Care Home: Broadleigh

What the care home does well The home is a large adapted and extended Edwardian building and it is situated in its own grounds. There are two lounge areas, plus other quiet areas for people to use if they wish. Staff members are polite and talk to people with respect. We talked to people during this inspection and they said the staff are nice, respect their privacy and one person said, "The nursing staff have been brilliant". One person`s visitor said the home and staff, "Looks after my mother 100% so giving my wife and myself peace of mind". Assessments are completed before people move into the home, they have contracts with the home and they say they have enough information before they move in. Comments from one person who returned a survey was, "A warm welcome from the Directors and a personal tour at no notice (open door policy). Comprehensive information pack was provided and appropriately answered questions". People can have visitors when they want and there are places where they can meet in private. Visitors said the home helps people keep in touch with then and relatives told us they are kept up to date with issues that arise. People are able to choose what they do and how they live; they can get up and go to bed when they want, go out, and decide where and what to eat. There is a hot main meal each day and people can have an alternative if they wish. Staff members stay with people who need help to eat. Everyone we spoke to said they like the meals and the food is good. People said about the meals, "Varied meals and plenty to eat often with a choice and even then staff will get you something different if you fancy it" and "don`t have favourites every day, but the meals are always nice". The home has taken part in a pilot study to look at assessing nutrition, and as part of an educational DVD for the Department of Health, also looking at nutrition. There are plenty of activities and things to do at the home. People said they don`t always join in, but they are able to go out to the local park or out into the garden when the weather is nice. One person told us, "There is always something going on in the home and no one is left out of activities. The Directors work hard to provide a variety of activities". There have been no complaints made to the home in the last year. Visitors to the home and people living there said they know who to talk to and how to make complaints. Staff members have training in how to keep people safe and what to do if they think abuse has happened. There have been no safeguarding referrals in the last year. Staff members are given induction training when they first start working at the home. There are updates of mandatory training when this is needed, and staff have other training, such as palliative care, to help them care for people properly. One person`s relative said, "there appears to be lots of staff training with staff encouraged to improve their skills". Non-nursing qualified care staff also complete National Vocational Qualifications and at the time of this inspection 69% of staff had obtained the qualification.Staffing levels are high enough so that staff can care for people properly. We were told that staff are available when they are needed and people get the care and support they need. One person said, "There are busy periods, but there is always someone who acknowledges you and gets to you as soon as they can". A quality assurance survey is carried out at least twice a year at the home, where people are asked what they think of the care and the environment in which they live. Action is taken about issues that are found and this information is put into a report that everyone can see. Money that is kept and transactions that are made on behalf of people at the home is recorded. Records are also kept of the health and safety checks that are carried out, which means the home can show if things are in good working order and what they have done to repair problems. What has improved since the last inspection? The way care plans are written has changed and this gives staff a quick guide to how to look after each person. More detailed plans are written about needs that are more complicated and need more explaining. Plans are also commented about in the next section, but generally they give enough information for staff to be able to care for people properly. Records that show medication administration has improved. The records are completed properly and there is information about who supplies controlled drugs. There are also records to show storage temperatures and these are acceptable. Recruitment checks are completed properly before people start working at the home, so that new staff members are safe to work there. What the care home could do better: Although most care plans are written with enough information, there are some that need more. Detailed care plans must be written when people have pressure sores. This is so that staff know what they must do to prevent the pressure sore becoming worse and to help it heal. One person didn`t have this and the pressure sore became worse, although this has since improved. There is also not enough information written on records that show how much food people eat and the position they are turned to. This must be done so that there is a clear record of what staff need to do to prevent malnutrition and pressure sores. The manager must have accurate and up to date information about people with complex needs. She is the person responsible for making sure care staff provide the correct care. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Broadleigh 213 Broadway Peterborough PE1 4DS     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Lesley Richardson     Date: 2 4 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. the things that people have said are important to them: They reflect 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. 