Care Home: Avonleigh Gardens

Similar services:

• Chirnside House
• Keer Sands Residential Home
• Ruskin Lodge
• Bushell House
• Langrigg House
• Parkside
• Dystlegh Grange
• Thornton Lodge

What the care home does well Detailed assessments were undertaken before people came to live at the home. This makes sure that the manager and staff know everything they need to know about what care the person needs and can reassure them that their needs can be met. Support plans had been written for each person to make sure staff knew what care they needed to provide and records were kept up to date with any changes to the person`s condition. People returning surveys to us all said they always or usually got the personal care and medical support they needed and that staff always or usually listened and acted on what they said. In answer to the question "What does the home do well?" comments included, "everything", "As far as we are concerned the home does well at everything it should do", "Staff are concerned, friendly and treat residents as individuals", "Staff always on hand to tend to residents` physical needs or just to chat", "All the staff - the manager, carers and cleaners are so kind and attentive and really seem to care for the residents as people", "X has had various physical issues as well as dementia but I feel totally confident that she is happy, safe and cared for. We are so lucky to have found this place" and "The staff are friendly and helpful". People living at the home that we spoke to during the inspection said, "You can`t beat it, I`m very happy, it`s perfect everything is very good day to day". A full time activities organiser is employed at the home who works 5 days a week including some weekends. A programme of events and entertainment is provided with opportunities for people to take part twice a day, each morning and afternoon. People said they liked the food provided at the home and they were given a choice at each mealtime. Systems were in place for people to be able to give feedback about the food and activities provided at the home and make their own suggestions about what they would like. In the AQAA the manager reported that 89% of the staff had successfully completed National Vocational Qualifications (NVQ). This qualification is obtained following training in providing personal care. This meant that staff had a good basic knowledge of the care they needed to provide and the reasons such care was needed. Records showed that staff were given further training in a range of topics to make sure they had the skills and knowledge to care for people properly. What has improved since the last inspection? At the last key inspection we made no requirements or recommendations. However work has taken place and is ongoing to improve the environment and facilities for people living at Avonleigh Gardens. Despite the building work people told us the home was clean and fresh and many bedrooms had been redecorated and refurbished since our last inspection. The building work to provide an extension to the home is scheduled to be completed in April 2010 and will provide considerable benefits for people living at the home. In the AQAA the manager told us about other improvements that had taken place since our last inspection such as: One of the staff has taken training in reflexology and now provides this service to people twice a week where requested. Guidance has been produced for staff regarding oral hygiene and some specific short term conditions such as urine infections, to make sure staff have the information about how to manage these conditions and the important things to consider. More reminiscence and multi sensory equipment and materials have been provided. What the care home could do better: Although the manager told us that guidance had been produced for staff about the Mental Capacity Act and the new legal processes in place to protect people who do not have the mental capacity to make decisions for themselves, staff need to have some training in this area and consideration needs to be given as to how people living at the home will be assessed to make sure their rights are being protected. Although the complaints procedure was displayed and most people we spoke to said they thought the manager was approachable and that if they did raise any concerns with her she would deal with them appropriately, 4 of the 6 people who returned surveys said they did not know how to make a formal complaint. The manager should review how people living at the home are given information about how to make complaints to make sure the procedure is clear and people understand it. In the AQAA the manager referred to 2 incidents that had happened at the home that had been investigated by the Oldham safeguarding team. We were not told about these incidents at the time. A list of events that we should be notified about is provided in the Care Homes Regulations 2001. The manager must ensure we are notified without delay about any such incidents so we can check that the proper procedures to protect people living at the home are being followed. Key inspection report Care homes for older people Name: Address: Avonleigh Gardens Clyde Street Oldham Lancashire OL1 4HT     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: Fiona Bryan     Date: 2 7 0 8 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: Avonleigh Gardens Clyde Street Oldham Lancashire OL1 4HT 01616275722 01616332688 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: www.mha.org.uk Methodist Homes for the Aged care home 40 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia 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 Dementia - Code DE The maximum number of service users who can be accommodated is: 40 Date of last inspection Brief description of the care home Avonleigh Gardens is a purpose built care home owned by Methodist Homes for the Aged. It is located in the Watersheddings area of Oldham and is situated close to a main road, bus routes and local amenities. Accommodation is provided in 40 single bedrooms all of which have en-suite facilities. The home is arranged in four units (wings), each of which comprises bedrooms, lounge, dining and kitchen facilities for service users. Care Homes for Older People Page 4 of 28 Over 65 0 40 40 0 Brief description of the care home The weekly fees range from £366 to £391, with additional charges for sundry items such as hairdressing services and newspapers. A service user guide is available on request. 