Care Home: Blackbrook House

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What the care home does well People living in Blackbrook House were happy with the standard of care being provided to them. Residents who completed our surveys were very complimentary about the care provided in the home, and their comments have been included within the main body of this report. People were supported by a competent, stable staff team. Relatives and people living in the home were complementary about the staff. The home encourages and promotes the involvement of family and friends. Relatives we spoke with told us that they are always made welcome in the home and are consulted with about their relatives care. The service deals with minor concerns as and when they arise and this helps to ensure that small issues do not escalate into complaints. People living in Blackbrook House are provided with a healthy and nutritious diet. Residents described the food provided as lovely. What has improved since the last inspection? Cleaning materials that are being used in the home are now locked away securely in a cleaning cupboard to which only senior care staff and domestic staff have access. What the care home could do better: No requirements or recommendations for good practice were made as a result of this key inspection. The service needs to continue to build upon its foundation of current good practice. Key inspection report Care homes for older people Name: Address: Blackbrook House Gun Hill Dedham Colchester Essex CO7 6HP     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Neal Cranmer     Date: 1 1 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Blackbrook House Gun Hill Dedham Colchester Essex CO7 6HP 01206323496 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: martin.murphy2@btconnect.com Carefore Homes Limited care home 52 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 registered provider may provide the following categories of service only: Care home only Code - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category Code - OP. Dementia Code - DE. Physical disability Code - PD.The maximum number of service users who can be accommodated is:52 Date of last inspection Brief description of the care home Blackbrook House is owned by Carefore Homes Ltd. It is a purpose built home set in its own grounds and was first registered in June 2007. The home is set in a rural location on the outskirts of the village of Dedham. The home is near to the A12 and approximately five miles from Colchester. There is a limited bus route between Colchester and Ipswich, which passes in front of the home. There is ample car parking on the site. Care Homes for Older People Page 4 of 28 Over 65 0 52 0 52 0 52 Brief description of the care home The home can accommodate up to 38 older people in two separate units. The dementia care unit is on the ground floor and is for up to 18 residents. The general care unit is on two floors and is for up to 20 residents over the age of 65 year who require personal care. The home can also accommodate up to 2 people with a physical disability. The fees at the time of inspection in December 2009 were £740 per week. Additional charges were made for hairdressing, private chiropody, private physiotherapy, manicures and pedicures, dry cleaning, toiletries and newspapers. For the most up to date information on fees please contact the home directly. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: A range of evidence was looked at when compiling this report, including care plans, rotas, menus and personal files. The manager completed an Annual Quality Assurance Assessment (AQAA), which is required by law to be completed by the service, with information about the home and sent it to us at the Commission when requested. Throughout this report this document will be referred to as the AQAA. A visit to the home took place on the 11th of December 2009 and included a tour of the premises, discussions with people living in the home, visiting relatives and members of the staff team. Completed surveys were received from people living in the home and members of staff, and we spoke with a number of relatives who were visiting the home at the time of our inspection. Observations of how members of staff interacted with and communicated with people living in the home have also been taken into account. Care Homes for Older People Page 6 of 28 On the day of the inspection we were given every assistance from the manager and the staff team. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents can expect their needs to be assessed prior to their admission to the home. Evidence: The home had a Statement of Purpose and Service Users Guide which provided prospective residents or their representatives with all of the necessary information that they needed to make an informed decision about the homes ability to meet their assessed needs. This information included details about the homes admission criteria, the registered managers and staffs experience and qualifications, the homes organisational structure, the accommodation provided including room sizes, the fees for residing in the home including what was and was not included, and reference to the homes complaints procedure. As part of our inspection we sent out a number of residents surveys, twenty of which were returned, all of which with the exception of one said that people had received enough information to help them to decide if the home was the right place for them. Both documents were last updated in June 2009 Care Homes for Older People Page 10 of 28 Evidence: and provided people with a good level of information to enable them to make an informed decision. The manager told us in the AQAA, We undertake a full and detailed pre-assessment for all prospective residents, this ensures that the resident, residents family/representative and the staff can form the basis of the individual need/care plan that will identify how we can meet these needs. All of the care plans