Care Home: Blatchington Court

What the care home does well The home provides prospective residents and their families, with a good level of information about what services are provided at the home. The admission procedure allows for a comprehensive assessment process of any prospective resident. The individual plans of care were good and reflected an individual approach to care. It included individual risk assessments and written records confirmed that these were responded to, and expanded on within the plans of care. All staff had a good understanding of resident`s needs and were found to have a professional approach to residents, handling situations caused by dementia with understanding and patience. Staff training records and discussion with staff indicated that staff working in the home receive a good level of training, with a high percentage of them having completed and National Vocational Qualification in care at level 2 or above. Visitors are seen as an important part of the home and are made to feel very welcome, with visiting arrangements being flexible and unrestricted. The management team are committed to the home, and in providing a good standard of care, providing clear leadership and direction for the staff. The AQAA confirmed that this team are also responsive to shortfalls identified, addressing these and learning from any errors. What has improved since the last inspection? On the whole the home has responded to the requirements made at the last key inspection. There are however some areas that need to be addressed, and these have been recorded within this report. The admission process now ensures that prospective residents are advised in writing if the home is suitable to meet their individual assessed needs, and further attention has been given to recording resident`s preferences and choices, within the care documentation. The care documentation has been upgraded and now reflects residents individual needs, taking into account individual risk assessments. Records seen confirmed that staff have received training on a wide range of subjects including dementia, to give them the skills to look after the residents in the home. The registered manager and proprietor confirmed that they have completed training on risk assessment, and complete the risk assessments in the home. The AQAA confirmed that ongoing upgrading to the environment is being progressed to benefit residents in the home. What the care home could do better: Two requirements have been made following this inspection, and the proprietor and care manager have also undertaken to address some further shortfalls recorded within the body of this report. Some medicines are being crushed before administration, this practice needs to be underpinned with a clear policy and procedure and recorded within associated documentation. This must clarify the reasons for this practice, demonstrate a multidisciplinary approach, and ensure individuals rights and safety are protected. Although environmental risk assessments are completed these were found not to be accurate in some areas. The risk assessment process needs to be robust in order to identify all risks. The home has been required to contact the Environmental Health department to review the risk assessment process in place to ensure suitable. Within the AQAA the management team acknowledged that they need to keep up to date with changes in legislation, and belong to a professional body to help them achieve this. Key inspection report Care homes for older people Name: Address: Blatchington Court 13 St Peters Road Seaford East Sussex BN25 2HS     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: Melanie Freeman     Date: 0 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 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: Blatchington Court 13 St Peters Road Seaford East Sussex BN25 2HS 01323896939 01323873883 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Phyllis Sammars care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users who can be accommodated is: 20 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia - DE Date of last inspection Brief description of the care home Blatchington Court is a residential home in Seaford and is registered to provide personal support and care for up to 20 people with a dementia type illness. The specialties and age range of the service is reflected within the homes statement of purpose, and is not limited to over or under the age of 65. The home is situated in a quiet area, approximately three quarters of a mile from the seafront. There are attractive gardens to the rear that are accessible and used by residents when weather permits, and there is small parking area to the side of the building. The premises provides fourteen single bedrooms and three double rooms, communal areas consist of two lounges on the ground floor, one is used as a dining area and for quieter activities. The other lounge is larger and residents are able to watch the television if they wish. There is sufficient space for religious and social Care Homes for Older People Page 4 of 29 0 2 0 3 2 0 0 9 20 Over 65 0 Brief description of the care home activities. There is no lift in the home and residents are only admitted if they can access the first floor using the stairs or chair lift with the assistance of staff. The homes fees at the time of this inspection range from approximately £440 to £650 per person per week, depending on the room to be occupied and the care needs of the individual. Additional costs are charged for chiropody, hairdressing and newspapers. Intermediate care is not provided at Blatchington Court. 