Care Home: Catherine Dalley House

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What the care home does well The service provides excellent personal and health care support to people who live there. We spoke with nine people who live at Catherine Dalley House and all of them were highly complimentary of the care they were given. All areas of the home were clean and smelled fresh. Good attention is paid to infection control procedures. A visitor told us that they, and their family can come at any time of the day or evening and are always made to feel welcome. The activities co-ordinator provides good opportunities for people living at Catherine Dalley House to engage in both group activities and one-to-one activities based on their individual interests. People living at Catherine Dalley House enjoy the meals and choices available on the menu. We saw meals were nicely presented, and that mealtimes are a pleasant, social experience. Staff sit with residents and eat with them. Staff have a good understanding of the individual needs of each person living at the home. During our visit they were seen to support people living at Catherine Dalley House in a sensitive way, and ensured the dignity of people at all times. Staff told us that they felt they worked well as a team. There have been no complaints about the service. When we talked to people living at Catherine Dalley House about whether they knew how to complain, the main response was `why would we need to, we have no complaints, they do everything we ask`. The administration of medication is managed well, and we observed medicines given to people in a safe way. Clothes are laundered well, and again there are good infection control procedures in the laundry. We saw all people living at Catherine Dalley House wearing clean and nicely pressed clothes. Health and personal care records are up-to-date and reflect the current needs of each person living in the home. The manager and her team run the home well with the interests of the people who live their as the priority. Staff are given good training to help them carry out their care responsibilities safely and effectively. At the time of our visit there were 23 people living at Catherine Dalley House. The staffing levels and the skill mix, provided good support to the number of people, and the needs of the people living at the home. What has improved since the last inspection? Staff have receive training in `Safeguarding Adults`. This means that staff have a better understanding of what to do if they suspect a residents is being harmed or abused. Some staff have also received training to help them understand new legislation such as the Mental Capacity Act and Deprivation of Liberty. Activities are now being offered on a more individualised basis, based on resident choice and need. Staff have undergone Fire Awareness and Fire Extinguisher training. What the care home could do better: The service could look at providing more reminiscence activities for people who have dementia. The service could look at improving the environment to support those with dementia. There are few signs and symbols around the home to help guide people with dementia around the home. Care plans could include more information about the medication being used by residents, and why it is being used. The service should check on an annual basis to see whether people living at the home would like a dental check-up. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Catherine Dalley House Scalford Road Melton Mowbray Leicestershire LE13 1JZ     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: Fiona Stephenson     Date: 2 9 0 7 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 26 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 26 Information about the care home Name of care home: Address: Catherine Dalley House Scalford Road Melton Mowbray Leicestershire LE13 1JZ 01664562487 01664562487 Telephone number: Fax number: Email address: Provider web address: www.leicestershire.gov.uk Name of registered provider(s): Leicestershire County Council Social Services care home 31 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia learning disability mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability sensory impairment Additional conditions: Catherine Dalley House Care Home is registered to provide personal care to male and female service users who fall within the following categories: Old age not falling within any other category (OP) 31. Dementia over 65 years of age (DE(E)) 20. Dementia (DE) 8. No person falling within the category DE can be accommodated at Catherine Daley House when there are 8 persons within this category already residing at the home. No persons falling within the categories DE(E) or DE can be accommodated at Catherine Care Homes for Older People Page 4 of 26 Over 65 20 4 6 31 10 4 8 4 8 0 8 4 Dalley House when 20 persons who fall within these categories/combined categories are already residing at the home. Learning Disability over 65 years of age (LD(E)) 4. Learning Disability (LD)4. No persons falling within the categories LD(E) or LD can be accommodated at Catherine Dalley House when 4 persons who fall within these categories/combined categories are already residing at the home. Mental Disorder, excluding learning disability or dementia over 65 years of age (MD(E)) 6. Mental Disorder, excluding learning disability or dementia (MD) 8. No person falling within the category MD(E) can be accommodated at Catherine Dalley House when there are 6 persons who fall within this category residing at the home. No Persons falling within the category MD(E) or MD can be accommodated at Catherine Dalley House when 8 persons who fall within these categories/combined categories are already residing at the home. Physical disability over 65 years of age (PD(E)) 10. Physical Disability (PD) 8. No person falling within the category PD can be accommodated at Catherine Dalley House