Care Home: Chipstead Lodge

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What the care home does well Chipstead Lodge caters for people of varying ages,abilities and levels of independence,all of whom have mental health needs.It meets the range of needs well in a safe and friendly setting. Service users,relatives and health professionals who sent us surveys included some complimentary comments, one from a health professional was "In all my allocated homes to visit Chipstead is the best" and a service user wrote,"This is one of the best homes in the area,management will always listen to residents whatever the problem". The standard of recording on care plans and other documentation is good and records are kept up to date. Care plans reflect the needs of service users and are becoming more person centred. There is effective liaison with health and social care professionals and health care needs are well met and recorded. The environment is homely,clean and well maintained overall. There are good systems for quality monitoring and the views of service users and other stakeholders are sought and where necessary changes are made in response to them. What has improved since the last inspection? Care plans have been made much more accessible,streamlined and most information has been put into a main folder and working care plan. More attention is being paid to making care plans person centred. A wider variety of activities is being offered and the activities coordinator was able to provide evidence that service users of all abilities are offered the chance to take part in some activities with other people or on a one to one basis. Daily activities are being clearly recorded. The daily menu is being displayed in the dining room and a main corridor. More care staff have now gained an National Vocational Qualification in care at level two or above. A new computer system has been purchased and is in use with the intent it will be used to store information about service users and improve efficiency of documentation. What the care home could do better: Care plans have improved and work now needs to progress on involving service users more in developing their care plans and planning personal goals. Whilst each persons daily activities are recorded by the activities coordinator, care plans and daily record sheets must also include information on any planned regular activities for each person and what they did during the day. Daily recording needs to be expanded so that it more fully shows the activities of the day. The bathrooms need to be made more attractive and the shower room needs fully upgrading so that these areas are more pleasant to use. Key inspection report Care homes for older people Name: Address: Chipstead Lodge Chipstead Lodge Hazelwood Lane Chipstead Surrey CR5 3QW     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Deborah Sullivan     Date: 1 9 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Chipstead Lodge Chipstead Lodge Hazelwood Lane Chipstead Surrey CR5 3QW 01737553552 01737559284 chipstead@careunlimited.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Care Unlimited care home 36 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia learning disability mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 36 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - LD Dementia - DE Mental Disorder, excluding learning disability or dementia Date of last inspection Brief description of the care home Chipstead Lodge is set in a rural area of Chipstead within walking distance of local shops. The property is an older style building that has a ground floor extension to provide further accommodation. There are two floors to the main part of the property and the first floor can be reached by a shaft lift. A number of the rooms, including a few on the ground floor, require the service users Care Homes for Older People Page 4 of 28 Over 65 0 0 0 36 36 36 Brief description of the care home who occupy them to have reasonable mobility as they need to access several steps up to them. There is plenty of car parking space at the front of the home. Communal areas include the dining room and three lounges one of which is a quiet lounge. There is a well kept garden and patio area. Service users are offered opportunities to participate in activities provided by the home The current weekly fees for the service range from one thousand two hundred and fifty five pounds a week to three hundred and fifty two pounds a week. 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: This unannounced key inspection took place over six hours,during the visit time was spent with service users,the Principal Partner of the organisation,the Human Resources manager,the Quality Assurance manager, the Personal Assistant to the management team,the Activities Coordinator and members of the care staff team. A tour of the home took place partially accompanied by a service user. Records and documentation were read including some care plans,staff files,medication records and samples of policies and procedures. Survey forms that we received from service users,staff,relatives and health professionals and the AQAA(Annual Quality Assurance Assessment) completed by the registered provider have also provided us with information that has been used as part of the inspection process, some of which is included in this report. Care Homes for Older People Page 6 of 28 What the care home does well: What has improved since the last inspection? What they could do better: Care plans have improved and work now needs to progress on involving service users more in developing their care plans and planning personal goals. Whilst each persons daily activities are recorded by the activities coordinator, care plans and daily record sheets must also include information on any planned regular activities for each person and what they did during the day. Daily recording needs to Care Homes for Older People Page 7 of 28 be expanded so that it more fully shows the activities of the day. The bathrooms need to be made more attractive and the shower room needs fully upgrading so that these areas are more pleasant to use. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 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. The home provides information for prospective service users and their representatives and they are welcome to visit so that an informed choice can be made before they take up a place at the home. Pre admission assessments take place before a place is offered to make sure that each persons needs can be met. Evidence: The home provides written information about the service it provides that is available to prospective service users and their representatives.Service users are welcome to visit before choosing to move in and trial periods can be offered. A service user and relative spoken with said they had visited the home and other services and chose Chipstead Lodge it as it seemed the most homely.The surveys we received from seven service users told us that they had been asked if they wished to move into the home. Care Homes for Older People Page 10 of 28 Evidence: Before a place is offered needs are assessed in liaison with health and social care professionals and relatives to make sure that the home can meet them.Pre admission assessments are included on care plans,the documentation used had been updated at the time of the last visit.Comprehensive information is gained on health and personal care needs and daily routines,sections relating to interests and social needs were included but not always completed in as much detail as the rest of the information so this area needs to be expanded upon.Although some assessments from other professionals did contain some of the information. The home caters for people who have a wide range of needs.From the evidence seen it demonstrates that it manages this well.Most service users are funded by local authorities,placement agreement contracts are drawn up with the relevant agency and private service users have personal contracts. 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. The health and personal care needs of service users are well met and they can be confident that any changes in health are recorded and responded to. Medication policies and procedures are in place that protect service users. Staff treat the people in their care with dignity and respect. Evidence: Each person has their own personalised care plan,work has continued since the last visit to make them more streamlined and person centred and the information is easy to access.There are daily working care plans and folders with more detailed and comprehensive information. Four care plans were sampled,one contained documents that had been signed by the service user.Documents in the folders include pre admission and background information,evidence that internal review of needs takes place monthly and reviews with sponsoring authorities are held regularly,there are also medical details,daily Care Homes for Older People Page 12 of 28 Evidence: recording sheets and risk assessments.One record of a fairly recent review attended by the local authority stated that it was satisfied that the persons needs were being met. Comments on surveys we received from health professionals were positive about the service,one stated, They are always well organised and allow us to do our job to the best of out ability.They always listen to our advice and act on it and another wrote, Clients in this home are well looked after,maintaining a high standard of health care. One service users survey included the comment that they felt very well looked after and another said the hometakes care of me well in a professional manner. Service users are encouraged to take responsibility for their personal health and are supported to attend appointments.A GP visits the home each week and sees any service users that staff are concerned about or who ask to be seen,a record of the visits and outcomes is kept.Examples of other health professionals accessed are District and Community Psychiatric nurses,dentists and specialist consultants. The AQAA tells us that a Community Psychiatric Nurse visits fortnightly and feeds back to doctors. Overall the quality of details about health needs including communication,mobility and any behavioural considerations is of a high standard, although the home needs to make sure that personal care preferences and needs in terms of socialisation and activities are more throughly recorded on main care plans. The home has purchased a new computer data base since the last visit and the intention is that it will contain full information about service users to be used alongside daily working care plans to enhance the quality of information.There are plans for staff to be trained to use it. Whilst service users needs are varied in some respects, all have some degree of mental health need.The home has acted in response to the safeguards in place under the Mental Capacity Act 2005 in assessing each person to see if they require a referral for a Deprivation of Liberty Safeguard (DOLS) assessment and prepared internal documents to record their assessments.So far referral has not been necessary for anyone. Some service users have very limited mobility due to age or illness,they are provided with equipment to help them maintain independence and to keep them safe and comfortable such as walking frames,hoists and reclining chairs. Staff observed during the visit were respectful toward service users and maintained their privacy. Medication is securely stored and the service has robust medication policies and procedures.Some medication recording sheets were examined,they had been Care Homes for Older People Page 13 of 28 Evidence: completed correctly.Staff who administer medication have been trained to do so and are assessed as competent. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are given opportunities to participate in a wide range of activities at home and in the community. The home welcomes contact from relatives and invites them to events. Meals are varied,healthy and nutritious. Evidence: The home employs a full time experienced activities coordinator who has developed a programme of activities that take place at home and in the community, which are designed to accommodate the varied needs and abilities of service users. Some people are able to go out independently locally or further afield whilst others need support and encouragement to join in trips and outings and activities at home.An example was given of a service user who had not been keen on going shopping but now was comfortable doing this in small shops. A programme of outings and events has been drawn up for this year,special occasions are celebrated and there are themed events throughout the year such as for Valentines day,Easter and bonfire night.One service user said they liked making cards for occasions such as Easter and Halloween and had enjoyed outings, for example to the theatre and more locally going out for coffee. Care Homes for Older People Page 15 of 28 Evidence: Service users are supported to practice their faith if they wish,a Church of England service is regularly help at the home and a service user attends church each Sunday. In the summer there are events in the garden including barbeques.Service users from other homes run by the organisation visit each other for coffee mornings. There are regular trips out arranged to some are to theatres,the cinema,the coast and more locally for coffee and shopping. Activities taking