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 reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term service user to describe those living in care home settings. For the purpose of this report, those living at Blatcington Court will be referred to as residents. This was a key inspection that included an unannounced visit to the home on Tuesday 1 December 2009, and follow up contact with visiting health and social care professionals. The allocated inspector spent approximately five hours in the home and was able to discuss matters with the care manager who facilitated the inspection process. The proprietor was also contacted following the inspection in order to share the inspection findings. A random inspection was completed on the 2 March 2009 in replacment of the scheduled Annual Service Review, this was changed following information received with Care Homes for Older People Page 6 of 29 regard to an accident in the home. The commission needed to confirm suitable arrangements were in place to ensure that residents were as safe as possible. All the communal areas were seen along with a selection of the residents rooms. A range of documentation was reviewed including the homes statement of purpose, service users guide, admission assessment procedures, the systems in place for handling complaints and protecting residents from harm, staff recruitment files, staff training records, and some health and safety records. The care documentation pertaining to two residents were reviewed in depth, along with medicine administration records. At the time of compiling the report, in support of the visit, the Care Quality Commission received survey forms about the service from nine residents, completed with help from relatives, and nine staff surveys. The required Annual Quality Assurance Assessment (AQAA) was completed by the registered manager and returned when requested, and was used to inform this inspection report. The AQAA used was completed in January 2009. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? On the whole the home has responded to the requirements made at the last key inspection. There are however some areas that need to be addressed, and these have been recorded within this report. The admission process now ensures that prospective residents are advised in writing if the home is suitable to meet their individual assessed needs, and further attention has been given to recording residents preferences and choices, within the care documentation. The care documentation has been upgraded and now reflects residents individual needs, taking into account individual risk assessments. Records seen confirmed that staff have received training on a wide range of subjects including dementia, to give them the skills to look after the residents in the home. The registered manager and proprietor confirmed that they have completed training on risk assessment, and complete the risk assessments in the home. The AQAA confirmed that ongoing upgrading to the environment is being progressed to benefit residents in the home. 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 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Blatchington Court provides prospective residents and relatives with a good level of information about the home, its facilities, services and the costs involved. The admission procedures allow for the needs of prospective residents to be assessed by a competent person before admission, to ensure their needs can be met by the home. Evidence: A copy of the homes statement of purpose and service users guide was available on request, and contained useful information on the home and services it provides. However it now needs to be updated to reflect the change in the registering authority. Further information on the service is available on homes website. The last two admissions to the home were identified and the records relating to the admission procedures followed were reviewed. This confirmed that pre admission assessments are completed and provide a clear assessment of prospective residents Care Homes for Older People Page 11 of 29 Evidence: care needs, and that other care professionals and and the prospective residents representatives views are taken into account. The assessments are completed by the manager, or the provider and are used to ensure new admissions to the home are appropriate, and that the home have the staff, equipment and environment to meet their care needs. Once the assessment is completed the manager or proprietor writes to confirm that the home is able to meet the prospective residents assessed needs, and this allows for an informed decision to be made about admission to the home. Although most of the documentation relating to the admission process was well completed some areas were identified that needed to be improved, these were highlighted to the care manager and proprietor, and included accurate dating and signing. Intermediate or rehabilitative care is not provided at Blatchington Court. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents care needs are met taking into account residents dignity with evidence of regular input from health care professionals as necessary. The arrangements for medicine administration in the home were found to be safe, although an individual approach to medicines administration needs to be established. Evidence: The care documentation pertaining to two residents were reviewed as part of the inspection process, and each of these residents were met with during the inspection visit to the home. Each resident had an individual plan of care that recorded their health and personal care needs. These were informative and showed that the care was updated regularly, with the plan reflecting the current care provision. Records held within the care documentation also confirmed that the home engaged with residents representatives in order to review and plan the care provided. Observation through the inspection visit indicated that staff use the care documentation, spending time updating and reading Care Homes for Older People