Care Home: Bayford House

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What the care home does well The service makes sure that everyone is properly assessed prior to admission to the home so that the home and the people who may choose to live in it are certain that they can meet their individual needs. The home makes sure that people are very well looked after by developing excellent care and health plans, with them, so that everyone knows how to meet their needs in the way that they prefer. Staff make sure that people are always treated with respect and dignity and people said that `staff look always treat us well`. The home works very hard to make interesting activities available to people whatever their abilities or interests are. This enhances peoples` lifestyle and improves their emotional health. The home makes sure that people are offered good quality and varied meals and that meal times are pleasant and relaxed. The staff of the home have a good understanding of how to protect people from harm or abuse and people who use the service feel comfortable and safe. Changes in the environment are made to enhance peoples` lifestyle and have resulted in a homely, clean and comfortable place for people to live in. There are enough staff to meet peoples` needs, these are used flexibly to meet peoples` individual needs. The home has a very strong and effective staff team, who are highly motivated and work together to give the best quality care and to make sure people have as enjoyable and interesting a lifestyle as is possible. The home benefits from an excellent management team who are very careful to ensure they enable staff to offer high standards of care and who run the service in the best interests of the people who live there. What has improved since the last inspection? The activities offered in the home have vastly improved and everybody, whatever their ability levels and interests is offered the opportunity to participate in them. The dining room has been moved nearer to the kitchen to ensure that people are served hot food and have a pleasant dining experience. Opportunities for training have improved so that staff can offer the best possible care to the people who live in the home. The home has appointed a new registered manager, since the last inspection, who is able to motivate and lead her strong team to offer consistently good quality care. What the care home could do better: The home offers excellent care and there are no requirements or recommendations as a result of this inspection. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Bayford House Rookwood Stockcross Newbury Berkshire RG20 8LB     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: Kerry Kingston     Date: 1 8 0 6 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 29 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 29 Information about the care home Name of care home: Address: Bayford House Rookwood Stockcross Newbury Berkshire RG20 8LB 01488608632 01488658606 bayfordhouseeveryone@bupa.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): BUPA Care Homes (ANS) Ltd The registered provider is responsible for running the service care home 53 Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 53 old age, not falling within any other category Additional conditions: 0 The maximum number of service users to be accommodated is 53 The registered person may provide the following category of service : Care home with nursing (N) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Bayford House provides residential/nursing care and accommodation for 53 older people. The registered provider is BUPA Homes Limited. The home is located in the rural village of Stockcross, four miles from the market town of Newbury, and is surrounded by extensive grounds with walkways and seating provided. Care Homes for Older People Page 4 of 29 Brief description of the care home The home was built at the turn of the 20th century and has been extended and modernised over recent years to provide care for older people. There are three floors that can be accessed by lift. Rooms are mainly single and have en-suite facilities. Bayford House has an information pack available on application to the home. The fees are from approximately 600 pounds, dependant on the room and the assessed needs of the people who use the service. There are additional charges for hairdressing, daily newspapers, chiropody, taxi fares, opticians and pysiotherapy. Care Homes for Older People Page 5 of 29 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 is a report for the key inspection of the service, which included a routine unannounced site visit. This took place between the hours of 9.45 am and 5.45 pm on the 18th June 2009. The last key inspection of this service was completed on the 19th July 2007. The information was collected fromt he Annual Quality Assurance Assessment, a document sent to the service by the Care Quality Commission and completed by the manager, of the service. Discussions with three staff members, the Registered Manager and eight people who use the service, took place. Other people were observed and spoken to throughout the day. Observing the home, staff care practices and reviewing residents and other records were also used to collect information on the day Care Homes for Older People Page 6 of 29 of the visit. What the care home does well: What has improved since the last inspection? The activities offered in the home have vastly improved and everybody, whatever their ability levels and interests is offered the opportunity to participate in them. The dining room has been moved nearer to the kitchen to ensure that people are served hot food and have a pleasant dining experience. Opportunities for training have improved so that