Care Home: Cavendish Residential Care Home Limited

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What the care home does well Residents are happy living at the home and with the services provided. They speak positively about the staff team and feel that the home provides a homely environment. Their comments on services and facilities are welcomed by the team at the home and acted upon. One survey returned by a realtive stated "We are fortunate to have our relative at Cavendish they are so well looked after" Another stated " The care is exceptional and the staff are so caring" The activities provided by staff in the home are popular with residents. The home is clean and well maintained and the proprietors are committed to improving the environment. A stable and well trained staff team support the residents. What has improved since the last inspection? Pre-admission assessments are now completed fully and contain good comprehensive detail and resident input where they can. Care plan reviews are now resident led and the team continue to try and involve residents and their relative in the care planning process where possible. Social and behavioural care plans are in place where appropriate and social histories and life maps completed also involving the resident or their relative where possible. The home now has a registered manager which ensures the home is run in the best interests of the residents promoting a consistent approach to the delivery of care. Staff training and in particular the numbers of staff that have taken part in safeguarding, dementia and NVQ level 2 and 3 has improved. This will improve the quality of the way in which they support and protect people living at the home. What the care home could do better: The team should continue to develop its approach to the assessment of residents and provision of care. Assessments and identified care plan problems, completed for residents, should correlate into the care planning process, so that the management of the identified risk and planned care benefits from a consistent approach. Interview records should allow for the interviewer to evidence that gaps in employment such as CRB checks have been explored with applicants. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Cavendish Residential Care Home Limited Cavendish Residential Care Home 26 Kings Road Clacton on Sea Essex CO15 1AZ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Helen Laker     Date: 2 3 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 28 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 28 Information about the care home Name of care home: Address: Cavendish Residential Care Home Limited 26 Kings Road Cavendish Residential Care Home Clacton on Sea Essex CO15 1AZ 01255423861 01255423114 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) : Cavendish Residential Care Homes Limited care home 21 Number of places (if applicable): Under 65 Over 65 3 21 dementia old age, not falling within any other category Additional conditions: 0 0 Pesons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 21 persons) The total number of service users accommodated in the home must not exceed 21 persons Three persons, over the age of 65 years, who require care by reason of dementia, whose names were made known to the Commission in October 2006 Date of last inspection Brief description of the care home Cavendish is a care home, providing personal care and accommodation for 21 older people with dementia. The home is located on the outskirts of Clacton town centre and has easy access to the local shops and other amenities. The home consists of a two storey, detached house. The bedrooms are made up of Care Homes for Older People Page 4 of 28 Brief description of the care home nineteen single and one double room. All but three of the rooms have en-suite facilities. There is a passenger lift. The home has private gardens, which are well maintained and accessible via a ramp. The current scale of charges is 383.00 pounds - 475.00 pounds weekly. Additional costs for items such as hairdressing, chiropody are charged separately. The home has an up to date statement of purpose and service users available. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This unannounced key inspection was carried out on the 23rd June 2009. As part of the inspection we checked information received by Care Quality Commission (CQC), looking at records and documents at the care home and talked to the proprietors, manager, care staff and the people living at the home. In addition the Annual Quality Assurance Assessment (AQAA) completed in May 2009 was considered as part of the inspection process and a tour of the premises was completed at the visit to the care home. The service sent us their Annual Quality Assurance Assessment (AQAA) which is required by law to be completed by the service when we asked for it. This contained information about what they felt they did well. The information was informative but required some more specific detail to inform us how Care Homes for Older People Page 6 of 28 the service was seeking to improve the outcomes for people living at the service, beyond their present provision. We sent surveys to people living in the home and their relatives, staff and external professionals. There was a good response and the information contained in these was used to inform us on some of the outcomes for people using the service. The manager, staff and the proprietor assisted the inspector at the site visit. Feedback on findings was given during the visit with the opportunity for discussion or clarification. We would like to thank the proprietor, the manager, the staff team, and people living at the service and their relatives for their help throughout the inspection process. What the care home does well: 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 8 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 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This judgement has