Page 13 of 29 Evidence: its contents. Contact with visiting professionals and the care documentation indicated that the residents medical needs are well attended to, with regular access to a General Practitioner, dentist, optician or chiropodist as required. The visiting community nurse complimented the standard of care and the level of communication from the home. Links with the Community Metal Health Team are well established and ensure a multidisciplinary approach to specific care needs is maintained. Feedback from residents representatives was positive with comments including Since going to Blatchington Court she has been treated with kindness understanding and respect at all times. I would recommend the home and its owners to anyone else making the difficult decision to have their relative admitted everything is great Residents and their families are encouraged to look upon Blatchington Court not as a care home but the residents own home Keeps me well informed about my mothers welfare. Treats mum with patience care and respect at all times. The care documentation included assessments for moving and handling, pressure areas, and a nutritional screening tool, that included the regular weighing of residents to identify and problems with nutrition at an early stage. No residents in the home self administer their own medicines, therefore staff are responsible for all medicine administration. Records confirmed that those staff who administer medicines have been trained to do so, and a record of their signatures were available for audit purposes. A selection of residents medicine records were reviewed and these were found to be accurate, and practice observed in the home was seen to be safe. When the medicine storage facilities were reviewed it was noted that the controlled drug storage arrangements did not fully comply with the current legislation. It was agreed that the proprietor would consult with her supplying pharmacist with regard to these facilities to ensure, whenever controlled drugs are bought into the home they are stored appropriately. Further information on this matter is available on the Care Quality Commission Internet within the guidance document The safe management of controlled drugs in care homes. Some medicines are administered on an as required basis this is identified separately on the medicine records, however further individual guidelines for each resident to clarify when these medicines are to be given, would ensure they are administered in a consistent way. This was discussed with the care manager who understood why this should be completed and agreed to progress this matter. Medicine records and the care manager confirmed that some residents are having Care Homes for Older People Page 14 of 29 Evidence: their medicines crushed and disguised within food. Although there was a record to confirm consultation had taken place with the General Practitioner. There was no evidence to confirm a multi-disciplinary approach had been adopted, or that the resident had been consulted. A clear procedure needs to be established to ensure whenever medicines are crushed before administration that this is done in an individual and safe way, that takes into account residents rights and wishes. During the inspection visits staff were seen to have a very pleasant approach to residents showing a genuine affection that was well received by residents. They were also respectful with regard to privacy, ensuring any treatment or care was provided discreetly. Bedrooms were personalised with pictures and photographs. The residents are well know to all the staff, and are spoken to as individuals with their preferred names being used. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Links with friends and relatives are encouraged and choices expressed are respected whenever possible. The provision of meals ensures residents have a choice and variety in their diet, and the arrangements for activities provide regular interaction and some group entertainment. Evidence: The homes care staff provide activities for the residents on a daily basis, these include some group activity, art and craft, videos, musical entertainment and some games. The care manager said that some residents enjoy the activities along with getting outside, weather permitting. Although the resident surveys recorded a good interaction between staff and residents, one survey requested more excercise and stimulation. During the assessment visit staff and residents were seen to be interacting positively. Staff engaged with residents throughout the day reading books, talking about their experiences and just chatting. Residents that were walking around the communal areas were discretely supervised and interacted with as necessary. Care Homes for Older People Page 16 of 29 Evidence: There are two separate communal areas at Blatchington Court, so residents have a choice of environment. One room had the television on whilst the other had background music only. There were magazines around the home and the care manager said that more books are to be provide in the future, possibly a library. The home has also recently purchased three Guinea pigs that the residents can be involved with if they wish. Life histories are recorded in the plan of care and staff spoken with had an knowledge of residents previous life styles, and family relationships. Observation confirmed that visitors are very welcome, with some staying for long periods of time in the home, having their meals and mixing with staff and residents. Choices and preferences are explored within the daily routine, with these being responded to by staff whenever possible. It was however noted during the visit that all bedrooms are locked. This raised the question of residents freedom to move around the home and spend time in his or her own rooms, without being restricted. This was raised with the proprietor for her to review this practice and enable residents to spend time where they want. Any decision to lock a door needs to be supported with clear documentation that takes into account the individuals rights, and evidence that this has been discussed within a multi-disciplinary team. Food is given a high priority in the home with the care manager very involved with the provision, ensuring its nutritional benefits, and suitability for the residents. She advised that supplies are sourced locally and are of a high quality. Meals are responsive to peoples likes and dislikes, that are recorded in the home. On the day of this visit residents had roast chicken, potatoes along with vegetables, a choice of dessert included a rhubarb crumble, or sponge pudding. 