when there are 8 persons who fall within this category residing at the home. No Persons falling within the category PE(E) or PD can be accommodated at Catherine Dalley House when 10 persons who fall within these categories/combined categories are already residing at the home. Sensory impairment over 65 years of age (SI(E)) 4. Sensory impairment (SI) Service users between 55-65 years who fall within the above categories and were resident in the care home at the date of registration may continue to reside there. The maximum number of service users to be accommodated at Catherine Dalley House is 31. Date of last inspection Brief description of the care home Catherine Dalley House is a care home providing personal care and accommodation for up to thirty-one older people, who may have associated conditions, including dementia, mental disorder, learning disability, physical disability and sensory impairment. The home also has two beds for people who need respite care, and two beds for assessment. The home is located in the market town of Melton Mowbray, which provides a range of shops and has public transport links. The accomodation is over two floors. The ground floor has three lounges. One of these lounges has a large dining area, and the other two have smaller dining areas for people to use. There is a small lounge/dining room on the first floor also. All bedrooms are single, and none have en-suite facilities. There are however, communal bathroom/shower rooms close to the bedrooms. The home has a garden surrounding the property including a secure garden with a seating area. People can get to the first floor by passenger lift or by stairs. The maximum weekly fee is £499.80; information about fees is written in the information given to people who are interested in living at Catherine Dalley house. There are additional costs for individual expenditure such as Chiropody, Optician and hairdressing services, and the fee will depend on the assessed need of the person. Care Homes for Older People Page 5 of 26 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 key inspection included a visit to the service. This is the first key inspection of Catherine Dalley House since 5th September 2007. We (the CQC) visited the home on the 29th July 2009. The registered manager and the staff in the home helped us during the visit. Our visit started at 8.25am and finished at 4.00pm. The main method of inspection we used was case tracking. This means looking at the care given to people in different ways. We did this by, - talking to the people who live in the home and their relatives, - talking to the staff and management, -watching how people are given support, Care Homes for Older People Page 6 of 26 -looking at records. We looked at the Annual Quality Assurance Assessment (AQAA). This is a document the provider (the person who owns the service) sends t us at the CQC, and it tells us what the provider thinks about the service they deliver to people who live at Catherine Dalley House. We also looked the surveys called Have Your Say About which are sent out to people who live and work at Catherine Dalley House, and professionals who visit the home to support staff with personal and medical care. We received seven surveys back from social and health care professionals; 17 from people living in the home ( a member of staff supported residents in completing them); and 11 from staff who work at the home. All surveys received, whether they were from residents, staff or health care professionals were very positive. Typical comments from resident surveys were: I cant find any faults they look after us well they look after us well and keep our home clean the home does everything well good food, good bed, the games we play, dominoes One resident felt that the home could maybe have more staff so the staff arent too busy, and another said they would like more active activities such as theatre trips, days out to the zoo and the seaside. We received responses back from a chiropodist, three G.P.s, a social worker and two district nurses. Comments made by health and social care professionals included: they communicate well with district nursing team. Residents always appear to be well cared for. I think they are a caring bunch (the staff) and it (the home) appears well run. I always find them helpful and they seem to know all their residents and their needs. staff are well informed if they request a doctor visit. The home is clean. Staff are always polite and helpful to both me and the patient. A chiropodist that sent a survey back, said that the home has an excellent record of care from all staff but felt that they could improve by ensuring regular foot care for all service users, not just ones with specific problems. All staff that sent surveys back responded that they felt the staff worked hard to ensure the needs of residents were met. Typical comments about what they felt the home does well included: the care given to our service users is always to the best of our ability the care of the resident is the upper most importance to managers staff and we all have their well being to mind we have a high standard of care which works well it cares very well for each individual resident with a very homely atmosphere the home always smells clean and fresh too Catherine Dalley is a very happy and friendly home to work in with happy staff and happy residents. Staff did comment on things they felt the home could improve on. Some registered concerns about staff sickness rates, and felt the home would benefit from more staffing. One thought it would be good for the home to become a more specialised dementia unit, and there were comments about the destabilising effect of the negotiations which have been taking place with regard to selling the home. During our visit we asked nine residents who could communicate with us, a range of questions about life at Catherine Dalley House. All nine we spoke with, spoke highly