Care Home: Burrswood House Nursing and Residential Home

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What the care home does well Management make sure that they assess the needs of people before they are admitted to the home. This is to make sure that staff only care for those people whose needs they feel they can meet. Residents feel that they are well looked after by the staff. Residents and relatives made the following comments: "I am happy with the care, no complaints". "Very kind and tolerant staff". " Its a good place to be in". The care plans contain a lot of information about how people are to be cared for, what they can do for themselves and what they need help with. The staff are very good at caring for people who are extremely ill and need a lot of nursing care. Activities are considered to be a very important part of the residents` day. The meals provided are varied, nutritious and the residents have a good choice of menu. The residents live in a very safe and very pleasant environment. Management make sure that they check people out thoroughly before offering them a job. This is to prevent the residents being cared for by unsuitable people. Management make sure that the staff are properly trained so that they have the knowledge and skills they need to protect and meet the needs of the residents. Management continually check out the quality of care and the services provided for the residents. What has improved since the last inspection? Management have employed additional activities people so that the residents can find further enjoyment and stimulation during their day. Activities are now provided over the weekend. There have been major improvements to the environment throughout the home. Each unit has been decorated and refurbished to a high standard. Magnetic detentes have been fitted to fire doors so that the doors will close automatically in the event of the fire alarm going off. This helps keep the residents as safe as possible. New security locks have been fitted to all units at the point of entry. This is to ensure the safety of the residents. New shower rooms and specialised bathing equipment have been installed. This should ensure the comfort and well being of the residents.Patio doors have been fitted to the ground floor lounges to allow easier access to the gardens for the residents. A sensory garden has been created for the enjoyment of the residents and their visitors. Management have employed a new member of staff who has the responsibility within the home to develop even further programmes of training. What the care home could do better: To make sure that the needs of the residents are met management need to keep the staffing levels on Crompton Unit under review. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Burrswood House Nursing and Residential Home Newton Street Bury Lancashire BL9 5HB     The quality rating for this care home is:   three star excellent 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: Grace Tarney     Date: 1 6 0 6 2 0 0 9 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. 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. 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 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Burrswood House Nursing and Residential Home Newton Street Bury Lancashire BL9 5HB 01617617526 01617634260 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : BUPA Care Homes (ANS) Ltd care home 125 Number of places (if applicable): Under 65 Over 65 0 125 0 dementia old age, not falling within any other category physical disability Additional conditions: 125 0 125 The registered person may provide the following category of service only Care home with nursing - Code N 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 - Code OP Dementia - Code DE Physical disability Code PD The maximum number of service users who can be accommodated is: 125 Date of last inspection Brief description of the care home Chestnut Court is a purpose-built detached property that is situated in a residential area of Bury, about one and a half miles from the town centre. The home is close to main bus routes and the motorway network. Shops and supermarkets are close by. There are well -maintained and stocked gardens surrounding the building and there is enough parking to the front and the side of the home for the use of staff and visitors. The front door of the home allows a level access for wheelchair users and people who have problems climbing steps. The home is registered to care for residents with a variety of needs. Care Homes for Older People Page 4 of 27 Brief description of the care home On the ground floor there is a unit for elderly residents who have dementia/ mental health needs and require specialist nursing input (Peel) and a further unit (Kay) for residents with dementia who require social care. On the first floor there is one unit for elderly residents with nursing needs (Dunster), and another unit for elderly residents who have social care needs (Crompton). The units on the first floor are reached either by stairs or a passenger lift. Each unit has a large lounge and dining room. The majority of the bedrooms are for single occupancy and most have an en suite toilet and wash-basin. The manager told us that the weekly fees within the home ranged from 373 89 pounds to 581 pounds. The amount of fees charged depend on the care required and whether the resident is privately funded. We were told that people who have their fees paid for by the local authority do not have to pay a top up. Additional charges are made for private chiropody, hairdressing and newspapers. This information was received on the 16th June 2009 Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The staff at the home were not told that this inspection was to take place although many weeks before the inspection questionnaires (comment cards) were sent out to some of the residents and to the staff. The questionnaires asked what people thought about the care and quality of the service provided. We received 2 comment cards back from residents and 16 from the staff. What they felt about the care and services provided is written in different sections throughout this report. Also before the inspection we (The Care Quality Commission) asked the manager of the home to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they did at present, what they felt they did well and what they needed to do better. This helps us to determine if the management of the home see the service they provide the same way that we do. Care Homes for Older People Page 6 of 27 Two inspectors spent 9 hours at the home and during this time we examined care and medicine records to make sure that the health and care needs of the residents were being met. In addition we looked at what activities were available for the residents and whether they were given choices about how they spent their day. We looked at what the residents were having for their meals, to make sure that there was a choice of meals and that they were varied and wholesome. We also looked around the building at some of the bedrooms, bathrooms, toilets and sitting areas to check if they were clean, warm and well decorated. We checked how many staff were provided on each shift to make sure that the residents needs were being met. We then looked to see if management recruited and trained the staff properly and safely. This is so the staff can do their jobs properly and the residents are protected from being cared for by unsuitable people. We also looked at how management check that the care and services they provide is what the residents and their relatives want, or expect. How the residents spending money is managed was also checked. In order to get further information about the home we spent time talking to 3 residents, 3 visitors, the activities person and 4 members of the care staff. What the care home does well: What has improved since the last inspection? Management have employed additional activities people so that the residents can find further enjoyment and stimulation during their day. Activities are now provided over the weekend. There have been major improvements to the environment throughout the home. Each unit has been decorated and refurbished to a high standard. Magnetic detentes have been fitted to fire doors so that the doors will close automatically in the event of the fire alarm going off. This helps keep the residents as safe as possible. New security locks have been fitted to all units at the point of entry. This is to ensure the safety of the residents. New shower rooms and specialised bathing equipment have been installed. This should ensure the comfort and well being of the residents. Care Homes for Older People Page 8 of 27 Patio doors have been fitted to the ground floor lounges to allow easier access to the gardens for the residents. A sensory garden has been created for the enjoyment of the residents and their visitors. Management have employed a new member of staff who has the responsibility within the home to develop even further programmes of training. 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.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. People are properly assessed before they are admitted to the home and this gives an assurance to everybody that a person is only admitted if the staff feel they can meet their needs. Evidence: Before any person was admitted to the home we saw that a senior member of staff from the home undertook an assessment of their needs. An assessment looks at what help and support a person who may be admitted to the home needs to help them make the most of their daily life. We looked at 2 assessments that had been undertaken. They were very detailed and showed clearly what the people were able to do for themselves and what they needed help with. Based on this information it was decided that the staff at the home could meet their needs and therefore their admission to the home was possible. The AQAA document sent to us stated that if prospective residents are unsure about whether to come into the home they are given Care Homes for Older People Page 11 of 27 Evidence: the option of a trial stay. We were told that the staff actively encourage people to look at other homes so an informed choice can be made. We were also told that visitors are welcome at any time of the day or evening to have a look around the home and they are advised to read the homes inspection report before they visit. Standard 6 does not apply. Intermediate care is not provided. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans and care practices ensure that the residents needs are met in a very safe, caring and dignified way. Evidence: Individual care plans were in place for each resident. A care plan details the individual care and support needs that a resident may have and also shows how those needs are to be met by the staff. The care plans of 4 of the residents were looked at, 2 on Kay Unit and 2 on Peel Unit. They were very detailed and gave clear instruction and guidance on how the care needs of the residents were to be met. They also provided a lot of information about the residents daily routine, their past life and their interests. Lots of emphasis was placed on what the person used to like to do before they were admitted to the home, their spritual beliefs and what relationships they had. This helps the staff and the resident to plan for their daily activities so that they can get as much enjoyment out of their lives as possible. The care plans were checked regularly by the staff so that any change in the residents condition could be identified and action taken if necessary. We did see however, that on Kay Unit the staff had identified that, due to Care Homes for Older People Page 13 of 27 Evidence: an increasing concern about a residents condition, the care plan and risk assessment had to be reviewed weekly. This had not been done, although staff were very aware of the changes in the residents condition and were in regular contact with the residents GP. Staff also identified that this resident had been losing weight. It was written in the care plan that the resident was to be weighed weekly. This had not been done. Staff need to make sure when they have identified a change in a residents health care needs, that they undertake the action agreed. In this case, increased monitoring. We looked at the care plans of 2 residents on Peel unit who were very ill and required a lot of nursing and medical care. Their care plans were very detailed and showed that there was a lot of involvement with the residents GPs, the nurses who specialise in caring for terminally ill people and the residents families. In all the care plans that we checked we saw that the staff looked at whether or not there was any risk in relation to the residents developing pressure sores. They also looked at whether there was any risk of the resident falling and also if a resident was at risk due to problems with their food and fluid intake. Staff also looked at and wrote down how any resident was to be assisted with being moved around and by how many members of staff and what equipment if any, was to be used to assist in safe moving and handling. We saw that residents were weighed regularly and their weight was recorded in their care notes. We went to look at the care being provided to 1 of the very ill residents. This resident looked very well cared for. Lots of specialised equipment was in place to ensure that every comfort and care was being delivered. The staff on the unit had also sought advice from nurses in the community who specialise in the care of terminally ill people. Equipment necessary for the prevention and treatment of pressure sores was available and in use. We saw that staff wrote in the care notes when the residents had received visits from health care professionals, such as dentists, opticians, district nurses and chiropodists. We spoke to 2 visitors who told us that they felt their relatives were very well looked after. Some of the comments from the surveys returned were: Very pleasant and extremely tolerant staff. Staff have a very caring attitude. They look after my mum very well. We looked at the how the medicines are managed on both Kay and Dunster Units. Qualified nurses on Dunster Unit are responsible for the managing the medicines and care staff who have received medicine training have responsibility for managing the medicines on Kay Unit. We looked at how medicines, including controlled drugs, were ordered, stored and recorded. A safe system of medicine management was in place. Medicines were stored securely and recorded accurately. Throughout the day we saw that the staff spoke to the residents in a very friendly and Care Homes for Older People Page 14 of 27 Evidence: respectful way. They knocked on bedroom, toilet and bathroom doors before entering and responded to the residents needs in a very dignified way. The residents looked clean and comfortable, were suitably dressed and looked well cared for. Staff confirmed that the importance of ensuring privacy, respect and dignity is part of their initial training. Care Homes for Older People Page 15 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 residents are supported and encouraged by staff to make choices about what they do, so that they can find enjoyment and satisfaction in their daily life and with the activities available to them. Evidence: The residents routines of daily living, such as when they go to bed and when they get up, and their social interests are recorded in detail in their care plans. The home has a full time activities organiser who is supported by 2 further activities people and a team of volunteers. The activities are provided over 7 days and residents are given the opportunity to choose their own activities. We were told that the choice is varied and includes craft work, art club, gardening club, trips out, bowling, tea dances and luncheon clubs. Whilst we were at the home we were aware that a group of singers were entertaining the residents on Crompton Unit. We saw that residents from other units were also visiting Crompton Unit to enjoy listening to the choir. A list of what is going on for activities is displayed in various parts of the home. The AQAA document sent to us stated that the majority of the residents were of the Christian Faith and there was 1 resident of the Muslim Faith. Staff told us that Care Homes for Older People Page 16 of 27 Evidence: residents of the Roman Catholic Faith, if they wish, are visited by members of their church and are able to receive Holy Communion. We were told that other clergy visit by request. Staff told us that the resident of the Muslim Faith received a Halal diet. A visitor confirmed that there were no unreasonable restrictions to him visiting at the home. He told us that he liked to visit his mother in her own room. He also told us that he was pleased with his mothers care. The AQAA document sent to us stated that the home employs an open visiting policy, taking into account the residents