Care Home: Bamford Close

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What the care home does well Bamford Close provides a homely and relaxing living environment. The accommodation is spacious, allows for small group living and enables service users to develop relationships and become accustomed to one another. We found that the staff at Bamford Close work hard at developing good relationships with everyone they deal with. We found that the variety and quantity of food provided to service users is satisfying and meets their needs. People said `The food is top notch`. We found that people living at Bamford Close were very satisfied and expressed a high level of satisfaction with the facilities and service in the home. We found that the routines in the home are flexible. We found that the home is effective at promoting the health and safety of people living and working there. We found that the home offers a well maintained nicely decorated, clean and comfortable environment. We found that there was good information available about peoples interest, hobbies and about what they would like to do. We found that the staff has a good relationship with health care professionals and people feel that they are well cared for. They said `It`s good the way people are- they are all lovable.` What has improved since the last inspection? Since the previous inspection we have found that the assessments completed about peoples care needs are more detailed, providing more detailed information about peoples health and social needs and choices so that those concerned care confident that these can be met at Bamfoird Close. Since the previous inspection the range of activities at Bamford Close and out in the community has increased. Since the previous inspection the manager has demonstrated that she operates an adult protection policy and procedure that it is in line with the Stockport Metropolitan Borough Council safeguarding adults guidelines. Since the previous inspection all staff have completed Protection of Vulnerable Adults training. This will help them to understand what behaviours could be considered abuse, help them recognise if abuse is occurring and also inform them in how to deal with incidents or allegations of abuse. What the care home could do better: The registered manager should make sure that they inform CQC about occurrences and incidents that have had a detrimental effect on people living at Bamford Close. The registered person should monitor and revise the mealtime routines to make sure that people are sat at waiting for their meals for as short a period as possible. The registered person should be able to show that money held on behalf of service users tallies with the amount expected. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Bamford Close Adswood Lane West Cale Green Stockport Cheshire SK3 8HT     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Michelle Haller     Date: 1 9 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Bamford Close Adswood Lane West Cale Green Stockport Cheshire SK3 8HT 01614806712 01614740585 bamfordclose@boroughcare.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Borough Care Limited care home 40 Number of places (if applicable): Under 65 Over 65 4 40 dementia old age, not falling within any other category Additional conditions: 0 0 The registered person may provide the following categories of service only. Care home only - code PC, to people 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, (maximum number of places: 40) Dementia over 65 years of age - Code DE (E) (maximum number of places: 4) The maximum number of people who can be accommodated is: 40 Date of last inspection Brief description of the care home Bamford Close is a purpose built, single storey building offering accommodation for up to 40 older people; four of whom may be diagnosed as having a degree of dementia. The home also provides a day care service for up to ten people. The home is situated within a short drive from the motorway network, Stockport town centre and the local shopping precinct. Public transport is easily accessible and there are local shops within walking distance. Care Homes for Older People Page 4 of 30 Brief description of the care home The home is one of 12 care homes owned by Borough Care Limited, a `not-for-profit? company. The home is divided into four units, each accommodating up to ten residents, all of who have single rooms. Each unit has a lounge, kitchen, bathing and toileting facilities that are conveniently situated for residents. Bamford Close presents as a lively home with lots going on. Day care and residential residents are able to meet and enjoy each others company in the main areas, with the individual units being restricted to residential care residents only. The home charges #365.00 to #428.00 each week. The previous CSCI inspection report was on display at the entrance to the home. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We conducted this inspection without informing the manager before hand and looked at all of the most important or key Care Homes for Older People National Minimum Standards (NMS). This is called a Key Inspection. The inspection involved looking at the information we had received about the service during the previous year and before visiting the home. This information included notifications or events that manager has told us about, information from other sources such as social services, health workers or people using the service. We also considered the outcome of the Annual Service Review (ASR) which we conducted in 2008. The ASR includes reviewing all the information received about the service to check that it continues to be well run. We do not visit the service for the ASR. All the information Care Homes for Older