Care Home: Brampton Lodge

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What the care home does well There is a welcoming and homely atmosphere. The Expert by Experience says, `staff members are caring and treat the residents with respect`. The Manager consults with people before they move in. This is so that they are confident that their needs can be met. One person says, `I was told about the place and I remember asking questions and being told things about what to expect. I don`t remember if I visited first of all but my (relative) did. I certainly do remember that all of the staff were wonderfully kind to me and took special care to help me fit in. I`ve never met anything but kindness here`. People say that they receive the assistance they need in ways that are right for them. One person says, `the staff are excellent really and helpful. They will always have a chat and they`re kind. It`s the staff who make the place and we`re lucky to have some really good girls. Most staff have been here a long time and that`s a good sign. They wouldn`t stay if this wasn`t the happy place it is, would they` There is a good range of special equipment such as mobile hoists to help people who have reduced mobility. People can receive visitors whenever they wish and they can meet with them in private. The Manager keeps in touch with relatives so that they know how things are going. There are reliable arrangements for the ordering, storage and administration of medication. People are helped to stay in good health. This includes keeping an eye on how everyone is and then calling doctors as soon as they are needed. The accommodation is very well presented. It provides a comfortable setting. The garden is neat and attractively laid out. The kitchen meets the requirements of the local Department of Environmental Health. There is a modern automatic fire safety system. The laundry is well equipped and well organised. Most of the care workers have completed a relevant National Vocational Qualification (NVQ). Security checks are completed on new members of staff. What has improved since the last inspection? A number of improvements have been made since our last Annual Service Review. A new form has been introduced to record each person`s individual plan of care. This has been done to make the records easier to use and easier to keep up to date. A computer game console has been purchased so that people can have fun while exercising. A small mobile shop has been established. It sells items such as confectionery and toiletries. A summer house has been erected in the garden. The menu has been revised to incorporate people`s suggestions. More care workers have obtained a National Vocational Qualification. This has enabled them to further develop their skills and knowledge. What the care home could do better: Some people might like more social events including trips out. One part of the complaints procedure needs to be changed. This is so that people are fully informed about all of the rights they have. The way in which concerns and complaints are recorded needs to be strengthened. This is necessary so that the Registered Provider can demonstrate how queries are investigated and resolved. Some care workers are not receiving all of the training that the Registered Provider says that they need. This might result in them not having all of the skills and knowledge they need. The quality assurance system does not fully involve all of the people who live in the Service. This means that some people might not be enabled and encouraged to contribute ideas about the improvement of the Service. Some parts of the fire safety procedure are not being followed. This might reduce the level of fire safety protection. Key inspection report Care homes for older people Name: Address: Brampton Lodge 4 Dixwell Road Folkestone Kent CT20 2LG     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: Mark Hemmings     Date: 0 8 0 2 2 0 1 0 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 30 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 30 Information about the care home Name of care home: Address: Brampton Lodge 4 Dixwell Road Folkestone Kent CT20 2LG 01303258227 01303258227 claire@brampton.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Brampton Care Ltd care home 18 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 18 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: Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Up to 18 older people who need personal care can make their home in Brampton Lodge (the Service). The property is a large detached house. There is a passenger lift that gives step-free access around most parts of the accommodation. Three bedrooms have two short flights of steps that lead to them. All of the bedrooms are single occupancy. They are laid out as bed sitting areas. They have a bed, bedside table comfortable armchair and wardrobe. All of the bedrooms Care Homes for Older People Page 4 of 30 Over 65 0 0 Brief description of the care home have a private bathroom. These have a walk in shower, toilet and wash hand basin. One of them has a special easy access bath rather than a shower. This has a seat that goes up and down. Each bedroom has a television point and a telephone point. People can make telephone calls from their bedrooms free of charge. There is a lounge and dining room on the ground floor. On this level there is also the Managers office, the kitchen and the laundry. There are two bathrooms, one on each floor. These have got easy access baths. Each has also got a toilet and wash hand basin. All of the bedrooms, the private bathrooms and the shared use bathrooms are connected to a call bell system. This means that people can alert a member of staff if they need assistance. At the back of the building, there is a large, enclosed garden. There is a patio area where there are garden tables and chairs. The Service is in a quiet residential street. The building is about half a mile from Folkestones town centre. There is a bus stop nearby and there is plenty of on street car parking. The Service does not have its own vehicle. The weekly fee for living in Brampton Lodge on a longer term basis runs from GBP580.00 to GBP650.00. The weekly fee for people who intend to stay for shorter periods of time is GBP675.00. Please contact the Manager to find out more details about the charges. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this Service is 3 Star. This means that the people who use this Service experience excellent quality outcomes. We arrived unannounced at the Service just before nine oclock in the morning. We were there for about seven hours. It was a thorough look at how well things are going. We took into account information provided by the Registered Provider in its self assessment. This is called the Annual Quality Assurance Assessment (the Assessment). We received this on time and it is adequately detailed. Further, we considered any other information that we have recently received about the Service. We did our last Key Inspection on 26 February 2007. In the intervening period we have also done two Annual Service Reviews. We completed the last one of these on 25 February 2008. This was an office based activity when we reviewed all of the information that we had gathered since the preceding Annual Service Review. Care Homes for Older People Page 6 of 30 During the present inspection, we spoke with eight of the people who currently live in the Service. We spent time in the company of another two of them while they were in the lounges. We spoke with the Manager and with the deputy manager. We also spoke with three care workers, the chef and with the administrator. We looked around parts of the accommodation and the grounds. Also, we looked at a selection of key records and documents. These included things like the individual written plans of care, medication records, the activities plan, the menu, complaints documents, the staff roster, staff training records, financial records and various health and safety certificates. Before we visited the Service, we asked some of the people who live there to fill out a questionnaire for us. We wanted them to tell us what they think of Brampton Lodge. Five of them kindly completed them for us. Later on in our Report, we will tell you the main things that are being said in these questionnaires. The Registered Provider has also asked people who live in the Service to fill out a questionnaire on what they think of their home. We will tell you some of the points they make in their replies. We were joined by an Expert by Experience. She has a thorough knowledge of the special needs of older people. She spent about three hours in the Service. During this time, she observed what was going on in the lounges. She also talked with people who live in the Service and with members of staff. She had a look around the main parts of the accommodation. This included going into some of the bedrooms by invitation. Later, she joined some people for lunch. Care Homes for Older People Page 7 of 30 What the care home does well: What has improved since the last inspection? A number of improvements have been made since our last Annual Service Review. A new form has been introduced to record each persons individual plan of care. This Care Homes for Older People Page 8 of 30 has been done to make the records easier to use and easier to keep up to date. A computer game console has been purchased so that people can have fun while exercising. A small mobile shop has been established. It sells items such as confectionery and toiletries. A summer house has been erected in the garden. The menu has been revised to incorporate peoples suggestions. More care workers have obtained a National Vocational Qualification. This has enabled them to further develop their skills and knowledge. 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 30 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are thinking of moving in are asked about what care they need and how they want this to be done. They are encouraged to visit the Service to get a first hand feeling of what it is like. People who want to stay for only a short time are supported to go home again. Evidence: The records show that the people who are thinking of moving in are asked about what care they need and want. They and their relatives are also invited to visit the Service. This is done so that they can be confident that moving in to Brampton Lodge is the right thing for them. If necessary the Manager also talks with people such as health and social care professionals. All of this helps her to build up a really good picture of how the person can best be supported. There is a Service Users Guide. This is a brochure that gives useful information about the facilities and the services that people can expect to have when they move in. Care Homes for Older People Page 11 of 30 Evidence: Copies of this document are available from the Manager. In their questionnaire replies people say that they had enough information when they were deciding about moving in. One person says, I was told about the place and I remember asking questions and being told things about what to expect. I dont remember if I visited first of all but my (relative) did. I certainly do remember that all of the staff were wonderfully kind to me and took special care to help me fit in. Ive never met anything but kindness here. Care workers say that the Manager shares with them the information she has obtained about someone who is due to move in. This is done so that they