Care Home: Beatrice Court and City Gate Lodge Home

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What the care home does well Beatrice Court & Citygate Lodge focus on delivering person-centered care, maintaining and encouraging choice and autonomy throughout. They focus on the people that use the service taking ownership of the home and having a lifestyle of their choice and expectation. They continue to provide high standards of individualised care in a warm, homely environment where individuals feel safe, secure and valued. Staff are well trained and encouraged to develop their skills further with regular training updates that incorporate changes in best practice and legislation. The environment is homely and kept clean and tidy, free from odours, with health and safety issues given a high priority. What has improved since the last inspection? The home have sourced training schedules for those staff who wish to further advance in the role of activities and therapies such as aromatherapy and reflexology. The manager has built up greater links with further education facilities for people that use the service so they can access same if they so wish. The home has provided new furniture and furnishings in some areas of the home and redecorated numerous bedrooms, main lounge and communal areas throughout the home. NVQ training has continued throughout and most of the care staff have NVQ 2 and more have progressed and have completed or are completing NVQ 3. Qualified Staff have had greater scope to access training in order to progress their skills and make valued contribution to their roles within the home. What the care home could do better: The manager hopes to have the provision of specialised equipment, such high profile electronic beds and recliner chairs and will endeavor to purchase them as required. The manager plans to continue with the upgrading and refurbishment plans, installing new furniture where necessary and redecorating further communal areas and bedroom facilities. No requirements were left at this inspection. Key inspection report Care homes for older people Name: Address: Beatrice Court and City Gate Lodge Home 36 St John`s Street Lichfield Staffordshire WS13 6NZ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Joanna Wooller     Date: 1 6 0 9 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 29 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 29 Information about the care home Name of care home: Address: Beatrice Court and City Gate Lodge Home 36 St John`s Street Lichfield Staffordshire WS13 6NZ 01543418341 01543418583 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Restful Homes Limited care home 128 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 128 The registered person may provide the following category of service only: Care Home with Nursing (Code N); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 128 Dementia (DE) 128 Physical Disability (PD) 128 Date of last inspection Brief description of the care home Beatrice Court and City Gate Lodge is a Care Home that provides personal and nursing care to 128 people. The main building has nursing staff on duty over a 24-hour period. It comprises of a 2 and 3 storey building and has several communal areas and a hairdressing salon. All parts to the home can be accessed via passenger lifts. There are small garden areas and court yard car parking. Care Homes for Older People Page 4 of 29 Over 65 0 128 0 128 0 128 Brief description of the care home City Gate Lodge is set in the same grounds and offers individuals personal care. Both units share a large kitchen and separate laundry. The whole complex is set in a town location close to Lichfield Cathedral and Beacon park. Visitors using bus and train services can easily access the home, as there is a bus station and railway station in close proximity. The registered care manager (RGN) is in charge of the home. First level nurses (both RGN and RMN), and teams of care assistants, provide care. Local GP practices and a pharmacist service the home. Community nurses, health service professionals, and NHS facilities are accessed as and when required. Several local GP practices and a pharmacist service the home. Activities, hobbies and entertainment take place with transport provided as required. 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: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means that that people who use this service experience good quality outcomes. This unannounced inspection took place on 16th September by one inspector over one day. The Manager was in the home and participated in the inspection process. The inspection included the following elements, a walk around the building, observation and inspection of records relating to provision of care, discussions with people, who use the service, case tracking whereby we select several people who use the service, chat to them and look at their care plans and lifestyle in the home. discussions with several of the staff members on duty, observation and sampling of other services provided such as catering and an inspection of the managerial aspects such as staffing issues, training, recruitment and health and safety. Care Homes for Older People Page 6 of 29 We were made very welcome in the home and all assistance was given to gain the evidence required for the report. We had dealt with no complaints since the last inspection. People who use the service were happy with the service and they told us the staff were very professional, kind and considerate. The home manager sent us their annual quality assurance assessment (AQAA) when we asked for it. This document was completed to a good standard and gave us all the information we asked for. The fee information given applied at the time of the inspection; persons may wish to obtain more up to date information from the service. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 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 9 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People moving into the home do so having had their needs fully assessed and assurances are given that they will be met. Evidence: The Aqaa told us Beatrice Court & Citygate Lodge is divided into seven separate units that allows us to closely tailor our provision with the needs of our residents. Through this flexibility we are able to fully meet all of their assessed needs and expand on same throughout as these needs may change. We strive to create a friendly, welcoming atmosphere in which we endeavor to give and receive information throughout with all prospective residents and/or their representatives; to ensure that we can provide the highest standards of care for each individual with as much knowledge gained as possible about them. We are committed to communicating with both residents and their families as much as possible and management is always available to discuss any aspect of life and the provision of care at Beatrice Court & Care Homes for Older People Page 10 of 29 Evidence: Citygate Lodge. We saw that people who are considering moving into the home or their representatives are invited to look around the home at a time that is convenient to them. The home provides a service user guide, terms and conditions and statement of purpose to each one viewing. We were told that the manager and her staff spend time getting to know the person to ensure that their needs can be met and their choice is appropriate. We saw evidence that the home do not accept emergency admissions without comprehensive pre-assessments. The manager told us that all preassessments are carried out thoroughly and should they show that the individuals needs could be met at Beatrice Court & Citygate Lodge or the person would not feel happy in the environment, then this information is given back to the individual, social worker or representative as to why we feel their placement would not be appropriate. We saw that every person entering the home has their own individualised careplan implemented and the careplan is verified by all those involved and signed in agreement to the care needs identified. Intermediate care is not undertaken in our Home. The manager told us The home have a website for the Homes group which affords prospective residents virtual tours of the Home. People that used the service told us Everyone made us welcome from day one, I never worry about my mother. I did not look at any other homes, its marvelous here. The staff are very friendly. Care Homes for Older People Page 11 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that use the service have their health, personal and social care needs set out in an individual care plan. They are able to make decisions about their care including the assistance required with medication administration. People living in the home feel that they are treated with respect and their right to privacy is upheld. Evidence: The Aqaa told us All careplans are individually and appropriately written to each residents needs and wishes. Careplans are updated regularly and changed accordingly in order to ensure that the individual needs are met throughout. These reviews and updates are carried out in conjunction with the resident and their representative where appropriate. Risk assessments are established within the careplan in relation to tissue viability, falls, moving and handling and malnutrition and needs identified from these assessments may result in using specialised equipment as appropriate. Residents have stated that they feel the care is good, carried out at all times with dignity and respect and meets their changing needs throughout. Staff always knock on doors before entering, announce who they are and explain how they are going to offer assistance. Staff give residents time to express themselves throughout whilst Care Homes for Older People Page 12 of 29 Evidence: respecting privacy and promoting dignity. All staff have full induction and continuous training therein to enable them to care at the highest levels for all residents with utmost understanding and ensuring they assist residents in fulfilling their potential with choice and autonomy. Focusing on promoting and maintaining individual independence, supporting choices and decisions made, staff assist each resident in taking appropriate risks and setting attainable goals. Risk assessments are in place to appropriately establish those individuals who may self-medicate and the Home has a policy for same; along with policies for the Safe Handling and Administration of Medication, Receipt of Medicines and Disposal of Medications. We have two local retained GP practices who each carry out twice weekly rounds in order for all residents to access this facility and meet their needs. The GPs work closely with the Trained Staff and have an excellent working relationship. Meetings with GPs and Senior Management regularly take place and have been most beneficial in progressing our holistic care approach; new legislation, formularies are discussed and incorporated as required. Residents who wish to retain their own GP may do so with the consent of that GP. All residents are able to access NHS facilities, external professionals and specialists as required. Evidence of good relationships formed with these professionals is found in their documentation within the careplans. All residents are able to access NHS Chiropody and Dentistry by direct referrals being sent from the Home on admission. We saw that all health, personal and social care needs are documented as appropriate and the documentation is meaningful, well written and states clearly the current condition of each person. There was evidence that two local retained GP practices carry out twice weekly rounds in order for all persons to access this facility and meet their needs. The GPs work closely with the trained staff and it was evident that they have an excellent working relationship. We saw that meetings with GPs and Senior Management regularly take place and have been beneficial in progressing with the homes holistic care approach. The home have a twice weekly visit from community psychiatric services and a Consultant Psychiatrist who visits the home every two months to further assist all those requiring this intervention. This has given the people a greater intervention with holistic care and allows them to lead a more controlled, calm life. The home use the IMCA services for those people requiring advocacy. People that use the service told us We are very happy with