People Page 6 of 30 received prior to this key inspection indicated that outcome for people using the service continued to be Good. We received seven completed Care Quality Commission (CQC) surveys from people working in the service. We visited the home and checked through written information including service user care files and staff employment records. We read through policies, guidelines and other documents concerned with running the home. We also talked to people and their relatives about their experiences of living at Bamford Close. We also interviewed members of staff and the manager of the service. The manager returned to us the Annual Quality Assurance Assessment (AQAA). The information requested included data about staff training, development of policies and procedures and compliance with health and safety checks when applicable. This information also influenced the outcome of the inspection. What the care home does well: What has improved since the last inspection? What they could do better: Care Homes for Older People Page 8 of 30 The registered manager should make sure that they inform CQC about occurrences and incidents that have had a detrimental effect on people living at Bamford Close. The registered person should monitor and revise the mealtime routines to make sure that people are sat at waiting for their meals for as short a period as possible. The registered person should be able to show that money held on behalf of service users tallies with the amount expected. 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 set out 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. The manager ensures that people who move into Bamford Close have their needs assessed so that people can be confident that these can be met by the staff and facilities at the home. Evidence: We looked at four care files and this included the fecords for the most recent admission to the home. We found that in each case an admissions checklist had been completed. Information family details, peoples interests and their likes and dislikes. The assessment also included health care and physical wellbeing, risk of falls, moving and handling needs, nutritional needs and communication needs. And so staff are given a fuller picture of support from the onset of admission. Care Homes for Older People Page 11 of 30 Evidence: The information about the most recent admission provided a clear idea of the persons needs and this was contained in a single assessment document. This is an improvement since the previous inspection. We found that because Bamford Close runs a day care centre a significant number of the people living there benefited from prior knowledge and experience of using the service before accepting a permanent place. People were positive about the process of moving into Bamford Close and were given choice said: I asked for the unit I am on and they swapped around a respite bed so that I could have I wanted. The majority of staff who responded felt that they always received sufficient information about people and also confirmed that There is a verbal and handover each day. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager ensures that people living at Bamford Close receive the health and social care support they require and that this is provided safely and with dignity and respect. Evidence: We looked in detail at the care plans and other reports and correspondence for four people. In each case the care plans provided clear and detailed information about what staff needed to do meet the assessed needs. This included peoples preferences in relation to when and how health and personal care was to be offered. For example preferred times for baths, getting up or going to bed. We found that the information in the care plans was individualised and related specifically to each person. There was also evidence through signatures and what people said that they were involved in developing their care plans and in the process to review and update the information. We found that care plans and risk assessments identified the expected outcome of Care Homes for Older People Page 13 of 30 Evidence: each intervention so that staff were able to monitor whether the care plan was effective in meeting peoples needs. We found that a record of reviews was kept in each file and that it was easy to track all of the care and support provided and also monitor the outcome of this. We found through the records kept in each file clear evidence that health care professionals were involved with people quickly enough to give people the best chance of recovery, or reduce deterioration in health and prevent discomfort. Reports, prescriptions and other correspondence confirmed that the health professionals consulted included: district nurses, opticians, podiatrist, general practitioner and dentists. We also found that people were supported to attend out-patient appointments for specialist check-ups and tests such as hearing tests or other health care matters. We found, through the records they made, that the district nurses were able to work successfully in the home and that staff alerted them to concerns about skin breaks or pressure area care. And their reports confirmed that staff followed instruction so that their input was successful. We found that medication is handled safely at Bamford Close. Medication is received into the home through a metered dosage system provided by the pharmacist. The medication record sheet (MARS) was looked at and no untoward gaps were identified. We discussed with the manager the need to inform Care Quality Commission of any instance where service users are without their medication for a period of time as this could have a detrimental effect on their health. We looked at the way in which controlled medication was managed by