staff can offer the best possible care to the people who live in the home. The home has appointed a new registered manager, since the last inspection, who is able to motivate and lead her strong team to offer consistently good quality care. Care Homes for Older People Page 8 of 29 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 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 29 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 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a comprehensive assessment system, which is completed prior to people moving into the home, so that people can be sure that the home can meet their current needs. Evidence: Assessments for four people who have been recently admitted were seen. The deputy or manager visit people in hospital or their own homes prior to admission to complete assessment documentation which is known as QUEST, within the organisation. It is an extensive and detailed assessment of all aspects of peoples needs specifically noting any special needs or requirements. It includes areas such as mental capacity, mental stage and cognition, communication , independence, social activities, skin integrity, mobility, emotional well being, eating and drinking, medication and personal care. The assessment is completed prior to admission and reviewed within the first week after admission so that any necessary changes can be made. Assessments are further Care Homes for Older People Page 11 of 29 Evidence: reviewed a minimum of six monthly and whenever there are any changes of need, for example one persons assessment has been reviewed after every hospital admission,when they return to the home, because of deteriorating health and additional needs. People who are referred to the service via the social services department have an additional care management assessment. The involvement of other professionals, family and individuals is noted on the initial assessment. Culture,religion,disability and sexual orientation are included in the assessment process. The assessment scoring system indicates if this area of care/life needs to be added to a detailed personal plan for the individual, this ensures that it is a very person centred assessment which meets any specific needs that people have. One person spoken to said that her daughter had found the home for her, she is very happy with the choice, the home meets all her needs very well and staff know what she likes and dislikes. Another person said that the staff knew all about her and had helped her to settle in quicker than she thought she could. Care Homes for Older People Page 12 of 29 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 home has detailed care plans which include personal, social and health care needs, these ensure peoples varied needs are fully met. People are treated with respect and dignity and medication is safely administered. Evidence: Care plans are developed from the QUEST assessment paperwork, the assessment scores individuals areas of need and a detailed personal plan is developed for that aspect of care. Some areas of care have to have a detailed personal plan, such as eating and drinking, personal care, medication and all health care matters. Additional personal plans are developed for people who have specific individual needs such as communication, mobility, mental health issues and tube feeding. Care plans also include a map of life completed by the activities co-ordinator and the individual, this notes peoples life history, work, family and friends, preferences, social activities, hobbies and interests. People are encouraged to be involved in the whole care planning process and work with whole team such as the chef, activities co-ordinator and their named nurse. It is clearly noted in individual care plans how to support Care Homes for Older People Page 13 of 29 Evidence: people to maintain as much indpendence as possible, and how people make choices and decisions for themselves. Risk assessments are part of the personal plans and influence how detailed the individual plan is, so if there is a high risk then it is a very detailed personal plan. The number of risk assessments and the detail contained in them is totally dependent on the needs of the individual. Health care is included in the assessment process and care plans note that everyone has a nutritional screening assessment and skin integrity assessment. All aspects of peoples general health and well being are noted on the assessment and developed into specific, detailed personal plans, as necessary. Records are kept of all visits by other professionals, such as the G.P , community mental health nurse, visits to the falls clinic, physiotherapists and visits to the memory clinic. Weight charts are kept for everyone, completed at different intervals depending on needs. Other well being charts are kept as necessary for the individual, such as nutritional intake and fluid intake. People who live in the home are able to choose their G.P, many local people keep the one that they have always had. The home works with five surgeries and has good relationships with all of them. Doctors visit as requested and the home has also developed a positive working relationship with the out of hours service. Care plans are reviewed monthly by named nurses and are audited by the manager and /or deputy, also on a monthly basis. Qualified nurses administer medication, using the Boots Monitored dosage System, medication is securely stored. West Berkshire Primary Health Care Trust completed an in-depth audit of the homes medication policies and procedures on the 28th May 2009, there were no requirements or major concerns at that visit. Staff were observed at meal times and throughout the afternoon on the day of the visit, they treated