Care Home: Aspen Lodge

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What the care home does well People who wish to consider staying at the home have access to information, which tells them about the service and the care they will receive if they decide to live at Aspen Lodge. People will be fully assessed before they come to stay. This makes sure the service can give them the support and care that they need. People receive the care that they need in the way that suits them best. The home keeps them as safe as possible while encouraging people to be independent and make decisions about their lives. People said the home had a friendly atmosphere and was comfortable. The majority of people living there were relaxed and content in their environment. The service had asked residents and relatives in surveys about the home. People told the service, "there is a warm and welcoming atmosphere and that `Aspen Lodge` is a happy place to live". People said, "The staff are caring and respectful, they said they were kind and considerate and sympathetic. The menu provides residents with a choice of appetising and nutritious meals, which people said they enjoy. A relative reported that the food is of a high standard, "the food always looks lovely and Mum has put on weight". Family and friends are welcome at the home and are encouraged to be involved in the care of their relatives. Health professionals and specialist services are contacted promptly if there are any concerns about a person. This means that people are kept as fit and healthy as possible. They receive the treatment and care that they need when they need it. Any complaints or concerns are taken seriously and acted on promptly. This means that people are listened to and know something will be done if they are worried or concerned. If people want to they can bring their personalised belongings to help them feel more comfortable and at the home. The registered manager makes sure that the staff working at the home have been fully vetted before they start. This protects the residents. Staff are provided with the necessary training to assist them in caring and supporting for the residents in the safest way. People are encouraged and supported to be involved in what is going on if they wish. What has improved since the last inspection? Peoples medication is now stored separately and individually. This has reduced the risk of errors occurring and promotes a person centred approach to care practises. The Registered Manager has made sure that she obtains a full employment history from staff and that any gaps in employment are explored at interview. This further protects people who use the service. There is an up to date picture of staff on their file. The home has developed its quality assurance systems to make sure that it is meeting its aims and objectives and is improving the service for the residents. The Registered Manager is auditing all the systems in the home and she is now checking staff competencies. This means that people are receiving all the care and support that they need by staff who are competent. They are protected and kept safe. All safety checks are now being done at the necessary intervals so people are living in a safe environment. There is now regular and consistent monitoring and recording of fire safety tests and fire safety procedures. The fire safety officer has visited the home and will be returning in September to make sure all the fire regulations have been met. Water temperatures are now being checked at regularly. The registered manager has now identified the shortfalls within the home and is addressing them. This means that the home is run safely and in the best interests of the people who live there. What the care home could do better: The service needs to continue to improve the environment in which people live. Some people commented on the decor saying its "worn and tired and needs updating". They also said "that the laundry systems need to be improved". The home needs to further develop their quality assurance systems to ensure that it is meeting its aims and objectives and is improving the service for the people living at `Aspen Lodge`. The registered manager told us that she is aware of these shortfalls and that they will be addressed. Key inspection report Care homes for older people Name: Address: Aspen Lodge Aspen Lodge London Road Sholden Deal Kent CT14 0AD     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Mary Cochrane     Date: 1 9 0 4 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 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) © 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 30 Information about the care home Name of care home: Address: Aspen Lodge Aspen Lodge London Road Sholden Deal Kent CT14 0AD 01304367985 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): sharonaspenlodge@talktalk.net Marcus Care Homes Ltd Name of registered manager (if applicable) Mrs Sharon Thomson Type of registration: Number of places registered: care home 25 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 25 The registered person may provide the following category/ies of service only: Care Home only (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) Dementia (DE) Date of last inspection Brief description of the care home Aspen Lodge is registered to provide care for twenty-five older people or up to twentyfive older people with dementia. The home is situated on the busy main road from Deal to Sandwich, within the village of Sholden. Care Homes for Older People Page 4 of 30 Over 65 0 25 25 0 0 3 0 9 2 0 0 9 Brief description of the care home There is dedicated parking at the rear of the property and a small parking area at the front. Accommodation consists of twenty-one single and two double bedrooms, arranged over two floors with a shaft lift and a stair lift to access the upper floor. Four rooms have en-suite facilities, the rest are fitted with a wash-hand basin. All rooms are fitted with a call bell system. The homes communal areas include a large L-shaped lounge, a conservatory, and a dining room on the ground floor, with a smaller lounge on the first floor. There is a pleasant, accessible, secure garden area at the side of the property and a small garden at the rear. The current fees for the service at the time of the visit range from £320.63 to £470.00 per week. Information on the Homes services and the CQC reports for service users will be detailed in the Statement of Purpose and Service User Guide. 