been made using available evidence including a visit to this service. People who use the service can expect their needs to be identified through a good pre admission assessment. The home provides accurate information to, and secures sufficient information about prospective service users to inform a good quality of care. Evidence: The team at the home have a set pre-admission assessment form in place that meets the required standard. The manager primarily undertakes the assessments, but has been training other staff in the home and they are all now able to undertake assessments in her absence. A range of assessments, completed by staff from the home, were reviewed. These were supported by information contained in social services assessments that the home had been given. Admissions to the home were seen to be appropriate and were very detailed giving a very clear picture of the care Care Homes for Older People Page 10 of 28 Evidence: required. Signatures were seen of residents who have been able to take an active part in the process. Where areas of need were identified, these are explored and much more detail is now recorded, including the individuals comments or preferences, giving a more person centred approach. For example one assessment said likes branflakes has gone off tomatoes and another stated Feels the cold likes to wear warm clothing. The team have a good care plan assessment tool in place, which cover all the activities of daily living and is used to inform the care plan. The AQAA states We aim to focus more on choice and provide the opportunity through person centred care for residents, relatives, family and friends to excercise that choice Residents spoken with confirmed this approach and one relative survey stated Residents are known and treated as individuals. The Service Users Guide was seen around the home and residents had copies in their rooms. When reviewing this document, the management were noted to have given further consideration to the format in relation to the needs of the residents currently in the home and it is now on audio tape and currently being reviewed and updated since the inception of the Care Quality Commission. Cavendish care home does not provide intermediate care. Care Homes for Older People Page 11 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This judgement has been made using available evidence including a visit to this service. People who use the service can be confident that all areas of their assessed needs are fully documented and understood by staff. Care provision at the home is good, giving residents positive outcomes and they can be sure their healthcare needs will be met. Evidence: A new, much improved person centred care planning system has been introduced within the home. Care staff can now take a more active part in care planning and this is evident in the records. Records show that the manager has been providing care planning training to staff individually in order to facilitate this change and more is planned for the future. The care planning system has an assessment tool in place that covers activities of daily living and then links into the care planning system. This is a good tool and was seen to be completed well and gave a good level of detail about the individual. These records also identified personal preferences well. Care plans were in place for identified needs and these were seen to be up to date and contained Care Homes for Older People Page 12 of 28 Evidence: sufficient detail to ensure service users needs could be met. Falls risk assessments and sleep care plans were seen to be in place, these are reviewed monthly, at the time of any fall or change and audited monthly. Records also showed that there is monitoring of residents falls being undertaken in liaison with the falls prevention team. General reviews of all documentation pertaining to the care plan are undertaken monthly, and reviews that may be necessary at other than planned times are done. For example a service user who had recently returned from hospital was noted to have had the whole care plan reviewed as their needs had now changed upon returning to the home. The AQAA states We feel that we are continually developing according to the needs of individual residents. we continually evaluate and monitor residents changing needs and actively involve all staff in health and personal care planning focusing on what an individual can achieve and provide support where necessary Staff spoken with showed a good awareness of service users needs and four surveys returned by relatives spoke positively of the care provided. One in particular stated Create a home for the residents with an excellent level of care. Residents are known and treated as individuals. Review notes seen were clear and reflected a good evaluation of current needs and choices. Care plans showed either resident or relative involvement. Relatives spoken with say that communication from the home was generally good. The manager states in the AQAA that the team have improved by involving residents, relatives and advocates in the care planning more ensuring maximum independence for service users. Use of appropriate assessments and the identification of strengths and abilities is of value in optimising residents and promoting self worth. The support plans seen concentrate on what an individual can do rather than what they cant and any changes associated with that. An example of this described how one resident dealt with catheter care before and after their needs changed. Care plans that relate to psychosocial needs and behaviour have also been developed further and the home ensures that social histories in the form of life maps are in place for every resident. Daily notes are recorded in the care plans. These were seen to be variable in some cases and staff should try and reflect the resident and their mood rather than just the care provided. The manager stated that training in this is introduced at an individual level