people with respect and ensured that they helped people to maintain their dignity, at all times. All eight people spoken to said that they were always treated with respect, further comments were, staff treat me very well, they are always polite, they never embarrass you, they always make sure the doors shut and they are very patient and couldnt be kinder. When speaking with staff it was very clear that they fully understood the issues of privacy and dignity and it had become part of the culture of the home. Care Homes for Older People Page 14 of 29 Care Homes for Older People Page 15 of 29 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. The home make sure that people have as interesting and stimulating lifestyle as possible, they remain part of the community and keep in contact with families and friends. The people who use the service are offered varied and nutritional food and mealtimes are a pleasant social occasion. Evidence: The activities co-ordinator has been in post since November 2008, she works full time, including some weekends and has a part time co-ordinator to support her work. The entire staff team support the activities work participating, whenever possible, in group events and offering one to one support for people who do not like/ are not able to engage in organised activities. Catering and other ancillary staff also participate to enable people to be taken out of the home and to ensure any special occasions are a complete experience for people. For instance the home is soon to have a round the world cruise one of the countrys it will dock in is India and the deputy manager is working with the chef to produce some Indian food on that day. A pub lunch was possible because all staff participated to help transport people to and from the meal. Care Homes for Older People Page 16 of 29 Evidence: The co-ordinator develops, with the individual a map of life to see if they can identify anything that might interest them. An activity plan is drawn up for each person to take into account their choices, preferences, interests and ability level. There are two organised group activities everyday aswell as peoples individual activity plan, which may include one to one sessions, for instance one lady goes with the co-ordinator into town shopping, every two weeks, she said she really enjoys this activity but does not like to participate in group activities. The co-ordinator had an in depth knowledge of the needs of all the residents, whatever their ability level. She described how she meets peoples diverse needs by spending some one to one time chatting to some people and/or works with colleagues to provide that service,involving people whatever their skill or ability levels in the gardening project and finding imaginative activities to encourage people along who dont like organised activities, such as wood turning, PAT dogs and a bird of prey demonstration.The home has also organised a garden fete, the ice cream man visited and regular rabbit observation sessions are held. Several people told me how they had been to the pub for lunch and how they enjoyed it. The coordinator has a picture board and photo albums of people participating in some of the activities. People spoken to described activities they had participated in, said they had plenty to do if they chose to and also described how they are encouraged to join in but do not have to if they dont want to. They said that staff will spend time with them one to one if they want to do anything special. The co-ordinator also described how she will try to meet the needs of people with sensory issues or very poor health, such as mobiles , smelly flowers and photographs/pictures. One person said that she very much enjoys the art groups and likes to knit with other people. During the course of the visit people, who use the service, were very communicative, appeared content and comfortable to ask staff for help. Staff were seen to be interacting with people in a very skillful and positive way. The pictures of events in the home showed participation of family members, friends and people form the local community such as during the garden party. The visitors book showed that there are a large number of visitors to the home, people said that their sons, daughters, grandchildren and friends visited often and were always made welcome. One lady said that her daughter was not able to come often but it was not so bad because the staff of the home act as my family and make me feel safe and happy. The co-ordinator is working on trying to enable people to attend religious services in the community and to increase trips and events outside of the home, they sometimes combine with a nearby care home so that residents can meet new people and see new faces. How people make choices and what their preferences are , is clearly noted in their care plans and residents said that they make decisions for themselves, including when to get up and go to bed, what to wear and what to eat. The chef uses BUPAs menu master system to develop menus, this is a system which Care Homes for Older People Page 17 of 29 Evidence: advises on the nutritional value of foods and ensures that people receive a balanced diet. Ordering is corporate but the chef is very aware of the quality of produce and makes her views known if there are any issues with this. The chef has a monthly budget which she reports as adequate although the special occasions catered for as part of the activities programme can be a bit of a strain on the budget. The kitchen participate fully in the activities programme such as the virtual world cruise, the garden party and firework night. The chef has an in depth knowledge of the residents likes/dislikes and nutritional needs. She said that she meets with them as soon as