examined contained copies of a pre-admission assessment, which had been undertaken by the homes registered manager or a representative of the home in the absence of the manager. The assessments were seen to gather information about peoples needs around the following areas: communication including sight and hearing, personal hygiene, mobility and dexterity, moving and handling needs, tissue viability, nutrition and hydration, mental state and cognition, and social interests and hobbies. Although none of the residents we spoke with were able to recollect their needs having been assessed, two visiting relatives said that they recalled being actively involved in their relatives assessment of need and said that they clearly recalled the registered manager visiting their relative to carry out an assessment. We determined that the level of information gathered from the assessment process was sufficient to enable residents needs to be identified. Care Homes for Older People Page 11 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can expect their personal healthcare needs to be identified and to be provided with the support to ensure that their needs are met as they would wish. Evidence: The manager told us in the AQAA, We actively involve family members and friends along with the resident to formulate a plan of care that is both individual and informative. By doing this we can identify what areas may need further support whilst ensuring that the individuals needs can and will be met. A sample of seven care plans were examined on the day of the inspection. The care plans clearly identified the need, the desired outcome for the person and the actions to be taken to meet the identified needs. All of the care plans examined were based upon the activities of daily living e.g meeting personal hygiene needs, eating and drinking. Guidance provided to staff to enable them to assist people were clear and unambiguous, and staff spoken with on the day of the inspection said that they felt the care plans provided them with the Care Homes for Older People Page 12 of 28 Evidence: necessary level of information that they required to be able to support people effectively. All of the residents surveys returned when asked Do you receive the care and support you need replied Always. All of the staff surveys returned indicated that staff were always given up to date information about the needs of the people they were supporting and caring for. People living in Blackbrook House and their relatives made positive comments about the care provided in the home, these comments included The staff are always helpful, nothing is to much for them. A relative spoken with said I am pleased with all aspects of my relatives care. The manager told us in the AQAA, All residents have access to a G.P. primarily located in the Dedham area. each resident can see their G.P. in the privacy of their own room with or without a member of staff, we have set up a open clinic on a Friday morning where residents can see the G.P. for no urgent issues. Each resident has the opportunity to visit the G.P practice if they wish to see a specific G.P. Arrangements will be made for transportation and escort to the surgery for these appointments. Once again residents can be accompanied for their appointment with the doctor if they so wish. Care plans examined contained records of how people are supported with their healthcare needs. There were details of visits from healthcare professionals including G.Ps and district nurses. At the time of our inspection visit district nurses were visiting the home twice weekly. Evidence was seen to confirm that a G.Ps surgery was being held in the home every Friday has stated in the AQAA, and some of the residents spoken with said that they had attended. All of the residents surveys returned said that the home always ensured that they received the medical care that they needed. Relatives spoken with said that they were always kept informed if their relative was unwell. The manager told us in the AQAA, The home has a stringent policy and procedure on all medication ordering, storage dispensing and recording of such medication. Staff training is paramount to ensure compliance, competence and adherence to the policy. The homes Medicines Administration Records (MAR) sheets were examined and were found to be appropriately completed with no evidence of any gaps or omissions. The homes controlled drugs ledger was also examined and found to be in order. The lunchtime medication round was observed in one area of the home, medications were dispensed on time and residents were seen to be well supported by staff during the administration round. Staff were seen and heard explaining to people that it was their medication and time was taken to allow people to understand. Medication is only dispensed by the senior care officers, seniors and all of the homes night staff, but Care Homes for Older People Page 13 of 28 Evidence: only upon completion of training provided by the homes dispensing chemist. Sampling of training records indicated that those involved in the dispensing of medicines had received the appropriate training. The manager told us in the AQAA, The staff under the direction of the senior team ensure that all residents receive the personal care that they need in accordance with the identified needs within the care plan. Careful attention is paid to their privacy and dignity when assistance is being given to the resident. it was evident from our observations that people were treated with courtesy and respect. Interactions between staff and people living in the home were friendly and respectful. residents spoken with said that nothing is to much for the staff, you only have to ask and they will do anything for you. Other comments received from surveys returned included: All of the nurses are very helpful Its friendly They do very well with everything, thats why I decided to stay Its a nice warm atmosphere. A member of staff who completed a survey told us when asked what the home does well , Care of the residents, family and friends, it is a very inviting home and they cater for every individuals needs. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home can expect to enjoy a lifestyle that meets their wishes, needs and interests. Evidence: The manager told us in the AQAA, Blackbrook House is a home that actively encourages all aspects of social activity whether it is something that the resident enjoyed when living at home or whether it is an activity that they have never tried. Records examined showed that the home was providing a range of activities including arts and crafts, a lady visits the home twice weekly to provide the arts and crafts session. Care plans were seen to be in place regarding peoples hobbies and records were kept of peoples interests. records were also kept in peoples care plans of activities that they had taken part in. At the time of our inspection the home was in the process of developing memory boxes for those people with dementia, these were to be positioned outside of peoples rooms as an aid memoir, later in the course of the day we witnessed the delivery of these memory boxes which had been ordered from a specialist dementia care organisation. Visiting relatives spoken with said that whenever they visited the home there were Care Homes for Older People Page 15 of 28 Evidence: always activities taking place. All of the residents surveys returned replied Always when asked Does the home arrange activities that you can take part in if you want to. Comments received from residents included I love it here, Im very happy. On the day of our inspection visit residents were seen taking part in Xmas activities including singing along to Xmas songs and dancing with staff. Later during the course of our visit we observed a school choir visiting the home to sing Xmas carols to the residents, after which the children supported by the home staff and their teachers served out drinks and mince pies to the residents. It was clear from the expression on the faces of the residents that they enjoyed this activity immensely. One resident of their own volition decided to give the children a vote of thanks, and this was meet with a huge amount of applause. The manager told us in the AQAA, At Blackbrook House we do not have set visiting times, we encourage families or friends to visit at anytime, many stay for lunch or supper-this is particularly important for our residents who would normally find accessing a restaurant difficult. Discussion with the registered manager indicated that the home did not have any set visiting times. This was confirmed by visiting relatives who said that they were able to visit whenever they wished and were always made welcome and were always provided with refreshments. Residents spoken with were complementary about the home. One of those spoken with described the home as Delightful they went onto say that they were free to come and go around the home as they wished. The manager told us in the AQAA, The home offers a wide and varied choice of foods, it caters for all dietary requirements whilst ensuring food of an excellent nutritional value. Hot and cold drinks and snacks are always available including during the night and again we cater for all tastes and requests. Residents spoken with and surveys returned indicated that the meals provided in the home were good. All of the respondents when asked Do you like the meals at the home replied Always. The menu for the week was displayed in each unit, and included the main meal and the evening meal. The main meal included two choices. on the day of the inspection visit the two choices were breaded scampi with chips, peas and a grilled tomato or an all day brunch. The evening meal consisted of only one option. Morning drinks consisted of two choices of tea or coffee with a biscuit. Afternoon tea is served daily at 3.PM and included a daily variation including; jam tarts, prunella cake, flapjack, buns, rock cakes or rice crispie cakes. Care Homes for Older People Page 16 of 28 Evidence: The lunchtime meal was discretely observed in the unit for people with dementia. The meal was observed to be taken in a relaxed and unhurried atmosphere. Music was turned down to a background noise level. Staff were available in sufficient numbers to meet the needs of people. Staff were seen and heard explaining and reminding people of what their meal was. Staff were also observed to be very supportive, one example of this was seen when a staff member was observed informing residents that the desert was apple strudel, the member of staff was observed going to each person in turn to ask them if they wanted custard with their desert or cream. residents were also seen to be provided with three choices of soft drink including orange, lemon or blackcurrant. All residents prior to their meal are offered a glass of sherry, residents spoken with confirmed that this is always the case, they went onto say how much they enjoyed their daily glass of sherry before their meal. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can be confident that their concerns about how they are treated are listened to and acted upon as stated in the complaints and safeguarding procedures. Evidence: The manager told us in the AQAA, We actively encourage open communication between alll users of the service as we feel that complaints are often borne out of poor or unsatisfactory communication. Residents and their families are encouraged to mention any concerns or complaints that they have immediately to enable us to act and put right the situation. The home has a rigorous complaints procedure which is displayed throughout the home and is also listed in the homes Statement of Purpose and the residents brochure. Both residents and visitors spoken with during the course of the inspection said that if they were unhappy with any aspect of the care provided they would speak to the manager. Residents spoken with were clearly aware of who the