Care Home: Briarcroft

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What the care home does well The excellent service at Briarcroft is provided with attention to detail. The owners are open to suggestions from any quarter and meet regularly both formally and informally with residents and staff. People who have dementia are cared for with consistency, sensitivity and understanding. Staff have time to give individual attention. It is a bright and lively home, where there is always `something going on`. Planned and spontaneous activities provide stimulation and interest. People said they were very happy and Briarcroft was a real `home from home`. Good and clear information is made available to people considering moving to the home and care is taken to admit people who will benefit from the service. Each person has their needs assessed and the care they need written in a care plan. These include their emotional and social needs, and are reviewed regularly so that staff are aware of any changes. Risks associated with ill health and ageing such as poor mobility and nutrition are assessed and actions described to reduce these risks. Personal and health care are very good, and carried out in a sensitive manner. Specialist advice is provided by the District Nursing Service. Unless they choose to stay in their room, people are not left alone during the day, as staff are constantly attending and encouraging them to engage in social activities. Musical entertainers are booked weekly, and staff have time for individual activities such as cookery, or taking a stroll or going for a coffee on the sea front. Meals were described as `excellent`, with varied menus and lots of fresh vegetables and fruit. The owners are freely available and can deal with any concern that might be raised immediately. Their constant presence in the home promotes good communication between staff, residents and relatives. They lead by example, listening to what people have to say, and striving for continuous improvement. The house is spacious, and cheerful, always well-maintained. Residents and their visitors can use the conservatory if they do not wish to join the main group in the lounge. The staff are kind, attentive, and competent. Staff were seen to care for staff with kindness and patience. What has improved since the last inspection? The owners have a continual programme of redecoration and re-carpeting. The dining room has been refurbished and redecorated and several bedrooms have been redecorated. People`s past social and family history has been recorded and is available in each person`s bedrooms, giving staff lots of information about the people they are caring for. A timetable of when individual staff supervisions sessions have occurred is now maintained to give an indication of how often staff are offered the opportunity to spend time with the care manager to discuss their work performance and training needs. What the care home could do better: Once again the owners and staff have demonstrated their commitment to providing a quality service to the people who living in the home: this is the fifth consecutive inspection at which no requirements have been made. Key inspection report Care homes for older people Name: Address: Briarcroft Dawlish Road Teignmouth Devon TQ14 8TG     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: Jane Gurnell     Date: 1 8 0 3 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 27 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Briarcroft Dawlish Road Teignmouth Devon TQ14 8TG 01626774681 01626774681 briarcroft@bluebottle.com www.briarcroftcarehome.co.uk Elaine Louisa Ann Walsh,Mr John Patrick Walsh care home 20 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Ground Floor to be registered for Service Users with OP category only Date of last inspection Brief description of the care home Briarcroft is a detached house, situated close to Teignmouth town centre and set back from the main road. There are sea views from some windows. Briarcroft is registered to care for up to 20 people over the age of 65, who may have dementia. There are keypad locks on the main entrances, and an attractive level decked area in a garden that is secure. Accommodation is on two floors with a passenger lift to the first floor. There is a spacious lounge, separate dining area and a sun lounge. All but one room is for single occupation. There is a separate self contained flat on the lower ground floor. The flat has two bedrooms, a lounge and dining area as well as its own kitchen and conservatory. Fees range from £391 to £500 per week. Care Homes for Older People Page 4 of 27 Over 65 18 20 0 0 0 7 0 1 2 0 0 9 Brief description of the care home The Home owners will provide a copy of their inspection report to any serious enquirer who does not have access to the web site. Care Homes for Older People Page 5 of 27 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: This inspection took place on Thursday 18th March 2010. Both Mr and Mrs Wash, the owners were present and they and their staff team provided information and assistance throughout. A tour of the premises was made and many of the people living in the home were spoken with as were the staff on duty. Time was spent in the lounge room observing staff going about their duties and interacting with people. Care records, staff files, the medication system, and health and safety records were examined. Prior to the inspection the owners had completed an Annual Quality Assurance Assessment (AQAA) detailing what the home does well and what has improved over the past year. Care Homes for Older People Page 6 of 27 What the care home does well: What has improved since the last inspection? The