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. The home has a clear complaints procedure to follow up on any concern raised. Staff awareness and information in the home ensures that any Safeguarding Vulnerable Adult issue would be responded to appropriately when identified. Evidence: A complaints procedure is available in the home, and the registered manager confirmed that a copy of this is included in the service users guide, that is given to each resident and their representative on admission. There have been no complaints since the last inspection. The records held in respect of any complaint or safeguarding matter received were examined. There was no clear log for these, and records did not record how these matters had been investigated, what had been found, and what action had been taken in response. The proprietor agreed to ensure full records are maintained in the future. The home has appropriately raised a safeguarding vulnerable adult alert with social services recently, and worked with them to investigate and resolve the concern raised. This demonstrated that staff had a good awareness of safeguarding matters and how to raise the concern. This particular issue related to resident contact with another, and has been resolved. Training records in the home recorded that staff had received training on safeguarding Care Homes for Older People Page 18 of 29 Evidence: vulnerable adults. Recruitment records confirmed that all staff have a protection of vulnerable adult (POVA) and Criminal Records Bureau (CRB) check completed on them. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Blatchington Court provides a comfortable, homelike environment, which is clean and reasonably well maintained. Evidence: Blatchington Court is a converted detached building within a residential area of Seaford. There is a secure garden area with a patio and seating facilities, and unrestricted parking is available in local roads. The front door is locked so that staff can monitor people entering and leaving the home. A tour of all communal areas was completed along with a selection of bedrooms. On the whole the home was found to be reasonably well maintained, with a plan for further upgrading in progress. Blatchington Court benefits from two sitting rooms and a separate dining room, with residents rooms on the ground and first floor of the home. The communal areas are attractive with comfortable and homely like furniture, and allow for different uses, ensuring residents have a variety of areas to spend their time. Some seating in the communal areas is low and residents were observed to need assistance when standing. The seating arrangements throughout the home need to be reviewed to ensure suitable, and are not restricting residents mobility. During the inspection visit staff were observed to use safe moving and handling procedures to assist residents with their mobility. The home does not have a shaft lift, but has a stair lift to the first floor. The home has to ensure that the residents placed on the first floor Care Homes for Older People Page 20 of 29 Evidence: have the ability to either use the stair lift safely, or are mobile. Whilst looking at residents bedrooms it was noted that the hand basins in most of the rooms are very small. The care manager advised that bowls are used when washing residents in their own rooms, and these are placed on the chest of draws next to the bed. This does not promote residents independence and ways of maintaining associated skills must be reviewed and developed as far as possible. The home has seventeen bedrooms, three of which are double, two single rooms have en-suite facilities. Some bedrooms have been fitted with alarms that notify staff at night if residents get out of bed, or leave their room. This enables staff to respond to people quickly, and assist them if they need any help. During the visit it was noted that two rooms had flat eclectic radiators, that had not been guarded. One of these was found to be very hot to the touch, and posed a high risk to residents. This safety matter was raised with the care manager for her to risk assess and take appropriate action immediately. She raised it with the maintenance man who ensured that these were made safe and that safe suitable heating was in place in all areas. Although environmental risk assessments are completed, the process followed did not identify the risk posed by the unguarded radiators. As mentioned previously all bedroom doors are locked and residents are not able to get back into the room without the key held by staff, and therefore may restrict access for residents. The use of door locks was discussed with the care manager and proprietor along with the need to individually assess any restrictions, to ensure practice is not routine based, and takes into account the individuality of each person living in the home. The home was found to be clean and fresh throughout with the standard of cleanliness being good. Systems to maintain a good level of infection control in the home have been established. Residents clothes were seen to be clean and well cared for. 