of the staff, the food, the care and the cleanliness of the home. Care Homes for Older People Page 8 of 26 What the care home does well: The service provides excellent personal and health care support to people who live there. We spoke with nine people who live at Catherine Dalley House and all of them were highly complimentary of the care they were given. All areas of the home were clean and smelled fresh. Good attention is paid to infection control procedures. A visitor told us that they, and their family can come at any time of the day or evening and are always made to feel welcome. The activities co-ordinator provides good opportunities for people living at Catherine Dalley House to engage in both group activities and one-to-one activities based on their individual interests. People living at Catherine Dalley House enjoy the meals and choices available on the menu. We saw meals were nicely presented, and that mealtimes are a pleasant, social experience. Staff sit with residents and eat with them. Staff have a good understanding of the individual needs of each person living at the home. During our visit they were seen to support people living at Catherine Dalley House in a sensitive way, and ensured the dignity of people at all times. Staff told us that they felt they worked well as a team. There have been no complaints about the service. When we talked to people living at Catherine Dalley House about whether they knew how to complain, the main response was why would we need to, we have no complaints, they do everything we ask. The administration of medication is managed well, and we observed medicines given to people in a safe way. Clothes are laundered well, and again there are good infection control procedures in the laundry. We saw all people living at Catherine Dalley House wearing clean and nicely pressed clothes. Health and personal care records are up-to-date and reflect the current needs of each person living in the home. The manager and her team run the home well with the interests of the people who live their as the priority. Staff are given good training to help them carry out their care responsibilities safely and effectively. At the time of our visit there were 23 people living at Catherine Dalley House. The staffing levels and the skill mix, provided good support to the number of people, and the needs of the people living at the home. Care Homes for Older People Page 9 of 26 What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.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 10 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 11 of 26 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 who wish to live at Catherine Dalley House are given good information about the home, and have their needs properly assessed prior to moving in. Evidence: We looked at the information given by the service, to people who are considering moving into Catherine Dalley House. We saw that the information clearly sets out the information people need to know when moving into a care home. It informs of how the service intends to provide care and support to people who live at the home, the accommodation, staffing, and how to make a complaint. It also includes information from the most recent quality assurance process, and how the service has listened to the views of people in making changes to the way they operate. We saw that no-one comes to live at Catherine Dalley House before a pre-admission assessment is completed to make sure that the service can meet their needs. Care Homes for Older People Page 12 of 26 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. Catherine Dalley house provides excellent health and personal care to people living in the home Evidence: We looked in detail at the care given to four people who live at Catherine Dalley House, and watched in general how staff supported the people living at the home. The care plans we looked at gave information about the life experiences of people before they moved into Catherine Dalley House, how they would like their daily experience at the home to be supported, and gave detailed information about their personal and health care needs. We saw that the care plans were regularly reviewed to ensure that staff understand the present needs of people living at the home. We also saw that staff write up notes for each section of the day, and these notes are used to inform the next staff shift of how residents are feeling and what their needs might be. We watched how staff support people at Catherine Dalley Hose and saw that they have a detailed knowledge of the individuals personal needs when providing support. Staff respond appropriately and sensitively in all situations involving personal care, Care Homes for Older People Page 13 of 26 Evidence: ensuring it is conducted in private and at a time and pace directed by the person receiving the care. During our visit we did not see anyone having to wait for staff to support them. We spoke with nine people who live at Catherine Dalley House, and one relative who was visiting on the day of our visit. We were told by people living in the home that the staff will always contact the GP if they request it, and they felt that staff looked after their care needs very well. The relative we spoke with also said they were very pleased with the support their family member was getting at the home. We received seven Have Your Say surveys from health and social care professionals, and all were very positive about the health care given to people living at the home, and the liaison staff had with them as health care professionals. We were told that if people have problems with their teeth, then a dentist appointment is made, and the same applies with contacting a chiropodist. People are not currently asked whether they would like a routine check up with the dentist. A chiropodist who attends to people living at Catherine Dalley house, although again very positive about