with all staff, and things have improved, as not all staff develop in the same way or at the same rate, and supervisions also aid the process of identifying where staff can develop individually. The manager states in her annual quality assurance assessment that she intends to ensure all staff have involvement in care planning and not just senior staff and will also undertake audits on the care planning to ensure consistency within care provision in the next 12 months. A wide range of risk assessments are in use, for example, manual handling, falls, pressure sores, general and nutritional tools. These were seen to contain good detailed information and were up to date. There is a need to work on linking any identified risks into the care planning system so that any action to be taken is clear and subsequently evaluated. Records show a proactive input with regard to GP services. Good records are Care Homes for Older People Page 13 of 28 Evidence: maintained of visits and advice given. Records also show that residents have regular access to chiropodists, opticians, dentists and are able to attend appointments at the hospital as outpatients. Records showed that residents weights are being regularly monitored. At the current time no residents in the home have a pressure sore. Some residents have pressure-relieving devices in place for preventative reasons. The district nursing team are visiting the home to see one resident for minor healthcare issues. The home has an appropriate amount of lifting equipment for the needs of the current residents in the home. The team at the home uses a monitored dosage and bottle to mouth system. The system was inspected and found to be well managed with medication fully checked in, clear records in place and returns system in place. Staff spoken with stated that attending doctors are good at undertaking reviews and this was evident on the MAR sheets and in the care planning records. No controlled medications were being held at the time of the inspection. Records show that care staff have undertaken learning courses in the safe handling of medication, the last one recorded was in November 2008. The proprietor and manager undertake regular audits of the medication systems to ensure that the management is correct. A discussion was held with the manager about the transcribing of medications to MARS sheets and the need for two signatures to be evident to ensure safe administrative procedure as a few sheets were noted to have not been signed. Evidence in the care records show that staff appreciate the diversity of the residents that they care for. Residents spoken with spoke highly of the staff team and the sensitive and respectful way they delivered care. Residents spoken with also felt that their need for privacy was respected. One stated They are very nice here you couldnt wish for better and another stated They know me and that is good, I get cared for very well 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. This judgement has been made using available evidence including a visit to this service. Staff are aware of the need to support residents to develop their skills, including social, emotional, communication, and independent living skills. Residents are consulted and listened to regarding the choice of daily activity and receive a nutritional meal service. Evidence: Residents daily routines are reflected in their individual care records. Records have been developed to evidence that residents have been consulted about this aspect of their lives. An activities co ordinator visits the home four days a week Mon to Thurs and records one to one discussions and activities in the care plan. A formal activities plan is not in place as residents have varying degrees of cognition however the home aim to aid this by ensuring appropriate interaction takes place. For example on the day of inspection a game of object discussion and dominoes was being participated in by most residents and the co ordinator was noted to include all service users in this in turn. Sleep care plans were good and detailed residents nightime choices. Residents spoken with felt that they were able to spend their time as they wished and were not Care Homes for Older People Page 15 of 28 Evidence: rushed by staff. They felt that staff were flexible and listened to their wishes. The AQAA states Residents all have a map of their life and are encouraged to spend their days how they choose with support to pursue hobbies and interests according to their capabilities. Residents are encouraged to be involved in the decision making and daily running of the home and what social activities they prefer. The activities officer is very popular with residents spoken to at the home. Individual social profiles were seen and have been completed and residents interests recorded. Where possible the activities officer has involved the resident. Daily notes show that whilst residents are taking part in activities, they are not always relating to their noted preferences and the team as a whole are working on this aspect of care. It is clear the home is trying to meet individual requests, for instance one service user who did not usually go out asked to see the sea and this was facilitated for them. Residents spoken with were very happy with the range of activities offered and generally events are publicised in advance. One resident said I enjoy the games they put a smile on my face and another said It is fun to watch On discussion, staff spoken with were very aware of residents interests and knew them very well. Some residents enjoy helping out with household tasks in the home and residents spoken to confirmed this. Photos around the home evidence that social events are held and families and friends are invited and many of the staff choose to attend. The home have made positive links with another home and have held tea dances in the past where residents have been able to meet up. There are plans for a bar be que to be held. External