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. On the whole residents are protected by the recruitment practice followed. The staff training ensures staff are aware of their roles, and are able to provide the support and care the residents need. The staffing arrangements and skill mix is flexible and appropriate to the assessed needs of residents. Evidence: At the time of this inspection visit there was 16 residents living in the home. The staffing arrangements included the care manager and three care staff working in the home throughout the day from 7 am till 10 pm. Additional catering and domestic staff also work on a daily basis, and two waking staff work at night from 10 pm to 7 am. The duty rota recorded that these staffing levels are maintained throughout the week, although at the weekend the care manager completes the catering duties. Staff spoken with and surveys received indicated that the staffing levels were appropriate but clearly these need to be constantly reviewed to respond to changing needs and activity in the home. All feedback received about the staff working in the home was very positive and comments included staff are always polite whenever I wish to speak to someone at Blatchington Court they are very helpful, polite, and informative my moter has been very settled at Blatcington Court There is always a welcome but professional atmoshere and the staff are very good. Visiing her and the Care Homes for Older People Page 22 of 29 Evidence: other residents is never an unpleasant experience due to the support and tenderness that is evident. Staff were seen to have a good awareness of residents needs and respond to them efficiently and effectively, prompting residents as necessary and responding to possible risks that occurred during the day. The recruitment practice in respect of two recently recruited staff members were reviewed and on the whole were found to be full. Records held included an application, health check, evidence of identity and the required Protection of Vulnerable Adults and Criminal Records Bureau checks. One carer did not have full references and the proprietor agreed to follow this up as a priority. Records relating to the interview and terms and conditions of employment, along with information asked for within the application need to be improved. The proprietor advised that she is already in the process of updating recruitment practice and documentation, with external specialist advice. Staff training is well organised and on the day of the inspection visit staff were attending training on equality and diversity. A staff training matrix is maintained and demonstrated that staff complete an induction programme, along with the required health and safety training. In addition a varied programme of training is completed to enable staff to meet the residents needs. Staff are supported and enabled to complete the National Vocational Qualification (NVQ) training with over 50 having this qualification at level 2 in care or above. 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. The home was found to be managed in an open and friendly manner. Systems are in place to safe guard residents financial interests and to monitor the quality of care and services in the home. The health, safety and welfare of residents and staff are generally promoted and protected, although further attention is needed regarding some risk assessment processes. Evidence: Blatchington Court is managed by the the proprietor and the registered manager jointly, they also manage Seaford Head Residential Home that is also owned by the same proprietor. Both are suitably qualified and are supported by a care manager who takes on many of the care responsibilities. The Care manager has a good awareness of residents needs, and how to treat people as individuals. Care Homes for Older People Page 24 of 29 Evidence: The management arrangements are suitable and provide a good level of leadership and supervision of the home. The care manager confirmed that the home does not accept any responsibility for the residents finances, and that they are supported by relatives or solicitors. Residents are invoiced separately by the home for hairdressing and chiropody. The last AQAA recorded that the home has an annual quality assurance monitoring system, which involves residents their representatives, and outside stakeholders. The proprietor confirmed that a quality monitoring system is still in place and is used to improve the service. The last AQAA also recorded that all relevant safety checks have been completed and that the homes policies and procedures are in place and regularly updated. Although environmental risk assessments are completed these were not accurate in all areas, and this raises concerns around the process used. The proprietor and manager have been required to contact the Environmental Health Department for further guidance on this matter. Care Homes for Older People Page 25 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 26 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 1 9 13 When medicines are 01/01/2010 disguised in food, there must be an assessment of mental capacity of the resident and a care plan agreed by a multidisciplinary team. A clear procedure to underpin practice also needs to be provided. This is to ensure that peoples rights are protected. 2 38 13 The registered person shall make arrangements in consultation with the Environmental Health Department, to ensure that all parts of the home are as far as possible free from hazards to safety, using a robust risk assessment process. This will ensure residents and staff are as safe as possible. 07/01/2010 Care Homes for Older People Page 27 of 29 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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