know what care they will need to provide. One care worker says, we want to help people to find their feet. Coming somewhere new, even to Brampton Lodge, can be a scary thing. Theres a new building to get used to, new people and a new bedroom. We welcome people and we make them feel welcome without being overwhelmed. People have the time they need to settle in. Everyones different. Most of the people who move in do so with the intention of making Brampton lodge their longer term home. However, some people stay for only shorter periods. This might be when relatives go for a holiday. Or they might have been in hospital and need some extra time before going home. The records show that the Manager carefully liaises with relatives and with health and social care professionals. This is done to ensure that the person has the necessary support when it is time to leave. Care Homes for Older People Page 12 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are written plans of care that describe what care is be provided. People are reliably receiving all of the care they need. They are treated with courtesy and respect. People have access to the medical and health care services they need. There are reliable arrangements for handling medication. Evidence: Each person has an individual written plan of care. These describe what care they need and how they want this to be delivered. Recently, a new form has been used to record these plans. There are various headings and prompts about what should be written down. The change has been done so that information in the plans is more consistent and is more clearly presented. Each of the plans is being kept up to date with regular reviews. In their replies both to our questionnaires and to those of the Registered Provider, people say that they reliably receive the care they need. They also say that care workers listen to them and act on what they say. One person says, the staff are excellent really and helpful. They will always have a chat and theyre kind. Its the Care Homes for Older People Page 13 of 30 Evidence: staff who make the place and were lucky to have some really good girls. Most staff have been here a long time and thats a good sign. They wouldnt stay if this wasnt the happy place it is, would they. One care worker says, we get to know the residents really well over time and we just know how each one likes to be helped. Whats right for one person isnt for someone else. Its a bit like a big family. Youve got to genuinely care about the residents or you wouldnt do this job and the staff here do care. Another care worker says, (The Manager) says that we are to treat people like wed want our own family cared for which I think is a good idea. In their replies to the Registered Providers questionnaire everyone is very satisfied or quite satisfied with the response they receive when they use the call bell. People are helped to have a bath or a shower whenever they want to. People are also assisted to use the toilet without having to wait unduly. Each person has an adequate wardrobe of clothes so that they can choose what they want to wear. Sensible steps are taken to help prevent people from having accidents. For example, people can have rails on their bed if they are worried about rolling out. The Expert by Experience says, staff members are caring and treat the residents with respect. Staff chat with residents while serving coffee and when time permits sit with them in the lounge and discuss things with those who were reading the newspapers. One person told the expert by Experience that, I didnt know that such happy places existed. The records show that people are receiving the medical care they need. This includes seeing professionals such as their doctor as and when they are needed. They also see specialist health and social care professionals. They give advice to the Service about how best to respond to people who have complicated personal and medical care needs. The records show that this advice is followed. For example special things have been done to help people take care of their skin so that it remains healthy. A chiropodist regularly calls to the Service. Arrangements are also be made for people to see a dentist or optician if this necessary. People can manage their own medicine if they want to and if it is safe for them to do so. At the moment everyone has chosen to have the care workers manage it for them. There is a system to check that the correct medicines are received from the chemist. Care Homes for Older People Page 14 of 30 Evidence: Once in the Service, medicines are stored securely. There is a procedure for administering medicines. This is designed to double check that the right medicines are given to the right people at the right time. There is a record that is completed on each occasion that a medicine is given. These are being completed correctly. Care Homes for Older People Page 15 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can take part in social activities if they want. People are free to receive visitors and to spend the day as they wish. Good quality meals are served. Evidence: People can choose to do a range of social activities such as gentle exercise, aromatherapy, quizzes and attending in house music recitals. In the summer the garden is very popular. People can sit out and enjoy their attractive surroundings. In the past six months there have not been any organised trips out. Recently, a computer games console has been purchased. This enables people to play games such as virtual bowls without them having to leave their seats. In their questionnaire replies most people but not everyone, says that they always or usually have enough social opportunities. One person says, I go to the lounge and we do the odd quiz. I dont get