Care Home: Brant Howe

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What the care home does well What has improved since the last inspection? Since the last inspection the manager has improved the quality of care records, particularly the risk assessments for peoples moving and handling needs. A set of sit on weighing scales had been purchased, and staff were about to receive training on nutritional assessments. Brant Howe DS0000022581.V376554.R01.S.doc Version 5.2 There was some new activities equipment, including a large `white board` for word games, and links had been made with the local Monday club which a number of people were now attending weekly. Following consultation with people living in the home, menus had been updated and some new activities, such as the skittles tournament had been introduced. A lot of decoration had been done, and new furniture, flooring and blinds had been provided in the dining room. The patio had been extended and new chairs, tables and sun shades purchased. One lounge was being decorated at the time of the inspection. An additional disabled toilet had been provided. A key pad lock had been fitted to the front door to improve general security. One staff member had been designated as the homes training co-ordinator, and this had improved the availability and range of training provided for staff. Formal staff supervision sessions had been implemented, and the quality of training and supervision records had improved. What the care home could do better: There were no requirements or recommendations made as a result of this inspection. The manager and his team continue to monitor the quality of the service they provide and to listen to what people who live in the home want. Key inspection report CARE HOMES FOR OLDER PEOPLE Brant Howe Fairbank Kirkby Lonsdale Carnforth Lancashire LA6 2DU Lead Inspector Jenny Donnelly Key Unannounced Inspection 20th July 2009 09:20 DS0000022581.V376554.R01.S.do c Version 5.2 Page 1 This report is a review of the 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. 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. Brant Howe DS0000022581.V376554.R01.S.doc Version 5.2 Page 2 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 Brant Howe DS0000022581.V376554.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brant Howe Address Fairbank Kirkby Lonsdale Carnforth Lancashire LA6 2DU 015242 71832 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) paul@branthowe.co.uk Mr Paul Martin Jackson Mrs Emma Louise Jackson Mr Paul Martin Jackson Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27) of places Brant Howe DS0000022581.V376554.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC To people of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of people who can be accommodated is: 27 12th March 2008 Date of last inspection Brief Description of the Service: Brant Howe is registered to provide personal care and support for up to 27 older people. The home is situated in a residential area in Kirkby Lonsdale with easy access to shops and transport. Care and accommodation is provided on the ground and first floor only with a stair lift in place. The top floor is used for staff accommodation, and the laundry is sited in the basement. There are two lounges, a conservatory and two dining areas. There is a mixture of single and double bedrooms although the double rooms are generally let as single. Some bedrooms have en suite bathroom, and there are two shared bathrooms and one shower room. There is a separate single storey building in the grounds which is used as an office for the manager. Information is supplied to people in the form of a brochure. There is a statement of purpose on display in the home which includes a copy of the homes latest inspection report. The weekly fees range from £398 to £550, according to the persons care needs and the bedroom occupied. Brant Howe DS0000022581.V376554.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 stars. This means the people who use this service experience excellent quality outcomes. This was the main or key inspection for the year. The lead inspector Jenny Donnelly asked the manager to fill out a form called the Annual Quality Assurance Audit (the AQAA). This asks for details of what has improved in the home since the last inspection and for the plans for the coming year. This was fully completed and returned to us by the date we asked. We also sent surveys to some of the people who live in the home, and to staff, their comments are included in this report. Jenny Donnelly made an unannounced visit to the care home on 20th July between the hours of 09.20 and 15.00. During this visit we (the Care Quality Commission) toured the building, spent time in the lounges, and dining room where we watched lunch being served. We spoke with people living in the care home and their visitors. We also spoke with the manager and the staff on duty. We looked at files and documents that backed up what we were told and what we saw. Since the last key inspection in August 2007, we have completed an Annual Service Review. This was done in October 2008, when we looked at all the information we had gathered about the service over the year. This included the managers Annual Quality Assurance Audit and surveys that we sent to people who live in the home. From this we made a judgement about whether the home was continuing to provide a good service to people, or whether we needed to inspect sooner than planned. We received positive feedback on Brant Howe and did not alter our inspection plan. Copies of the annual service review are available on request from us, or from the care home. What the service does well: Brant Howe is a friendly and welcoming home. People were given good preadmission information to help them decide if the home would be right for them. Admission procedures helped staff to understand people’s needs, and staff spent time with new people to help them settle in. The planning and delivery of care