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: This key unannounced inspection, which included a visit to the home took place on Thursday 27th August 2009. The staff at the home did not know that this visit was going to take place. All the key standards were assessed at the site visit and information was taken from various sources, which included observing care practices and talking with people that live at the home, the manager and other members of the staff team. Key standards refers to those standards we feel are particularly important in ensuring the health, safety, welfare and quality of life of people living at the home. The care and services provided to two people were looked at in detail, looking at their experience of the home from their admission to the present day. A selection of staff and care records was examined, including medication records, Care Homes for Older People Page 6 of 28 training records and staff duty rotas. Before the inspection, we asked for surveys to be sent out to people living at the home and staff asking what they thought about care at the home. 6 people and 3 staff returned their surveys. Comments from these questionnaires are included in the report. We also asked the manager of the home to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they did well, and what they needed to do better. This helps us to determine if the management of the home see the service they provide the same way that we see the service. The manager completed the form well and showed that she was able to identify the areas where the service could be developed. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? At the last key inspection we made no requirements or recommendations. However work has taken place and is ongoing to improve the environment and facilities for people living at Avonleigh Gardens. Despite the building work people told us the home was clean and fresh and many bedrooms had been redecorated and refurbished since our last inspection. The building work to provide an extension to the home is scheduled to be completed in April 2010 and will provide considerable benefits for people living at the home. In the AQAA the manager told us about other improvements that had taken place since our last inspection such as: One of the staff has taken training in reflexology and now Care Homes for Older People Page 8 of 28 provides this service to people twice a week where requested. Guidance has been produced for staff regarding oral hygiene and some specific short term conditions such as urine infections, to make sure staff have the information about how to manage these conditions and the important things to consider. More reminiscence and multi sensory equipment and materials have been provided. 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. Peoples needs are assessed before they move into the home to ensure that their care needs can be met. Evidence: We looked in detail at the care provided to 2 people. Assessments had been undertaken for both of them before they were admitted to the home. People were assigned key workers who were responsible for carrying on the assessment process following admission to the home, adding extra information about peoples abilities or as their needs changed. It was evident from the records that people had been involved in their assessments and they had been asked to sign their assessments to indicate that they had been discussed and agreed with them. Care Homes for Older People Page 11 of 28 Evidence: Assessments were person-centred and focused on peoples abilities, as well as determining what their care needs were. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal care needs were met in a way they preferred. Evidence: We looked in detail at the care provided to 2 people. Each person had a detailed support plan, which gave staff information about their abilities, care needs and preferences regarding their daily routines. Support plans were specific to the individual concerned and provided a good picture of the care staff needed to provide. Risk assessments had been undertaken for pressure areas, moving and handling, falls and nutrition. Support plans were updated on a very regular basis and checked (audited) monthly to make sure all the information was accurate and up to date. The manager told us that staff were just completing End of Life training to help them deal with this subject sensitively and professionally. In the care files we looked at, each person had information about their final wishes so staff could make sure these Care Homes for Older People Page 13 of 28 Evidence: were respected. Records showed that people had seen their GPs, podiatrists and opticians. Where people had hospital out patient appointments, staff made sure they were able to attend. Requests from the GP e.g. for urine samples were followed up and there was a good system to make sure results of tests were obtained and treatment prescribed where necessary. We looked at how medicines were managed for a small number of people. Systems were in place to minimise the risk of errors and promote the safety of people living at the home. Six people living at the home returned surveys to us. All of them said they always or usually got the care and support they needed and that staff always or usually listened to them and acted on what they said. Comments included, Staff are concerned, friendly and treat residents as individuals, Staff are always on hand to tend to residents physical needs or just to chat, All the staff - the manager, carers and cleaners are so kind and attentive and really seem to care for the residents as people, X has had various physical issues as well as dementia but I feel totally confident that she is happy, safe and cared for. We are so lucky to have found this place and The staff are friendly and helpful. We spoke to several people during our inspection and they were all happy with the care they were receiving and thought the home provided a good service. One person told us the home was perfect and said, You cant beat it - everything is very good day to day. Care Homes for Older People Page 14 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. People are provided with activities and a variety of home cooked food, which they enjoy. Evidence: A full-time activities organiser is employed at the home who works five days a week, on a rotational basis, so sometimes she works at the weekends. A designated activities room was provided, which was spacious and well equipped with a variety of materials for arts and crafts, games and videos, etc. Since the last inspection the activities organiser has trained in reflexology and provides this service twice a week for those that request it. A range of activities were offered and people were encouraged to put forward suggestions about the type of events they would like arranged. Special events throughout the year were advertised on the noticeboards e.g. St Patricks Day, Remembrance Day, Halloween and Wimbledon high tea. A programme of activities for the week was displayed on notice boards on both floors of the home. Activities included pamper days with foot spas and manicures, armchair exercises, ball games, dominoes, board games and cards, word games, poetry and