Care Home: Broadwater Lodge

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What the care home does well The home operates a structured admissions programme providing sufficient information to residents and relatives to help them choose to live in the home. Thorough needs assessments prior to admission determine the suitability of the placement. Sometimes residents are known to the home having used the day centre, or the respite facilitirs in place. A relative stated "Staff were very open when showing me around", and another sated "We looked at several homes before deciding on this one". Good care plans outline the care and support provided and are updated daily by care staff. These are maintained electronically. The complaints procedure in place is clear and accessible to all residents. The complaints logged have all been resolved using the complaints process. A relative stated that complaints are taken serious and acted upon. A resident said "I have no need to complain". The standard of the accommodation is good providing residents with single bedrooms some of which have en-suite facilities. Communal space is ample and there are courtyard gardens where residents can sit. The activity arrangements are varied providing residents with a wide range of programmes to follow. Activities are planned weekly and posted on the notice board for information. A resident stated "we are always amused". Spiritual and diverse needs are supported. The home has a prayer room and various clergy visit the home on request. Family links are maintained and visitors are welcome in the home at any time. Relative meetings are facilitated at weekends when more people can attend. The staff team are competent and have the skills necessary to undertake their roles. The organisation is committed to the training and development of the staff. They were seen to interact with residents in a polite and professional manner. A resident commented "The staff are lovely". Systems are in place to monitor quality assurance. Questionnaires are used to obtain feedback from residents, relatives, and other stakeholders. A care manager said " the home are pretty good at meeting my clients needs, and will always inform me of events". The health, safety, and welfare of the residents and the staff are observed and promoted. What has improved since the last inspection? All the requirements made at the last inspection have been met. Team leaders now ensure that any changes in health care needs are identified are referred to appropriate health care professionals for action. They then update the care plan accordingly. All staff undertake safeguarding as part of their induction training and this is overseen by the training coordinator. Formal staff supervision is now in place. The home has become very efficient at reporting incidents and accidents that adversely affect residents well being. The manager has been proactive in the clearance and redevelopment of the courtyard areas providing safe and pleasant areas for residents to sit. Individual bedrooms have been redecorated in residents choice of colours. Additional activity staff have been employed to extend the leisure activities to the evenings and the weekends. What the care home could do better: The home continues to develop and know what improvements they have to make. A programme of refurbishment is ongoing with the manage implementing this according to priority. The carpets in identified areas of the home are due to be replaced to manage odour control. The manager is in the process of introducing alternative catering arrangements in the home by employing a new chef. This will enable food to be cooked and served on the premises allowing residents more autonomy and choice. Key inspection report Care homes for older people Name: Address: Broadwater Lodge Summers Road Farncombe Surrey GU7 3BF     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Mary Williamson     Date: 1 6 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 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) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Broadwater Lodge Summers Road Farncombe Surrey GU7 3BF 01483414186 01483422232 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): manager.burroughs@careuk.com Care UK Community Partnerships Ltd Name of registered manager (if applicable) Mr Edwin Phillip Steyn Type of registration: Number of places registered: care home 67 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 67 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - OP Dementia - DE Physical disability - PD Date of last inspection Brief description of the care home Broadwater Lodge caters for the needs of older people, providing permanent and respite care, including specialist dementia care and a day care service. The home is situated in Farncombe a short distance from the local shops. Community facilities are Care Homes for Older People Page 4 of 27 Over 65 0 67 0 67 0 67 Brief description of the care home nearby and easily accessible to the home. Residential accommodation comprises of 5 self-contained units. All bedrooms are of single occupancy, and the seventeen newly built rooms have en-suite toilet facilities. Each unit has its own bathrooms, toilets, lounge, dining area and kitchenette. The gardens are nicely arranged and safe for the residents to enjoy. Broadwater Lodge has spacious communal areas and the residents are encouraged to use and enjoy the whole building. The home has a shop run by volunteers, to enable residents to purchase toiletries, drinks, books and a number of other items on sale. There is ample parking in the front of the building. The fees at this service range from £430.00 per week to £800.00 per week. 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: 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 TWO Star. This means that people who use this service experience GOOD quality outcomes. This was a key inspection and was unannounced. The inspection was undertaken by Mary Williamson Regulation Inspector over seven hours. The home manager represented the service for the duration of the inspection. The home manage was due to have his fit person interview with The Care Quality Commission two days after this inspection. The inspector was shown around the home and introduced to residents and staff by the manager. Records relating to the care of the residents and the management of the home were examined. These included needs assessments, care plans, medication records, menus, Care Homes for Older People Page 6 of 27 activity programmes, staff training records, staff employment files, and health and safety arrangements. It was possible to view the care plans held electronically on individual units with the help of staff. The inspector had the opportunity to meet with several residents throughout the individual units and gain their views about living in the home. It was also possible to hear relatives feedback regarding Broadwater Lodge. Staff confirmed during discussion the training they had received and the support available to them. Time was spent in the activity room talking to staff and hearing their plans to extend the activities to evenings and weekends. The manager completed an Annual Quality Assurance Assessment (AQAA), that provided us with the information required and has been used as part of the inspection process. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? All the requirements made at the last inspection have been met. Team leaders now ensure that any changes in health care needs are identified are referred to appropriate health care professionals for action. They then update the care plan accordingly. All staff undertake safeguarding as part of their induction training and this is overseen by the training coordinator. Care Homes for Older People Page 8 of 27 Formal staff supervision is now in place. The home has become very efficient at reporting incidents and accidents that adversely affect residents well being. The manager has been proactive in the clearance and redevelopment of the courtyard areas providing safe and pleasant areas for residents to sit. Individual bedrooms have been redecorated in residents choice of colours. Additional activity staff have been employed to extend the leisure activities to the evenings and the weekends. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 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 10 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. Prospective residnets have access to sufficient information in order to help them make a choice about living in the home. Good pre admission needs assessmnets ensure that the home can meet individual needs and goals. All residnets or a designated have a copy of the terms and conditions of occupancy. Evidence: The home has a statement of purpose, charter of rights, and residnets guide in place. This is available to all residnets and their relatives providing them with sufficient information to help them make the right choice of home. A relative stated that there was opportunity to view a selection of homes before making a decision. These documents are retained in individual bedrooms for information. The manager explained the admission procedure in place. All prospective residnets have a needs assessmnet undertaken by a team leader or himself. This is then Care Homes for Older People Page 11 of 27 Evidence: discussed by the senior team to establish the suitability of the placement. Assessmnets can be undertaken in residnets own homes or in hospital. The home also has a day care centre and some prospective service users will be known to the home having previously used this centre. A selection of needs assessmnets were seen and are well documented and informative. There is also a procedure in place for the admission of respite care and includes a letter of admission and expectation, a discharge letter, report to the care management team, and a feedback survey. Individual contracts of occupancy include the accommodation offered, the support provided, and the amount and frequency of the fees paid. The home does not provide intermediate care. Care Homes for Older People Page 12 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. Residents health and personal care needs are identified and outlined in good care plans, that are maintained electronically. Appropriate arrangements are in place to ensure that residents health care needs are being met. The medication policy in place protects the residents living in Broadwater Lodge. Privacy and dignity of residents are promoted ensuring residents are treated with dignity and respect. Evidence: Individual care plans are in place. These are maintained electronically and have been compiled using information gathered at the per admission needs assessment, input from residents, and relatives care management assessments, and any other relevant reports. It was possible to sit with care staff on two units who demonstrated a selection plans of care plans on computer. They were confident using the system and were knowledgeable about individual needs and choice. Detailed daily records of care provided are maintained by staff. A team leader demonstrated the system at a central computer at the team leaders station. She explained the process for reviews of care plans at least monthly or when needs change. She was also able to demonstrate how Care Homes for Older People Page 13 of 27 Evidence: risk assessments are undertaken for example tissue viability, manual handling, nutritional screening, and falls and how the system generates review dates for these undertaken by team leaders. A relative stated that they were always kept up to date with the care and treatment provided and when anything changes. Good arrangements are in place to meet he health, personal and emotional needs of the residents. All residents are registered with GPs from two local practices. They visit the home weekly or more frequently if required. The manager stated that there was good district nurse support for clinical guidance. Chiropody treatment is arranged, and the dentist and optician also visit the home. Specialist input can be arranged on referral by the GP and the psychiatrist visits the home regularly to review treatment and medication for residents suffering with dementia. There is a comprehensive medication procedure in place. One team leader is responsible for the ordering, monitoring, auditing, and recording of medication in the home. She was able to demonstrate this procedure during the inspection. All medication is supplied either in blister pack format or individual containers. This is stored safely in two medication storage rooms that are locked. All medication received into the home is double checked and signed for. Medication is checked and signed at the end of each shift. Only team leaders administer medication and they undertake medication safety training on a regular basis. The medication recording charts were seen and are well maintained. Currently there are no residents in the home that self medicate. Privacy and dignity are observed. Residents can have visitors in the privacy of their own rooms or there are quite areas on each unit that can also be used for this. Staff address residents in a polite and respectful manner, and were observed to knock on individual bedroom doors prior to entering. The manager stated that some residents have asked for keys to their bedrooms, and were provided on request. personal care is undertaken in the privacy of residents own rooms. Care Homes for Older