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 Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Broadleigh 213 Broadway Peterborough PE1 4DS 01733562328 01733895551 amarjara@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Shamshad Bano Marjara Type of registration: Number of places registered: Peterborough Care Ltd care home 32 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category terminally ill Additional conditions: Date of last inspection Brief description of the care home Broadleigh is a large converted and extended house, situated on a main road near the centre of Peterborough. The care home provides care and support, including nursing care for up to 32 residents over the age of 65 years. The home has 3 places for people over the age of 65 years, who have a formal diagnosis of dementia. The home has 24 single rooms and 4 double rooms; all rooms have en suite facilities. Resident accommodation is on two floors, the upper floor being accessible by stairs or lift. There is a large communal area available to service users on the lower floor, with smaller areas on the lower floor and upper floors. Residents have access to the gardens surrounding the home, which are tidy and attractive. The home is situated within one mile walk of the centre of Peterborough, where there is a wide range of shops, pubs and public amenities. A current range of fees for the home are available from the Care Homes for Older People Page 4 of 28 Over 65 3 32 32 0 0 0 Brief description of the care home home, the minimum and maximum range is given in the summary. Additional costs include those for hairdressing, toiletries and private chiropody. A copy of the inspection report is available at the home or via the CSCI website. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was a key inspection of this service and it took place over 6 hours and 50 minutes as an unannounced visit to the premises. It was spent talking to the manager and staff working in the home, talking to people who live there and observing the interaction between them and the staff, and examining records and documents. The requirements from the last inspection have been met. There has been one further requirement made as a result of this inspection. Information obtained from the Annual Quality Assurance Assessment and from returned surveys was used in this report. Care Homes for Older People Page 6 of 28 Three surveys were returned from people who live at the home, and one was returned from visitors to the home. We received four surveys from staff members. Fees for the home range between 450 and 687 pounds per week. What the care home does well: The home is a large adapted and extended Edwardian building and it is situated in its own grounds. There are two lounge areas, plus other quiet areas for people to use if they wish. Staff members are polite and talk to people with respect. We talked to people during this inspection and they said the staff are nice, respect their privacy and one person said, The nursing staff have been brilliant. One persons visitor said the home and staff, Looks after my mother 100 so giving my wife and myself peace of mind. Assessments are completed before people move into the home, they have contracts with the home and they say they have enough information before they move in. Comments from one person who returned a survey was, A warm welcome from the Directors and a personal tour at no notice (open door policy). Comprehensive information pack was provided and appropriately answered questions. People can have visitors when they want and there are places where they can meet in private. Visitors said the home helps people keep in touch with then and relatives told us they are kept up to date with issues that arise. People are able to choose what they do and how they live; they can get up and go to bed when they want, go out, and decide where and what to eat. There is a hot main meal each day and people can have an alternative if they wish. Staff members stay with people who need help to eat. Everyone we spoke to said they like the meals and the food is good. People said about the meals, Varied meals and plenty to eat often with a choice and even then staff will get you something different if you fancy it and dont have favourites every day, but the meals are always nice. The home has taken part in a pilot study to look at assessing nutrition, and as part of an educational DVD for the Department of Health, also looking at nutrition. There are plenty of activities and things to do at the home. People said they dont always join in, but they are able to go out to the local park or out into the garden when the weather is nice. One person told us, There is always something going on in the home and no one is left out of activities. The Directors work hard to provide a variety of activities. There have been no complaints made to the home in the last year. Visitors to the home and people living there said they know who to talk to and how to make complaints. Staff members have training in how to keep people safe and what to do if they think abuse has happened. There have been no safeguarding referrals in the last year. Staff members are given induction training when they first start working at the home. There are updates of mandatory training when this is needed, and staff have other training, such as palliative care, to help them care for people properly. One persons relative said, there appears to be lots of staff training with staff encouraged to improve their skills. Non-nursing qualified care staff also complete National Vocational Qualifications and at the time of this inspection 69 of staff had obtained the qualification. Care Homes for Older People Page 8 of 28 Staffing levels are high enough so that staff can care for people properly. We were told that staff are available when they are needed and people get the care and support they need. One person said, There are busy periods, but there is always someone who acknowledges you and gets to you as soon as they can. A quality assurance survey is carried out at least twice a year at the home, where people are asked what they think of the care and the environment in which they live. Action is taken about issues that are found and this information is put into a report that everyone can see. Money that is kept and transactions that are made on behalf of people at the home is recorded. Records are also kept of the health and safety checks that are carried out, which means the home can show if things are in good working order and what they have done to repair problems. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get Care Homes for Older People Page 9 of 28 printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 10 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 11 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have enough information before moving into the home, which means they are able to decide if they would like to live there. Evidence: All the people we received surveys from said they had received a contract and that they had enough information before moving to the home. One comment was, A warm welcome from the Directors and a personal tour at no notice (open door policy). Comprehensive information pack was provided and appropriately answered questions. A visitor also said they had enough information before their relative moved into the home and we spoke to one person during the inspection who said she had visited before moving in. The manager told us that assessments are completed before people move into the home and assessments by health and social care teams are also obtained to provide Care Homes for Older People Page 12 of 28 Evidence: more information. We looked at the care records of three people who had moved into the home since the last inspection. There were written assessments completed by the home, and assessments from health and social care teams. The home does not provide accommodation specifically for intermediate care or for rehabilitation purposes. Care Homes for Older People Page 13 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Most care records are completed in enough detail and staff care for people in a positive way, which ensures the health and welfare of people living at the home. Evidence: People who commented in surveys said they get the care and support they need from staff members and during the inspection people told us care staff are nice, are polite and treat them with dignity and respect. We saw this during the inspection and that staff knock on doors before entering rooms. People we spoke to said staff are nice and one person commented, staff are good, efficient. A comment from one of the visitors who returned a survey was, Looks after my mother 100 so giving my wife and myself peace of mind. The home has recently changed the format of its care plans. The new format gives a brief outline of each persons needs and needs that are more complex have another more detailed plan just for that need. Care plans for 4 people were looked at as part of this inspection. They show that each person has a plan that gives staff members Care Homes for Older People Page 14 of 28 Evidence: information about what they need to do to meet most of the identified needs. Risk assessments, for things like falls and moving and handling, are completed and reviewed regularly. We found the care plans give staff members advice about how to meet most of peoples needs, but that the level of detail varied between different people. The home reviews care plans with people at the home or their relatives every 3-4 months. This is recorded in the care records and we saw this during the inspection. We talked to one person who said she was aware of the plan but didnt want to see what was written. She said she is happy with the care she is getting, and looking at the care plan isnt going to change that. Plans are reviewed by staff every month and we saw that some information and changes are recorded, and the plans are rewritten to give staff updated guidance. Everyone who returned surveys said they receive medical attention when they need it. There is information in care records to show health care professionals, such as specialist nurses, opticians and chiropodists, are contacted for advice and treatment. Even though some plans are updated, not all changes about medical needs are written into plans. Two people, whose care records show they either have or have had pressure sores, did not have detailed plans telling staff what to do to improve these. For one person this meant that dressing changes were not carried out often enough and the pressure sore got worse. However, this has improved since then; dressings are changed more often and the pressure sore is healing. The other person told us that staff are applying cream, the sore has healed and she is no longer in discomfort. Recommendations made by a Speech and Language Therapist about sitting a person up when giving him something to eat and drink have not been put into a care plan, although the recommendations are in the appropriate area of the care records. We also looked at one persons records that show what people eat and when and which position they are turned to. These are not completed in enough detail to show the person is getting enough to eat, or which position they are turned to. We talked to a staff member about this person. She told us the times this person is turned and this is not as often as the care plan says it should be. She also said there are no records to show which position the person is moved to. The records for recording food eaten do not show clearly how much food is being eaten, for example, vegetables x 2 had been written but there was no other information to show if this was two spoonfuls, 2 scoops or just two different types of vegetable. The staff member was able to say that the person would have had 2 scoops of different vegetables, but could not accurately say if this was the amount they had eaten. Although we only looked at these records for one person, it