bored, I fill my own time and I like my bedroom and the peace it gives me. I could do more if I wanted. Another person says, I dont get at all bored, I like my room and the girls are always popping in for a chat or to help me. I look out of the window and think. I dont want too many things to do. Someone else says that more social events should be held. They also want to have the opportunity to go out on trips. One care worker says, theres always something for our ladies to Care Homes for Older People Page 16 of 30 Evidence: do. Many like to stay in their bedrooms and they do not want to be jollied into things. They know that if they come to lounge they will have the chance to do something most days. Once a week care workers organise a small mobile shop. This enables people to buy things such as confectionery, stationery and personal toiletries. People are free to receive visitors whenever they want. They can speak with them in the privacy of their bedroom if they wish. The Manager says that she keeps in touch with relatives so that they know how things are going. People are encouraged to make their bedrooms their own private space. They are helped to arrange them as they want them to be. People can use their bedrooms whenever they want. They can choose to have private time on their own or to be in company. The Expert by Experience says, the bedrooms and en-suite facilities are a good size, nicely furnished and personalised with residents own furniture, photographs and memorabilia. The cleanliness of the rooms is of a high standard. The Registered Provider does not get involved in helping people to manage their financial affairs. Most people are helped by their families. The records show that there is a varied menu. This is kept under review so that it can be changed to incorporate peoples suggestions. The main meal is lunch and the sorts of dishes served are things like duck in redcurrant sauce, spaghetti bolognaise and toad in the hole. There is a choice of main dish at each meal time. There are drinks and cakes and biscuits served mid morning, mid afternoon and later in the evening. People can dine in their bedroom if they wish. In their replies to the Registered Providers questionnaire most people say that they are very satisfied or quite satisfied with their meals. One person says, the meals are excellent, very good indeed because we have a very good cook. I always look forward to my meals and theyre nicely served. The Expert by Experience says, residents praise the quality, variety and quantity of the food. There is a good choice and also residents can request an alternative if they wish. Wine and soft drinks are offered with lunch. The food served at lunch time during my visit was tasty, hot and well presented. Tables are laid tastefully and vegetables are served at the table from separate dishes. When meals are taken to those in their rooms this is carried out quickly and efficiently. The residents who eat in their rooms comment, it is always hot and nicely presented and they help me if I cannot manage on my own. Care Homes for Older People Page 17 of 30 Evidence: Care Homes for Older People Page 18 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a complaints procedure. The receipt and investigation of concerns and complaints are not being fully recorded. There are systems in place that are designed to keep people safe. People are protected from prejudice and discrimination. There are reliable systems for helping people to manage their personal spending money. Evidence: There is a written complaints procedure. This explains how someone can raise concerns about the Service. It states, if you are unhappy in any way please tell us so that we can do something about it for you. In their questionnaire replies people say that they know how to make a complaint. One person says, I can say anything I want to but I dont have any complaints at all, the place is excellent. You get what you pay for dont you. And here we get the best really so theres no need to complain. Another person says, Im fine here and if I wasnt Id speak to (the Manager) about it all. The staff are all so kind I shouldnt imagine Ill ever need to say anything, but if I did I would. One part of the procedure does not accurately describe one of the rights that people have which is laid down in the Regulations. The Manager is going to address this matter by 1 March 2010. Since our last Annual Service review we have not received any complaints about the Care Homes for Older People Page 19 of 30 Evidence: Service. The Registered Provider has received two relatively minor concerns. These were from people who live in the Service about different aspects of the care they had received. The Manager says that she promptly investigated each matter. She says that one of them was substantiated. She also says that both were resolved to the satisfaction of the complainant. There are no records of the steps she took when doing this. Without them it is more difficult for the Manager to demonstrate to us how she complied with the Registered Providers procedure. People who live in the Service are confident that they are safe and that their wellbeing will be promoted. In their questionnaire replies everyone says that members of staff always treat them well. The care workers are confident that people are being kept safe. One care worker says, the residents come first here and nothing would be allowed that undermined that. None of the staff would allow it, it just wouldnt happen here. The Assessment commits the Registered Provider to promoting diversity in the Service. This means respecting each person who lives there as an individual. It also means making sure that no one experiences any form of prejudice or discrimination. The records show that care workers