was very good. People told us they got all the help they needed from staff in a way that was acceptable to them. People were consulted about their individual wishes and choices and had been involved in developing their care plans. Arrangements for health care were Brant Howe DS0000022581.V376554.R01.S.doc Version 5.2 Page 6 good, with people having good access to a range of general health services. Medicines were safely managed. People enjoyed good links with the community, through attendance at the local ‘Monday club’ and through visits to the home from local school children and the choir. There was a range of visiting musicians and entertainment, and staff ran a weekly programme of in house activities, which people enjoyed. • • “I go out to the Monday club every week” “I enjoy the staff doing my nails, and we sometimes play games” People were happy with the food provided, saying there was a good variety and meals were of good quality. • “The meals are very good and we never get the same thing twice in a week” People were encouraged to voice their views and opinions about the home, especially about activities and menus, through the residents meetings and in individual discussions with the head of care. The manager and staff were good at listening to people and had received no complaints. People said they knew how to complain, but had not needed to as they felt safe and well looked after. • “I went to the residents meeting, so we can have our say” The care home was well maintained and decorated and furnished to a very high standard. There was a chair lift, grab rails, hoists, special mattresses and bath seats for people who needed them. The home was clean and fresh throughout and people told us it was ‘always this clean’. People’s clothes were nicely laundered and returned promptly. Staffing levels were sufficient to meet peoples assessed care needs. There was good training provided and staff were organised and worked well with people. There was low staff turn over and people knew the individual staff well and liked them. Staff received regular supervision sessions to help them understand their job role and to identify any training needs. Overall management of the service was good. There were quality checks in place to make sure the standard of service was as intended, and that peoples views and opinions were heard and acted on. What has improved since the last inspection? Since the last inspection the manager has improved the quality of care records, particularly the risk assessments for peoples moving and handling needs. A set of sit on weighing scales had been purchased, and staff were about to receive training on nutritional assessments. Brant Howe DS0000022581.V376554.R01.S.doc Version 5.2 Page 7 There was some new activities equipment, including a large ‘white board’ for word games, and links had been made with the local Monday club which a number of people were now attending weekly. Following consultation with people living in the home, menus had been updated and some new activities, such as the skittles tournament had been introduced. A lot of decoration had been done, and new furniture, flooring and blinds had been provided in the dining room. The patio had been extended and new chairs, tables and sun shades purchased. One lounge was being decorated at the time of the inspection. An additional disabled toilet had been provided. A key pad lock had been fitted to the front door to improve general security. One staff member had been designated as the homes training co-ordinator, and this had improved the availability and range of training provided for staff. Formal staff supervision sessions had been implemented, and the quality of training and supervision records had improved. 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. Brant Howe DS0000022581.V376554.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Brant Howe DS0000022581.V376554.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 5 and 6 People using the 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 admission process helps people to know if the home will be suitable to meet their needs, and helps them settle in quickly. EVIDENCE: There was good written information available for people interested in finding out about the care home, and this was presented in the form of an enquiry pack. People were welcome to visit the home to look around and to speak with the manager and staff. People did visit during our inspection and the manager spent some time helping them with their enquiries. Staff had been instructed on how to deal with new enquiries and what information to give out to people, in the absence of the manager. This meant people still received a professional response when the manager was not available. Brant Howe DS0000022581.V376554.R01.S.doc Version 5.2 Page 10 We looked at the admission arrangements for two people fairly new to the home, and found these were very good. In both cases the manager had visited the person and spent time with them to carry out a needs assessment, before offering them a place in the home. The assessments were thorough and covered all activities of daily living and included information about people’s individual wishes and choices. Where applicable the manager had also obtained copies of people’s assessment by their social worker. From these assessments an initial plan of care was drawn up and people were asked to sign their agreement with this. Staff said they paid special attention to new people, introducing them to other residents and generally helping them to settle in. We saw that people had been given a copy of their contract of residency, and this showed the fees payable. The manager used a ‘check list’ to make sure all admission paperwork had been fully completed for each person. The home is registered to accommodate a maximum of 27 people, but as double bedrooms are often used singly, general occupancy is 23. There were 21 people at the time of our inspection. Brant Howe does not provide an intermediate care service, although they do provide short term respite care if they have a room available. Brant Howe DS0000022581.V376554.