the home and this was satisfactory. We observed that staff made sure that people wore glasses that were clean and oral hygiene appeared good, people also wore their hearing aids. This fostered effective communication between residents and care staff. We observed that all the people living at Bamford Close were very well groomed. Their clothing was spotless and nicely ironed. The majority of people wore socks, stockings or tights and shoes or slippers which were clean. The gentlemen had neat well groomed hair and looked spruce. The ladies looked well kept, with clean hair and nails, many wore jewellery and make-up according to their choice. We found that in previous years the care staff have completed a course that highlights Care Homes for Older People Page 14 of 30 Evidence: the importance of good personal grooming called Look good - feel good. We found that staff treated people with dignity and respect. People living at Bamford Close felt that staff were kind and gentle and they said that they felt safe living at the home. We observed that staff were always polite towards people. The general atmosphere and interaction was relaxed and informal. Staff encouraged people to reach their full potential and spent time talking through different events during the day. We noted that daily records were always written using respectful language and referred to people by name. The information written usually gave a picture of the physical and psychological well being of the person and demonstrated that staff, were observant, understood the care plans and took steps to ensure that people were as content and healthy as possible during their time at Bamford Close. People told us that they felt that health and personal care provided at Bamford Close met their needs and was effective. Comments included: When I was poorly the night staff were wonderful, offering drinks and checking that I was alright. and The doctor comes if Im poorly and they would talk to my daughter. They all know my ways and the doctor is coming on account of my eyes. Everything is okay. Care Homes for Older People Page 15 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. People living at Bamford Close are given opportunities to experience a lifestyle and activities that meets their needs and expectations. Evidence: We found that all staff have a responsibility to develop and maintain a stimulating environment for people living in Bamford Close. We observed that they spent time talking to people and discussing events in the home and peoples personal interests as they went about their work. We found that Bamford Close runs a day service and activities are planned by a trained activities coordinator and everyone in the home is able to join in with these activities. On the morning of the inspection people were seen enjoying armchair exercises set to specific armchair exercises compact disk with music and instructions. We interviewed an activities coordinator working at Bamford Close. She confirmed that there was a daily program of activities or events. The activities calendar included bingo, quizzes, arts and crafts, sing-along, entertainers, manicures, darts and video afternoons. The manager also ensures that special days, such as saints days, Care Homes for Older People Page 16 of 30 Evidence: birthdays and significant anniversaries are celebrated. We saw that people were reading newspapers and books, watching television and speaking to each other and staff. Since the last inspection the televisions have been updated and there is a television room with a large screen TV which is used for film evenings. At the previous inspection we found that people felt that there were insufficient activities away from the home. Records and reports indicated that in the past year outings have been increased. People told us that they had enjoyed going to local tea dances, garden centres and a trip to Blackpool was booked. The activities coordinator said that she felt the Borough Care as an organisation supported her efforts to improve activities for people living at Bamford Close. Comments about activities and relationships at Bamford Close included: I enjoyed the exercises this morning.; The staff have introduced him to other people and helped him to integrate.; and They make sure that I never miss a football match- they set me up in my room just how I like. We noted that visitors came throughout the day and every one interviewed felt that they could receive visitors when they wanted. People also commented that they regularly went out with friends and family. Visitors said: The carers are very welcoming and always offer you a drink. In relation to diet and meals we found that the lunchtime meal is usually soup and snack followed by a hot pudding, and the main meal is served in the late afternoon. On the day of inspection the lunchtime choice was golden vegetable soup to start, spaghetti on toast and then homemade apple crumble to follow. Other lunchtime choices included a variety of soups; beans or egg and toast, sandwiches,fishcakes and filled jacket potatoes. Teatime meals included a variety of casseroles, roasted meats, fish dishes, flans and pies. Care Homes for Older People Page 17 of 30 Evidence: We found that effective measures were taken to ensure that people remained well nourished and the weight records indicated that, in the main, people maintained their weight while living in the home. Furthermore additional steps were taken to investigate and deal with weight loss. We observed that the dining area of each unit is nicely decorated, bright and clean. The lunch time on the yellow unit was observed and this was a pleasant, calm and quiet social occasion. Staff supported people in a dignified manner. And people were offered an alternative if they did not want the