entertainers visit the home and some residents attend a day centre weekly. Additionally the home networks with other homes and attend quiz events for staff. Relatives who commented in surveys said said that they have a wonderful time and more outings would be good The team actively encourage families and friends to visit residents at the home and they are invited to events throughout the year. The manager plans to develop more links with the local community over the next twelve months. The team are holding a fete in the summer months. Residents spoken with say that staff in the home respected their wishes. Information on advocacy is available on display in the home. The chef consults with residents on the menus and makes changes in line with residents views. Residents spoken with were very happy with the meal service in the home and it is possible for relatives to take lunch with residents if they wish. Appropriate and sensitive assistance and help was seen to be given to residents and the tables were nicely laid and condiments available. The home provides a range of meals via a four week rotational menu. Records are in place that records each residents intake well. A good example of this was a special nutritional chart maintained for a resident whose weight was a concern. Residents are having plenty of choice as records reflect this on the menus - especially at teatime. A variety of choices are available for breakfast and a cooked breakfast is regularly Care Homes for Older People Page 16 of 28 Evidence: offered. Care Homes for Older People Page 17 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. This judgement has been made using available evidence including a visit to this service. Residents can be reassured that their concerns would be listened to and dealt with effectively. Staff are trained and systems are in place to help ensure the protection of vulnerable adults. Evidence: The home has a satisfactory complaints procedure in place, which is available on display in the home and in the service users guide. Residents and relatives spoken with knew about the procedure and whom they would speak to in the first instance. On inspection, the manager keeps very good detailed records of all concerns at every level. The AQAA details that the home has received eight complaints since the homes last key unannounced inspection in June 2007. The majority of complaints were seen to be minor and dealt with appropriately. The manager states in her annual quality assurance assessment Staff are encouraged to view complaints as a positive chance for learning and improving quality. All complaints are treated as a matter for the whole organisation rather than just individuals. The homes culture is an open door policy. Relatives spoken with say that they are happy with the complaints procedure and one commented I have no problems and have never needed to make a complaint. The home has a satisfactory adult protection procedure in place and this includes local guidance. Training records show that all staff have received training in adult Care Homes for Older People Page 18 of 28 Evidence: protection, the last course attended was in June 2008, and the manager shows a good understanding of such issues. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This judgement has been made using available evidence including a visit to this service. The home is clean and well maintained and provides a pleasant homely environment. Changes made to the facilities are generally resident led and their input is valued, giving positive outcomes for residents. Evidence: A tour of the home was undertaken. The home was seen to be very clean and well maintained with no odours noted. Since the last inspection the ground floor communal areas and some bedrooms have been decorated, some carpets have been replaced and a new television and piano purchased. The main bathroom downstairs has been upgraded and there are plans to get a new boiler fitted. The AQAA states There are also potential plans to develop a sensory garden and conservatory/sun lounge. The home has a large secure garden to the rear, which gives good privacy to residents. This is a pleasant area to sit and team at the home have expanded the vegetable garden so that residents can have input should they so wish. A remembrance spot has also been developed in the garden where residents can plant trees or plants, purchase a bird table or statue and place it to remember a relative. Residents have been able to personalise their rooms and the team have introduced signage for the doors, incorporating hobbies, to help residents with varying degrees of dementia. The Care Homes for Older People Page 20 of 28 Evidence: manager in the AQAA states that they will continue to encourage residents to be involved in the decoration choices for their rooms. Following input from residents, the team have moved the lounges around, so now there are two separate lounges allowing for a quiet lounge should residents so wish. This gives a more homely environment and there is one television in each room. Arrangements in relation to fire safety were inspected in relation to the maintenance and testing of equipment and completion of a risk assessment. These were found to be in order and up to date. A previous fire officers visit stated that fire safety arrangements at the home were good and another inspection is scheduled for 2nd July 2009. The manager also stated another visit which involved health and safety praised the home for their enviromental risk assessments. These were seen to be in good order. New infection control policies have been introduced and all staff have received training in infection control. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This judgement has been made using available evidence including a visit to this service. Residents can feel assured that the recruitment processes of the home do have sufficient safeguards in place to ensure they are protected. Staff training provided enhances the quality of the individual care and support that residents receive. Evidence: Changes in the care staff team and a new manager being appointed has brought about positive changes in the home, which is now felt to have more relaxed homely atmosphere and content staff. The AQAA confirms Staff morale is very good Staff spoken with on the day of inspection spoke positively regarding staff morale overall, and one of two staff surveys returned stated The home gives fair treatment regardless of race and the manager and homeowner are very supportive to the needs of the staff. Staff shift times have been changed in relation to resident need and all staff are now awake at night. Staffing levels remain the same and are three staff during the day shifts and the manager, who also works flexible hours and does undertake work on the floor as well as the office. Two awake staff are provided at night. NVQ qualifications are encouraged and all of the fourteen care staff have achieved NVQ qualifications. Four staff have achieved NVQ level two with another three Care Homes for Older People Page 22 of 28 Evidence: currently undertaking it and three staff have achieved NVQ level three with another four currently undertaking it. Recruitment procedures at the home are sound and administration improvements have been made to the staff files. Four files inspected were found to contain all the required checks and documentation. One file evidenced a CRB check which had warranted discussion prior to employment and there were no notes to evidence this. This was discussed with the manager and evidence should have been in place showing it had been explored. The manager showed signatory evidence that all staff have been issued with the GSCC Code of Conduct. New staff undertake the Skills for Care induction programme and records to evidence this were available for inspection. Training records show that the home has a busy training programme for its staff and attend training in food hygiene, care planning, fist aid, malnutrition screening, diabetic blood monitoring, fire safety, dementia care management, health and safety, infection control and manual handling. The manager reports in the AQAA that she is continuing to work on identifying staff training needs through supervision and appraisal. Staff spoken with are very keen to participate in training provided at the home. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This judgement has been made using available evidence including a visit to this service. People living at the service can expect to be supported by a manager and staff who have demonstrated their suitability for the role and have their health and welfare maintained. Evidence: The home has a registered manager who has settled well into the home and is working with the proprietor to develop the business and the services and facilities offered. She is continually striving to develop the staff team and has made improvements to the delivery of care and record keeping at the home. Staff meetings are held and records show that a wide range of subjects are covered. Relatives and residents meetings are also held and minutes are kept. The last meeting recorded for combined resident/relative meeting was 21/01/2009 and for residents was the 29/05/2009. Residents meeting minutes show a good attendance and comments are welcomed Care Homes for Older People Page 24 of 28 Evidence: from residents on all aspects of life in the home. The proprietor meets with the manager regularly and completes comprehensive reports under Regulation 26, which also include feedback from residents. These reports were seen to be very objective and open with a range of comments from residents. the last one to be completed was on the 29/05/2009 Action points raised were also followed up. The proprietor and manager have a quality assurance system in place, which consists of a full audit of all systems and services. This was completed in January 2008 and and another audit is currently in progress and records show that the manager has dealt with any action points raised. The team also undertake regular audits of the medication and health and safety via a new form which has been devised. Feedback forms have been developed for relatives and are with feedback incorporated into an annual report. Since coming into post the manager has also completed short pieces of work, obtaining feedback from residents on different aspects of the home, for example, mealtimes and menus and the layout of communal areas. Residents spoken with said that They are a lovely bunch and they care for me very well and I have no complaints I have everything I would want. One health care professional who completed a survey commented Staff always helpful and residents settled on arrival, no problems when I visit The team hold monies on behalf of many of the residents in the home. The manager has introduced a new system whereby residents and relatives can have a printout every month of the activity on the account. The system was found to be in order with receipts available. A two signature audit system is also in place to ensure service users are protected. The home has a health and safety policy in place and this was up to date. Accident records were checked and seen to be detailed and followed up where required. The incidence of accidents at the home is low and falls are monitored and audited. Random sampling of maintenance and safety certification for equipment and fixtures in the home were seen to be in order and up to date and planned. 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 1 8 Assessments and identified care plan problems, completed for residents, should correlate into the care planning process, so that the management of the identified risk and planned care shows a consistent approach by staff to meeting the care needs. Care Homes for Older People Page 27 of 28 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. 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