Care Home: Ashmeade

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What the care home does well Current and prospective residents were provided with appropriate written information. This ensured the residents were aware of the services and facilities available in the home. The admission process included a thorough assessment of people`s needs. This enabled the registered person and prospective residents to determine whether or not their needs could be met within the home. All residents had a comprehensive care plan based on their assessment of needs. The plans provided clear guidance for staff on how to meet people`s personal, health and social needs. The residents were involved in the care planning process, which meant they were able to express their views and opinions about the level and type of care they were provided. The daily routines were flexible and designed to meet the needs and wishes of the residents. The residents spoken to felt they were well cared for and the staff respected their rights to privacy and dignity. One resident told us, "I don`t think you could find a better place to live". The residents were able to participate in a wide range of activities, both inside and outside the home and some were looking forward to a holiday in Lytham St Annes later in the year. Varied and nutritious meals were served. All the residents spoken to said the meals were "excellent", with plenty of variety and a choice each meal time. Visitors were welcome in the home at any time and residents were supported to maintain good contact with their family and friends. The residents were provided with clean comfortable bedrooms and could personalise their rooms, with their own belongings. The sitting areas were decorated in a homely fashion, with a variety of armchairs, footstools, side tables, ornaments and pictures. A high percentage of staff had achieved NVQ (National Vocational Qualification) level 2. This qualification provided the staff with the necessary knowledge to carry out their role effectively and efficiently. The staff were well supported by the registered person and the management team and had the opportunity to regularly discuss their training needs and the care of the residents. The registered person had maintained a quality assurance system, which was based on the outcomes of the monitoring systems and the views of the residents and their relatives. This meant the residents and their families were able to have some input into the future development of the service. What has improved since the last inspection? Since the last inspection, the registered person had employed an apprentice to assist with recreational activities in the home. This person was supernumerary to the staff team and was therefore able to offer the residents additional support. A care plan review summary had been introduced. This was designed to alert staff to changes in the residents` care plans, which meant the staff had access to current information about the residents` health and well being at all times. Various improvements had been made to the premises, for example five bedrooms had been refurbished and decorative railings had been installed around the perimeter of the property. At the time of the inspection work had commenced to build a new patio area at the front of the building and a ramp to provide wheelchair access to the front door. The residents had been informed about the building work and arrangements had been put into place to minimise any disruption to the residents. What the care home could do better: The residents spoken to were very pleased with all aspects of the service provided, all records viewed were complete and up to date and all legal requirements were met. Key inspection report Care homes for older people Name: Address: Ashmeade 379 Padiham Road Burnley Lancashire BB12 6SZ     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 Playfer     Date: 1 7 0 3 2 0 1 0 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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: Ashmeade 379 Padiham Road Burnley Lancashire BB12 6SZ 01282425142 01282454956 Ashhfe@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Kathleen Mary Rhodes care home 15 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home only - Code 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 - Code OP The maximum number of service users who can be accommodated is: 15 Date of last inspection Brief description of the care home Ashmeade is registered to provide accommodation and personal care for 15 Older People. The home is a detached property set in its own grounds with well-maintained and attractive gardens. There are car-parking facilities at the rear of the building. The home is located close to local shops and other amenities and is on a major bus route. Accommodation is provided on two floors, linked by a passenger lift, in 9 single rooms and 3 double rooms. Four of the single rooms have an ensuite facility. Communal Care Homes for Older People Page 4 of 28 Over 65 15 0 1 9 1 1 2 0 0 8 Brief description of the care home space is provided in two lounges and one dining room. A visitors room is also available adjacent to the green lounge. At the time of the inspection the fee was £435 per week. Information was made available to prospective residents by means of a statement of purpose and service users guide. The guide was usually given to prospective residents and/or their relatives on viewing the home or at the point of assessment. The previous inspection report can be viewed at the home or downloaded free of charge from the Commissions website at www.cqc.org.uk Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: A key unannounced inspection, which included a visit to the home, was conducted at Ashmeade on 17th March 2010. The inspection was carried out by one inspector, however, the report refers to we as it was written on behalf of the commission. We lasted visited this service on 19th November 2008. The last key inspection was conducted on 19th June 2007 and annual service reviews have been carried out on 27th May 2008 and 26th May 2009. At the time of the visit there were 15 people accommodated in the