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11 People using the 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 received the health and personal care they needed in a way that was acceptable to them and promoted their choices and well being. EVIDENCE: Each person had a written plan of care in place that had been drawn up from their pre-admission assessment. We looked at the care plans of four people, with different care needs, and found them to be comprehensive, up to date and personal to each individual. Care plans set out in detail the level of support people required from staff and included information about how they liked to be cared for. We could see what time people generally liked to get up and go to bed, and whether they preferred a bath or shower. Care plans showed if a person needed the support of more than one staff member, and whether they needed any special equipment such as a hoist or pressure reducing mattress. Care plans had been Brant Howe DS0000022581.V376554.R01.S.doc Version 5.2 Page 12 reviewed every month and updated as necessary and staff were sent reminders to read the updated care plans. Residents or their relatives were consulted on any changes to the care plan and invited to sign their agreement. We saw evidence that people had good access to healthcare services. The doctor visited a number of people during the inspection, with staff saying this was a routine weekly visit. We noted the doctor saw people in the privacy of their own bedrooms and staff either accompanied the doctor or spoke with them afterwards to see if any changes in the persons care or treatment were needed. Some people received a district nursing service. We saw there were arrangements in place for people to see a dentist, optician and chiropodist, who visited the home every one or two years. Some people had set up their own healthcare arrangements privately. Risk assessments had been completed and updated monthly, for people’s general safety and for any moving and handling needs. People’s skin was monitored during bathing and any concerns about skin integrity reported to the district nurse for advice. Staff were due to receive training the following week on assessing peoples nutritional status, and the manager had purchased a set of sit on weighing scales so peoples weight could be checked more easily. People looked well cared for and those we spoke with said they were helped to have bath or shower either once or twice a week according to their preference. People told us; • “The girls help me into the shower twice a week, and then wait outside the door, as I can sit and wash myself. I know they are nearby when I need help to get out”. • “I’m very contented here, I’ve seen the doctor today and the staff help me with all I need”. We looked at the way peoples medicines were managed and found this to be safe. Staff we spoke with were aware of the homes policies and procedures about medicines and had received appropriate training to administer medicines. There was an assessment procedure for people to manage their own medicines if they wanted and were competent to do so. There was a homely remedy policy, which meant people could have simple ‘over the counter’ remedies for ailments such as coughs or mild pain, without having to wait and see their doctor. Medicines were securely and appropriately stored and we saw the records for the receipt, administration and disposal of waste medicines were good. We did some random stock checks and found these to be accurate. We looked at some medicines given at odd intervals such as on alternate days or once a week and found these were being well managed. We also checked on medicines given in relation to blood test results and found these were also safely managed. Staff we spoke with were knowledgeable about peoples Brant Howe DS0000022581.V376554.R01.S.doc Version 5.2 Page 13 medicines and knew when bloods, or other tests, were due. The manager carried out monthly checks on the medicines to ensure all was in order. The home had information to guide staff on how to care for dying people and their families. Some staff had also attended ‘end of life’ training. People’s wishes about their end of life care were discussed and recorded as appropriate, including any specific cultural or religious preferences. Brant Howe DS0000022581.V376554.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People using the 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 were helped to make choices and to live as they wished. There was a good provision of activities and entertainment and people were pleased with the quality and choice of meals. EVIDENCE: People said they were able to continue their own daily routine while living at Brant Howe. People chose what time to get up and go to bed and how to spend the day. Whilst many people used the shared lounges and ate together in the dining room, some preferred to remain in their own bedrooms, and were able to do so. We saw that a number of people had a daily routine of meeting for morning coffee to have a chat. Many people had a daily newspaper delivered. There was a programme of weekly in house activities advertised, these included things like the ongoing skittles tournament, manicures, word and board games, soft ball and walks. Some people we spoke with remembered having bell ringers and other musical entertainment, which they had joined in Brant Howe DS0000022581.V376554.R01.S.doc Version 5.2 Page 15 with and had enjoyed. The home had visiting musicians once a month and a visiting hairdresser and library service. There was a Holy Communion service held in the home twice a month. A group of people attended the local ‘Monday Club’ held in the town hall. Private taxis as well as the local voluntary driver scheme were used for transport. We saw posters advertising the homes forthcoming ‘Cream Tea afternoon’ and the next music session. The home had two large screen televisions which were also used for film afternoons, and they had purchased a large white board for activities such as word games. Many people also enjoyed individual outings with friends and family. The home had good contact with the local community and enjoyed visits from the local school and choir. Visitors told us they were always made welcome. Throughout the morning we saw staff helping people with their newspapers, handing out and helping with post, and taking time to sit and chat with people. In the afternoon we saw staff helping people to do crossword puzzles and giving manicures. We saw that ideas for activities, entertainment and menus had been discussed in the recent residents meeting. Everyone we spoke to told us the food in the home was very good. We saw lunch being served in the two dining rooms. One person preferred to have their meal at a small table in the lounge, and a few stayed in their bedrooms. Lunch was the main meal of the day and consisted of a bacon chop with potatoes and vegetables. There was a vegetarian option of mushroom and potato bake in béchamel sauce. People told us they got what they wanted and had enjoyed their lunch. One person had rice instead of potato as was their wish. We heard staff offering an alternative dessert to people who did not want the sponge pudding. Staff discreetly assisted those who needed help. The evening meal was lighter, and was served at 4.15pm, today it was a buffet with a cake as it was someone’s birthday. A supper of sandwiches, crumpets or toasted tea cakes was served with a hot drink at 7pm. People told us; • “We are very happy here; we get our newspapers, we like the music people and we are having a birthday tea today” • “I went to the residents meeting, so we can have our say” • “I go out to the Monday club every week, and use a taxi to visit local friends every other week” • “I enjoy the staff doing my nails, and we sometimes play games” • “The meals are very good and we never get the same thing twice in a week” Staff surveys told us; • “All staff have good relationships with residents and their families” • “People have good entertainment and enjoy excellent food here” Some of the staff surveys said it would be nice if there were more outings such as mini bus trips and shows. The manager said he has tried to arrange such outings in the past but people had not wanted to attend. Brant Howe DS0000022581.V376554.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People using the 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 told us they felt safe living at Brant Howe and were confident that staff would listen to them and help them with any concerns or complaints they might have. EVIDENCE: The service had a complaints procedure that guided people in how and who to make any complaint to. The manager told us he had not received any complaints since the last inspection, and none had been made directly to us. People we spoke with confirmed they knew how to raise concerns and felt the manager would listen to them and act accordingly. No one we spoke with voiced any complaints or concerns. The head of care met with everyone individually every two weeks, to have a chat and give people an opportunity to talk about anything that worried them. Staff we spoke with were aware of their responsibilities to safeguard people from harm and abuse, and there were written procedures to guide them in what do to should any allegation be made. The manager had a copy of the Cumbria multi-agency guidance for safeguarding people and had used this to update the homes policies and procedures on how to make a safeguarding referral. There had been no safeguarding referrals since the last inspection, and staff were able to tell us the actions they would take, should this be Brant Howe DS0000022581.V376554.R01.S.doc Version 5.2 Page 17 necessary. The people we spoke with said they felt safe living in the home and said staff ‘looked out’ for them. Brant Howe DS0000022581.V376554.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26 People using the 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 lived a clean, comfortable home that was decorated and furnished to a high standard, and was suitably equipped to meet their physical needs. EVIDENCE: Brant Howe was a very well maintained, comfortable and clean care home. There was an excellent standard of décor throughout, which was maintained through an ongoing programme of repair and renewal. The home had two lounges, two dining rooms and a conservatory, plus small seating areas in the hallways where people liked to sit and see who passed by. The communal rooms were decorated to a high standard and benefited from plenty of natural light. New dining furniture, flooring and blinds had been provided, as well as an additional disabled toilet. One of the lounges was Brant Howe DS0000022581.V376554.R01.S.doc Version 5.2 Page 19 being decorated at the time of inspection and was temporarily out of use. There was large garden which was easily accessible. The patio had been extended, and new tables, chairs and sun shades had been provided. A key pad lock had been fitted to the front door to improve security. Bedrooms were individual and varied in size and shape, and some had the benefit of an en suite bathroom. All were furnished and decorated to high standard. People had made their bedrooms homely by bringing in personal items or pieces of furniture. People said they were happy with their accommodation and told us the home was always clean and tidy. The home was suitably equipped to support people with mobility problems. There were two hoists, and an additional hoist had been purchased for the sole use of one person. There was a chair lift on the stairs and grab rails in bathrooms and toilets. There were two baths with seats and a shower room. We saw the laundry was tidy and well organised, and people told us their clothes were nicely laundered and returned to them promptly. There were good hand washing facilities for staff and a polite notice at the front door asking people not to visit if they were suffering from coughs or colds, to reduce the spread of infection. People told us; • “It is beautiful here” • “It is always clean and tidy” • “They are always decorating and keeping the place nice” • “My bedroom is lovely and I have my own shower” Brant Howe DS0000022581.V376554.