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: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this Service is 2 Star. This means that the people who use this service experience good quality outcomes. We arrived unannounced at the home at 9:30 and we were there for about three hours. We took into account information provided by the Registered Manager and Provider in the self assessment. This is called the Annual Quality Assurance Assessment. (AQAA). We looked at the last inspection report and the requirements that were made. We looked to make sure that the service had met these requirements. We also looked at any other information that we have received about the Service since the last inspection. We did our last Key Inspection on 3rd September 2009. Care Homes for Older People Page 6 of 30 We observed how staff supported residents during social activities and when offering care. We looked at interactions and communication between the people living at the home and with staff. During the visit, we spoke with four of the people who currently live in the home and two visitors. We also observed and looked at what people were doing in the communal areas and had a general chat with them. We spoke with the Registered Manager and with three care staff. We looked around parts of the accommodation. We also looked at a selection of records and documents. These included things like the individual written plans of care, medication records, the activities plan, the menu, complaints documents, the staff roster, staff training records, financial records and the quality assurance systems used by the service. Care Homes for Older People Page 7 of 30 What the care home does well: What has improved since the last inspection? Peoples medication is now stored separately and individually. This has reduced the risk of errors occurring and promotes a person centred approach to care practises. The Registered Manager has made sure that she obtains a full employment history from staff and that any gaps in employment are explored at interview. This further protects people who use the service. There is an up to date picture of staff on their file. Care Homes for Older People Page 8 of 30 The home has developed its quality assurance systems to make sure that it is meeting its aims and objectives and is improving the service for the residents. The Registered Manager is auditing all the systems in the home and she is now checking staff competencies. This means that people are receiving all the care and support that they need by staff who are competent. They are protected and kept safe. All safety checks are now being done at the necessary intervals so people are living in a safe environment. There is now regular and consistent monitoring and recording of fire safety tests and fire safety procedures. The fire safety officer has visited the home and will be returning in September to make sure all the fire regulations have been met. Water temperatures are now being checked at regularly. The registered manager has now identified the shortfalls within the home and is addressing them. This means that the home is run safely and in the best interests of the people who live there. 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 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are given the information they need to let them know what the home has to offer. People who are thinking of moving in are asked about what care and support they need and how they want this to be done. Prospective residents can be confident that their needs will be assessed, and that they will not be admitted unless the home can meet these needs. Evidence: We saw the Statement of Purpose and Service Users Guide written by the service. This is information which tells people about the company, the home and the service it provides. Since the last inspection the registered manager reviewed and updated all the information and the document now contains the relevant information. It sets out the objectives of the service. It tells people about the services and facilities provided. The service user guide has also been re-written. It is now in a format which makes it Care Homes for Older People Page 11 of 30 Evidence: more accessible and understandable for the people who use the service. People told us that they received information about the home and what it has to offer before they made a decision about if it was the right the place. The guide contains information about how to make a complaint and about terms and conditions. The home has a pre-admission assessment procedure. We looked at the assessment of the most recent person to move to Aspen Lodge. We saw that the Registered Manager visits prospective residents in their own home, in hospital, or in their existing placement to carry out a pre-admission assessment. This helps the service decide on whether they will be able to offer the person the support and care they need. The assessment looks at the prospective residents physical and mental health, personal care and social needs. It looks at specific health issues. It considers peoples mobility and nutritional needs. It also looks at their life history, cultural and religious needs. Some people also had an assessment done by the local social services care management team. The Registered Manager told us the home will not accept any resident unless they are confident that they can give the care and support that they need. The home does not offer intermediate care. Care Homes for Older People Page 12 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with the personal and health care they need and are supported by a multi-disciplinary health care team. The ethos of care ensures that residents are treated equally and with kindness and respect. Evidence: Since the last inspection the home has continued to improve and develop the plans of care for the people living at the home. Plans are more person centred and individual. Each person has a care plan in which people can say what assistance and support they want and how they want it to be done. Everyone now has a key worker and we were told that this is working very well. We looked at three of the care plans in detail and at specific things in another plan. They give a clear account on the support and care people need and who needs to do what and why. They did reflect what people can do for themselves. Care Homes for Older People Page 13 of 30 Evidence: The plans also gave details on how best to support people with regards their nutrition, personal care, skin and how best to manage some behaviours. One plan we saw gave a step by step