Care Home: Athenaeum Residential Care Home

What the care home does well The home is clean and furnished to a high standard. Attention is being given to making it appear attractive, cosy and safe for residents. There are no offensive odours. The large garden is well maintained, accessible and residents were seen using it. Care documentation is of a high standard. The care provided is regularly reviewed and residents said they are treated with respect and dignity. Staff are carefully selected and personnel records are well maintained. There is an ongoing programme of training to ensure that staff are able to meet the needs of residents. Regular recorded supervision and support are provided by the manager. The home has a system for obtaining the views of residents and their representatives of the quality of care provided. This ensures that the service is of a good quality and responsive to the needs of residents. Staff indicated that the directors of the company take a close interest in the running of the home and visit the home regularly to speak to residents and provide close support for the manager and his staff. What has improved since the last inspection? This is the first key inspection since the re-registration of the home. What the care home could do better: The Statement of Purpose and Service User Guide must be updated to reflect changes in the management of the home. This is to ensure that prospective residents are fully informed. Changes in the management of the home must be promptly notified to us. This is to ensure that CQC is fully aware of and agree to management changes affecting the care of residents. Key inspection report Care homes for older people Name: Address: Athenaeum Residential Care Home 36 Athenaeum Road London London N20 9AH     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: Daniel Lim     Date: 0 6 1 1 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Athenaeum Residential Care Home 36 Athenaeum Road London London N20 9AH 02084458251 02084459084 athenaeum@ventry-care.com www.ventry-care.com Brownlow Enterprises Limited Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Jean Christopher Tranquille Type of registration: Number of places registered: care home 21 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: 1. 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 cataegories: Dementia over 65 years of age Code DE(E) Old age not falling within any other category - Code OP 2. The maximum number of serivce users who can be accommodated is: 21 Date of last inspection Brief description of the care home Athenaeum House is a care home owned and managed by Brownlow Properties Ltd. The home is registered to provide care and personal support for a maximum of twenty one older people, some of whom may have dementia. It was re-registered in June 2009. It was previously owned by Ventry Residential Care Ltd, a company commonly owned with Brownlow Properties Ltd. The registered manager is Mr Jean Christopher Tranquille. Care Homes for Older People Page 4 of 28 Over 65 21 21 Brief description of the care home The homes stated aim is to provide a comfortable and happy care home where residents will find enjoyment living there. The statement further mentions that it will do everything possible to respect the rights of all the people in the home by observing the values of privacy, dignity, independence, choice, civil rights and fulfilment. The home is a three storey detached house. The bedrooms are on all three floors. There are two double and seventeen single bedrooms, all with ensuite facilities. The home has a lift. Bathrooms are on each of the floors. One bathroom has a hoist and another has a walk-in mobility bath. Grab rails are fitted in all the toilets. There is a small paved parking area at the front of the building and a large garden at the back. There is a patio at the back overlooking the large garden. There is a ramp at the front and at the rear. The home is in the residential area of Whetstone and within easy reach of public transport, shops and leisure amenities located along Whetstone High Road. The fees charged by the home range can be obtained from the home manager. The CQC had been informed by the company that in the coming weeks the company Brownlow Properties Limited intended to change its name to Brownlow Enterprises Limited. The company Brownlow Enterprises Limited would then be trading under the name Ventry Residential Care for the management of Athenaeum House. 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: The quality rating for this service is 3 star. This means the people who use this service experience EXCELLENT quality outcomes. This inspection was carried out on 3rd November 2009 by Daniel Lim (inspector) and took a total of seven hours to complete. A second visit was made on 6th November to view documents not available on the first day. We were assisted by a director of the company, Damien Heneghan on the first day and Mr Jean Christopher Tranquille, the homes registered manager on the second day. Five residents and a relative were interviewed. The feedback received from them was positive and indicated that they were satisfied with the care provided. Completed survey forms were received from five residents, five staff and two healthcare professionals. These indicated that the respondents were generally satisfied with the Care Homes for Older People Page 6 of 28 care provided at the home. Statutory records were examined. These included four residents case records, the maintenance records, accident and incident records, financial records, complaints records and fire records of the home. The premises including residents