meal provided. We noted that people sat at the dinner table for about 20 minutes before the meal was served and this is a long time to wait. The manager could revise this routine. Comments about living at Bamford Close included: Its good the food is top notch. And Its home from home. Care Homes for Older People Page 18 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. People are protected as complaints are dealt with fairly and openly, and there are robust and effective arrangements and procedures to prevent and deal with abuse. Evidence: We looked at how complaints had been managed by the manager by examining the complaints record and speaking to people about their experiences. There were no records of complaints and one safeguarding investigation had been conducted. The records confirmed that the manager took all the steps necessary to protect those involved and ensure that the investigation was open, transparent and conducted by the local authority safeguarding adults team. The outcome of the investigation was that the allegation was unfounded. The training records confirmed that since the previous inspection staff have received protection of vulnerable adults (POVA) training. And those spoken to understood their responsibility in recognising, preventing and reporting abuse. They were also confident that their concerns would be listened to. One person stated: The pova training was really good - you just dont realise how many levels of risk exist for elderly people- it opens your eyes. The complaint procedure is readily available in the home and people said that if they Care Homes for Older People Page 19 of 30 Evidence: had a complaint they would feel able to speak to the managers or any member of staff. People said I would talk to the unit leader or the manager - I can go to any of them really. When asked people said that they felt safe living at Bamford Close. Care Homes for Older People Page 20 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and environment of Bamford Close enables the residents to live in a clean, safe, well maintained, flexible and comfortable environment. Evidence: We conducted a tour of Bamford Close. The areas looked at included the entrance, the communal lounge which is also used for day care, the four units and a number of bedrooms and bathrooms. We found that all the rooms and areas inspected were clean, warm and met the needs of the service users. The majority of bedrooms had been personalised and had pictures and furniture chosen by the occupant. One person said that he had requested for his room to be redecorated and that this was arranged. We observed that the division of the home into units encourages friendships and gives a homely atmosphere. Also each unit has a kitchen area and people are able to have snacks and drinks when they want. We observed that the layout of the home promotes independence and people were observed mobilising and using aids such as handrails. There are aids to assist with bathing. Care Homes for Older People Page 21 of 30 Evidence: In the information returned to us the manager said that improvements to the environment included the installation of a new shower room and updating the call bell system so that people can summon staff from anywhere in the home. The manager also confirmed in this information that the laundering system protects against cross infection and that the washing machine has a sluice facility and reaches a temperature which will disinfect. People said about the environment: One of the reasons why I chose the home was because when you walked in there was no smell. Care Homes for Older People Page 22 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. Bamford Close provides staff who are employed using a robust selection process, they are well trained and deployed in sufficient numbers to meet the needs of those living in the home. Evidence: On the day of inspection there were 39 people living at Bamford Close, with an additional 6 people attending the home for day care. There were fourteen staff on duty fulfilling the following roles, there was the registered manager, one activities coordinator, six care staff, a cook and kitchen assistant, laundress and three housekeepers. We checked the staff duty roster for the week and found that this was the usual level of staffing during the week. On the day of inspection none of the people living at Bamford Close required intensive support. People living at Bamford Close felt that staff were available to them when needed. Of the seven staff who returned surveys five felt that the service was usually staffed to Care Homes for Older People Page 23 of 30 Evidence: meet peoples needs and two felt this was achieved sometimes. We looked at the frequency of falls, the number of times people had baths, the incidence of pressure sores, the general grooming of service users and complaints received by the home. We did this because problems in these areas could indicate that aspects of staffing could be improved, however, we did not find any problems for people living at Bamford Close that could be related to staffing issues. We found that falls mostly occurred in peoples rooms or in sight of staff, we also found that staff took steps to risk assess and deal with the reasons for falls very quickly. We found that people were able to have a bath when they wanted and that most chose to have a bath once a week and records confirmed that this was achieved. We also found that staff are encouraged to offer people a bath at different times of the day. There were no incidence of pressure sores in the home on the day of inspection and we saw evidence that staff had the time to ensure that preventative steps were taken if skin became sore looking or if skin tears or breaks were discovered. We saw that all the