the overall care they saw people receiving at the home, said they felt that the service could ensure regular foot care for all service users not just one with specific problems. We looked at the way medicines are given to people who live at the home. We also looked at how they are stored, and the stock of medicines. We saw by looking at the MAR sheets (Medication Administration Record), that medicines were being given appropriately and signed for. We observed how they were being given to people, and saw that they were being given safely. We were informed that no-one living at the home currently uses controlled drugs. We saw that the current storage for controlled drugs does not comply with recent changes to the legislation which requires all care homes to have a controlled drugs cabinet which has been approved to be used for the storage of controlled medication. During our visit, the manager ordered one in keeping with the legislation. Care Homes for Older People Page 14 of 26 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. People living at Catherine Dalley House have a good daily life, and enjoy a range of social activities. Evidence: We spent time watching the daily life of people living at Catherine Dalley House. We saw that, as much as possible, people were choosing what to do with their day. This was supported by staff being made aware of residents likes and dislikes and preferred daily routines written in the care plan. During our visit we saw the activities co-ordinator painting the nails of female residents. Whilst watching the activities co-ordinator we heard her, residents and a visitor talk about the recent quiz nights and race nights that people living in the home have enjoyed. We spoke with the activities co-ordinator who also told us of the one-to-one activities she undertakes with people living in the home, such as scrabble, dominoes, jigsaws. We saw that these activities had been written up in the residents care file. We were told that although the vast majority of people living at Catherine Dalley House have some form of dementia, the activities are not specifically geared to meet these needs. We were made aware from the AQAA that the management of the home see this as an area to improve on; and the activities co-ordinator is looking to Care Homes for Older People Page 15 of 26 Evidence: how activities can reflect these specific needs. We were told by people living in the home, and by the visiting relative, that they can have visitors at any time, and that visitors are welcomed to the home. We spoke with kitchen staff and looked at the menus for people living in the home. We saw that the service has a four-week menu which is comprised of the favourite meals of people living there. We saw that the cook ensures that people with diabetes are offered the same range of choice as those without diabetes. We spoke with people who live in the home and they told us that they really enjoy the food provided. We saw both breakfast and lunch being served and saw that both were presented well. We saw that residents could have a range of breakfast options, including a cooked breakfast, and on the day of our visit, residents enjoyed a lunch of either quiche and vegetables, or lamb and vegetables, followed by ginger steamed pudding and custard, or muffin and custard. Yogurts and fruit were also available. We were told that work is being done to make the menu more accessible to people who have dementia, as they often dont remember what a dish comprises of. Staff are looking at presenting the menu in photo or picture format to help with recognition. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Catherine Dalley House are well protected. Evidence: We spoke with people living at Catherine Dalley House about making complaints if they were unhappy with any aspect of care. All said that they have never needed to complain because the care is always good. They said that they would feel able to talk to staff if they needed to make a complaint. We checked the complaints record at the home, and this confirmed that there has not been any complaints made about the service. We at the CQC have also not received any complaints or concerns about the delivery of care at the home. We looked at the Regulation 37 notifications. These are notifications the service has to send to us at the CQC if anything happens which effects the well being of an individual or a group of residents (eg. injuries to residents, hospital stays etc). We were satisfied that the service had taken appropriate action in relation to the notifications sent to us. We spoke with staff to find out whether they knew of policies and procedures to follow if they had concerns that a resident was being abused. Staff spoken with knew about the different forms of abuse, and who to report their concerns to. The AQAA told us that most staff have received training in Safeguarding Adults. Care Homes for Older People Page 17 of 26 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. People living at Catherine Dalley House live in a clean, tidy and comfortable environment. Evidence: We looked at the bedrooms of the people we case tracked and saw that they were clean and tidy and smelled fresh. The decor was good, and the bedrooms were warm and welcoming. None of the bedrooms have en suite facilities and so we checked the communal bathing and toileting facilities. These again were in good condition and nicely decorated. We saw that the service had also bought new commodes which are more comfortable for larger residents to use. People living at Catherine Dalley house have the benefit of three lounges to chose from on the ground floor, and a lounge on the first floor. All but one lounge are lounge/dining rooms. The communal areas were pleasantly decorated, but furnished mainly with single high backed chairs, which gave an institutional feel to them. We saw that many people living at Catherine Dalley House use aids and