home. During the inspection we spent time with the residents, looked round the home, read some of the residents care records and other documents and talked to the staff, visitors and the registered person. We also consulted our records about the service and information we have received since the last key inspection. As part of the inspection process we used case tracking as a means of gathering information. This process allows us to focus on a small group of people living at the home, to assess the quality of the service Care Homes for Older People Page 6 of 28 provided. Prior to the inspection, the registered person completed an Annual Quality Assurance Assessment known as AQAA, which is a detailed self assessment questionnaire covering all aspects of the management of the home. This provided us with useful information and evidence for the inspection. Satisfaction questionnaires were sent to the home for distribution to the staff and the residents. Five questionnaires were returned from the staff and three were received from the residents. Some of the residents relatives had also made comments on the questionnaires. The responses from the questionnaires were collated and used throughout the inspection process. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? Since the last inspection, the registered person had employed an apprentice to assist with recreational activities in the home. This person was supernumerary to the staff team and was therefore able to offer the residents additional support. A care plan review summary had been introduced. This was designed to alert staff to Care Homes for Older People Page 8 of 28 changes in the residents care plans, which meant the staff had access to current information about the residents health and well being at all times. Various improvements had been made to the premises, for example five bedrooms had been refurbished and decorative railings had been installed around the perimeter of the property. At the time of the inspection work had commenced to build a new patio area at the front of the building and a ramp to provide wheelchair access to the front door. The residents had been informed about the building work and arrangements had been put into place to minimise any disruption to the residents. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents had their needs properly assessed and they were provided with appropriate written information to enable them to make an informed choice about where to live. Evidence: Written information was available for residents in the form of a statement of purpose and service users guide. The service users guide had been issued and explained to all residents and their families. The documents seen were presented in an easy read format and provided useful and informative information about the home. All the residents who completed a questionnaire indicated they had received enough information prior to moving into the home. Copies of the last inspection report were included within the service users guide. All residents had been issued with a contract, which set out the terms and conditions of residence. A copy of the contract was included in the service users guide. The Care Homes for Older People Page 11 of 28 Evidence: contract was easy to read and was presented in a clear format. This meant that residents and their relatives were aware of their rights and obligations and knew what they could expect from the service. The case tracking process demonstrated that the residents had their needs assessed prior to admission by a social worker and/or the registered person. The pre admission assessment was carried out at a convenient time and place for the prospective resident, to ensure they had the time and opportunity to participate in the assessment process. Copies of the preadmission assessments seen covered a range of individual needs including personal, social, health and cultural needs. It was evident that admissions were not made to the home in the absence of a full needs assessment. This meant the registered person could be confident the staff had the necessary skills and knowledge to meet the assessed needs of prospective residents. Following the assessment of needs a letter was sent to prospective residents and their families to confirm the residents needs could be met in the home. This meant residents could be assured the home was a suitable place for them to live. The registered person confirmed prospective residents were invited to spend as much time as they wished in the home prior to making the decision to move in. This enabled the person to meet other residents and staff and experience life in the home. Following admission, the contract and the service users guide stated that a trial period of four weeks was offered to every new resident, so both parties could make sure the placement was successful and the residents individual needs could be met. 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 health and personal care received by residents was based on their individual needs. Care practice took full account of the residents privacy and dignity. Suitable arrangements were in place to ensure the safe handling of medicines. Evidence: Three residents files were looked at in detail as part of the case tracking process. From this we could see all three files seen contained a care plan, which was based on the residents assessment of needs. The care plans also included a personal profile, which provided staff with details about the residents past life experiences and significant events. The plans were supported by records of personal care, which provided information about changing needs and any recurring difficulties. The records had been made on a daily basis, to ensure staff were provided with up to date details about the residents well being. The records were detailed and the residents needs were described in respectful and sensitive terms. The care plans covered the residents personal, social and health needs and provided staff with clear guidance on how best to meet these needs. Staff who completed a Care Homes for Older People Page 13 of 28 Evidence: questionnaire indicated that they were given up