies and is a popular area for residents that smoke. There are raised flower beds in the centre of the quadrangle which are well kept and attractive. Some of the adjoining bedrooms and communal lounges have French doors that open onto the garden, these rooms are particularly favoured by the residents. There is comfortable seating and sun umbrellas in the quadrangle, which were being well used and enjoyed by a large number of residents at the time of inspection. Residents confirm that their visitors are made most welcome at any time and are offered appropriate hospitality during their visits. A number of social events are held throughout the year which promotes community involvement and which provide Care Homes for Older People Page 18 of 30 Evidence: residents families with the opportunity to engage with the staff and residents on an informal and regular basis. Residents at the home confirm that the menu provided is varied and nutritious. They are encouraged to take meals in the dining rooms to aid socialisation but may choose to eat in their rooms if they choose. Several residents have their own fridges in their bedrooms and often buy snacks and drinks from local shops. The home can cater for special diets including diabetic, vegetarian, low fat and other culturally appropriate meals. Residents made comments about the food including, its good, but there is always too much for me, I like the food theres plenty of choice and variety and I suppose you shouldnt complain but I miss home cooking. Care Homes for Older People Page 19 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a satisfactory complaints system. Residents feel their views are listened to and acted upon. Residents are protected from abuse and exploitation by staff that can demonstrate knowledge of the homes safeguarding adults and whistle-blowing policies. Evidence: The complaint policy in the home meets the requirement of Regulation and Standard. Residents are provided with information on how to make a complaint and the stages and time scales for action. The complaints procedure is written in plain English and is easy to understand. It is provided to every resident on admission. Examination of the complaint records indicated that there have been three complaints made to the home since 1st January 2009. The details of the complaints were well documented and evidenced any investigation undertaken and the outcome provided to complainants. The AQAA stated that the home feels that it can learn from complaints so that the same matter does not occur again. Responses to CQC surveys indicated that 12 out of 21 residents knew how to make a complaint and felt confident that concerns or complaints would be dealt with in timely fashion. The rest of the respondents either left the question blank or seemed unsure about how to formalise a complaint. Care Homes for Older People Page 20 of 30 Evidence: There was evidence in staff files and from discussion with staff, that they receive training in safeguarding adults as part of their formal induction to the home. Their learning is later consolidated when undertaking NVQ training in which it forms a core module. Staff interviewed understood the importance of protecting users from abuse and exploitation at all times and were conversant with the homes whistle blowing policy. Residents and others associated with the home stated they felt satisfied with the service. Residents in the main felt safe and well supported by the home and felt their protection and safety was a priority for staff and management. One resident responded in a survey I feel much safer here, I know staff are trying to do their best for me Care Homes for Older People Page 21 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The standards of decor and furnishings in this home offer residents a comfortable and homely place to live. Standards of hygiene are good throughout. Evidence: The home is well maintained throughout. It provides a pleasant safe place to live with the majority of rooms being highly personalised to reflect the preferences of residents. The management and staff encourage residents to see the home as their own and encourage residents to bring in small items of furniture, pictures and ornaments to make their bedrooms more homely. There have been a number of improvements made to the home in the past year. This includes new bedrooms on the top floor which are spacious light and airy. The new rooms have proved popular with residents as they are in a quiet area of the home. The corridors on the ground floor have been colour coordinated and decorated with baskets of flowers to aid recognition by residents and to offer residents a bright and cheerful environment. All doors have knockers and personalised pictures so that residents can easily identify their own bedroom. The quadrangle has a smokers area with a covered deck which can be used in inclement weather. The smokers lounge adjoining Wrens Unit has been converted into Care Homes for Older People Page 22 of 30 Evidence: a games room which is popular with residents. There is new furniture in Unit One lounge which enables residents and their relatives to sit together in comfort. Two bathrooms have been converted into wet rooms to meet the needs of the residents. There is on going refurbishment of the kitchen area and adjoining dining room to enable residents to serve themselves from a bain marie. There is a new front lobby where people access the home. There is a new themed frieze in the hallway adjoining the lobby. A complaints and suggestions box has been added to this area to aid communication between residents, relatives and management. Residents were complimentary about the quality of decor and furnishings in the home. They said that the home was always clean, comfortable and hygienic. They said that the domestic staff always kept the toilets and bathrooms clean and fresh and vacuumed and dusted their rooms regularly. Communal areas were spacious bright and airy and comfortably furnished. Residents spend much of their time in one of the lounges or in the quadrangle where they may smoke. Residents said that they liked the area since it has been revamped. One resident said its a nice place to have a sit down and smoke, there always people to chat to. Residents made comments about the home such as, its a lovely home, its always smells so clean and the house is well kept, its obvious the cleaners work hard. The home has effective infection control measures in place. Staff are trained in health and safety and infection control as part of their induction to the home. The home has recently been awarded a safer homes award for its infection control standards. Care Homes for Older People Page 23 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff recruitment procedures are robust and protect residents from harm. Staffing levels are sufficient to meet the needs of the residents. Evidence: Examination of four staff files evidenced that the selection and recruitment procedures at this home are robust. All necessary checks are carried out on staff to ensure that they possess the necessary attributes to care effectively for the residents. Records were well kept and met the required standard. Feedback from six relatives surveys said,friendly staff, individually and as a team they succeeded in providing care to the individual, they provide an excellent standard of care. Other comments were, The staff are always polite and thoughtful and I am very impressed with this nursing home, the staff are on the whole excellent. As part of the recruitment process for qualified staff the qualifications of nurses have been checked effectively to ensure they are fit to practice. The nurses Pin numbers and Statement of Entry on the Register were well recorded and up to date. The recruitment process has been strengthened recently by incorporating a resident Care Homes for Older People Page 24 of 30 Evidence: and relative onto the interview panel. Management confirm that their opinions and views are valued and acted upon. The home has a comprehensive training matrix, which provides the manager with details of the whole staff teams need for training. The Registered Manager and Training Manager both have professional trainer certificates which helps them to cascade training to other staff. The Training Manager and Head of Care are moving and handling trainers and the Training Manager is also a challenging behaviour trainer. There was evidence that care staff have been properly inducted to Skills for Care Standard and have received training in core skills such as fire safety, first aid, medication, communication, nutrition, manual handling, food hygiene, health & safety, COSHH, data protection, anti-discriminatory practice, loss & bereavement, dementia care, confidentiality and infection control. All staff have received training in adult protection as part of their induction and as a core module in NVQ training. All staff at the home are well motivated and have either achieved or are working toward a National Vocational Qualification at level 2 or 3. The home has six NVQ Assessors and one Verifier who support the staff whilst gaining their qualifications. The staff are provided with training in challenging behaviour, de escalation and breakaway techniques in order to deal with incidents of challenging behaviour at the home. All staff are required to participate in the training which is carried out over four sessions. Refresher training is frequent and mandatory. Additionally all staff have had training on the Mental Capacity Act and Deprivation of Liberty to heighten their awareness. Several staff have also received training in activities and meaningful occupation for people with dementia to help them support residents more effectively. The home has a stable staff team and there has been no use of agency staff for the past nine years. At the time of inspection there were sufficient levels of staff on duty of to effectively meet the needs of residents. Staff confirmed that they have opportunities to express their views in supervision sessions, professional discussions and team meetings. It is evident from the response to surveys that staff feel well supported, valued and appreciated. Care Homes for Older People Page 25 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from living in a well managed home, where there is evidence that their health, welfare and safety is of primary importance. Evidence: The Registered Manager Jill Chu is a highly experienced RMN who has gained further qualifications to enhance her skills and knowledge. In the past year Jill has attended a number of conferences and training sessions including study sessions on the DOLS legislation. She has completed an NCFE distance learning course in Occupational Health & Safety, Healthy Eating and safe handling of medication. Jill works closely with the Head of Care who is also a qualified mental health nurse. Jill is well respected by the staff team, residents, relatives and other professionals. Staff say that she is keen to support their personal development and communicates well as a professional leader and manager. Staff confirm they are provided with ample opportunity to have a say in how the home operates and how the care is delivered to Care Homes for Older People Page 26 of 30 Evidence: residents. The home regularly monitors its own performance against quality standards. The home sends out surveys on a regular basis to all stakeholders. The results are collated and used to identify areas for improvement. The home also has an AQAA group who decide how the home can achieve improvement. The AQAA group consists of residents, relatives, staff of all disciplines and members of management. The Proprietor is a regular visitor to the home and carries out (Regulation 26) visits. These are used to measure the homes success in meeting its published aims and objectives. The home has monthly quality meetings. One of the relatives, who was a committee member, said that she found them useful and enlightening. A topic is chosen each month for discussion and there are outside speakers. The most recent meeting involved the Links who came to discuss their role. Other topics have been the comfort of pillows in the home and fire training. From discussion with a number of residents it was evident that they are regularly consulted on issues that affect them and feel that their views are taken into account. The registered Manager ensures that residents control their own money except where they state they do not wish to or they lack capacity. The system for administering residents personal monies was examined and evidenced that a safe procedure is followed for deposit or withdrawal of residents money. It is both a computer based system and in hard copy. Receipts are kept of all transactions made. Examination of a sample of health & safety records indicated that they were up to date and in good order. Routine servicing and maintenance of equipment is undertaken at appropriate intervals to maintain the home as a safe and risk free environment for the residents. Unnecessary risks to residents are identified using comprehensive risk assessments that are reviewed at frequent monthly intervals. So far as possible risks are reduced or eliminated. Care Homes for Older People Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 28 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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 30 of 30 - 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!