adaptation such as mobilators, and hoisting equipment. We saw that regular checks have been made on these to ensure they are safe for people to use. The majority of people living at Catherine Dalley House have dementia. Most display Care Homes for Older People Page 18 of 26 Evidence: this with short-term memory loss, however the service has not looked at how the environment can be adapted to meet the needs of people who have more advanced dementia, and who require more support to orientate themselves within their home environment. Care Homes for Older People Page 19 of 26 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 experience, attitude, training, and level of staffing, contributes to the high quality of care provided to people living at Catherine Dalley House. Evidence: On the day of our visit there were 23 people living at Catherine Dalley House. From 7.30am to 3.00pm they were supported by four care staff, and this was reduced to three care staff between 3.00pm and 10.30pm. They were also supported by two domestic staff in the morning, and one in the afternoon, an activites co-ordinator in the morning, a cook and kitchen assistant throughout the day, and at least one manager throughout the day. A handy man does the required maintenance work each day from 8.30am to 1.30pm. At night time residents are supported from 10.30pm with two waking night staff, plus a sleep-in manager who is on call should they be needed. We looked at the training staff have done since working at Catherine Dalley House. We saw that 84 of staff have completed a National Vocational Qualifiation in Care to level 2. We saw that 53 of staff have had training in dementia care, 63 have had training in the Safe Handling of Medication and 74 have had basic food hygiene training. We saw that all staff have received training in Client Moving and Handling. Care Homes for Older People Page 20 of 26 Evidence: During our visit we saw that staff knew the needs of the people they were supporting very well. We noted that the atmosphere in the home was relaxed and unhurried. We saw that staff were available to residents to support them when they wanted it, and people did not have to wait lengthy periods of time to get support. We saw a good rapport between staff and people living at the home, and saw that staff were sensitive to the needs of the people living there. We observed good practice when staff supported residents in using a hoist. We attended the staff handover period and this gave the new shift a good understanding of the areas of support required for the later shift, and helped with continuity of care. Care Homes for Older People Page 21 of 26 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 management at Catherine Dalley House provide good support to the people who live at the home, and the staff who care for them. Evidence: The manager has a degree in Social Work, the Registered Managers Award, and is a qualified National Vocational Qualification assessor. She has many years experience in managing a care home which has consistently been rated as good. The manager demonstrated a clear understanding of the aims and objectives of the service. Both her, and her team provide the staff working at Catherine Dalley House with effective support, and ensure that staff receive training to support them in providing good quality care in a safe environment. We saw that due to long-term sickness of one of the assistant managers in the home, not all staff had received formal supervision within the 4-6 week period the local authority expects its staff to have. But we were satisfied that staff were given support and supervision if required to ensure that people living at the home were getting effective care. Care Homes for Older People Page 22 of 26 Evidence: The AQAA sent to us contained clear information about how the service delivers good quality care to people who live at the home, but also informed us of areas it had identified needing improving, and how the service intended to make the improvements. The service has in-depth quality assurance questionnaires it gives to people who live at the home, and their relatives, to help management to see what they are doing well, and what can be improved. The residents and staff at Catherine Dalley House have been through, and continue to go through a period of uncertainty, as the local authority is looking to sell the home to another provider. Management have supported residents, their relatives and staff well, during this period. We looked at the management of health and safety in the home, and the management of the finances of people who live at Catherine Dalley. We saw that in both areas, good systems were in place to protect people who live in the home, and the staff who support them. Care Homes for Older People Page 23 of 26 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 24 of 26 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 2 1 7 Ensure the written information has the new name and address of the regulator. The service could add to the information about medication in the care plans, the reasons why people take the medication, and any potential adverse side effects. The service could ask people living in the home if they wish to have access to a dentist or chiropodist for checks before there are noticeable problems. The service should continue to look at improving activities to support the needs of people with dementia, and to look at improving recognition of menu choices. The provider should consider how the environment can be adapted to support the increasing number of people living in the home with dementia. The provider should consider buying new lounge furniture which can both meet the needs of people living in the home, but create a less institutional environment. 3 8 4 12 5 19 6 19 Care Homes for Older People Page 25 of 26 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. 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