bedrooms, communal bathrooms, laundry, kitchen, dry food store, garden and communal areas were inspected. Four staff on duty were interviewed on a range of topics associated with their work. They were noted to be knowledgeable regarding their roles and responsibilities. Staff records, including evidence of CRB disclosures, references, supervision and training records were examined. In addition, the minutes of residents and staff meetings were examined. These indicated that residents and staff had been consulted and informed of changes affecting the running of the home. The completed Annual Quality Assurance Assessment form or AQAA was received by us. Information provided in the assessment was used for this inspection. Care Homes for Older People Page 7 of 28 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 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 8 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 9 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. People who use this service experience an excellent outcome in this area. This judgement has been made from evidence gathered both during and before the visit to this service. Significant time and effort is spent making admission to the home personal and well managed. Prospective residents and their families are treated as individuals and with dignity and respect for the life changing decisions they need to make. Admissions are not made to the home until a full and comprehensive needs assessment has been undertaken by a suitably qualified member of the company. This ensures that the home is able to meet the needs of residents. The home has developed a Statement of Purpose and Service User Guide, which is very specific to the resident group. Evidence: The AQAA of the home states: Care Homes for Older People Page 10 of 28 Evidence: The home has a comprehensive pre-admission assessment form which is completed by the manager prior to acceptance at the home. Though this, we are able to confirm and demonstrate that home has the ability to meet the needs of the individual. These documents are not static and evolve as methods or care change in the home to reflect current good practice. The pre-admission assessments which were examined were noted to be appropriate and comprehensive. The assessments included details of the personal, mental, cultural and spiritual needs of residents. Risk assessments together with strategies for minimising identified risks had also been prepared for residents admitted to the home. The assessments were well prepared and provided essential information for ensuring that the needs of prospective service users can be met by staff. Residents in the home were noted to be clean and appropriately dressed. The five residents who were interviewed informed us that they were well treated and their care needs had been attended to. This was reiterated by a visiting relative who was interviewed and in completed questionnaires received by us. Comments made by residents included : I am satisfied with the care provided. No complaints. Lovely home. The manager stated that the home does not provide intermediate care. The home has a Statement of Purpose and a Service User Guide. We however, note that they had not been update to reflect changes in the management of the home. This is required. The registered manager agreed that this would be done. Care Homes for Older People Page 11 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 arrangements for meeting the healthcare and personal care needs of residents are satisfactory and these are recorded in residents care plans. Residents are protected by the homes satisfactory arrangements for the administration of medication. Evidence: The AQAA states : Athenaeum is a homely, comfortable environment. We believe that life is for living and enjoying. We will provide service users with as much or as little supervision and assistance as they require to lead a comfortable and happy life. The concepts of privacy and dignity are automatically upheld and promoted within this environment. The homes care plan has been carefully designed to enable easy access to information and to be user friendly. Every service user has their own care plan which has been personalised with their assistance and is reviewed at least monthly by their key worker to reflect their changing needs. Care Homes for Older People Page 12 of 28 Evidence: Residents who were interviewed indicated that staff had treated them with respect and dignity. They stated that staff took good care of them and had attended to their personal and healthcare needs. When interviewed, they indicated that they could see a doctor if they needed to. The case records contained evidence that residents had access to healthcare professionals such as the GP, chiropodist, community nurse and optician. Healthcare professionals who returned completed questionnaires indicated that residents needs had been monitored and attended to. Individual care plans had been prepared for residents. A sample of four care plans which was examined was found to be well prepared and they easy to read. There was documented evidence of regular monthly care reviews. The care plans had been signed by residents or their representatives. The plans were of a good standard and addressed the holistic needs of residents. This ensures that staff are provided with appropriate guidance and residents specific care needs are attended to. Appropriate risks assessments had been prepared for residents. One of the residents who had previously experienced seizures and fits was noted to have a comprehensive risk assessment. This ensures that potential risks are minimised and