receive training about this subject. The Manager says that this commitment to promoting diversity is also expressed in practical terms. For example, in the way that each person receives individualised care in ways that respect their preferences and wishes. One of the Registered Providers policy documents states, Brampton Lodge is committed to ensuring that all people are treated equally and to ensure that the home is a living and working environment which promotes this equality of treatment. We will challenge any discrimination we encounter. Suitable safeguards are in place to protect the interests of people if someone needs to have aspects of their freedom temporarily restricted. People are helped to handle their personal spending money. Usually this means that relatives bring in small amounts of money that are put into safekeeping by the Manager. The money is then used to pay for things such as for seeing the hairdresser. The records show that the system is working in a reliable and transparent way. Care Homes for Older People Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The accommodation is very well presented. There is a modern fire safety system. There are some shortfalls in how this is being checked. The kitchen is well equipped. There is enough equipment to help people who have difficulties with their mobility. There is a suitable laundry. Evidence: The building provides a suitable range of facilities for the people who live there. These are in line with what the Registered Provider has committed itself to deliver in its Statement of Purpose. This is a legal document that describes in some detail the facilities and services that are available in Brampton Lodge. Copies of this document can be obtained from the Registered Provider. The building is very well maintained on the outside. The garden is neat and attractively laid out. On the inside, the accommodation is very well decorated and furnished. The lounges are comfortable spaces. The Expert by Experience says, the home is fresh and bright. A new summer house has been erected since our last Annual Service Review. It is hoped that this will provided shade for people who want to enjoy the garden in the summer. Also, it will enable people to do artwork in a sheltered spot. There is a range of equipment to help people who have reduced mobility. There are special baths that Care Homes for Older People Page 21 of 30 Evidence: have hoists. These mean that someone can remain seated while getting into and out of the bath. There is a mobile hoist that can be used in the lounges and in the bedrooms. There are also other things such as special sheets to help people change position in bed. There are banister rails in the hallways. Also, rails are fitted to the wall near to the toilets so that people can hold onto them and use the facilities safely. There is a modern automatic fire detection system. This has been assessed by the Registered Provider to make sure that it continues to meet the national standard. Most but not all of the required checks are being done to make sure that the system remains in good working order. The Manager says that the remaining checks will now be reliably completed. People say that the accommodation is always comfortably warm. It was warm on the day of our visit even though it was a very cold day. One person says, Im always toasty warm and never have to get dressed up just to be warm. The radiators are fitted with guards. This has been done so that their heated surfaces cannot get hot enough to burn someone. Most of the hot water system is temperature controlled. This has been done so that it does not get hot enough to scald someone. The Manager says that in the next few months all of the showers in the private bathrooms are also going to be fitted with a temperature control mechanism. The kitchen is clean and well equipped. The local Department of Environmental Health says that the kitchen meets its requirements. The chef knows about the importance of good hygiene. Safe systems are used in the storage and preparation of food. As part of this, there are regular checks to make sure that refrigerators and freezers are cold enough to store food safely. Checks are also done to make sure that hot foods are cooked through. There is a system to date mark food so that it does not go beyond its use by date. The laundry is well equipped with washing machines and dryers. The washing machines are fitted with a special cycle for items that need a particularly hot wash. The area is well organised and clean. There are suitable arrangements for promoting good standards of hygiene. There is a sluice. This is used for items that need cleaning before they are put in the wash. Care Homes for Older People Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are enough care workers on duty. Care workers are receiving most but not all of the training that is intended for them. Security checks are completed on new members of staff. Evidence: There are 14 people in residence. The records show that there are two care workers on duty from early in the morning until later in the evening. There is a waking staff presence at night. During the day there are other people who do the housekeeping and who work in the kitchen. Care workers say that there are enough members of staff on duty. One care worker says, we normally have enough staff on duty. I know two doesnt sound much but we get through the work without having to rush. Many of our ladies can do things for themselves and dont want us fussing around them. We would need more if we are full or if someone is unwell and needs a lot of care. If that happened we would have the extra one Im sure. Another care worker says, it depends on the day but usually we manage okay. We do seem to manage. It can be hard