guide to staff about what to do if a person became agitated. They also contained information about what items of interest to use with the person which distracted and calmed them if they were becoming restless. This approach had been successful. Residents skin integrity is monitored. Appropriate aids and equipment are available to prevent skin breakdown. People had special mattresses on their beds and they were sat on cushions that help prevent the skin from breaking down. Some people had cream applied to their pressure areas. We spoke to care workers and they were able to explain about the support and care they give to people and how they do this in a way that best suits that person. We saw evidence that they did this according to the individuals care plan. One person told us, I am happy here I get everything that I need. The staff are good and always happy to help you in any way they can Staff keep a daily record of what people do during the day. More information is being put in these so there is good picture of how people spend their time and what significant events have happened. We saw that care plans are reviewed on a monthly basis or more regularly if care and support needs changed. We found that people have visits from doctors or other specialists. A record of this is kept in the persons file. We found that changes made to peoples care had been transferred in to the care plan so that all staff were up to date and knew what to do to care for the person in the best way. The home has contact with the district nursing team. The home also has contact with the local older peoples mental health team, speech therapists, the home treatment team and other specialists are contacted when they are needed. This means that people at Aspen Lodge are well supported and can easily access the specialist community services when they need them. Visiting professional reported the home offers a good standard of care. The residents have regular appointments with opticians, a chiropodist and dentists. Health care needs of people are identified and they are incorporated into each persons Care Homes for Older People Page 14 of 30 Evidence: plan. We found that there was guidance in place to direct staff on what to do if a person experienced deterioration in their condition. We did find in one plan for diabetes there was no information in place to tell the signs and symptoms experienced by the person if their blood sugars went high or low and what action they had to take. Staff were able to tell explain what they would do. The manager said she would address this and incorporate the information into the plans. The home looks at ways in which people can be kept as safe as possible while at Aspen Lodge. They have risk assessments in the individual care plans. This means that they have looked at areas which might present a risk and have taken steps to reduce this. The registered manager is currently logging on a map of the home areas where incidents and accidents have occurred to try and see if there are specific areas where incidents and accidents happen. Medication procedures were looked at. These have improved since the last inspection. All staff who administer medication have received training. We saw evidence to show that their competencies are checked at regular intervals. The prescription sheets were all signed and no gaps were identified. Medication policies and procedures are in place. The medication being used is stored safely and at the correct temperatures. A lot of the peoples medication is given by using blister packs which are made up at the pharmacy. This system reduces the risks of errors when giving out medication. We found that procedures for medication which has to be given from the original packing is now stored in individual containers. This also reduces the risk of errors and means that the service is treating peoples as individuals and holistically. The Registered Manager told us that she is meeting with the pharmacist to further improve their procedures. We saw there is now guidance and direction for staff on when to give medication on when required basis. This means that there is a consistent approach by staff. People can be sure they will receive their medication when they need it. We found that the home did have evidence in place to show that they check the ability of people who self medicate. There was a risk assessment available for one resident who is self medicating. There was evidence in the care plan to show how this was being managed to make sure the person was supported and monitored. All creams that are prescribed by the doctor are now administered and signed for on Care Homes for Older People Page 15 of 30 Evidence: the prescription sheet. The Registered Manager and staff continue to give a lot of attention to how the residents are respected and treated and how their privacy and dignity is upheld. We observed that staff are polite courteous and attentive to the residents. Staff spoke quietly and politely to people. They were discreet when supporting people from the lounge to the bathroom. We saw that they knocked on doors before entering peoples rooms. Residents and relatives told us that the staff are very approachable and obliging. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home does provide people with opportunities and facilities that enable them to maintain an appropriate and fulfilling lifestyle in and outside the home. Family links are encouraged and maintained wherever possible. The home provides nutritious and varied meals for the people who live there. Evidence: We looked at what people did during the day to make sure they were involved in and included in the daily life of the home. We regarded activities not only as those that were laid on by staff, such as arm chair exercises, but being happily occupied, such as speaking with other residents or enjoying listening to music. We found that staff were friendly and attentive. We saw that most of the people had some opportunity to have quality contact with staff, through support with meals, or conversations. We saw that staff were kind and patient when helping people with personal care. We observed that everyone was included in conversations no-one was ignored or left Care Homes for Older People Page 17 of 30 Evidence: out. We saw a lot of people smiling and people were engaged with an activity or another person. They were included in what was going on around them. People displayed signs of confidence and well-being. Interactions with staff were respectful and marked by warmth and concern for