staff are fully informed. The arrangements for the ordering, administration, storage and disposal of medication were satisfactory. The medication charts of four residents were examined. These indicated that medication had been administered as prescribed and signed for. No unexplained gaps were noted. The temperature records of the room where medication was stored had been recorded daily. These were satisfactory and no higher than 25 C. The medication fridge temperatures were satisfactory. This ensures that medication is stored correctly. The controlled drugs record book was examined and we note that drugs administered had been recorded and signed for. Comments made by residents in this area included the following : I am well cared for. Staff are respectful and polite. I can see the doctor if I need to. My medication has been given to me regularly. Care Homes for Older People Page 13 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The daily life, meal arrangements and routines of residents are well organised. People using the service are given the opportunity to take part in activities both within the home and in the community. They also have opportunity to maintain important family relationships. Evidence: On both inspection days, we note that staff had made effort to engage residents in various activities. The programme of weekly social and therapeutic activities were on display in the dining area and included art and crafts sessions, walks, board and ball games, music, exercise and entertainment sessions. Residents interviewed were able to confirm that various activities had been organised and they could participate in them if they wanted to. Arrangements had also been made for religious services to be held in the home for residents who are unable to attend services outside the home. We noted some residents were able to walk along the path around the garden. Residents confirmed that they had been able to maintain relationships with their relatives and friends. This was also reiterated by a relative who was present. She stated that her relative who was a resident had been well treated and staff were helpful and friendly. Care Homes for Older People Page 14 of 28 Evidence: The kitchen was clean and well equipped. The cook was knowledgeable regarding the meals to be provided. The dry food store located beside the garden was tidy, well stocked and kept clean. A record of daily fridge and freezer temperatures had been kept. These were satisfactory. The menu appeared varied, balanced and reflected the ethnic composition of residents. Residents interviewed indicated that they were satisfied with the meals provided. One resident stated that she wanted more sliced roast beef. The manager provided evidence that such food was served three times a week. One resident requested to have salmon. We note that there was documented evidence in the menu that this had been responded to. This was also confirmed by the director and manager of the home. Care Homes for Older People Page 15 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The arrangements for responding to complaints and for adult protection are satisfactory. The home has an open culture that allows residents to express their views and concerns in a safe and understanding environment. The required policies and procedures for safeguarding residents are in place and give the required guidance to staff. Training in safeguarding had been provided for staff. Evidence: The AQAA of the home states : We do not shy away from complaints and we do understand that many older people do not like to complain through feelings of difficulty or fear of being victimised. Therefore we provide service user with a comfortable forum to make complaints through service user meetings. This forum enables service user to feel confident in making suggestions and complaints without any fear of victimisation. This approach is complimented by the open door policy of the managment and the key worker system in operation. We continue to promote abuse awareness among staff and service users so as they are able to identify different kinds of abuse and are aware what to do in that event of suspecting abuse, so ensuring that there is an open protective culture within the home. Due to the small nature of the home, the manager is able to listen and interact with the service users and their representatives on a daily basis thus allowing the manager to respond to their concerns and queries quicker. Care Homes for Older People Page 16 of 28 Evidence: Residents and a relative who were interviewed by us indicated that they were well treated and satisfied with the care provided to residents. The home has an adult protection procedure. It included examples of abuse and guidance to staff on reporting allegations of abuse to Social Services and The CQC. The local authority guidelines were also available. The manager and his staff who were interviewed were aware of the homes policy and procedures for the protection of vulnerable adults. There was evidence that staff had been provided with the required training. No allegations of abuse has been received by us since the re-registration of the home. The home has a record of complaints received. There was documented evidence that they had been promptly responded to within the required timescale of 28 days. Residents were aware of who to complain to if they had concerns. We note that concerns made by residents had been promptly responded to. This was especially evident in the provision of meals and documented evidence was provided. The home has a record of compliments which indicated that service users and their representatives were satisfied