Care Home: Broughton Lodge

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What the care home does well Each person has a needs assessment by the manager or appropriately trained person prior to admission to ensure that the home can meet the needs of that person. The manager does not undertake any admissions to the home unless he is relatively confident that they will `fit in` with people already living at the home. Activities are provided and people have the choice if they wish to participate. People are supported through activity to maintain their independence and also establish and maintain contact within the community. The homes environment is comfortable, homely and maintained to a very good standard. The environment has been developed with the people using the service comfort in mind. The needs and preferences of people are taken into consideration when changes to the environment are made. Staffing levels at the home are adequate to meet the people`s needs. The home provides a consistent staff team with sufficient training and skills to meet the needs of people using the service. People using the service are all very complimentary about the staff. There was evidently a good relationship between staff and people using the service and staff appeared to know the people well. People using the service told us that they felt safe and well looked after. Health and Safety measures are in place to promote protection and policies and procedures are in place to ensure good practice. What has improved since the last inspection? The home has had a further extension built and an increase in beds from 10 to 16. The environment has been maintained and developed to ensure a consistent standard throughout the home. The manager has developed an admission bulletin which gives a brief view of any new persons physical and emotional status to be used as a prompt for staff for the first week of admission and subsequent care provided. The manager told us that the home has introduced dependency assessments as a multi purpose tool completed by a key worker and the person using the service and is included within their care plan. The home now undertakes personal history`s which are completed and stored in each persons care plan, these provide staff with immediate information about the choices and preferences of each person. The manager has worked towards increased awareness of dementia and as a first stage has introduced additional signs near all nurse call points and picture signs to illustrate toilets and bathrooms. What the care home could do better: The Manager/Provider listened to what we told him at inspection and made the necessary changes to documentation at that time. Therefore, whilst these areas are noted within this report, no Statutory Requirements or Good Practice Recommendations have been made. Key inspection report Care homes for older people Name: Address: Broughton Lodge 88 Berrow Road Burnham-on-sea Somerset TA8 2HN     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: Gail Richardson     Date: 1 6 1 1 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 28 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 28 Information about the care home Name of care home: Address: Broughton Lodge 88 Berrow Road Burnham-on-sea Somerset TA8 2HN 01278782133 01278788492 frailtytowers@onetel.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: MRS MANDY MATTHEWS,Mr Michael Matthews care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is is 16. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home Broughton Lodge is registered with the Commission for Social Care Inspection to provide personal care for 16 people over the age of 65. Nursing care is not provided. Broughton Lodge is located close to the town centre and the sea front in Burnham -onSea. Public transport passes the home for the town centre and on to Weston Super Mare or to Highbridge. Broughton Lodge Care Home is a large detached house set in its own grounds. All rooms are for single occupancy and are set over two floors with a stair lift between. All communal areas are on the ground floor and are accessible to all residents. Access to the home is through the main front door. The home is owned by Care Homes for Older People Page 4 of 28 Over 65 16 0 Brief description of the care home Mr & Mrs Mathews and Mr Michael Mathews is the registered manager. The current fee scale is £402.00 to 525.00 and does not include hairdressing, chiropody and some newspapers. A selection of newspapers are provided each day. 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: 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 was an unannounced inspection, which took place over 1 day ( 7 hours ) on the 16th November 2009 by Regulation Inspector Gail Richardson. As part of this inspection, the term we will be used when referring to the Care Quality Commission). The last key inspection was undertaken on 10th October 2006. An Annual service Review was completed on the 17th March 2007 and 18th March 2008. No unannounced inspection visits to the home have taken place in the interim period. As part of the Inspecting for Better Lives program we can use Experts by Experience to look at specific aspects of life at the home. At this inspection the Expert by Experience looked at activities provided, routines of daily life and the dining experience. An Expert by Experience visited the home on the day of inspection and stayed for approximately Care Homes for Older People Page 6 of 28 3 hours. The Expert by Experience spent time talking with people and stayed for lunch. At this inspection there were 14 people currently residing at the home receiving personal care to varying levels. The home also provides day care for 2 to 3 people each day but this is not regulated by the Commission. The home has provided the Care Quality Commission with a completed AQAA ( Annual Quality Assurance Audit ) which was completed by the Registered Provider/ Manager and gives details of all aspects of the home. A tour of the home took place and most of the bedrooms and communal areas were seen. We spent time observing the care being provided. We spoke to more than 6 people using the service and 6 members of staff The Registered Manager/ Provider was available throughout the inspection. As part of this inspection we surveyed the opinions of a selection of people using the service, GPs, District Nurses and Care Workers. We received a large amount of responses from all people surveyed. Records relating to care including 4 care plans, 2 staff files, finances and health and safety records were examined. The focus of this inspection visit was to inspect relevant key standards under the CSCI Inspecting for Better Lives 2 framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are excellent, good, adequate and poor. The following is a summary of the inspection findings and should be read in conjunction with the whole of the report. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: The Manager/Provider listened to what we told him at inspection and made the necessary changes to documentation at that time. Therefore, whilst these areas are noted within this report, no Statutory Requirements or Good Practice Recommendations have been made. Care Homes for Older People Page 8 of 28 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 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 10 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered provider/manager is thorough in ensuring that prior to admission, prospective people using the service will have their needs assessed to establish that all their care needs can be met at Broughton Lodge. Information is supplied to inform people of the services available and staff are trained to meet peoples needs. Evidence: The Manager provides a Statement of Purpose and Service User Guide to inform any prospective people what the service can provide. The Manager also provides an individual Statement of Terms and Conditions/Contract that specifies the fees to be paid and the room to be occupied. Considerable effort is made to obtain information about the person to ensure that the admission is successful and that staff have the information they need to meet peoples specific preferences and needs. The manager or appropriate member of staff undertakes a pre admission assessment and includes the involvement of appropriate Care Homes for Older People Page 11 of 28 Evidence: health professionals. Prospective people and their relatives may visit to test run the service. The manager will only proceed with the admission if he is confident the person can be cared for at the home and that the person will fit in with the people already using the service. We spoke with people and they told us, I chose to live here, I came and looked around, I have never regretted it and My family chose this home for me. People told us that they had sufficient information about the home before they moved in. The staff receive sufficient training to ensure that both individually and collectively they have the skills to meet peoples needs. We received 12 surveys from people using the service. When we asked people if they received the care and support they needed, 10 said always, one said usually and one said sometimes. Eleven people confirmed that staff always listened and acted on what they said. Surveys told us I have always been looked after well , I have complete care, All the girls look after me well and I have no complaints, The home provides respite care but does not provide intermediate care. Care Homes for Older People Page 12 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans are detailed to ensure that each persons care is tailored to their needs and preferences. Medication systems are in place to ensure safe medicine management. People are treated with dignity and their right to privacy, support and independence is respected. Evidence: We looked at 4 care plans for people using the service. They highlighted all the peoples care needs and provided a clear plan for staff to follow to meet those needs. The care plans were very specific to each person. They highlighted what is important to each person and what staff could do to ensure that those choices were met. The manager has developed a system of monitoring which involves a daily handover sheet which is very detailed.The care plans are reviewed weekly and updated. This includes using information from that handover sheet for both day and night times and other relevant documentation such as nutrition records, accident records and medication reviews. The manager is currently considering an alternative method of recording which would involve each person having an individual daily record instead of weekly, to ensure that daily monitoring is clearer. Care Homes for Older People Page 13 of 28 Evidence: The care plans contained a record of visiting health professional to each person and community nursing and mental health staff visit the home to support people where there is an identified need. Equipment is provided where there is an assessed need and it was observed that there were adaptations and aids provided around the home to promote mobility independence. People told us that they got up and returned to bed at times of their choosing. When we arrived at 10am it was observed that some people were having a late breakfast and that some people had had several breakfasts. People told us that staff were very supportive and that Nothing is too much trouble. People also told us that They know what we like and what we dont like and They bend over backwards to get you what you want. One person also told us Staff are marvelous, they are here at night and There is always a cup of tea when you want one All staff who dispense medication have received the appropriate training. One senior member of staff takes overall responsibility for the organisation of the medication systems. The home uses the monitored dosage system to administer medication and recordings are clear and accurate. The home has developed clear systems to monitor changes in medication and records any effects to ensure accurate feed back to the appropriate health professionals. One survey from a visiting health professional told us The team are always approachable and appear caring and concerned about their residents. Another told us, They use medical services correctly and calls are timely and well thought through, Staff are always caring and are aware of patients medical, social, care and privacy needs. Care Homes for Older People Page 14 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a lifestyle which involves supporting peoples personal choices and preferences of activity.The home offers freshly cooked meals and a balanced, attractive diet. Evidence: The home provides activities which are specific to peoples preferences. People are supported to continue with their interests and social contacts. There is a green house which people use to grow fruit and vegetables for use at the home. People attend social clubs, the library and visit family. A mini bus is provided to enable transport to be available. One survey received at the home said that the thing they liked the best was The freedom of movement around the home and garden. Life history books are being developed to promote a greater understanding of peoples lives. The Expert by Experience noted, The staff treated the residents in a friendly and helpful way, and I was told that when assistance was needed at night the response was quick. Apart from activities provided in-house, residents were able to