owners have a continual programme of redecoration and re-carpeting. The dining room has been refurbished and redecorated and several bedrooms have been redecorated. Peoples past social and family history has been recorded and is available in each persons bedrooms, giving staff lots of information about the people they are caring for. A timetable of when individual staff supervisions sessions have occurred is now maintained to give an indication of how often staff are offered the opportunity to spend time with the care manager to discuss their work performance and training needs. Care Homes for Older People Page 7 of 27 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People considering moving to Briarcroft are provided with sufficient information about the services provided at the home to enable them to make a decision about the homes suitability to meet their needs. Pre-admission assessments ensure peoples needs are well known by the staff team in readiness for their admission. Evidence: Briarcroft has produced information for prospective residents and their representatives which is clearly presented and includes all required information, including comments from residents. They have an attractive and informative web site at www.briarcroft.co.uk. They describe how their service is designed to meet the needs of people with dementia. The owners and care manager confirmed that people considering moving to the home and their relatives are invited to visit at home to have a look around, to view the available bedroom, and meet the other people living in the home and the staff. People are invited to spend as long as they wish and to have a meal. Care Homes for Older People Page 10 of 27 Evidence: In a letter of thanks recently received by the owners a relative said she was impressed with the homes response to her initial enquiry and her visit to the home, saying, first impressions are crucial and that initial visit left me in no doubt that Briarcroft offered a safe and caring environment. With regard to the homes information, the letter goes on to say, I can honestly say everything in your excellent publication is accurate. Assessments are undertaken by either Mrs Walsh or the care manager to ensure the home is able to meet prospective residents needs and to prepare for their admission. These assessments were seen in all three care files examined as well as additional information supplied by hospitals or social services. Care Homes for Older People Page 11 of 27 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. Peoples personal and health care needs are well met by kind and competent staff and the system for administering medication was safe. Care plans are clear and give a good description of peoples needs. Evidence: Many of the living in the home were spoken with. The majority of people had a diagnosis of dementia and although unable to comment on life in general in the home, they were able to say how they felt at the time of the visit: comments included, Im happy, I like it here. Those people who were able to comment about life in the home said they were very happy living at Briarcroft and have the freedom to come and go as they pleased, saying its lovely here and its a home from home. The care plans for three people living in the home were examined, including one for someone newly admitted to the home, one for someone with dementia and one for someone with complex healthcare needs. All the care plans addressed peoples health, social and emotional needs, and the approach to be taken in meeting these. Care needs, goals, action to be taken and on-going care are specified. All contained Care Homes for Older People Page 12 of 27 Evidence: information about the persons preferred daily routine and highlighted what is important to them. Each care plan included risk assessments relating to mobility, pressure area care and nutrition. The care manager confirmed that due to the frailty and restricted mobility of many of the residents they had been provided with pressure relieving mattresses for their beds as a precaution. Those people who had been assessed as needing assistance to eat or drink had their nutritional intake monitored and recorded. The majority of staff have received training in the nutritional needs of older people from the local specialist dietician team. The care manager checked the care plans monthly, and there was evidence that relatives had been consulted at these reviews. The role of the keyworker, a member of staff with specific responsibility towards a small number of people living in the home, makes sure that people have all they need, and will speak to relatives, for instance, if there is a need for items, such as clothing or slippers. Doctors visits are recorded separately, for clarity. The care manager confirmed that the home has an excellent relationship with the District Nurses who provide specialist support and guidance for people with complex care needs. A chiropodist visits regularly and staff report any foot care problems to the care manager who ensures that treatment is obtained. Currently none of the people living in the home were able to manage their own medication and the care manager confirmed that although all staff have received training in safe medication practices, only the senior care staff on duty administer medicines. Medicines were stored securely and records were neat and accurate. Unwanted or out of date medications were recorded and returned to the pharmacist. People with terminal illnesses may remain at the home as long as the staff and the District Nursing Service can continue to meet their needs. A relative had written to the owners following the death of their father, paying tribute