with the care and support provided. Comments made by residents and relatives included the following: The staff here treat me with respect. The staff provide outstanding care. I am well cared for. We note on both days that staff were gentle and respectful in the way they dealt with residents. The registered manager and his deputy informed us that they walk round at the start of each shift to talk to residents and discuss any concerns they may have. The directors of the company who were present also indicated that they regularly visit the home to check on the welfare of residents. Care Homes for Older People Page 17 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 home is clean, tidy and furnished to a high standard. The manager and directors have ensured that the physical environment of the home provides for the individual requirements of people who live there. The necessary equipment and adaptations for supporting residents are available. Residents are allowed to personalise their bedrooms. Overall, the home provides a pleasant, comfortable and attractive environment to live in. Evidence: The homes AQAA states : The houses retain their homely feel, and this is appreciated by the service users, who like the fact it is not clinical, cold, and austere in feel. The building and grounds are subject to a rolling maintenance programme of work, organised and executed by service provider, that ensures the fabric and appearance of the building and grounds, in addition to its fixtures and fittings are kept in best condition. The home has a large well maintained garden which is accessible and loved by the service users, who in good weather spend large parts of the day enjoying it. The home has prevented the problems so often associated with infections among the elderly. The home believes that good basic hygiene is the most powerful weapon against infection, and to that end there are infection control stations situated throughout the building which include hand sanitising gel, aprons, and gloves. Care Homes for Older People Page 18 of 28 Evidence: All residents interviewed stated that they were happy with the accommodation provided and their bedrooms had been kept clean. The bedrooms, lounges, and other communal areas were found to be clean, tidy and cheerfully furnished. Flowers and plants were used to adorn the corridors and attention had been given to ensuring that the home looks attractive. No offensive odours were detected. Comments made by residents included the following: The home is spotless. Nice home. I am happy here and can walk round the gardens. Bedrooms inspected had been personalised by residents with their own pictures and ornaments. These appeared cosy. All bedrooms have ensuite facilities and were well furnished. The large back garden was attractive, colourful and seating and shade had been provided. There is a circular path round the garden and residents were noted to be using the path. The home has a lift which serves all floors. Specialist equipment for the care of residents was available in the home. These included hoists, assisted baths and wheelchairs. One bathroom has a hoist and another has a walk in mobility bath. Grab rails are fitted in all the toilets. There is a ramp to the front door and rear garden. On each floor of the home, is a storage area where gloves, apron, a first aid box and other hygiene products were kept for the use of staff when attending to residents. For safety reasons, glass panels had been fitted to corridor doors. The manager explained that this allowed residents and staff to see who is on the other side of the door. This therefore reduces the risk of accidents happening. The laundry was inspected and arrangements for laundering of soiled linen were found to be satisfactory. The deputy manager reported that care staff followed procedures for ensuring that soiled linen and clothes are put into the appropriate bags and washed in a special cycle at a high temperature. This ensures effective infection control and protects the health of residents. We note from the training records that staff had been provided with training in infection control. The required safety inspection had been carried out on the gas, electrical installations Care Homes for Older People Page 19 of 28 Evidence: and portable appliances and documented evidence was kept in the homes maintenance folder. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has a good recruitment procedure that is followed in practice. The manager recognizes the importance of training and tries to deliver a programme that meets statutory requirements. Residents and their representatives are satisfied with the staffing arrangements. Evidence: The AQAA states : The home has a core of staff team working according to the rota, both old and new staff, providing continuous excellent care to service users who appreciate it and view the staff as much as friends as carers. We arrange for the new staff to have two weeks induction training, shadowing senior staff, learning the routine and work methods of the home to ensure that when they are placed on shift they can meet the needs and expectations of the service users. Once this is achieved they can then begin their work on core induction standards, these completed within the 12 weeks. All staff have continuing training and supervision. The service users are in safe hands at all times and are supported and protected by the homes recruitment policies and procedures. The five staff who were on duty were interviewed on a range of topics associated with Care Homes for Older People Page 21 of 28 Evidence: their work. They were noted to be knowledgeable regarding