place at the home include music sessions,exercise,painting,crosswords,bingo and reminiscence. During the visit there was a bingo session,some service users went out shopping in the afternoon and individual support was given for activities such as painting. Gardening has been added to the regular activities and there are plans to extend gardening opportunities by creating raised beds. Service users were spending time in their rooms,chatting,watching TV or freely accessing shared areas. Some service users participate in group sessions, others prefer one to one activities or choose not to participate on a regular basis,their personal choice is respected. The activities coordinator is supported by care staff with sessions.Importance is given to making sure that each person has opportunities for involvement,the activities coordinator and staff spend time with people in their rooms if they prefer supporting them with activities such as knitting,doing jigsaws or manicures.This is time consuming but with support from carers is possible.The small number of service users who choose not to participate in activities are regularly approached in case they change their minds. A record of each persons daily activities is kept by the coordinator.A service user wrote on the survey they returned to us in the section asking what the home did well that Activities for able and disabled residents are provided by a permanent activities organiser.There are good functions,barbeques,Xmas parties,birthday cakes for all residents and weekly shopping trips. The homes self assessment tells us that it plans to encourage the more able service users to take up new activities and educational courses and to offer more social outings. Service users who are able to are are encouraged to keep their rooms clean and tidy and to take part in the daily running of the home,the activities coordinator had supported some service users to be responsible for designated tasks for example one person helps to make visitors welcome. The home has routines that are flexible and choice is promoted.Service users whose mobility allows access shared areas of the home freely whilst for safety reasons only Care Homes for Older People Page 16 of 28 Evidence: those who are assessed as safe would be able to access outside areas alone and there are locks on external doors. The home welcomes contact with friends and relatives,one relative spoken with visits on more than one occasion each week.A member of staff said that at a Christmas party a large number of relatives had been present and there was good contact overall with families. Two relatives who returned surveys said they felt that they would appreciate staff keeping them more up to date with their relatives progress. There is a varied five week menu,the daily menu is displayed in a main corridor and in the dining room.Service users who are unable to read the menu easily are asked what they would like to eat each day by carers or the activity coordinator. The lunch on the day of the visit was freshly cooked and well presented.Staff said were always daily meal alternatives,one person was having sandwiches for lunch and not eating in the dining room.They said they had specifically asked for sandwiches that day as they were not keen on the main meal and that usually they took their meals the dining room and were happy with them. 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. The home has systems in place for managing and addressing complaints and service users have access to a complaints procedure. Staff are made aware of the policies and procedures in place for the protection of service users and their responsibility to report any concerns. Evidence: The home has a complaints procedure that is on display,one complaint had been received during the last year from a service user. The home had responded fully to the person. The Quality Assurance Manager for the organisation monitors complaints. Surveys returned by service users told us that they knew who to speak to if they were unhappy about anything. There are safeguarding vulnerable adults and whistle blowing procedures in place,new staff receive safeguarding training and it is updated each year.Staff spoken with confirmed that they had been on the training. There have been five safeguarding alerts referred to the local authority in respect of the service since the last visit.All are now closed.Two were raised via CQC by a service user,the home fully addressed their concerns,the service user was consulted with and measures put in place to minimise their anxieties. The home demonstrates that is takes safeguarding seriously and has raised a safeguarding alert regarding a service user who independently accesses the community,it had been looked into and no current action is considered necessary Care Homes for Older People Page 18 of 28 Evidence: whilst the home is remaining vigilant. 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. The environment is relaxed and friendly and the home is clean,comfortable and well maintained. Bedrooms reflect the individual tastes and interests of the occupants. Bath and shower rooms need upgrading and redecorating to make sure that they are pleasant to use and safe. Evidence: The home has a friendly relaxed feeling,it is clean,well decorated and well maintained. A tour of the home took place which included some bedrooms on both floors,a service user escorted part of the tour. There are several shared areas including a bright and airy large main lounge, a quiet lounge,seating in the entrance hall area and an activities/seating area leading onto the conservatory,the conservatory is the designated smoking room.The smoking room sign is clearly displayed. Plans for improvement to the environment include reviewing the seating arrangements in the lounges to make them feel less formal,currently chairs tend to be round the edges of the rooms,although this does allow space for activities. Some bedrooms are en suite,there are bathrooms on both floors,there is a small shower room upstairs and a dedicated hairdressing room. The shared bathrooms and Care Homes for Older People Page 20 of 28 Evidence: shower room were rather bare and functional looking,one bath had chips on the surface in places.The shower especially needs upgrading as it is looking shabby and there was staining on the surrounds. The dining area is split over two rooms in either side of a corridor, the two rooms are large enough to accommodate all the service users.Bedrooms are located in the older part of the building and the newer annexe. All the bedrooms seen were clean,well decorated and reflected the personal interests and personalities of service users.Some people had clearly brought furniture from their previous homes and there were photos,pictures and ornaments on display.One room visited held the occupants tank of tropical fish. One person spoken with said they were settled in their room and although they knew it needed redecorating and the provider had offered this several times, they had declined the offer and preferred it as it was. There are three double rooms which have curtaining in place to protect privacy. The laundry room is clean and well ordered,care staff do the laundry.Domestic staff are responsible for cleaning the home. The garden is attractive and well kept with a patio area and good quality patio furniture.Service users and staff said it was used in good weather and some service users help with gardening. 