to the care and support he had received, saying that staff had been able to meet his exceptional needs and that his final days were dignified. The letter goes on to say I take great comfort in the fact that he died peacefully in bed and your excellent care and supervision. Care Homes for Older People Page 13 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Routines are flexible and people have the opportunity to be involved in a variety of daily activities: staff have time to give individual attention. Meals are varied and well balanced. Evidence: In the AQAA the owners said, Residents live their life as they choose. They make as many decisions as they are able. This includes routines of daily living such as when to get out of bed, what to wear, what to eat, where to sit, what activity they may wish to do right up until they wish to go to bed. Evidence of these preferred routines were detailed in the care plans examined as was information about each persons past social and family history. This information is important for staff to have knowledge of significant people and events in peoples lives, particularly for those people with dementia. On the day of the visit to the home people were seen to be getting up at various times and breakfast was available throughout the morning. The development of the keyworker system has resulting in more individual and small group outings, as staff have been given responsibility to consider the individual needs of the people living in the home. Care staff said that they can take people out for a stroll if they wish, and if a resident wishes, or is restless in the lounge they can bring Care Homes for Older People Page 14 of 27 Evidence: them to the conservatory to do cooking or another individual activity. People have recently enjoyed being taken for coffee or a cream tea at the sea front and out for meals at the local pub. A professional entertainer is engaged every week, with forthcoming performances posted in the hallway. Staff lead daily activities such as games of bingo, skittles or karaoke as well as quieter activities such as manicures. Staff said they have started to encourage people to become involved in the everyday domestic activities of the home such as folding laundry or dusting to involve them in ordinary tasks which research has demonstrated as being important for the well-being of people with dementia. Themed days have been arranged for the interest and enjoyment of the residents and their families and these have included Mothers Day, Easter, St. Georges Day and the Queens Birthday. The owners said that throughout the year there are celebration buffets for birthdays and special family gatherings. The owners take photos of people involved in an activity they enjoy, and with their relatives to act as a reminder of the event. Staff confirmed that people are never left alone in the lounge and a staff member is always available to engage people in conversation when not involved in the planned activites: this was witnessed during the inspection with all the staff congregating in the lounge room when not assisting someone elsewhere in the home. Staff also said that they attend to the people who prefer to remain in their rooms regulary to ensure they do not feel isolated. People have the opportunity to be involved in regular meetings with the owners and staff to enable them to air their views, be involved in planning activities and menus, and for the owners to pass on information about events in the home. Amongst the ideas raised were more cream teas, more colourful plants in the garden and suggestions for trips out. Meals were described as excellent. A cooked breakfast is offered several times a week, there is a choice of at least two cooked meals at lunchtime and more often than not a hot meal at tea time: sherry is served each day. People can take their meals in the dining room or the conservatory, as well as their bedroom if wished, however the staff do encourage people to eat together to promote social activity and friendships. Staff were seen to give people the help they needed and were seen to quietly feed those who needed help. A small number of people living the home required a liquidised meal due to ill health and swallowing difficulties: each food item was liquidised separately to ensure people could still enjoy the taste of the meals. Care Homes for Older People Page 15 of 27 Evidence: The owners and staff confirmed that the cook consults with people about the menus and their preferences. Fresh fruit and vegetables were plentiful, and all pies and cakes are home made. Relatives are invited to share a meal at no extra cost. Night staff can make toast or sandwiches and hot drinks for anyone who wakes during the night. Care Homes for Older People Page 16 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that any concern brought to the attention of the owners or care manager is taken seriously, recorded and dealt with promptly and any allegations of misconduct by staff have been dealt with effectively. Evidence: The owners meet with the people living in the home each day and as such say they are able to pick up on any concerns or worries and deal with these immediately. They and their staff team recognise the importance of listening to people and responding to what they say. Regular meetings with people allow good communication about developments within the home. The owners said they are also available at any time to meet with relatives and friends. When people were asked by us for suggestions that would make life in the home better, no suggestions were made and people said they felt well cared for and safe. The home has a complaints procedure that contains all relevant details