their roles and responsibilities. The duty rota was examined. This indicated that in addition to the manager there was normally three care staff on duty during the day shift and two care staff, both on waking duty during the night. There were nineteen residents in the home. The training records examined, indicated that staff had been provided with most of the required training. The manager explained some new staff had been recruited recently and training would be arranged for them after their induction period was over. Recruitment records examined indicated that the required recruitment procedures, including obtaining of satisfactory CRB disclosures and references had been followed. Staff had been provided with job descriptions and a list of their daily duties and responsibilities was available in the office. Staff interviewed were knowledgeable regarding their responsibilities. They indicated that the staffing levels were generally adequate. We were informed of an area of good practice. The manager provided evidence that some staff who had come from overseas had also been asked for additional CRBs from their home countries. He stated that this was for the protection of service users. Staff interviewed stated that they worked well as a team and they found the manager supportive. There was documented evidence that regular staff meetings and formal staff supervision had been carried out. This was also confirmed by staff interviewed. The supervision notes indicated that staff had opportunity to discuss any work related problems, issues related to the care of residents and their training. The issue of equalities and diversity was discussed with the manager and his staff. Staff were noted to have an understanding of the need to treat all residents sensitively and with respect regardless of disability, gender, race, religion or sexual orientation. They were aware that they must not discriminate against residents and they indicated that this was stressed to them during their induction. Residents and a relative who were interviewed indicated that they had been treated with respect and dignity by staff. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home can be assured that the home is well run and the manager has skills and ability to deliver a good quality of care and meet its stated aims and objectives. Records are well maintained. There is an effective system for maintaining health and safety. Residents and their representatives are consulted regarding the care provided and the management of the home. Evidence: The registered manager was found to be knowledgeable regarding his role and responsibilities. He had completed a National Vocational Qualification at level 4 in Care and Management. He stated that he was working to ensure that staff are supported to deliver the best possible outcomes for people living at the home. Staff indicated that the directors of the company take a close interest in the running of the home and provide regular and close support for the manager and his staff. Two of the directors were present during this inspection. We were informed by one of the Care Homes for Older People Page 23 of 28 Evidence: directors that a director of the company visits the home daily to speak to residents and support staff. We were also informed by a director that there is a a single dedicated senior managers telephone number for all managers or staff to use at any time day or night when support or guidance is needed. We note that the manager had occasionally assisted in the running of another home belonging to the same company and the deputy manager was referred to as the acting manager in the minutes of a meeting examined by us. The directors stated that we had been informed although no written evidence was available for inspection. The directors agreed to provide us with full details of the management changes. This was received at the time this report was completed. All future management changes in the home must be notified to us. This is to ensure that CQC is fully aware of and agree to management changes affecting the care of residents. There was evidence that staff and residents were consulted regarding the management of the home. The minutes of these meetings were available for inspection. There was evidence that systems were in place to review the quality of care provided. Consumer survey forms had been sent out. The manager stated that none had yet been received. Regulation 26 reports had been carried out by the directors. Weekly fire alarm checks, fire drills and fire training had been documented. The home has an up to date fire risk assessment. The required fire drills had been organised. Windows in all bedrooms inspected had been fitted with window restrictors. These were engaged. The home has a current certificate of insurance. The financial records of one resident was examined. These were noted to be well maintained. Receipts had been obtained for transactions made on behalf of residents. Care Homes for Older People Page 24 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 25 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 1 1 4 The Statement of Purpose and Service User Guide must be updated to reflect changes in the management of the home. 31/12/2009 This is to ensure that prospective residents are fully informed. 2 32 39 Changes in the management 31/12/2009 of the home must be promptly notified to us. This is to ensure that CQC is fully aware of and agree to management changes affecting the care of residents. Care Homes for Older People Page 26 of 28 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. 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