the care in the home, the staff inform us of any changes and any issues. We look at the care plan and sign it monthly, they are a very caring team. They respect peoples dignity and are compassionate to people, I watch the staff when i am visiting and they are very professional. I visit at differing times of the day Care Homes for Older People Page 13 of 29 Evidence: and the staff always welcome me and my relatives. One lady told us I am more than happy here, its nice. Care Homes for Older People Page 14 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home find that their lifestyles match their expectations, they maintain contact with family and friends and have choice and control over their life. People receive a wholesome, appealing balanced diet in pleasing surroundings at a time convenient to them. Evidence: The Aqaa told us At Beatrice Court & Citygate Lodge we provide a range of daily planned activities around the likes/wishes and requests of the residents therein. Preassessments assist in gathering initial information on a residents preferred social activity and their hobbies, which incorporated into their careplan are developed as much as possible; in accordance with risk taking, health conditions and physical/mental status. Some of our residents have been able to access and benefit from weekly outings to both the over 60s club and stroke club. We have an open visiting policy for all relatives/friends in accordance with each residents wishes and we provide meals throughout for those who visit around mealtimes should they require same. All residents are able to enjoy the company of their visitors within the communal lounges, own rooms or relatives room as to their own preference. Residents are able to have their own phone lines in their own rooms and some also choose to use mobile phones or e-mailing facilities on their own computers. Residents Care Homes for Older People Page 15 of 29 Evidence: are able to access local amenities with assistance of staff members and/or their representatives as we are so close to the centre of Lichfield. Excursions are arranged to the local garden centres, tea rooms and parks as and when residents wish to go. We provide regular in house entertainment and at special events during the year; such as Halloween, Remembrance Day, Christmas and New Year, with a variety of external entertainers providing songs/music and reminiscence. we generate posters advertising same to all areas of the Home in order for all to be invited. The Head Chef maintains auditing of his menus and finding out residents likes/dislikes and appropriately actioning any changes due to same within the menus and provision of foods throughout. All special dietary requirements whether due to health, religion or cultural preferences are catered for. Fresh good quality food is sourced from local suppliers who deliver regularly throughout each week. All residents are able to request where they have their meals, whether it be at the dining tables, or on vari-tables in the lounge or in their own room and their choice is documented accordingly. Staff assist those residents who may not always be able to communicate their decision re: choice of meal by using their knowledge of likes/dislikes. Staff assist residents to eat in an discreet manner at all times to promote good nutrition and maintain dignity. We saw that staff encourage all people living in the home to participate in the Home activities ensuring choice and autonomy are maintained. A variety of activities take place from active games to board games. Individuals are able to have their own phone lines in their bedrooms and some also choose to use mobile phones or emailing facilities on their own computers. We saw that the home have a main hairdressing salon for all to use, and the hairdressers will make visits to individuals in their own rooms, if requested to. The hairdressers are in the home up to five times a week. We saw that staff assist those people who may not always be able to communicate their decision with the use of their personal history. The staff were seen to assist people to eat in an unhurried and discreet manner, to promote good nutrition and maintain dignity. We saw that people were given a choice with regards to where they ate thier meal. People that use the service told us The staff keep the people motivated through talking to them and some activities. I always find that if I am here at lunch time, the staff assist those people that need feeding with compassion. The activity girl is very nice. One lady was seen having her nails manicured and she interacted with the manager to have a chat. On one of the units a gentleman was seen enjoying a ball game with a Care Homes for Older People Page 16 of 29 Evidence: member of staff, and a lady was reading her book. Staff were seen to observe the individuals well. Care records stated the activities they had been involve with during the day. We met with the chef on duty, the kitchen had been awarded a 3 star rating for Rate my Place, issues relating to lack of paper work had been corrected and the environmental aspects of the kitchen were noted to lower the score due to the age of the building. Meals were delivered to the units in hot trolleys for the staff to individually serve. One lady told us The food is lovely and choices were always given. Care Homes for Older People Page 17 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that use the service are confident that their complaints will be listened to, taken seriously and acted upon. People are protected from abuse. Evidence: The Aqaa told us Residents are protected throughout from any form of Abuse. All staff are fully vetted prior to employment including POVA(Protection of Vulnerable Adults),two references and CRB(Criminal Records Bureau) checks. Staff receive POVA training on induction and continuous updates throughout their employment. Staff have received training in the Mental Capacity Act and are aware that residents capacity may change on a daily basis and learn to assess this on each individual decision. Staff have had new legislative training on DOLs (Deprivation of Liberties) and this leads on from the above capacity issues and further need to assess residents and ensure they are protected