People Page 14 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The activity arrangements in place are good and meet the recreational needs and expectations of the residents. Spiritual and diverse needs are observed and promoted. The systems for autonomy and choice are good enabling residnets to exercise choice and control over their lives. The home is currently looking at alternative catering arrangements to maintain and promote residnets nutrition needs and choice. Evidence: There are individual activity programmes in place that reflect individual need and choice. The service has recently employed two activity coordinators making a team of three to oversee activities in the home. They had recently decorated the activities room in a Halloween theme that was very impressive. Group activities include exercise class, art and craft, cookery, reminiscence, card games, and board games. Activities also take place on individual units that include floor snakes and ladders, quiz, puzzles, nail painting, hand massage, one to one reading and poetry, and reading the daily newspaper. Organised entertainers include Tickled Pink pantomime production, magicians, live music, and singers. Community facilities are accessed and include trips to the town, and local park. The Care Homes for Older People Page 15 of 27 Evidence: local school come to the home to sing carols, and invite residents to the school play. Residents are due to attend the school by invitation of the headmaster to learn some IT skills. There is also a day centre on site for community participants and residnets are more than welcome to attend activity sessions if they wish. Spiritual needs are supported and visits from various clergy are arranged. Holy Communion is organised and there is a prayer room in the home for private worship and meditation. Family links are maintained and relatives and visitors are welcome in the home at any time. A relative stated that she visits every day and always made to feel welcome. Another relative stated that she likes to visit at weekends and there is always someone available to talk to if she need to. Relatives were very pleased with the support they receive from the home and attend relatives meeting every three months. The manager stated that he arranges various topics to be discussed at these meetings for example understanding dementia. Residents are given the opportunity to make choices regarding all aspects of their daily lives. They can choose when to get up or go to bed, when they wish to bath or shower, what clothing they wear, how they spend their day, what activities they take part in, if they wish to be alone or in company and to choose to take their meals in the dining room or their bedroom. The catering arrangements in place are under review and the manager stated that there was a new chef due to commence employment two days after the inspection. The training coordinator is currently taking responsibility for the kitchen and supporting the kitchen assistant who has been covering the chef vacancy for over a year. At the moment meals are prepared by an outside catering firm, and delivered to the home in a cook/chill stage. Menus are arranged over a four week rota and offered residents a choice of two main dishes. Lunch was observed and included a choice of either meat balls or chicken stay, with potato wedges and peas. One resident stated that the food was nice, another stated this is awful. Generally there was very mixed comments about the food. Special diets are catered for including soft or diabetic meals. Staff were observed to offer sensitive support the residents who required help with feeding. The home is moving to wards providing the main meal of the day in the evenings enabling residents to be more active and participate in in more activities during the afternoons. Fresh fruit was observed in all the units of the home. Staff undertake training in food hygiene as part of induction training. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints procedure and the safeguarding vulnerable adults procedures in place protect the residents living in the home. Evidence: The home has a complaints procedure in place. This forms part of the residents charter and a copy is retained in each bedroom for information. Staff, residents and relatives are aware of this procedure. The complaints log was seen and there were several complaints recorded regarding issues about how laundry is managed, and items of clothing getting lost. This was discusses at a relatives meeting and one relative has set up a sewing group to colour code clothing according to units in order to reduce the amount of clothing getting lost. There was also one anonymous complaint received by The Care Quality Commission regarding staffing issues that was given to the home to manage. This was resolved using the complaints procedure. The home also receives many thank you cards and letters of appreciation from relatives and residents. The home has a safeguarding vulnerable adults procedure in place and all staff undertake safeguarding training during their induction period. During discussion with staff it was evident that they were knowledgeable about the procedure and would not hesitate to tell another member of staff if an incident of abuse was suspected. The home also has a copy of Surreys Multi Agencies policies and procedures on Safeguarding Vulnerable Adults in place. The senior staff have attend external local Care Homes for Older People Page 17 of 27 Evidence: authority training in these procedures. Currently there are two safeguarding issues being investigates using these procedures. 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 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 suitable for its stated purpose. The residents live in a comfortable, homely, and well maintained environment, which meets their individual and collective needs. The standard of cleanliness is good, and procedures are in place to minimise the spread of infection. Evidence: The manager accompanied the inspector around the home and introductions were made on each unit. It was possible to talk with residents regarding the facilities available to them. Accommodation is organised over five units all of which benefit from a lounge, dining room, and a kitchenette. The home is comfortable, homely and decorated to a good standard. There is an ongoing programme of refurbishment in place and several areas of the home have been redecorated since the last inspection. The manage stated that new dishwashers were on order for all units. Bedrooms are single occupancy, seventeen with en-suite facilities. Most bedrooms have been redecorated in various colours of residents choice. Residents can bring items of furniture and personal possessions with