as outlined in this standard and everyone living in the home has been provided with a copy. A record of concerns raised is maintained and these detail the action taken to resolve the matter. No concerns have been received by the home nor the commission this year. The Home has a policy on Protecting Vulnerable Adults from Abuse, Whistle Blowing and physical restraint. This is covered as part of the staff induction process. The Care Homes for Older People Page 17 of 27 Evidence: Devon County Council Alerters Guidance has been available to staff, who have signed to say they have read it. The Policies on Abuse and Whistle Blowing both include directions to staff on who they should speak to if they have any concerns. The owners have demonstrated that they act robustly in accordance with their policy if the need arises, and staff also know what they must do if any allegation of abusive behaviour is reported. The owners and care manager have consistently raised awareness of abuse within the home, to encourage people and staff to speak up if anything bothers them and staff are provided with regular training. Care Homes for Older People Page 18 of 27 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. Briarcroft provides a spacious and comfortable home to the people who live there. There are sufficient facilities and aids to meet peoples needs and the home is maintained a high standard both indoors and in the grounds. Evidence: Briarcroft is an spacious and attractive home, set on the hillside above Teignmouth, with fine sea views from some rooms. It was found to be clean and tidy with no odours. There is a programme of maintenance and improvement to ensure the home is maintained in good order. For example, this past year the owners have purchased new lounge and conservatory furniture. The grounds are pleasant and provide a safe and secure garden area for people to enjoy without risk if they wander. All exits have a security keypad, which is linked to the fire alarm system, which will allow them to open in the case of an emergency. The lounge is very pleasantly decorated room, it is bright and airy with windows overlooking the garden and the view across the estuary. The dining room has recently been refurbished and redecorated. The conservatory has comfortable seats and a table and chairs for activities or dining, this leads on to the decked area of the garden, which had lots of colourful plants in pots. Bedrooms are situated on the ground and first floors: all were found to be in good Care Homes for Older People Page 19 of 27 Evidence: order, well decorated and with attractive soft furnishings. People are encouraged to bring in items of furniture with them to personalise their rooms and make them more homely. Radiators were covered to reduce the risk of burns should someone come into contact with them when they are on. A passenger lift provides access to the first floor for people with restricted mobility. There is also a two-bedroom self-contained flat on the ground floor which is suitable for people without dementia who have made a choice to share such a married couple. Staff offer assistance as required and people can live a more independent lifestyle with the security of having the services of the care home close to hand. The home has a bathroom on the first floor and a shower room on the ground floor. Hot water for bathing is plentiful, and staff have access to a booster button for heating and hot water if it is ever required: hot water temperatures have been restricted to reduce the risk of scalding. Hand rails, raised toilet seats, walking aids and a lifting hoist are used to assist people with restricted mobility. Although the lifting hoist is regularly serviced Mr Walsh maintains a record of how often the hoist is used to ensure parts are replaced in line with the manufacturers recommendations. The owners confirmed that should a persons mobility needs change a referral is made to an Occupational Therapist to ensure the home is best equipped and staff trained to meet their needs. Liquid soap and paper towels were available in communal toilets to reduced the risk of cross infection from bar soap and towels. The laundry room was clean and tidy. The risk of cross-contamination between clean and dirty clothes is reduced by the used of sealed bags that can be placed directly in the washing machine. The owners confirmed that all staff have received training in infection control and health and safety to ensure keeping the home clean and safe is a shared responsibility. Care Homes for Older People Page 20 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are competent, well trained and have a kind and caring attitude. They are employed in sufficient numbers to meet the needs of those currently living in the home, as well as to provide individual attention. Recruitment practices protect vulnerable people. Evidence: The people living in the home said the staff were very kind and were good friends to them. A letter from a family member praised the commitment of the staff to care for her father, saying the care he received was exceptional. Staff were observed carrying out their work with kindness, commitment and understanding: there was a lot of laughter and interaction between people. A written rota is kept, which showed that there are generally four care staff on duty in the mornings (including one Senior), and three in the afternoons and evenings, plus a cook from 7.30am - 1.30pm every day, and a cleaner from 8 - 2pm. This is seen to be sufficient in terms of meeting peoples personal care needs and to allow time for individual attention and social activities: there were 19 people living in the home at the time of this visit. At night