throughout. Complaints or queries are dealt with immediately and residents/relatives are assured that should they have any complaints/queries or suggestions for improvement that they will be listened to and improvements will be actioned promptly and appropriately. We maintain a culture and ethos that inspires confidence and open interaction with all, ensuring good communication at all times and therefore reducing complaints as through good communication we are better able to meet our residents current needs and anticipate their future needs. Residents and their representatives are encouraged to voice any concerns they may have. We saw that the homes ethos inspires confidence, ensuring good communication at all Care Homes for Older People Page 18 of 29 Evidence: times and therefore reducing complaints as through good communication they are better able to meet the individuals current needs and anticipate their future needs. Everyone in the home is encouraged to voice any concerns they may have. The home has an open door policy so that the Manager is always available to discuss any issues and this extends to the trained staff who will always set aside time to address any issues that arise immediately. The homes complaints procedure is clearly written and openly accessible to all. All new admissions are informed of this procedure and are fully supported by the staff in making a complaint. We saw that all complaints received are recorded, and the action taken and the outcome are documented. The manager showed us that they had received many thank you cards and written compliments from appreciative families and these were available to be read in the homes reception. We saw that advocacy service information is provided and accessed as required. The homes policies and procedures for ensuring the protection of people using the service are used in staff training, regularly reviewed and updated. The policies clearly outline who to contact internally or externally if an incident should occur. No complaints had been received by CQC, and only one received in the home which has been dealt with. There had been one safeguarding alert which had been resolved through strategy meetings with the multidisciplinary team. The staff had been trained to deal with looking for signs of abuse and how to report it. One lady told us If I had a problem I would speak to the nurse in charge or the manager, they are more than happy to deal with any concerns or issues that I might have. Care Homes for Older People Page 19 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that use the service live in a safe, well maintained environment that is clean, pleasant and hygienic. Evidence: The Aqaa told us We provide a homely, pleasant, hygienic environment that is free from unpleasant odours where health and safety matters are paramount. We have risk assessments in place to safeguard the residents within the environment and staff training is at the forefront to continue this safety aspect. All staff have training in Health and Safety, Infection Control, COSHH etc. We have a full complement of ancillary staff who strive to maintain the cleanliness of the Home at all times. We incorporate an external health and safety auditor with our in house audits to maximise environmental issues. We have maintenance contracts in place to ensure all equipment used is safe and of appropriate standards including gas boilers, emergency lighting, nurse call system etc. All residents rooms are either fully en-suited or contain handbasins; those that are not en-suited are situated alongside bathrooms and further toileting facilities. All equipment required to maximise residents independence is provided within the Home. Access to specialist equipment is sought and assisted provision is made as and when required. The Home has small enclosed gardens as well as open aspect patio frontages to the building which are accessible to all residents and are utilised throughout the year in accordance with residents wishes. Our laundry is separated into clean and dirty access areas with separate entrances/exits. Each Care Homes for Older People Page 20 of 29 Evidence: resident has their own named laundry storage box to hold their named clothing in, following the laundering processes and are put back in their rooms following same. We evidenced that no infection control issues had been reported. The home was clean, tidy and in good order. No malodours were noted, and the environment was well kept. One lady told us The home is always clean and tidy, obviously sometimes if the staff are busy things can look untidy, but the first chance they get the home is looking its best. The staff work hard together to keep everywhere homely and fresh. One staff member told us We work together to keep the home looking nice for the people who live in it. We saw that environmental risk assessments were in place including prevention of falls for those more mobile individuals. Care Homes for Older People Page 21 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that use the service have their needs met and are kept safe by the number and skill mix of staff. The homes recruitment policy and practices protect the people living in the home. The staff are trained and competent to do their jobs. Evidence: The Aqaa told us We have a full complement of trained, care and ancillary staff within the Home. we do not use agency staff of any kind as we have a reliable team of staff and a large bank of relief staff who have been trained by us and who are aware of our ethos of care. Our staff come from a variety of different cultures and backgrounds and are trained to the highest standards throughout. We saw that all recruited staff have full POVA/CRB CHECKS in place prior to commencement along with references, PIN number verification and previous training certificates verified. There was evidence that all the staff employed at the home were issued with terms and conditions of employment, job descriptions and contracts of employment. Each individual member has an employee handbook, personnel file and training file all in house and external training is recorded in this document. There was evidence that mandatory training is upheld yearly. We evidenced that the staff had a good