possible after admission to check their individual needs/preferences, this is usually on the first day of admission. The dining room, which has been moved nearer the kitchen so that the food is served fresher, is attractively laid out for lunch with individual place settings and flowers on the tables. People are actively encouraged to eat in the dining room but they also have the option of a small dining area on the ground floor and they can choose to eat in their rooms, if that is their real preference. Lunch was observed to be a very calm and social event, people had different food if they didnt want to choose one of the two choices on the menu. They were routinely offered more food and a glass of sherry is supplied to those people who want it, soft drinks are available for those who dont. People said the food is very good , sometimes too much of it but that s much better than not enough, we can have a snack whenever we want, they always give you something you like and the food is lovely, couldnt be better. Cooks work from 8am to 8pm , seven days a week and also prepare a Nite bite menu, this consists of snacks that people can have at anytime throughout the evening and night, including sandwiches and biscuits. Care Homes for Older People Page 18 of 29 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 home listens to peoples complaints and they are confident that something will be done about them. People feel safe and comfortable and are kept safe from all forms of abuse or poor care practice. Evidence: The homes complaints procedure is displayed by the main door and everyone who uses the service has a copy of the policy and procedure. The home has received one complaint since Jan 2009, this was fully investigated, was upheld and the complainant was satisfied with the outcome.The provider and registered manager audit complaints monthly to ensure that appropriate action is taken if complaints are repeated or establish a pattern. The home has received nineteen compliments about the standard of care given to the people who live in the home and I received many more on the day of the inspection visit, from individual residents. The home has comprehensive safeguarding policies and procedures, which include whistle blowing and staff standards of conduct. All staff including ancillary staff have safeguarding (POVA) training which is up-dated as necessary. Safeguarding leaflets are distributed throughout the home, to ensure everyone has access to them. Care Homes for Older People Page 19 of 29 Evidence: I spoke with three staff who gave very positive responses to how they would protect the people they work with and were very committed to their well-being. An incident of whistle blowing was described and staff felt it had been dealt with quickly and in the best interests of the people who live in the home. The registered manager confirmed that the home does not use any type of physical intervention but staff are receiving training to help them manage people who may be developing dementia. People who use the service spoken with said I feel very safe, I would talk to the deputy or the manager if I had any concerns, of course I know how to complain but I have never had cause to make one, you could trust these staff with anything, I always feel safe and comfortable, if you have the slightest concern you can talk to one of the staff and they will put it right for you. The Commission has received no information with regard to complaints or safeguarding issues about this home. Care Homes for Older People Page 20 of 29 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. People are provided with a pleasant, homely environment to live in, which meets their group and individual needs. Changes are made to the home to enhance the daily lifestyle of the people who live there. Evidence: The house is an old building adapted to meet the needs of a group of elderly people. Peoples rooms are adapted to meet their specific needs such as special beds, lifting/handling equipment and mobility aids. The home is registered for 53 people but the registered manager said that it can only comfortably accommodate a maximum of 41 and they would not admit any more than that, unless a couple wanted to share. The dining room was recently moved to be nearer to the kitchen to improve the quality of food and mealtimes for the people who live int he service. The home is very well kept, clean and hygienic, there were no odors evident and vases of flowers around the home made it feel homely and cared for. People said, its always kept so nice, its always like this it hasnt been done for your benefit its done for ours. The kitchen received a five star , excellent rating from the environmental health officers inspection in April 2009. Care Homes for Older People Page 21 of 29 Evidence: The laundry was very orderly, clothing is pressed and well cared for, enabling people to present themselves as they choose, residents looked very smart and individual, according to their personal tastes. The garden is well kept and maintained so that people can make good use of it comments included, I love the garden, we use it all the time, the grounds are very nice and we have garden parties . Care Homes for Older People Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager ensures that the number and skill mix of staff are able to meet all the assessed needs of the people who use the service. Staff are well trained, committed, work as a team and able to offer people the best possible care . Evidence: The home has a large care and nursing team, supported by a team of ancillary staff. The home rarely uses agency staff, staff shortfalls are covered by bank staff or more often staff doing overtime shifts. The manager adjusts staffing numbers,dependent on how