there are two waking night staff, to provide care for the more dependent residents. In addition, both owners work every weekday in the home and are available during the evenings and weekends. No agency staff are used as the owners and staff believe the people in the home should be cared for by staff known to Care Homes for Older People Page 21 of 27 Evidence: them and not by strangers. The owners described that staffing is flexible and would be increased as peoples needs change to ensure people still receive good quality care and support. The owners are supported by two care managers and one senior care staff who manage each shift. One has specific duties and is referred to as the lead care manager as she has the responsibility to oversee peoples day-to-day personal and health care needs, to review each care plan and to provide supervision for the care staff. The leadership qualities of the three senior staff are good, and their example in relating positively with people with dementia, and communicating well, enhances the work of the team. They also carry out the daily checks of care tasks with attention to detail, to ensure that good standards of care are maintained. There were 16 care staff employed at the time of this inspection and of these over half have achieved at least NVQ2 or equivalent. A training profile and individual training records provided evidence that staff received training in moving and handling, first aid, health and safety, food hygiene, fire safety and dementia care ensuring they have the skills to care for older people and can respond to emergencies. Briarcroft has a sound policy and procedure for recruitment of staff, has been found to implement this in a consistently thorough manner. Files of recently appointed staff were examined, and as at previous inspections, contained the documents required to assure residents safety - written references, Criminal Record Bureau clearances, and application forms including employment histories. New staff are provided with a buddy, a more experienced member of staff, to work with until they are more confident and are assessed as competent to work unsupervised. The home has its own induction pack specific to the homes policies and ways of working and also provides new staff with accredited induction training which includes the principles of good care and valuing peoples different needs. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The owners have consistently lead their team in the provision of a well run, safe, caring service, providing continual improvements. Evidence: The owners have many years experience in the care of elderly people who have dementia and have owned Briarcroft for over 13 years: they are committed to ensuring the people in their home receive the best possible care in a safe and homely environment. Mrs Elaine Walsh has CSS and a management development certificate as well as a City in Guilds in teacher training and is an NVQ assessor. Mr John Walsh has qualifications and experience in Quality Assurance and Health and Safety. Staff said they feel well supported by the owners and staff retention is very good at Briarcroft. This is most important to the well-being of the people living in the home as consistency, familiar faces and their relationships with staff are important, particularly for those people with dementia. Staff, residents, and visiting relatives appreciated the daily presence of the owners who are available - apart from their annual holiday - to Care Homes for Older People Page 23 of 27 Evidence: solve problems, listen to suggestions, and provide improvements. The information provided in the AQAA supplied to the commission shows that all systems are kept under regular review and reassessment. They have provided a clear explanation for their staff of what they mean by Quality Assurance. They have introduced and maintained a system of regular checks, covering peoples personal needs, household maintenance, and all records and documentation. Staff have received training in Quality Assurance, and all are expected to undertake this. The owners hold regular staff and residents meetings and also consult family members, visitors, GPs and District Nurses, the chiropodist and hairdresser, and the regular musician to gain their views of the quality of the care and services provided in the home. The results of the most recent consultation were very positive. The care manager said she and Mrs Walsh share the responsibility of individual supervision sessions with staff to review their work performance and to identify any training needs: a timetable indicates when these meetings have occurred and a record of the meeting is maintained. The people living in the home and/or their relatives are encouraged to retain responsibility for managing their own finances and the owners do not get involved. There is an excellent commitment by the owners to maintenance of health and safety within the home. Mr Walsh takes responsibility to ensure equipment such as the fire alarm system, lift and hoist are serviced regularly to maintain them in good working order. Staff have received regular training in fire safety from a professional trainer: the next training session was booked for 31st March. The owners also provide inhouse Fire Awareness training up-dates and ensures that Night Care Staff achieve 3monthly up-dates. Staff involved in food preparation have received training in safe food hygiene. Care Homes for Older People Page 24 of 27 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 25 of 27 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 26 of 27 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. 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