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People using the 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 were cared for by a well trained, caring and organised team of staff, who understood people’s individual needs and wishes. EVIDENCE: Staffing levels were sufficient to meet the needs of the people currently living at Brant Howe. There were three care staff on duty throughout the day, plus a fourth person on some days to assist with bathing. At night there was one waking, and one sleep-in carer. The manager was in the home most days and staff said he was available by telephone for advice as needed. Catering and domestic staff were employed for several days each week, and care staff or the manager undertook these duties on other days. The manager had designated one staff member to become the homes training coordinator. We saw and heard that staff had received training in various topics over the last year including fire safety, medicine handling, food hygiene and infection control. The home continued to support staff to achieve a National Vocation Qualification in care, and 70 of staff had achieved this. We saw notices advertising forthcoming training sessions on nutrition, continence, dementia care, and safe moving and handing. Staff confirmed they had good Brant Howe DS0000022581.V376554.R01.S.doc Version 5.2 Page 21 access to training and we saw the majority of training was provided by qualified external providers. Staff told us; • “We get good training here…I’ve done loads of courses” • “We always have a senior carer on shift, and can call the manager or head of care at any time if there is a problem”. Through discussions with the staff on duty we found they were knowledgeable about people’s individual needs, and were clear about the homes policies and procedures and what was expected of them. We saw that staff were well organised and had clear instructions for what they needed to do during their shift. Staff had time to sit and chat and engage in activities with people. There were regular staff meetings to keep staff informed of any changes, and to discuss any day to day issues in the home. We looked at the records of some new staff, and saw that full pre-employment checks, including references and criminal records bureau checks had been carried out before they started work. This helps to safeguard people from having unsuitable persons working in the home. Staff files were well organised and check lists were used to ensure all the necessary paperwork had been completed for each staff member. Staff turnover was very low, and people spoke highly of the whole staff team, saying they had every confidence in them. Brant Howe DS0000022581.V376554.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36, 37 and 38 People using the 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 lived in a well run care home, their views were listened to and they received a consistently good quality service. EVIDENCE: Mr Paul Jackson was suitably qualified and experienced to run the care home efficiently and effectively. There were good systems in place to make sure peoples views were listened to and acted on. We saw evidence of, and were told about regular residents meetings and staff meetings. The manager periodically sent out satisfaction surveys, and there was individual consultation with people every fortnight. This helped people to express their views and suggestions about the home in both public and private forums. The Brant Howe DS0000022581.V376554.R01.S.doc Version 5.2 Page 23 information gathered helped to inform the homes annual business and development plan. Other checks were also in place to ensure the home was running smoothly and staff were working as expected. These included quality audits of care plans, medicines and health and safety checks on the building. The manager completed our Annual Quality Assurance Audit fully and with a good level of detail. During inspection he was able to support and evidence the information he had provided about the care home. The manager did not handle people’s personal finances. This was managed by family members or by independent advisors. We saw evidence of ongoing investment into the home both through the upkeep of the building and the provision of staff training by external providers. A new staff supervision policy had been set up and staff were getting individual supervision sessions with a senior every two months. Care practices and training needs were discussed in supervision and this fed into the homes training plan. All records examined were up to date, accurately maintained and securely stored. We saw evidence that the homes equipment and services were checked regularly, this included testing of the fire systems, water safety, the boilers and electrics. Equipment such as bath seats and hoists had been serviced regularly. Staff had received up to date training in health and safety including moving and handling, fire safety, and infection control. The environmental health officer had visited the home in 2008 and awarded the kitchen ‘4 stars’ for food safety. Brant Howe DS0000022581.V376554.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 4 3 3 3 3 3 4 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 3 Brant Howe DS0000022581.V376554.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Brant Howe DS0000022581.V376554.R01.S.doc Version 5.2 Page 26 Care Quality Commission North West Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: 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. 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