wishes. We saw what the residents on Peel Unit were having for their lunch. Most of the residents were seated in the dining room but some were sitting in the lounge or were having their meals in their rooms. The tables were very nicely set with tablecloths and napkins. We were concerned to see however, that the residents who were served their meals in the their rooms were served all their meal at the same time on the tray. The total meal included soup, main meal, dessert and hot drink. Serving everything together could result in food going cold before the resident is ready to eat it. It can also be overfacing for them. We did actually see one resident eat her dessert before her soup. We spoke to the staff about this concern and they told us that they did not have the staff at meal times to serve food individually. We then spoke to the manager who told us that the serving of meals this way was something that they were aware of and were trying to address it. We looked at the menus and saw that the residents have a choice of meal at breakfast, lunch and evening meal. We saw a variety of hot and cold drinks being served at lunch time and throughout the day. We were told that milky drinks and light snacks are served at supper time. The residents that we spoke to told us that the meals were very good, well cooked and there was always plenty of it. 2 residents wrote and told us: The food is good. Care Homes for Older People Page 17 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. There are systems in place to ensure that people know how to and to whom they can complain. Staff have a good knowledge and understanding of what abuse is and know what to do if it happens. This helps reduce the possible risk of harm to the residents. Evidence: A notice is displayed in the reception area and throughout the home explaining to people how and to whom they can complain, and how their complaint will be dealt with. It is easy to understand and tells people that complaints will be looked into and a full written response will be given within 28 working days. We saw that a record is kept of any complaint made and includes details of the investigation and any action that the management may have taken to put things right. No complaints have been made to us since the last inspection of June 2007. We spoke to some of the staff and asked them to tell us what they would do if they felt that a resident had been mistreated in anyway. They were very aware of what to do and how to report it. They told us that they had been trained so that they could, as far as possible, protect the residents from harm. We saw evidence of this training in their training files. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents live in suitably adapted, clean, safe and very pleasant surroundings. Evidence: The home is purpose built and the accommodation is provided on 2 floors that can be reached either by a lift or stairs. It is situated in very pleasant, well stocked gardens that have seating areas for the residents and their visitors. There are now also 2 secure garden areas for the people who have dementia. This enables them to walk around safely and enjoy the gardens. There is also a sensory garden for the residents to enjoy. The home is divided into 4 separate units. On the ground floor are Peel and Kay Units and on the first floor are Crompton and Dunster Units. We looked at all the units, some in more detail than others. Each unit has been totally refurbished since the last inspection. They have been decorated and furnished to a high standard. Peel and Kay Units. The lounges and dining rooms have been redecorated and refurnished. They were clean, warm and welcoming. The corridors have been redecorated and each corridor has a themed decor. Themes such as sports, films and transport are in place. On Kay Unit there is a table laden with old, mainly household, items. We were told that this was really useful as it helped the residents to reminisce. Bedroom doors on both units are painted in different colours to make identification of the rooms easier for the residents. Outside each bedroom door there are memory boxes. These contain photographs and mementoes that are, or have been, of importance to the resident. All Care Homes for Older People Page 19 of 27 Evidence: the toilet and bathroom doors are painted red and are identified by large pictures of toilets or baths or showers. This is also for ease of identification. The toilets are easy to get to, as they are close by to bedrooms, lounges and dining rooms. The bathrooms and toilets have a lock on the door to ensure privacy and have suitable aids on them so that the residents can use them safely. Both units also have a newly installed shower room and a specially adapted bath to assist people with a disability. Most bedrooms also have an ensuite toilet and handbasin. We looked at some of the bedrooms. They were furnished and decorated to a good standard. Each bedroom has co-ordinating curtains and bedclothes. New laminate flooring has also been laid. The bedrooms were clean and warm. Each bedroom door has a safety overriding lock and each bedroom has a lockable space to store anything that is of value or importance to the resident. Dunster and Crompton Units We did not look in detail around these units but we could see that both units have been totally refurbished to a high standard. They had new shower rooms and specially adapted bathing facilities to assist people with a mobility or physical disability. The rooms throughout the home were centrally heated by underfloor heating. We were told that thermostatic control valves were fitted to baths and showers. This reduces the risk of residents being harmed by protecting them from accidental scalding. We saw that all the bedroom and communal doors had been fitted with magnetic detentes. This means that the doors can be left open but in the event of the fire alarm going off they would close automatically, thereby keeping the residents as safe as possible. The home was clean and there were no unpleasant smells. Disposable hand washing equipment (liquid soap and paper towels) was in place in bathrooms, toilets and bedrooms and disposable gloves and aprons were provided for the staff to wear. Providing this equipment helps to reduce the spread of infection and therefore helps to protect the residents health and wellbeing. 