go out to the shops or the sea-front, sometimes in the mini-bus, or to do anything else of which they were capable. For example, one lady was taken by friends on Sundays to her former church in the next town and also to other activities there during the week. The Care Homes for Older People Page 15 of 28 Evidence: twice-weekly visit from a hairdresser was obviously appreciated and everyone looked very clean and well-cared for. The Expert by Experience also observed, I feel I cannot put it more clearly than to say Broughton Lodge gives the impression of being a real home (with a small h) rather than one with a capital H and this opinion was reinforced by the residents with whom I spoke. I was particularly struck by the fact that in response to the standard question Are you quite happy here? I was told in every case that they were - but without the qualification which I have found usually follows but of course its not like home and I feel this sums up what the owners have achieved. People have access to local churches and clergy also visit the home. All people are registered to vote should they wish to. The Expert by Experience noted, The kitchen had been awarded five stars for hygiene. Mrs Mathews was in charge of cooking and certainly everything looked very appetising. I was invited to join the ladies for lunch. A non-meat meal with several choices was offered and I can confirm that the food was very good. Certainly the three ladies with whom I shared a table enjoyed their meal, and they old me that an alternative could always be asked for if they wished. One lady did not want her lunch but asked for bread and jam, which I understand is her favourite, and this was willingly provided. There was general satisfaction with the quality and choice of meals throughout the day. Care Homes for Older People Page 16 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. The Complaints Procedure and Adult Protection Procedures have been updated to protect people using the service. Evidence: The Care Quality Commission has not received any complaints since the last inspection. A complaints procedure is in place, this details the timescale for initial responses people would be expected to have. We spoke with people using the service who told us that, Any problems I talk to my key worker or any of the staff I feel safe here; they make sure we are ok. All 12 surveys told us that people knew who to talk to if they were not happy. Staff have a good understanding of the complaints and whistle blowing procedures and have undertaken adult protection training as part of their National Vocational Training. All staff surveys told us that they knew what to do if someone had concerns about the home. The home has a copy of the safeguarding Adults in Somerset local policy and also demonstrated a proactive approach to issues arising in the home which may affect people using the service Care Homes for Older People Page 17 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in safe, comfortable, clean, homely environment. The environment is decorated to support the abilities, choices and interests of people using the service. Evidence: Broughton Lodge is an older building with a new extension completed March 2008. Accommodation is over two floors with access to the upper floors by shaft lift or stairlift. There are adapted bathrooms on both floors and the kitchen, dining room and two lounges are on the ground floor. There is a paved area to the rear of the home which has been made into a seating area with a greenhouse. There is parking and access to the public road from the front of the house. The house is decorated to a very good standard. Fixtures, fittings and furnishings are of a good standard and the home is clean and odour free. All rooms are single occupancy . Each room is individual with the personal belonging of people being evident . Rooms contained lots of family pictures and evidence of hobbies and interests. The manager confirmed that prior to personal items being brought to the home, safety checks are undertaken. All areas have access to nurse call points, these are clearly signed for help press button. The main lounge has a hearing loop fitted to assist people who have difficulties hearing. Care Homes for Older People Page 18 of 28 Evidence: Rooms with en suite facilities have curtain access to ensure privacy and dignity and promote ease of access. Rooms without en suite facilities have a toilet/bathroom nearby. Lighting in each en suite is activated by movement allowing people to mobilise freely in sufficient light. In the new part of the home heating is supplied underfloor and is thermostatically controlled in each room. Radiators in other areas have either low surface temperature or are risk assessed in care plans to identify any risks of burns when people request the radiators be turned up high. Each room has telephone and digital connection. Equipment is supplied where there is an assessed need and hoists and wheelchairs are available. Each bedroom has a lock available and peoples care plans indicate if the person wishes this facility to be used. The Expert by Experience observed Everywhere was clean and fresh, and the standard of decoration was outstandingly good. Bathrooms had different bathing options. Bedrooms had good quality bedspreads, chairs and curtains in matching fabrics, and the en suite facilities had been particularly well designed: in the larger rooms in the old part of the house instead of using an alcove a triangular section had been formed in one corner which was accessed not through a door but by an opening with a curtain. for privacy if needed. Obviously some thought had gone into this arrangement in that the lack of a door, whichever way it might open, made it easier for anyone with a walking frame to enter. Another feature was that each toilet was on a raised platform to help those whose knees were not quite as supple. There was a very good system to control the heat from the radiators and in the new extension there was underfloor heating which seemed to work well. Furniture was standard throughout - I liked the design which had rounded comers instead of the usual sharper angled ones - but some residents had also brought an item of their own, and there was, of course, the usual array of photographs and ornaments. The 12 surveys received from people using the service told us that the home is always clean and fresh. The home does not currently employ cleaning staff and staff told us that a cleaning schedule is undertaken by the day and night shifts to maintain the standard of cleanliness. All bathrooms are well maintained and have appropriate infection control measures in place. Adapted baths are in each bathroom to assist and promote Independence and comfort. The laundry area is functional