Care Homes for Older People Page 15 of 28 Evidence: story telling sessions written and told by staff and residents, arts and crafts, singalongs, flower arranging and coffee mornings. A mobile shop was provided for people to purchase small items such as sweets and toiletries. Once a month local clergy visited to hold Sunday Worship. On the day of the site visit a group of about 8 people had congregated in the activities room and spent the morning joining in with a quiz. Following the morning session we chatted with the group and asked their opinions about how the home was run. Everyone said there were plenty of activities and confirmed daily routines were flexible and their visitors were made welcome. People told us the food provided at the home was good and that they had a choice at each mealtime. The daily menu was displayed on blackboards in the dining rooms on each unit and menus were also provided on the dining tables. On the other side of the menu a list of that weeks social events and activities was provided. We had lunch with some of the people living on the Bluebell unit. The choice was bacon hotpot or chicken stir fry. We chose the stir fry and it was tasty and quite spicy! Throughout the meal people were served cups of tea and added their own milk and sugar from jugs and bowls on the tables. The meal was unhurried and relaxed, with the carer chatting with people as they ate. Following the meal the carer told people what the choices were for tea so she could make a list for the kitchen staff of what people wanted. The choice for tea was lasagne or egg and cress sandwiches. Those people that requested sandwiches were asked if they wanted white or brown bread. One person chatted with a member of the kitchen staff about breakfast; she had enjoyed a boiled egg that morning and asked if she could have eggs every other day, which the kitchen staff agreed was no problem. All the people that returned surveys said they always or usually liked the meals provided at the home and that there were always or usually activities arranged that they could take part in. Care Homes for Older People Page 16 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. Policies and procedures are in place, which help to ensure that people using this service are protected from harm or injury. Evidence: The complaints policy is displayed on the notice boards on both floors of the home. Most people that we asked, said that if they had a complaint they would speak to their families, but some people did say they would go to the office or speak to their key worker. All the people we spoke to said they knew who the manager was and saw her regularly around and about the home. People thought the manager was approachable and that if they did raise any concerns with her she would deal with them appropriately. Of the 6 people that returned surveys everyone said there was someone they could speak to informally if they were unhappy but 4 of the 6 said they did not know how to make a formal complaint. A record of complaints had been maintained. This showed a small number of complaints and the action taken to rectify them. In the AQAA the manager told us there had been 2 complaints that had been referred to the Oldham safeguarding team. These had not been included in the complaints log Care Homes for Older People Page 17 of 28 Evidence: but should have been to provide a full list of all complaints about the service and the actions and outcomes of any investigations. One of the complaints had not been substantiated but an investigation into the other had found that staff had not involved the appropriate agencies when one person living at the home had been aggressive towards another. This meant there was a risk that people were not properly protected. However, the incident took place over a year ago and the manager said that since then she has made sure that safeguarding procedures are followed in line with the Local Authority interagency policy. It was reported that all staff had training in safeguarding adults from the Local Authority and there were two 24 hour confidential phone lines run by external agencies for staff or people living at the home to report concerns. Information about the Mental Capacity Act and Deprivation of Liberty Safeguards (MCA DOLS) was displayed on the notice boards for the information of staff, people living at the home and their relatives. The manager said the company were in the process of arranging training for staff regarding this topic. At the time of our visit there was no formal record in peoples care files that any assessment had been undertaken of their mental capacity and consideration should be given as to how and when assessments should be undertaken and recorded. No one living at the home was subject to an application being made under DOLS requirements but training for staff is recommended to ensure that staff understand when an application may be necessary. Care Homes for Older People Page 18 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Avonleigh Gardens provides a safe and comfortable environment and the scheduled improvements will be of great benefit to people living at the home. Evidence: At the time of our inspection building work was being carried out to create an extension to the home and to upgrade and refurbish existing facilities. We were told when this work began and the arrangements that were in place to keep people living at the home and their families informed about how the work was progressing. Although the work was extensive the home was clean and tidy and disruption to people living at the home had been kept to a minimum as far as possible. People told us the building work was not affecting them too much and the manager reported that people had enjoyed the buzz in the home and the workmen were very friendly and had taken time to talk to people living at the home and involve them in what they were doing. Of the 6 people that returned surveys 5 said the home was always or usually fresh and clean. People we spoke to during our inspection said the standard of cleaning in the home was good or excellent and that the laundry service was very good. Care Homes for Older People Page 19 of 28 Evidence: Since the last inspection new staff call and fire alarm systems had been installed. A new kitchen had been provided and all bedrooms had been redecorated. The extension when finished will provide 17 more en suite bedrooms, a coffee shop, reflexology room and upgraded bathrooms. The outside area will also be improved with additional seating and a herb and sensory garden. The work is scheduled to be completed by April 2010. 