the persons needs and well-being. There was a friendly, relaxed and welcoming atmosphere on the day of our visit. We saw that there was a range of things people could do and records showed that people did different things. One person told us There are things that you can do. I enjoy listening to music. You can do what you like. We saw that people were offered a choice on whether they joined in or not. Some people preferred to stay in their rooms. The Registered Manager told us that the present staff work along side the activivites co-ordinator to make sure a wide variety of activities are provided. She said that this gives people more opportunity to do the things that want when they want. They are currently looking into further developing the key- worker roles to include taking people out more. Some people did tell us that they go out at times. We spoke to two visitors. They said they are made to feel welcome at the home at all reasonable times and no restrictions are imposed. One person said, they could not do any more. The standard of care is very good. Another said, I feel confident about how they look after my husband. They are so patient and kind. The people we spoke to felt they are able to have some choice in regards to their day to day life. Examples given were that they could get up and go to bed when they liked. They could choose what to eat and where to eat their meals. Generally they felt happy with the choices they are offered. The home is demonstrating how it offers more diverse choices to people so they are encouraging them to be as independent and in control of their lifes. The home employs two cooks who cover the kitchen seven days a week. The service told us that they have a four weekly menu and an alternative choice of meal is always on offer. Special diets are catered for. People said they enjoy their meals and there is always enough to eat. A record is kept of food that is eaten. This makes sure that any Care Homes for Older People Page 18 of 30 Evidence: dietary problems are quickly identified and the appropriate action taken. 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 people who use the service are confident complaints will be listened to and dealt with appropriately. People who use the service are protected from abuse. Evidence: The home has a complaints procedure which is available to the people who live at the home and their families. We spoke residents who told us, If I was worried about anything I would tell Sharon the Manager. She sorts things out. There have been no complaints made to the home since the last key unannounced inspection. Any complaints that are received are dealt with according to the homes policies and procedures. The last AQAA told us Aspen Lodge now provides more support for the families of the service users. The home fosters open, honest relationships with relatives so they feel they can talk to us about any worries or concerns they may have. The home told us that it has policies and procedures relating to safeguarding adults. The staff have received up to date training in safe guarding adults. Staff were able to tell us about abuse and what they would do if they suspected or evidenced that someone was not being treated as they should be. Staff told us they knew about the Care Homes for Older People Page 20 of 30 Evidence: whistle blowing policy. The homes recruitment procedure includes undertaking formal checks to ensure that potential employees are suitable to work with vulnerable adults. The home has policies and procedures in place to assist in and support people to manage their finances. The policies and procedures protect people from financial abuse. 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 service continues to improve and maintain the environment to provide people with a comfortable, homely and safe place to live. On the whole people benefit from a clean and homely environment. Evidence: We looked around parts of the home. The residential accommodation in the home is set on the ground and first floors of the building. There is plenty of communal space to meet the needs of people with separate dining area, lounge and conservatory on the ground floor and a small lounge on the first floor. The Registered Manager told us she has plans to develop this into a sensory room as it not used very often. There is a pleasant out door space, which people can enjoy in the better weather. There are three assisted bathrooms available in the home plus shower rooms on the first and ground floor, and a total of eleven toilets. Four of the bedrooms are fitted with en suite toilet facilities, all other rooms are fitted with a wash hand basin. The manager told that over the next four months the bathrooms will be up-graded. Peoples bedrooms are comfortably furnished and are personalised to meet their individual needs. People we spoke to said that they like their rooms and they can furnish their rooms however they choose. Care Homes for Older People Page 22 of 30 Evidence: The service employs a maintenance person. He does general maintenance around the home when it is needed. The service now has developed a planned maintenance and renewal programme with timescales for the ongoing up keep and improvements within the home. In recent surveys completed by residents and their relatives, people said, there is a warm and welcoming atmosphere at the home and it is a happy place to live. Several people commented said, the decor was worn and tired and in need of updating. The service has recently up-graded and refurbished the kitchen. They have also just purchased a large screen T.V for the main lounge so everyone has a good view of their favourite programmes. Bedrooms are being redecorated when it is convenient to people. The Registered Manager has plans to replace carpets and furniture to make the environment more suitable for people with dementia. We did see that the home provides the necessary equipment and aids to meet the needs of the residents. Two large hoists are stored in the lounge area. This did detract from the homely and conducive atmosphere of the lounge. The home is clean and hygienic with no unpleasant odours. Procedures are in place to control the spread of infection There are the facilities available in all the appropriate areas for hand washing and the home has the appropriate facilities for the disposal of clinical waste. There is a laundry room and soiled laundry is transported correctly in red bags and washed at the appropriate temperatures. People have reported to the home that they feel the laundry service could improve. Sometimes drawers and wardrobes are untidy and on occasions people get the wrong clothes. The Registered Manager told us that she is in the process of reviewing the laundry system and improvements have already been made. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are adequate numbers of staff with sufficient training and experience to meet the needs of the residents. The staff have a good understanding of the residents and positive relationships have been formed. Recruitment practises protect people. Evidence: The Registered Manager told us that since the last inspection there has been an increase in staffing hours which means that there are more staff available to make sure everyone is getting the support and the care that they need throughout the day and night. She told us that that the role of the senior staff has developed and they are now delegated certain tasks that they are responsible for completing. For example each senior staff member has been allocated five care plans to keep under review and up to date. This means that people changing support and care needs are identified and met promptly and effectively. Twelve members of the care staff team are delegated as key -workers. They each Care Homes for Older People Page 24 of 30 Evidence: have special responsibilties for two residents. This means they take a particular interest in these residents and make sure they have everything they want when they want it. The Registered Manager told us that the staff are taking their roles very seriously and are often going beyond the call of duty to make sure people are happy and satisfied. We also saw that a lot of training is being provided by the service. Staff have now completed mandatory and specialist training. Six staff are in the process of doing an extended medication training and another six are doing dementia training. The Registered Manager is also accessing diabetes and epilepsy training. Other specialist training is also planned. This should provide staff with the skills and knowledge to help them look after and support residents in the best possible way. Staff told us that, the home continues to improve. You get all the training you need and more. I am very happy working here. I enjoy coming to work. New staff receive an induction which they first start work at the home this is linked to the Skills for Care programme. The service told us that over 50 of staff are trained to NVQ level 2 or above. We saw that staff are caring and kind. They interacted with people throughout the visit. They supported people to become involved in what was going on. They continually checked if people were alright and if they wanted anything. Staff approaches were seen to be consistent and in line with what was written in peoples plans. At the visit we saw peoples needs being anticipated and promptly met by staff. When people asked for anything they where responded to quickly. We looked at the staff file of the most recent person to come and work at the home. It contained a completed application form. The files did contain safety checks and references. There was also a record or interview questions and responses. A full employment history had been obtained and the file had a up- to date picture of the staff member. 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. The Registered Manager is qualified and has relevant experience to run the home. She is aware of the areas that need improvement and has plans to do this. People can be sure that their health, safety and welfare is promoted and protected. Evidence: The Registered Manager of the home has the necessary qualifications, skills and experience to manage the home. Residents, staff and relatives reported that they thought the Manager was good. We observed at the visit that the people at the home have a positive and relaxed relationship with her. Staff told us that the she is approachable and understanding. They said that they could speak to her about any concerns they might have. They said that she listened to what they said and acted on it. Since we last visited the home there have been improvements especially in quality assurance, fire safety, care planning, staff responsibilities and training and medication Care Homes for Older People Page 26 of 30 Evidence: procedures. The Registered Manager has completed Mental Capacity Act training and Deprivation of Liberties training. Quality Assurance systems are in place and these are being developed. The last annual assurance report was recently published. The results have been collated to identify the strengths and weakness of the home. This means the home is working towards further improving the service given to the people who live at Aspen Lodge. The Registered Manager is in the process of developing the quality assurance questionnaires to include staff and other stakeholders. The manager is also completing monthly audits on all the systems in the home to make sure all the necessary work and checks have been completed. Relatives and residents meetings are held on a regular basis to keep people updated and get any feed-back. There are meetings with the staff to make sure any suggestions comments or complaints are identified and acted on. This means that the views of the people who use the service are listened to and acted on promptly and effectively. The Registered Provider of the service visits the home at least monthly and writes a report to look at what the home is doing well and the areas that need to be improved There is a system whereby each member of staff meet regularly with someone senior to discuss their work. This means that they can talk through any work problems they may have and how they plan to develop. Financial procedures are in place to safeguard peoples monies. At the last visit we identified shortfalls around fire precautions, safety checks and procedures. The home has been visited by the Fire Officer and improvements have been made. The Fire Officer will be visiting the home again in September to make sure all the fire requirements have been met. The fire book was in good order and weekly fire tests have been completed. The home has completed a fire risk assessment. Environmental risk assessments are also in place. We also found that the home is now regularly checking the water temperatures to make sure that people are safe if they go into the bathroom alone. Mandatory training has been provided for all staff and is on-going. 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). 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