them on admission to help them personalise their rooms. Several residents stated that they liked their rooms. There are sufficient bathrooms and toilets located on individual units, some of which have been adapted to meet the mobility needs of the residents. Care Homes for Older People Page 19 of 27 Evidence: Considerable work has been undertaken to provide courtyard gardens for residents to sit and enjoy. The main gardens are well maintained and there is also a pet corner for residents to wander. The standard of cleanliness is good. Five domestic staff maintain hygiene standards within the home. There was evidence of mal odour in some areas of the home and the manager stated that new carpets had been ordered to address this issue. Some bedrooms had laminated flooring in place to manage this issue. The laundry is well equipped for the requirements of the home. There is an infection control policy in place and all staff undertake this training to prevent cross infection in the home. Disposable aprons and gloves are provided for staff. Arrangements are in place for the collection of clinical waste. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents assessed needs were being met by the number and skill mix of staff on duty. Staff training and development is ongoing providing a competent staff team to care for the residents living in the home. The recruitment and vetting of staff is good promoting the safety and wellbeing of the residents. Evidence: The staff duty rotas were seen and staffing levels discussed with the manager. Ten care staff were on duty with three team leaders providing sufficient staff to meet the assessed needs of the residents. One team leader and five care staff are employed for night duty. The home also employs five cleaning staff, one full time and one part time administrator, three activity coordinators, a training coordinator, a maintenance team and a kitchen assistant. Residents were very complimentary of staff, people are very kind here, the staff are lovely and staff would do anything for you were some of the comments made. Staff training is ongoing and this was confirmed by various staff during discussion. The home has a training coordinator in post and she is responsible for overseeing the development of staff. She explained that all staff undertake induction over a two week period. Mandatory training includes first aid, manual handling, food hygiene, health and safety, and fire safety awareness which is updated accordingly. There is a training Care Homes for Older People Page 21 of 27 Evidence: room provided in the home, and external training is also sourced. The home is committed to NVQ training and currently 64 of staff have either achieved NVQ level 2 or 3. Ten more staff have been identified to commence this training in November. Third Force is the provider used for NVQ registration and a facilitator was visiting the home during the inspection enrolling staff for this award. The training coordinator stated that NVQ training for domestic staff was due to commence in the near future. The home follows a robust recruitment procedure. All staff have a job description and contract of employment in place. Three staff employment files were seen. These are well maintained and include two written references, an employment history and a CRB (Criminal Records Bureau) disclosure. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The arrangements for the day to day running of the home are good ensuring that the home is well managed. Sound systems in place for the monitoring of quality assurance ensure that the home is managed in the best interests of the residents. Financial procedures safeguard residents money. The health, safety and welfare for residents and staff are promoted and protected. Evidence: The home is well managed by the home manager who was due to be interviewed by The Care Quality Commission two days following the inspection, to become the registered manager. He has worked in the organisation at managerial level for several years and has an RMA (Registered Manager Award). He operates an open and inclusive style of management and has a good rapore with residents and relatives. Comments included if I have a problem he will sort it out for me, Philip comes to see me every day, a relative said Philip always keeps me informed of what is going on. The manager has the support of three team leaders and a senior staff team with the skills and knowledge required for the operation of a home of this size. Between Care Homes for Older People Page 23 of 27 Evidence: them they operate a good system and make themselves available to relatives and staff for support and direction. The team leaders are allocated responsibility for specific areas to include health and safety, medication administration, and staffing arrangements. There is also good organisational line management support. Systems are in place to manage quality assurance. Regulation 26 visits are undertaken monthly and reports retained in the home for inspection. Customer feedback questionnaires are distributed to residents, relatives, and various stakeholders for comments. Feedback is analysed and acted upon. This is also included in a newsletter. Resident meetings take place and suggestions noted, relatives meetings are facilitated and are chaired by an independent person, stakeholder comments are also acted upon. Staff supervision is in place and takes place at least six times a year. This is recorded in personal files. Staff appraisal is also undertaken. Residents money is protected by the financial policies and procedures in place. The home can hold small amounts of personal money on behalf of residents to pay for hairdressing, newspapers, and sundries. No staff member acts as appointee for residents. The health, safety, and welfare of the residents and the staff are observed and promoted. All staff undertake training in health and safety during induction training. One team leader takes responsibility for health and safety issues in the home and will work with the maintenance team ensuring that all repairer are addressed in a timely fashion and that certificates of safety are in place. Fire safety is observed and all staff have regular training in fire safety awareness. There is a contract in place for the maintenance of fire fighting equipment and emergency lighting. Risk assessments are in place for all identified risks and safe working practice. COSHH (Control of Substances Hazardous to Health) procedures are adhered to. The home keep us informed of incidents occurring in the home that adversely affects the well-being or safety of residents, and accidents are recorded appropriately. 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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