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. People receive care and support from staff who have the skills to support them correctly. Evidence: At the time of the inspection there were 38 people living at the home. This number will increase when the extension to the home has been completed. In general the numbers of care staff on duty were as follows: in the mornings 1 senior carer was on duty with 4 carers. This meant there was 1 carer on each of the 4 units in the home, with the senior available to administer the medicines and liaise with doctors and other allied professionals. In the afternoons the number of carers dropped to 3 with 1 senior carer to supervise, so again each carer including the senior worked on one of the 4 units. We asked what happened when the senior had to administer the medicines and we were told that the other carers had to cover the unit the senior was working on for that period of time. The manager and/or the deputy manager would also be on duty and the activities organiser worked full time on a rotational basis that covered the seven day week. Two carers were on duty overnight. All the 6 people that returned surveys said there was always or usually enough staff on duty to meet their needs although 1 person did comment that the home could improve by increasing staff levels. Three staff members also returned surveys and they all agreed there were usually enough staff. Most people that we spoke to during Care Homes for Older People Page 21 of 28 Evidence: the inspection did feel that another pair of hands would be beneficial. One person said, They all work very hard. Sometimes we have to wait a bit because 2 people are having to do the work of 3. Staffing levels will have to be reconsidered once the extension is finished and the number of people living at the home increases. We looked at 2 staff personnel files. Records showed that each person had been recruited following a thorough vetting system to ensure they were suitable to work within a care environment. Staff that returned surveys and those we spoke to during the inspection confirmed appropriate pre employment checks had been carried out before they were able to start working at the home. In the AQAA the manager said 89 of care staff had successfully completed NVQs, with more staff undergoing the training. It was reported that all new staff received induction training that included moving and handling, health and safety, fire safety, first aid and safeguarding adults. A training matrix was maintained that showed staff had undertaken recent training in a range of topics such as managing challenging behaviour, dementia care, infection control, end of life care and care planning. Staff that returned surveys said they were given training that was relevant to their role, although 1 staff member commented that they now did a lot of the training on the computer, rather than with a tutor. They said that this was of learning may not be the best way for all staff as some people learned better with more personal interaction. 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. Avonleigh Gardens is managed with systems, policies and procedures in place to ensure the health and safety of staff and people living there are promoted and protected. Evidence: The manager has NVQ level 4 in Health and Social Care, and NVQ level 4 in Management and has completed the Registered Managers Award. All staff and people living at the home said that the manager was approachable and supportive. We observed the manager as she was walking round the home and noticed that people living in the home were happy to approach her and chat with her and she was warm and friendly with them. People told us they thought Avonleigh Gardens was a good home. Residents meetings were held regularly and the minutes of the meetings showed that people had been asked for and were able to put forward their own suggestions about future activities and plans. Minutes of staff meetings also confirmed that staff were included Care Homes for Older People Page 23 of 28 Evidence: in the plans for developing the home and were able to voice their opinions about how the home was running. Methodist Homes for the Aged have a detailed quality assurance and quality monitoring system with regular checks being made on all aspects of care and practices within the home. Records were available to show that checks (audits) were carried out regarding health and safety, medicine management, care planning, fire safety, food safety and cleaning systems among others. The majority of people living at the home are helped by their families to manage their money. Some relatives leave small sums of money as a float for people to use for sundry items. It was reported that ledger sheets were held for these people and records kept of all transactions but these were not examined at this inspection. The manager confirmed in the AQAA that regular checks were made of the building and equipment to ensure they met with health and safety requirements. We did not look at the records for these during this visit. Staff told us they had enough equipment to carry out their jobs safely and were observed using safe working practices. The environmental services directorate of Oldham Local Authority had awarded the home an excellent rating in their Scores on the Doors rating system for compliance in food safety and a fire safety audit carried out on 12/6/08 had been confirmed as satisfactory. The manager had not notified us about the incidents discussed in the Complaints and Protection section of this report, that were investigated by Oldham safeguarding team so we did not know about them until we received the AQAA. The manager must ensure that we are told about incidents that may adversely affect people living in the home. These are called notifications and are a legal requirement. The information provided in the AQAA was detailed and showed that the manager had a good understanding of how the home was performing and the areas that could still be developed. 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 38 37 The manager must notify us without delay of the occurrence of any incident detailed in Regulation 37 of the Care Homes Regulations 2001. This will ensure that we can confirm that appropriate action has been taken and the appropriate agencies notified to protect people living at the home and promote their safety. 30/09/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 16 The manager should review how people living at the home are given information about how to make complaints to make sure the procedure is clear and people understand it. Training should be provided for staff in relation to MCA DOLS and steps should be taken to make sure the legislation is considered and complied with where appropriate. This will ensure that people who do not have Page 26 of 28 2 18 Care Homes for Older People 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 the mental capacity to make their own decisions have their rights protected. 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. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!