knowledge of each individual including their lifestyle choices to ensure they are maintained. We saw and relatives confirmed that the staff assist to the best of their abilities in giving quality of life to all throughout. The manager encourages the staff to Care Homes for Older People Page 22 of 29 Evidence: complete their minimum NVQ 2 qualification and over 65 have achieved this with the majority of the rest of the staff planning to complete it. The manager told us that Valuing their staff is paramount to the smooth running of the Home and all are given support and encouragement in further advancing their skills/learning opportunities, ultimately ensuring greater benefit to all our service users. The staff ensure that independence is promoted and choice is at the forefront of each residents lifestyle in Beatrice Court & Citygate Lodge. There was evidence that through induction training and continuous development training all our staff benefit from this knowledge and this assists in meeting the needs of all different registered client groups. Good knowledge of each individuals ensures that their lifestyle choices are maintained and that staff assist to the best of their abilities in giving quality of life to all throughout. Staff are encouraged to complete their minimum NVQ 2 qualification and over 65 have achieved same with the majority of the rest of our care staff signed up to this study. The home have established and maintained a good study/work/development relationship with the local college which assists in meeting the training needs of all of our staff. There was evidence that all people that live in the home are assessed in their dependency and the Home is staffed in accordance with these assessed needs. Staff were keen to speak to us and were happy in their work. There was a warm ambiance in the home which relatives told us was the norm. Care Homes for Older People Page 23 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home which is well managed by a person of good character. The home is run in the best interests of the people living in it and their financial interests are safeguarded. The health, safety and welfare of people who use the service and the staff are promoted and protected. Evidence: The Aqaa told us The Registered Manager has a wealth of experience within the Care Home Sector, along with thirteen years of Care Home Management and RMA status. She upholds an open and inclusive atmosphere within the Home and supports the staff personally and professionally. She competently strives to safeguard the best interests of the residents with high standards maintained and delegated through to all staff/personnel working within the Home. The Manager has a clear sense of leadership which in turn enables the staff to relate to the ethos, aims and objectives of the Home, ultimately increasing awareness of residents needs and providing the best outcomes for them. The Home maintains its ISO9001 Certification and Accreditation with Policies/Procedures and Quality Assurance. We use external auditors in particular Care Homes for Older People Page 24 of 29 Evidence: regard to Health and Safety and have dedicated helplines with them should we require advice on any health/safety issue. The Home is financially viable and Directors use suitable accountancy and budgeting procedures at all times. The Financial Administrator maintains personal ledgers for the residents which are correct and auditable. Residents who wish to handle their own finances are encouraged to do so. Valuables and belongings that are brought into the Home are documented in property/valuables books. Accident/incident forms are regularly audited to check for patterns that may have formed and introduce changes or measures to reduce the occurrence of same happening again. We regularly audit and use Reg.26 forms, quality assurance/feedback forms to ensure quality of services that are provided. Our employers/public liability insurance certificates are up to date and prominently displayed in Main Reception. We have up to date records for the maintenance of the Home including lifts, fire equipment, gas testing, hoists, electrical installation tests, portable appliance testing, water temperatures, emergency lighting and call bell panels. Policies and Procedures within the Home are appropriately actioned and are regularly reviewed/updated to ensure the health, safety and wellbeing of residents are paramount. Staff and residents have access to all Policies and Procedures and updates or new legislation is passed on efficiently to all. We evidenced that the registered manager is competent to run the home and openly meets the companys aims and objectives. The manager is able to demonstrate through qualifications, experience and ability that she is competent in care of older people, quality assurance systems, she has good people skills and strong leadership of her staff which leads to confident workers. Other professionals told us that they know the manager consistently provides a good quality services. The CPN (Community psychiatric nurse) told us that the staff were well managed and their interaction with the people using the service was avoiding them being transferred to acute hospital beds. The home uses audits to assist in maintaining good standards throughout the home and we saw positive feedback from relative surveys sent out from the home. Comments included Everyone is kind and caring. Kind, caring and thoughtful, its lovely. Very good quality of care. Good friendly atmosphere, nicely decorated. The home actively encourages individuals who wish and are capable, to manage their own money and valuables, making sure they have the facilities to do this safely. The registered persons are committed to ensuring the health, welfare and safety of the people that use the service and the staff. We saw evidence that the ethos of the home Care Homes for Older People Page 25 of 29 Evidence: is open and transparent with the views of both staff and people that use the service are listened to, and valued. 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 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 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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