work at busy times but nothing we cant manage. The records show that the necessary security checks are being completed for new care workers. These include things such as confirming their identity, taking up references Care Homes for Older People Page 23 of 30 Evidence: and doing a police check. This is done to make sure that they are trustworthy people to work in the Service. Care workers do introductory training before they join the roster. One care worker says, I got a lot of training when I first came. I met all of the ladies and was told about things such as how to help people get up and move about. I was also told about the fire panel and what to do if the alarms sound. I was gradually shown how each person likes to be helped. I wasnt rushed at all and so I could get my confidence. After their introduction, there is ongoing training in key subjects such as first aid, health and safety and how to help people who have reduced mobility. Most but not all of the care workers have had the training that the Registered Provider has committed itself to provide. The Manager says that more training is planned for early 2010. One care worker says, the training is good actually. We seem to do quite a lot and I have done training in moving and handling and fist aid and in adult protection. Weve got some more planned for next year and there always seems to something that were going to. Since our last Annual Service Review four more care workers have completed a relevant National Vocational Qualification (NVQ). This means that most of them now have the qualification. The award is designed to further develop their ability to provide people with the assistance they need. The Manager says that all of the care workers will be encouraged to obtain the qualification. Care Homes for Older People Page 24 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Manager is registered with us. The quality assurance system does not fully involve everyone who lives in the Service. There are reliable health and safety arrangements. Evidence: The Manager is registered in her post. This means we have confirmed that she has the knowledge and skills necessary to ensure that people reliably receive the care they need and want. She has a formal nursing qualification and a management qualification. Members of staff say that there is good team work in the Service. One care worker says, the teamwork is very good. Most people have worked here a long time and we have all got to know each other and we work together as a team. The Manager works with us and is dead easy to talk to. Another care worker says, this is a really wonderful place to work and is like a part of the family. Theres no us and them in the team we all get on. Staff are treated with respect and the place has just got a lovely welcoming feeling to it. Care Homes for Older People Page 25 of 30 Evidence: There are handover meetings at the beginning and end of each shift. These are when care workers discuss how things are going so that they can plan what needs to be done. There are occasional team meetings. The Manager says that she wants these to be held more frequently from now on. The Expert by Experience says, this is a well run home and because it has a relatively small number of residents, has a homely atmosphere. The Manager has been in post for a number of years and many of the staff have also. The majority of the residents appear happy and contented. The home gives a good quality of life to residents. As noted previously, people who live in the Service, their relatives and other stakeholders are invited each year to complete a questionnaire. There is no system to give feedback to people who have completed them. The Manager is planning to start a quarterly newsletter. This means that she will be able to tell people what is going to be done to respond to any suggested improvements. There are no house meetings where people can get together to talk about their home. Someone senior from the Registered Provider calls to the Service at least once each month. The records show that they speak with people who live in the Service and with members of staff. They also check various records and look around the accommodation. All of this is done to make sure that the Service is operating in the correct way. The records show that members of staff receive regular fire safety training. There has been a recent fire drill. Before that there was quite a long period since the last one. The Manager says that in future, there will be two drills each year. There is a health and safety policy. This commits the Registered Provider to maintaining a safe environment in the Service. The records show that items of equipment such as the passenger lift, the hoists, the electrical wiring installation and gas fire appliances remain in good working order. There have not been many significant accidents in the Service since our last Annual Service Review. The records show that the Manager monitors the occurrence of accidents. This is so that she can see if anything needs to be done to help prevent them from happening again. She says that nothing particular needs to be done at the moment. The Manager regularly completes an informal health and safety audit of the building Care Homes for Older People Page 26 of 30 Evidence: and the accommodation. This is done to help make sure that there are no minor hazards that might result in someone having an accident. The Manager says that there are no particular hazards that need to be dealt with. We did not notice any either. Care Homes for Older People Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 28 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 29 of 30 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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