to date information about the needs of the residents. The residents and their families had been consulted wherever practicable during the development and review of their care plan. Written records seen on the personal files demonstrated that the care plans were reviewed each month by the residents keyworker and updated in line with changing needs. Since the last inspection, a care plan review summary had been introduced, which alerted staff to changes in the residents care plans. This meant that staff had access to current information about the residents health and well being at all times. Healthcare needs were considered during the assessment process and included within the care plan. This meant that staff were provided with information about how to monitor and respond to specific medical conditions. There was written evidence within the personal care notes and professional visitors record to indicate the residents accessed NHS services and received specialist support as necessary, for instance the District Nurses. Charts were maintained to monitor the residents weight, to ensure any fluctuations were noted and acted upon. Risk assessments had been carried out as necessary, in respect to moving and handling, pressure sores and falls. The risk assessments were supported by risk management strategies, which provided staff with guidance on how to manage and reduce any identified risks. This meant the staff were able to respond consistently and safely to any identified risks. The risk assessments were reviewed alongside the care plans, to ensure an holistic view was taken of the residents needs. The residents spoken to felt the staff respected their rights to privacy and dignity and all made complimentary remarks about the staffs approach, for instance one person said, They are very good, they look after us very well. The residents and relatives, who completed a questionnaire indicated that they received the care and support they needed. One relative who made comments on a questionnaire wrote, The carers make sure that all the residents are warm and content and they are always there when needed. The staff were observed to interact with the residents in a positive manner and they referred to the residents in their preferred form of address. During discussions, staff demonstrated an awareness of treating people with respect and considering their dignity when providing personal care. Policies and procedures were in place to cover the management of medicines and these were available for staff reference in the policy and procedure file. The home operated a monitored dosage system of medication, which was dispensed into blister Care Homes for Older People Page 14 of 28 Evidence: packs by a local Pharmacist. Appropriate records were maintained in respect to the receipt, administration and disposal of medication. All staff designated to administer medication had received accredited training. Suitable arrangements were in place for the storage and administration of controlled drugs and procedures were in place for the administration of as necessary and variable dose medication. This meant medicines were handled in a safe and consistent manner. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents were able to exercise choice and control over their lives to enable them to lead a fulfilled lifestyle. The residents were provided with a nutritious and varied diet, which met with their expectations. Evidence: The residents preferences in respect of social activities were recorded and considered as part of the care planning processes. A range of activities was planned and implemented by the registered person and the staff team. These included nail care, dominoes, arts and crafts, keep fit and music and wine afternoons. The residents were encouraged and supported to participate in the activities as they wished. Residents spoken to confirmed there sufficient activities to occupy their time in a meaningful way. The residents were consulted on a daily basis about what activities they wished to pursue. Information about forthcoming activities was displayed in each lounge. On the day of inspection, the aromatherapist and hairdresser visited in the morning and staff asked the residents if they wished to have their nails manicured in the afternoon. The residents said they were looking forward to going away on holiday to Lytham St Annes later in the year and had enjoyed a holiday in the same resort last year. Since the last inspection, the registered person had employed an apprentice, who was Care Homes for Older People Page 16 of 28 Evidence: supernumerary to the staff team, to assist with recreational activities in the home. The staff who completed a questionnaire felt the home offered a wide variety of activities, one person wrote, The home does well with activities as the residents have activities within the home and go on day trips out to theatres and weekends away. The residents were supported to continue with their chosen form of religious worship. Representatives from local churches visited the home for prayers and communion on a regular basis. The routines were flexible and were primarily designed to meet the needs of the residents. The residents spoken to said they had a choice in the times they got up and went to bed. The staff were observed to seek the residents views throughout the inspection and the residents spoken to felt comfortable to comment on life in the home. The residents had the opportunity to develop and maintain important personal and family relationships. There were no restrictions placed on visiting times and residents were able to receive their guests in private, should they wish to do so. Refreshments were offered to visitors, to ensure they felt welcome in the home. Relatives spoken to during the inspection were satisfied with the quality of care. All residents spoken to said they liked the food provided. There was a choice of food each meal time and residents were asked prior to each meal what choice they wished to make. The food was mostly homemade and breakfast was served throughout the morning to suit the preferences of the residents, who wished to have a lie in. The menu was displayed on the dining tables. Residents were asked their opinion of the food on an ongoing basis and they could make suggestions for future meals. The meal served on the day of inspection was plentiful and well presented. Residents were given sensitive and appropriate support to eat their meals. Drinks and snacks were served throughout the day and at other times on request. 