is important because this person has a pressure sore and their weight is at a Care Homes for Older People Page 15 of 28 Evidence: level that shows he is at a high risk of malnutrition. Medication administration records (MAR) were looked at for all of the people whose care records we looked at and another seven people. The MAR sheets are completed and there are no records with entries missing. Entries for medications that have not been given show the reason for this. Amounts of medication remaining in blister packs of medication tally with the amount the MAR indicates are remaining. Records showing the dispensing pharmacy for controlled drugs received into the home is also available. We found two MAR sheets with a prescription for as required medication. Although neither of these people had care plans to guide staff in when to give the medication, one person is able to say when she wants the medication and what for. The other person had only been given the medication once in the previous three and a half weeks. Although the person cannot ask for the medication, the reason for it being given was well documented in the daily care notes. Stock levels of medications are acceptable; no medication had been out of stock and there are no stores of medication nearing its expiry date. Medication fridge and storage room temperatures are taken and recorded as being at an acceptable level for the safe storage of medication. Care Homes for Older People Page 16 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff members have a good understanding of peoples needs, and care records show how people are supported to live as they would like. Evidence: The home has an activities co-ordinator who arranges for entertainers to visit the home, activities and events in the home. One person told us, There is always something going on in the home and no one is left out of activities. The Directors work hard to provide a variety of activities. There is an area in the main lounge room that displays the activities available and those that people have taken part in. All of the people who returned surveys to us said there are activities that they can take part in. During the inspection everyone we spoke to said there are activities at the home, although not everyone said they join in. Those people that said they dont join in said it was their choice. They told us they go out to the local park or out into the garden when the weather is nice. They also told us about a recent entertainer at the home, who showed them how to belly dance. Staff members record information about time that is spend with people and activities and events that have gone on in the home. However, little of this information is Care Homes for Older People Page 17 of 28 Evidence: written into the care plans and social needs are not considered in the same way as physical needs. People are able to make everyday choices about when to get up and go to bed, how to spend their days, whether that is in their own room, or in the main lounge areas. We saw and listened to how staff members interact with people and found they ask what people would like and how they would like it rather than telling people or giving limited options. The home has an open visiting policy and people can have visitors at any time of the day. The visitor who returned a survey said the home helped their relative keep in touch and they are kept up to date with issues concerning that person. The main meal is served at lunchtime and although there is only one hot meal every day, there are alternatives if the offered meal is not acceptable. We saw lunch being served in the main dining room in the home. Food was served appropriately in a relaxed and unhurried way and drinks were offered throughout the meal. Everyone we spoke to said they like the meals and the food is good, one person said it was excellent when he had finished his meal and other people said that they have never needed to ask for alternative as they are always happy with meal presented. Staff help people if they need this and we saw them being attentive and mostly concentrating on what they were doing without being distracted. Comments were received in surveys and during the inspection and include, Varied meals and plenty to eat often with a choice and even then staff will get you something different if you fancy it, dont have favourites every day, but the meals are always nice and Frank loves the food here, very rarely does he waste any. Care Homes for Older People Page 18 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know how to make complaints and concerns known and can be confident that these will be listened to. Evidence: All of the people returning surveys said they know who to speak to, that they know how to make a complaint if they have to, and that staff listen to what they say and act on it. People we spoke to during the inspection also said they know what to do if theyre not happy about something. The visitor who returned a survey also said they know how to make a complaint and they are appropriately dealt with. This person said, My Mum usually approaches the owners, if she feels there are any problems. They do have leaflets at the home and she will approach Age Concern for help should she need it (they appear to be very informed about procedures). Everyone we spoke to during this inspection said they are happy with the service given to them. The home has a complaints procedure and keeps a complaint log to show how they have looked at and the outcome of complaints that have been made. We were told before the inspection there have been no complaints made to the home in the last 12 months. The staff training matrix shows that all staff members, care staff and housekeeping staff, have received training in safeguarding (adult protection) within the last year. Care Homes for Older People Page 19 of 28 Evidence: Information provided to CSCI before the inspection shows there have been no safeguarding referrals or investigations in the last 12 months. Care Homes for Older People Page 20 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is generally clean and provides a safe environment, giving most people a pleasant place to live. Evidence: The home is a large adapted Edwardian house with an extension at the back of the property and is situated on the outskirts of Peterborough. People living at the home have access to a number of communal areas, including a garden at the back of the original house. The general decor of the home is good, and it was clean and tidy, with no offensive smells. Everyone returning surveys said the home is clean and tidy and people at the home said the home is clean. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are enough staff members with the training and skills to be able to care for people properly. Evidence: Staff records show new staff members are given induction training, which includes mandatory health and safety, fire and moving and handling training. Staff members who returned surveys said induction training covers everything they need to be able to care for people very well. Additional training is given to staff so that they are able to properly meet peoples needs, and certificates are kept in staff records to show this. For example, the home is developing palliative care and we saw certificates in staff files for palliative care and bereavement training. One visitor described this, there appears to be lots of staff training with staff encouraged to improve their skills. Information in the AQAA tells us only between 28 and 36 of non nursing qualified care staff have a National Vocational Qualification at level 2 or above. There are another 2 staff members working towards the qualification. However, during the inspection we found the actual number of staff with this qualification or another equivalent qualification was 69 . The recommended number of non-qualified staff Care Homes for Older People Page 22 of 28 Evidence: that should have this qualification is 50 . All of the people who returned surveys said staff members are available when they are needed and that they get the care and support they need. Two comments from the surveys were, There are busy periods, but there is always someone who acknowledges you and gets to you as soon as they can and They are very busy people, but always helpful and caring. People we spoke to during the inspection said there is usually enough staff on duty. Three quarters of the staff members who returned surveys said staffing levels are usually enough and they have staff with the right experience and skills to properly care for people. We looked at recruitment records for two staff members employed since the last inspection and they contained the appropriate recruitment documents including references, application forms, and PoVA and CRB checks. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is a safe place to live and people are asked their opinion so that things they are not happy with are changed. Evidence: The manager is a nurse and is registered with the Nursing and Midwifery Council (NMC). She has been managing the home for a number of years. She has completed training in the last year that updates her mandatory health and safety training and completed training that gives her new skills and knowledge, such as palliative care training. Despite this, the manager does not always have accurate and up to date information about people living and being cared for at the home. Information given to us before the inspection shows no people at the home have developed pressure sores. At the beginning of the inspection the manager told us there was no one at the home with a pressure sore. However, we saw in the care records that two people had developed pressure sores, although one of these had healed. The other persons pressure sore had become worse when care records show dressings were not being Care Homes for Older People Page 24 of 28 Evidence: changed often enough. Care records for this person are also not detailed enough to show the care that is being given to heal the pressure sore. Quality assurance surveys are carried out by staff at the home at least twice a year, and usually more often. Reports are written and show the issues that were found. The last survey was carried out in June 2008 and information about it are displayed in the main lounge room for everyone to see. Results are written in different ways, so that it is easy for most people to understand. For example, responses to questions are written as percentages but graphs are also produced for people who prefer looking at a picture format. Everyone who returned surveys and who we spoke to during the inspection said staff members listen to what is said to them and act on the information. We asked the home to complete and return an Annual Quality Assurance Assessment (AQAA) before the inspection. They did this within the time we asked for it and they gave us the information we asked for. The home keeps some money on behalf of people who live there. Accounts are kept of transactions of money put in and taken out. We looked at 3 of these records; all three are clearly written and show how money has been spent. Information provided before this inspection shows equipment, like hoists, lifts and firefighting equipment has been serviced or tested as recommended by the manufacturer. We looked at fire equipment around the home; this has been tested within the last 12 months. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 8 17 Records must be kept to 05/11/2008 show all the treatment given in relation to pressure sores and nutrition. This is so that accurate assessments of nutritional needs and effectiveness of pressure sore treatment can be made. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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 © (2008) Commission for Social Care Inspection (CSCI). 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. 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