manager was (to highlight this point, just by coincidence the manager walked by and the resident said Look theres the man himself). A compliments/complaints book was kept in the foyer of the home, sampling of which indicated that since the last key inspection a number of compliments and minor complaints had been received. The record included the nature of the complaint, who Care Homes for Older People Page 18 of 28 Evidence: the complaint had been received by, the investigation carried out and the outcome. the homes complaints procedure was posted on the notice board and included the contact details of the Care Quality Commission. Between the completion of our inspection and the writing of this report we received a concern from a relative of a person living in the home. This person told us that it was their experience that whenever they had had cause to make a complaint it had not always been dealt with as positively as perhaps it could have been. The manager told us in the AQAA, We take protection of vulnerable adults very seriously and this is emphasised during training on the subject which takes place in house. The training is open and interactive, and staff are encouraged to talk about their experiences and what they would do in certain circumstances. The staff training matrix for the home was examined and indicated that all staff had received safeguarding training. Staff spoken with had a good understanding of their responsibilities around keeping people safe. There had been no referrals made to the local authority under their safeguarding processes in the last year. Personnel records examined confirmed that staff undergo Criminal Record Bureau (CRB) enhanced disclosures and Povafirst checks to ascertain that they are not prohibited from working with vulnerable people. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can enjoy living in an environment that suits their lifestyle and which is well maintained and clean. Evidence: The manager told us in the AQAA, The home is well laid out and specifically designed to enable the residents to be as independent as possible. Wide corridors, door ways that are suitable for electric and self propelled wheelchairs and numerous disabled access doorways to the outside ensure ease of movement throughout the building. During the course of our inspection we undertook a tour of the premises including residents personal rooms, bathing and toilet facilities and communal areas. The home was found to be very well decorated. Residents spoken with were very complimentary about the home describing it as very pleasant furnishings and fittings were of a very good quality, and there were numerous areas situated around the home where people could sit and spend quiet time if they so wished. Residents spoken with said that they had been able to bring personal possessions with them when they had moved into the home. The home benefits from an extensive garden area which was safe and secure and provided residents with the opportunity to walk around on their own or with support in Care Homes for Older People Page 20 of 28 Evidence: a safe and secure environment. The garden area was accessible to people who were less mobile via ramps. Some of the flower bed areas had been raised to enable people to reach or touch them without to much effort. Residents spoken with said that they liked to go out into the garden when the weather was good. Comments received from residents who returned surveys included nice warm environment the general atmosphere is very good lovely clean home, not like my own home but under the circumstances I could not be in a better place The manager told us in the AQAA, The standard of cleanliness at the home is excellent, particular attention is paid to the potential problem of odour. On our tour of the premises we noted that the home was very clean throughout and there was no evidence of any unpleasant odours. The homes laundry facility was well equipped with industrial style washing machines and dryers. The home employs laundry assistants who o have responsibility for all residents laundry. Residents laundry is stored in individual wash baskets and is transferred to peoples rooms by the laundry assistants. Residents were all observed to be nicely dressed and presented. The laundry assistant and the manager reported that the number of complaints related to damaged laundry had dropped off significantly. This they felt was due to the installation of an Otex system which allows washing (even soiled washing) to be washed at lower temperatures. Soiled laundry (Sheets) are sent to an external cleaning service with whom the home has a contract. Soiled waste products are stored in yellow bags and are collected by an external collection service for appropriate disposal. The staff training matrix showed that staff had received training around infection control. Staff observed undertaking cleaning tasks were observed to wear personal protective equipment (PPE) e.g. gloves and aprons Cleaning materials were seen to be stored in a locked cupboard situated on the ground floor, to which only senior carers or domestic staff had access. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home can be confident they are cared for by a competent staff team who can meet their needs. Evidence: Discussion with the registered manager and staff as well as sampling of duty rotas indicated that the home has ten care staff on duty in the morning and nine in the afternoon, this establishment is made up of a senior care officer, a senior care assistant and care staff. The registered manager is employed in a supernumerary capacity, although they do spend time working alongside staff if necessary. In addition to care staff the home employs ancillary staff including: two chefs, domestics, laundry assistants, kitchen assistants and evening kitchen assistants. the home also employs an operations manager who is responsible for the maintenance and upkeep of the fabric of the building. On the day of the inspection we observed that peoples needs were being meet promptly by the staff on duty and they were not waiting unduly when they needed support. When asked in our surveys are the staff available when you need them all of the respondents replied Always. Residents spoken with during the course of our inspection said that staff were very helpful and nothing was to much for them. A sample of four personal files were examined and these were found to be in order. Care Homes for Older People Page 22 of 28 Evidence: There was a checklist of the contents on the front and all of the documentation required by regulation was in place, including application forms, two written references, relevant proofs of identity, Povafirst checks and Criminal Records Bureau (CRB) enhanced disclosures. The manager told us in the AQAA, We hold staff files which are comprehensive and informative, alongside these each staff member has a training folder which holds copies of all of their certificates. Staff have received training around: first aid, fire training, manual handling, dementia care, food hygiene, infection control, medication, prevention of abuse, dementia care mapping, common induction standards, use of continence products, Parkinson disease and wound care. The home has a computerised training matrix which is maintained by the Director of Care Services, this matrix uses a traffic light system to identify when staff training is becoming due. Sampling of the training matrix indicated that staff had received training around fire training, safeguarding, manual handling, infection control, medication administration and food safety. Relatives spoken with during the course of our inspection spoke positively about the support that their relative received, one said I visit my relative twice weekly and on every occasion I have found the staff to be caring and supportive. A member of staff who completed a survey told us The staff go out of their way to get things right and staff support each other. The manager told us in the AQAA, Our staff are well trained and many have or are undertaking NVQ or other care related training courses. Out commitment to continuing personal development encourages staff to want to learn and progress through to more senior roles which in turns raises staff morale and ensures that staff feel valued. On the day of the inspection we discussed NVQ with the manager who demonstrated a commitment to supporting staff to achieve the award. The AQAA dataset confirmed that of thirty one care staff employed nineteen held a national Vocational Qualification (NVQ) at level 2 or above. A sample of personal records examined contained evidence of NVQ certificates. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience 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 appropriately managed in the best interests of the people living there. Evidence: We were told in the AQAA, The manager is fully qualified and competent to manage the service, he has completed a year long course in dementia care, looking primarily at the person centered approach to caring for people living with dementia, he is also just completing an NVQ in leadership and management. The registered manager is a registered general nurse (RGN) who has ten years experience of working in the care sector. He has been the registered manager of the home since 2007, and is trained in intensive care and palliative care. The manager hold a diploma in dementia care and had just completed a course in leadership and management. discussion with residents, relatives and staff indicated that they found the manager to be very supportive and approachable. Observations of him interacting with both residents and staff were very positive. He always had time for both residents and staff and nothing appeared to much for him. Residents seemed to have Care Homes for Older People Page 24 of 28 Evidence: a very good rapport with the manager and it was clear that he knew each and every one well. The manager told us in the AQAA, The home has a good quality assurance programme including monthly residents meetings, residents questionnaires, relatives questionnaires, letters expressing thanks, a rigorous complaints procedure which actively encourages transparency and involvement from all parties, call logging systems for residents and the support of a Director of care services, Operations manager and Managing director. This open and transparent approach ensures that everyone feels comfortable about bringing any concerns or issues to the management at anytime. Residents and staff meetings are held monthly. Minutes of the last residents and staff meeting were provided for viewing and a copy of the residents meeting was seen to be available in the main foyer of the home. Quality assurance questionnaires are sent out yearly and annual relatives meetings are held following the quality assurance audit. As part of the homes quality assurance process Regulation 26 visits are carried out monthly by the Director of care services and copies of this report are made available to the home, sampling of the last visit showed that residents and staff were consulted with during this visit. In the interest of establishing good relations all relatives are provided with a card with the contact details of the manager so that they may contact him at anytime if they have any concern about their relative. As mentioned elsewhere in this report the home employs an operations manager who has responsibility for all aspects of the homes maintenance. A sample of health and Safety documentation was examined and found to be in order. This included maintenance certificates relating to the lift, fire extinguishers, fire alarm testing and portable appliance testing (PAT). personal records examined confirmed that staff had received training around Health and Safety and infection control training. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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). 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