people living at Bamford Close were supported to maintain a good standard of personal grooming. We have not received any complaints about the home that indicated that staffing levels or staff competency was of concern or was having a detrimental effect on service users. We observed that staff were able to sit and talk to people and that staff interacted with people in a relaxed and unhurried manner. We conclude therefore that the staffing levels on the day of inspection met the needs of the people using Bamford Close. We discussed the concerns raised by staff about the numbers of care staff with the manager, and it was agreed that she would monitor the situation. Remarks included Yes there are enough staff we are kept busy. and Sometimes because of sickness there is a problem but everything gets done. and The home is in four units and not always got 6 carers- one for each unit and two to float. Care Homes for Older People Page 24 of 30 Evidence: Staff records and the training calender confirmed that since 2007 staff training had included, pressure area care, basic and advanced first aid, loss, grief and bereavement, food safety, falls prevention, recording accidents, infection control, moving and handling, palliative care, fire safety, managing conflict, protection of vulnerable adult alerter and Yesterday Today and Tomorrow dementia care training. The manager stated that most of the training is provided through the Borough Care organisation of which Bamford Close is a part. Supervision records were also on file and confirmed that issues discussed included, the needs of residents, future development needs and current issues concurring person. In the information she returned to us the manager stated that 19 out of 26 permanent care staff have achieved the National Vocational Qualification (NVQ) in Care level 2, and three others are completing this course. We noted that the safety of those living in the home is protected, as the majority of staff have a recognised first aid qualification. We found that staff were complimentary about working conditions, the training received and care provided in the home. Comments from staff included We get very good training, theres a choice its very helpful. and We get updated training, are updated in supervision, team meetings and when we have reports daily. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Bamford Close is an effective and efficiently managed home and people are given opportunities to influence how the home is run. Evidence: We found that the registered manager has attained the National Vocational Qualification level 4 in management award, and continues to update her knowledge. The training calender confirmed that additional training she has received includes The Mental Capacity Act; deprivation of liberty and safeguarding and care development. The manager is on the Borough Care Management Development programme and will be given opportunities to learn more about business and leadership skills. We found that the home ran efficiently and supervision records confirmed that that staff are well managed and given guidance and support as needed. We found that Borough Care conducts a yearly review of Bamford Close and this Care Homes for Older People Page 26 of 30 Evidence: includes finding out the opinions of service users and their relatives. The outcome of this review is published and made available for all concerned. We found that the residents at Bamford Close were given opportunities to comment and influenced what happened in the home. At the last residents meeting 15 people attended. The records showed that issues discussed included past events such as the Christmas festivities; the purchase and use of a new large screen television; choice of activities and to introduce more opportunities to play bingo and also discuss the daily news paper. The records also indicated that there was a mixed reaction to the a pantomime that took place. We talked to the manager and looked at the records of transactions kept at the home. We discussed concerns about the total amount been pooled although there were clear records including receipts and ledgers confirming how much belonged to each person. The manager should be able to show that the amount she expects to be available matches with what has been deposited. In the information she returned to us the manager confirmed that she ensures that the health and safety in the home is maintained. Accident reports are maintained and these are now recorded in a manner which meet confidentiality legislation. Borough Care audits the accidents and incidents that are reported by Bamford Close. An analysis is developed and additional risk assessment and intervention put in place if required. The manager also confirmed that electrical and gas safety checks were conducted in accordance with the relevant regulations. 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 1 9 The registered person should make sure that they are familiar with the incidents and occurrences that take place at Bamford Close that need to be reported to the Care Quality Commission. This is so that we are able to monitor how events that have had a detrimental effect on people are dealt with. The registered person should monitor the amount of time are kept waiting at the dinner table for their meals as long waits can cause people to become concerned and anxious, there by causing emotional discomfort The registered person must be able to show that the amount of money held on behalf on the residents tallies with what is recorded in the individual accounts. This is so that errors can be quickly identified and dealt with. 2 15 3 35 Care Homes for Older People Page 29 of 30 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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