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 were able to express their views and any concerns and had access to a clear complaints procedure. There were established ways of working to respond effectively to any suspicion or allegation of harmful practice. Evidence: Arrangements were in place to ensure the registered person and staff listened to and acted on the views and concerns of the residents and their relatives. This was achieved during daily conversation, one to one discussion, residents meetings and satisfaction questionnaires. The residents spoken to said they felt comfortable about expressing their views and were aware of whom to speak to in the event of a concern. Staff who completed a questionnaire also indicated that they were aware of what to do if the residents or their families had a concern. This ensured systems were in place to ensure any problems could be promptly and readily rectified. The complaints procedure was included in the statement of purpose and service users guide and was also displayed behind all wardrobe doors. The residents had been issued a personal copy of the complaints procedure as part of the service users guide. The procedure contained the necessary information and relevant contact details should a resident or their representative wish to raise a concern. According to information in the AQAA, the registered person had not received any complaints during the last twelve months. An appropriate recording system was in Care Homes for Older People Page 18 of 28 Evidence: place in the event of a complaint being made. Policies and procedures for safeguarding vulnerable adults were available and provided guidance for staff should they suspect or witness any harmful practice. Issues relating to the protection of vulnerable adults were incorporated into the induction training and staff received specific tuition as part of mandatory and NVQ training. The staff also had access to a whistle blowing procedure. This meant staff had access to appropriate information to enable them to direct an alert to the relevant agency. There were established arrangements in place to safeguard the residents financial affairs and the registered person operated a robust recruitment procedure, to ensure the residents were protected from unsuitable people. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents were provided with an attractive, clean, comfortable and well maintained environment. Evidence: Ashmeade is a detached Edwardian property, which was converted to a residential home in 1981. The home has gardens to the front and a patio garden to the rear. It is located close to a park and other local amenities such as shops and a post office. Accommodation is provided in nine single bedrooms and three shared rooms. Four of the single rooms have an ensuite facility. Shared space is provided in two lounges, a dining room and a visitors lounge. The residents had free movement around the home and were able to choose where they wished to spend their time. From a partial tour of the building we could see the residents had personalised their rooms with their own belongings and decoration was a high standard throughout. The residents said they liked their rooms, which they described as comfortable and spotlessly clean. Pressure mats had been placed in each bedroom and were connected to the main call system. These alerted the staff if a resident was out of bed in the night and potentially at risk of a fall or in need of assistance. The use of the mats was discussed and agreed with the residents and their relatives on admission and residents could express a wish not use the mats if they wanted to. Care Homes for Older People Page 20 of 28 Evidence: Since the last inspection, five bedrooms had been refurbished and decorative railings had been installed around the perimeter of the property. At the time of the visit, the first floor bathroom was being refurbished and building work had begun to build a new patio area at the front of the building and a ramp to provide wheelchair access to the front door. Later this year, three additional single bedrooms will be built at the rear of the property. The residents and their families had been fully informed about the proposed changes and arrangements had been put into place to minimise any disruption to the residents. There were established arrangements in place for the general maintenance of the building and the deputy manager carried out audits of the environment in order to identify any repairs. Records were maintained of the repairs carried out. The residents had been provided with aids and adaptations to assist their independence skills, these included grab rails, handrails, raised toilets, an oxford hoist and assisted bathing facilities. A passenger lift provided easy access to the first floor accommodation. The provision of specialist equipment was determined by the needs of the residents. The home was clean and odour free at the time of the inspection. The residents and relatives spoken to said a good level of hygiene was maintained at all times. All the residents who completed a questionnaire indicated that the home was always fresh and clean. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents benefited from experienced, competent and well-trained staff. Evidence: A staff duty roster was drawn up in advance and provided a record of the number of hours worked by the staff in the home. The roster indicated that sufficient care staff were on duty throughout the waking day. Two members of staff were on waking watch duty with an additional person available on call. All staff who provided personal care were aged over 18 and all staff left in charge of the building were aged over 21. Many of the staff had worked at the home for several years, which meant they had a good knowledge of the needs of the residents. A recruitment and selection procedure was available, which covered current legislation. The file of one member of staff was looked at in detail. From this we could see, the applicant had completed an application form, provided a full working history and had attended the home for an interview. CRB (Criminal Records Bureau) and POVA (Protection of Vulnerable Adults) checks had been obtained prior to the applicant commencing work in the home, along with two written references. This meant the registered person had collated all records and checks in accordance with regulatory requirements, to ensure the residents were protected from unsuitable staff. Arrangements were in place for all new employees to undertake induction training, Care Homes for Older People Page 22 of 28 Evidence: which incorporated the Skills for Care standards. The latter provided underpinning knowledge for NVQ level 2. According to information supplied by the registered person 13 out of 15 care staff had achieved NVQ level 2 or above, which equated to 87 of the overall staff team. This meant the vast majority of the staff team had achieved the necessary qualifications to enable them to carry out their role effectively. All staff who completed a questionnaire confirmed they received training relevant to their role and all commented that they were well supported by the management team with any training needs. Staff attended both internal and external training courses and had at least three paid days training a year. In addition to mandatory health and safety training, staff had completed training in Nutrition and Dementia Awareness. The home was linked via a computer to the LWDP (Lancashire Workforce Development Partnership). This organisation operates an internet based staff training record and plan and provides access to training courses. It was noted staff discussed their individual training needs during their supervision sessions and there was an overall staff training plan displayed in the hallway. This meant the registered person could readily identify future training needs for individual staff and for the staff team as a whole. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management and administration practices were effective in ensuring the home was run in the best interests of the residents. Evidence: The registered person had overall responsibility for the management of the home and had achieved the Registered Managers Award and NVQ level 4 in Care. The registered person is also a Registered General Nurse and an NVQ Assessor. In addition to these qualifications, the registered person had also undertaken periodic training to update her knowledge and skills whilst managing the home, which included Food Hygiene, Supervision and Nutrition. The registered person had a sound understanding and knowledge about the care of older people, which was communicated to the staff team by means of daily interactions, formal supervisions and staff meetings. The management approach was consultative and there were established ways of working to consult the staff and residents on an ongoing basis. Relationships within the home were positive and staff spoke to and about the residents with respect. Care Homes for Older People Page 24 of 28 Evidence: Further to this, a member of staff wrote in a questionnaire, We work well as a team to fulfill the needs of the residents and staff and another member of staff commented, I feel the home does everything well, it is a very loving and caring home not just for the residents, but for the staff as well. There was a programme in place for staff supervision and the topics discussed during supervision were recorded on a suitable format. Staff received formal supervision six times a year with a designated line manager, as well as an appraisal once a year. This enabled the staff to identify any future training needs and discuss the care of the residents. In addition to supervision and appraisals, staff were given the opportunity to attend regular staff meetings and handovers. This meant the staff were able to share experiences and discuss future developments. The service was reaccredited with an Investors in People Award in March 2010. This is a professionally recognised quality assurance award, which focuses on staff development. Satisfaction questionnaires had been distributed to residents and their residents in March 2009. The results of the questionnaires had been collated and the residents had been provided with feedback about the outcome of the survey at a residents meeting and in a newsletter. The registered person had produced a business plan, which set out the objectives for the forthcoming year based on the results of the quality monitoring processes. This document linked with the AQAA questionnaire submitted to the Commission. All sections of the AQAA were completed and the information provided gave a clear picture of the current situation within the service and the planned areas for development. Appropriate arrangements were in place for handling money, which had been deposited with the home by or on behalf of a resident. A random check of the records and monies deposited on the premises was found to be correct. This meant the residents financial affairs were safeguarded. There was a set of health and safety policies and procedures, which included the safe storage of hazardous substances and infection control. Staff received health and safety training, which included moving and handling, food hygiene, first aid, fire safety and infection control. Documentation seen during the inspection and information supplied in the AQAA indicated the electrical, gas and fire systems were serviced at regular intervals. The fire log demonstrated that the staff had received instructions about the fire procedures during their induction and participated in regular fire drills. Appropriate arrangements were in place to record accidents and incidents in the home, which ensured the residents condition was closely monitored following an accident or incident. 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. 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