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. The residents are cared for by staff that are suitably trained and safely recruited. This helps to keep them as safe as possible. Evidence: A check of the duty rotas and inspection of the training files showed that there was enough suitably trained staff on duty throughout the day and night to care for the residents. Staff on Crompton Unit did tell us however, that they felt that due to the needs of the residents, they found it difficult at times to spread their time between actually caring for the residents and doing the office work. We discussed this with the home manager who agreed to look at the staffing levels and the dependency of the residents on the unit. The residents told us in the survey forms returned to us that the staff looked after them well and that they listen and act on what they say. The information that we looked at in the training files and the information given to us in the AQAA document showed that 26.4 of the staff had obtained their NVQ (National Vocational Qualification) level 2 or level 3 in care. We were told that some staff have not yet finished the training and that some are waiting to start. Care Homes for Older People Page 21 of 27 Evidence: We looked at how the management recruit their staff. The personnel files of 2 staff members were looked at. All were in order and these staff had been properly and safely employed. This helps protect residents from being cared for by unsuitable people. The information received from the AQAA form showed that management provide a staff induction programme for all newly employed staff. This is to make sure that they understand what is expected of them and that people are cared for properly and safely. We also saw that lots of training has been provided for the staff. They have had training in 1st Aid, moving and handling, basic food hygiene, fire safety, health and safety, medicine management, dementia care and other subjects connected to their jobs. Staff told us that they felt the training was very good. Management have appointed a person within the home who is developing programmes of training for the staff. She works 3 days as a trainer and 2 days as a care assistant. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is safe and very well managed. Management continually look at the care and facilities they provide so that the residents welfare is protected Evidence: The Registered Manager of the home has several years of experience in the care of the elderly and she has a management qualification. She is supported in her role by 2 Senior Nurses. The staff that we spoke to told us that the Manager was very supportive. Some of the comments were: She is spot on. Absolutely excellent. Things are so much better since she became the Manager. We saw that a great deal of work goes into providing a quality assurance system for the home. This is to check on the quality of the care and services provided. From what we looked at it is obvious that the company want to make sure that they get things right for the residents. The Senior Nurses and the Manager of the home have to check Care Homes for Older People Page 23 of 27 Evidence: on lots of things that affect the health, safety and well-being of the residents. They have to record all their findings and then these are checked on by other senior management staff who then make sure that anything that may need attention is put right. Management also send out surveys to residents and relatives asking for their views on the care and services provided at the home. The system in place for the management of residents money was safe. We were told that they mainly handle money brought in for the residents expenses. We saw that receipts were given for any money received and receipts were kept for any money that was spent on behalf of the residents. We saw that regular weekly checking and testing of the fire detection system, fire exits and emergency lights was undertaken and documented. New fire evacuation blankets have been provided and there is now a residents register in the Fire Emergency Folder. Information from the AQAA document showed us that the equipment and services within the home were serviced on a regular basis. The AQAA document also told us that regular health and safety meetings take place and that there is a dedicated Health and Safety team within the region to offer advice and support. 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 1 7 Staff need to make sure when they have identified a change in a residents health care needs, that they undertake the action agreed. The system for serving the residents with all their meal at once should be changed so that each course is served individually. This should ensure that their meal is unhurried and does not get cold. 2 15 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or 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) 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. 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