with washing machines and separate dryers provided. Fouled items are washed separately in a washing machine located outside of the Care Homes for Older People Page 19 of 28 Evidence: building. At inspection we discussed and agreed the use of alginate bags for washing fouled items to further reduce the risk of cross infection. Care Homes for Older People Page 20 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 staff in sufficient numbers with appropriate training to meet the needs of people using the service. Recruitment procedures must be followed to ensure the safety of people using the service and were updated at the inspection. Evidence: There are 2 care staff on duty at all times, with the manager being supernumary but available on a daily basis, also one of the providers who works as a cook at the service. The manager is also available on call at all times. The staff team is stable with very low turnover of staff. No agency staff are used. Staff told us that they felt there were sufficient numbers of staff each shift to meet the needs of people using the service. As noted in the previous outcome group. The care staff undertake a cleaning role on both day and night shift. The standard of hygiene is excellent. However, staff surveys made 5 comments about the time spent cleaning, these included, They should employ a cleaner so that care staff would have more time with residents. There are only two staff at the weekend and they have to care, cook and clean plus answer phones and see to visitors. This area may need to be reviewed by the registered providers. Staff spoken with at inspection have all been employed at the home for several years Care Homes for Older People Page 21 of 28 Evidence: and told us that they were happy working at the home. They told us that staff morale is good. One staff member told us Its like having 14 Grans- its lovely. Others told us, It runs like a family home, Residents wishes and choices are respected, It is a happy friendly place and I am proud to be part of the team. People using the service who spoke with us were all very complimentary about the kindness of the staff. Quality Audits in the home contained several comments about the staff which included, Mum is happier than I have seen her in years, I cannot fault your excellent care you gave our mum, Mum feels like part of the family, Over and above what we expected. We also received comments on surveys which included, I am treated well, and I am very happy. People also told us at inspection I dont think you will find anything wrong with here Staff training is ongoing. Staff training records were up to date in all mandatory areas. Further training in specific areas relevant to the people using the service was also provided. The home has designated trainers for moving and handling and medication. Staff are encouraged to undertake NVQ training and 11 out of the 12 staff employed have completed an NVQ in care to level 2 or 3. This demonstrates a commitment to learning and development by the service. Staff receive regular supervisions and appraisals to promote good practice and provide an opportunity to identify and develop skills. This supervision is not formalised or recorded. We discussed at inspection why this recording is important and a plan was put into place to record future supervisions. We looked at 2 recruitment files of people recently employed at the service. The procedures in place were not consistently followed to ensure safe practice. The employment histories for both files were not fully completed and so did not give the dates of when people changed employment. This detail is recommended to provide a clear record of where people have been employed and any gaps should be explored and documented. Each person had two references but it was unclear if they were the most recent employer. This appeared to be an issue with the forms used which did not ask for this information. Whilst at the inspection, the manager produced an updated application form which would mean that all new staff have to provide the details needed. This form would also be signed and dated and include a clear declaration of any offenses previous committed. Care Homes for Older People Page 22 of 28 Evidence: All staff have have a Protection of Vulnerable Adults Check (POVA) and a Criminal Record Bureau Check (CRB) and no staff are employed before those checks have been received to ensure the safety of people using the service. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes leadership and management provide a positive experience for people using the service and staff. The views of people using the service are used to develop the service provided. The health, safety and welfare of people using the service and staff are promoted and protected. Evidence: The Registered Manager / Provider is Mike Mathews. He has managed the home for many years with his wife who is a Registered Provider and Cook. Both providers are involved on a day to day basis in the home and have demonstrated a clear vision of how they want the home to be run. The management style appears to be open, positive and inclusive. Staff told us The management are always ready to listen to staff ideas that would benefit the home, A nice friendly atmosphere and each person is treated as an individual, Good support from the management. Care Homes for Older People Page 24 of 28 Evidence: Annual quality assurance questionnaires are undertaken and the responses are used to monitor the quality of care provided and change practice where needed. Review of the recent audit showed very positive responses from both relatives and people using the service. The management of peoples personal monies appears to be well managed and is audited weekly to ensure that clear financial records are maintained. All records are stored securely in line with the Data Protection Act. The homes policies and procedures are comprehensive, there is no indication that they have been regularly reviewed, the manager is advised to ensure that when reviews take place that this is recorded. Accidents are recorded appropriately, the home also contacts family with updates and information following any falls and this information is stored in the persons care plan. Sensor mats are used in some rooms to alert staff in the night or afternoon if people are moving in their rooms to promote accident prevention whilst maintaining independence. The homes maintenance records folder showed that the fabric of the building and the equipment within it are regularly and properly maintained for the safety of all. 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 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: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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