many people are in residence. The minimum staffing when the home has 41 people in residence is ten in the morning and seven in the afternoon, these numbers do not include the activity co-ordinator, the manager or other non-direct care staff. There are a minimum of two qualified nurses on duty. The manager explained that she bases the staffing ratios on the layout of the building and peoples individual assessed needs. Recruitment of staff is no longer a problem for the home, which is consequently almost fully staffed. Recruitment records for three staff showed that the home has all the necessary Care Homes for Older People Page 23 of 29 Evidence: paperwork, to ensure the suitability of staff to work there, prior to appointment. The home has induction portfolios, a mentoring system for new staff, supervises staff a minimum of 2 monthly and a comprehensive training matrix for all staff. The manager co-ordinates all training and supervision and checks supervision records for all staff including those supervised by other senior staff. The AQAA states that 13 of the 22 care staff have an N.V.Q 2 or above qualification. The manager and staff talked about their commitment to training, staff confirmed that they received all the necessary mandatory training and were given the opportunity to attend training appropriate to their role,any which will benefit the people in their care and professional training. The deputy manager described the personal best programme which is a training course outlining the principles of customer care and helps staff , in whatever role, to always do their best to adhere to good practice and fulfill their role to a high standard. The morale of staff appeared to be high, there is very little short term sickness and staff work as a team. Staff were observed treating people with great respect and care, for instance, not rushing them at lunch, communicating with people at all times, offering choices and sharing news and information with them. The Chef came to dining room to ask if everything was OK and staff in the small dining room were observed offering choices and encouragement to people to make their own choices. Some of the comments people who use the service made were, the girls are lovely, the staff always treat you well, theyre more like family than staff, everyone knows what theyre doing and theres always someone there if you need them. Care Homes for Older People Page 24 of 29 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. The home is very well managed , in the best interests of the people who live there. People are kept as safe as possible by adherence to Health and Safety procedures and policies. Evidence: The manager has been a deputy since 2002, she has been in post since the previous manager left and was registered in October 2008. She has nearly completed her Leadership Management in Care Services (LMCS) qualification. Staff and people who use the service are very positive about the management of the home staff comments were the best manager I have worked with, supporting, motivating , approachable and she always helps you to find a solution,she has definitely improved things and is a good manager, it is an excellent home, things have really improved, the manager is very supportive and approachable. People who use the service commented, the manager is very approachable, she always has time to listen and theyre always doing things to make it nicer to live here. Care Homes for Older People Page 25 of 29 Evidence: The home has a robust Quality Assurance system which is still developing, this includes monthly audits by the manager and deputy they cover areas such as care plans, medication, pressure areas,complaints and safeguarding training. Incidents and accidents are audited quarterly. Annual questionnaires are sent to people who use the service and other interested parties. The annual development plan is developed by the manager for the following year, it is regularly monitored. Different aspects of the running of the home are monitored at different intervals depending on need, the manager will closely audit an area of care until she is sure that any concerns or issues have been resolved. Personal contact by the manager with the people who use the service is also used as a quality monitoring tool. The home, nor staff within it act as appointees for any of the people who live there, some people are able to order their own finances others have families who do it on their behalf, the local authority or an outside advocacy group do it if there is no appropriate family to assist. The administrator has a thorough understanding of the financial systems and all monies are kept safely. They use a pooled bank account for personal expenses but people are able to easily find out how much they have individually and receipts are kept as necessary. The home has a financial audit form head office on a regular basis. The manager completes a monthly health and safety audit, maintenance and health and safety checks are completed by the maintenance man/gardener. He is trained in any areas necessary, such as PAT testing, he completes monthly water temperature checks and checks other areas as necessary. All staff regularly receive health and safety training, with up-dates as necessary these include infection control. Accident and incident forms are detailed and audited to ensure any action that needs to be taken to mininmise potential risk is taken in a timely manner. Care Homes for Older People Page 26 of 29 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 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 28 of 29 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. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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