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. Service users can feel confident that their needs will be met by a well trained and well supported staff team. The organisation operates a robust recruitment process that protects service users. Evidence: The organisation has thorough recruitment procedures in place and systems for the support and appraisal of staff.During the visit they were discussed with the Human Resources manager and evidence was seen on staff files.The HR manager liaises with the home regarding recruitment. Staff files that were sampled evidenced that the necessary recruitment checks take place,one file of a carer who had been employed for several years lacked past employment dates,but they were in place for newer staff and the file of a quite recently appointed carer was complete in terms of recruitment documents. Responses on staff surveys confirmed that recruitment checks were undertaken before they started work,induction was given and they felt well supported.One staff member wrote that the home would be improved by having more staff and a carer spoken with said that sometimes when staff need to go out with service users to appointments there could be more staff on duty. Three waking care staff are on duty at night. Care Homes for Older People Page 22 of 28 Evidence: The staff team is diverse,there are more female than male carers employed overall.A male carer was on duty and a carer said that as far as possible gender preferences for the delivery of personal care are respected. New staff receive induction and core training which is updated each year and tracked by the HR manager. Just over half of the care staff have gained a NVQ(National Vocational Qualification) at level two or above,senior carers are expected to take NVQ 3.The provider has told us in the AQAA that they plan to increase the number of staff who who hold or are taking an NVQ. Staff also have opportunities to attend specialist training relevant to the needs of services users such as dementia,epilepsy and managing conflict. Staff receive a minimum of six recorded supervision meetings a year and have annual appraisals,due to changes in the homes management some appraisals were a little late but the HR manager had recently been completing them. The home was adequately staffed,as well as carers and the activities coordinator,catering and domestic staff are employed and there is a personal assistant to the management team.There is low staff turnover and members of the management team spoken with during the day remarked on how staff had coped well over the past nine months when there had not been a manager for the home most of the time.The evidence gained during the visit supported this view. The provider and other senior members of the organisation have been supporting the staff team and the provider has been managing the home since late 2009. Staff observed and spoken with during the day were friendly, had a good rapport with service users and treated them with respect.Those spoken with were knowledgeable about service users needs. Surveys from relatives included positive views about staff such as,In general all the staff are very helpful and caring-a very well kept home and They are all a very caring and cheerful team. 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. The home has a relaxed and friendly atmosphere in which service users can feel safe and supported. The provider has put effective temporary management systems in place prior to a new manager starting work. Robust quality assurance systems are in place which include service user consultation. Evidence: The home has a friendly and welcoming feeling and a relaxed atmosphere.It has gone through a period of management instability since the last registered manager left in March 2009,since then the provider and principal partner of the organisation,a deputy manager and a home manager employed for a short while have managed the home. Currently the provider has assumed management responsibility and is at the home most days,the experienced deputy manager who is now part time covers weekends. The organisation has kept us fully informed in writing of any changes in management Care Homes for Older People Page 24 of 28 Evidence: and measures put in place to make sure the home continues to be run efficiently and safely. Recent successful recruitment had taken place for a new manager who was due to start at the beginning of February,the principal partner and Human Resources manager confirmed the person is well qualified and experienced in management.It was hoped a full time deputy could also join the home. The organisation has well established systems in place for monitoring the quality of its services.The Quality Assurance Manager was present and discussed the processes and evidence gained.They visit the home each month to undertake an internal assessment of the home as is required,reports of the visits and compliance with work that is identified as being needed is recorded. An annual survey takes place involving service users and other stakeholders and the results are collated.The 2009 survey results were seen,no major concerns were identified and the overall response to the survey had increased.The home responds to issues raised on surveys,last year there had been an increase in lack of satisfaction with meals, as a result service users have now been more involved in planning menus. Residents also have opportunities to air their views at monthly residents meetings. Other internal auditing tools are used such as monthly quality reports. The standard of record keeping is good,the records seen pertaining to service users were up to date and all confidential information is securely stored. Staff were seen to be using safe working practices throughout the day and to be using protective clothing when necessary. The safety of service users is promoted and the Quality Assurance Manager monitors any accidents to make sure preventative measures are put in place. 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 1 19 23 Regulation 23 (2)(b)(d) The premises are kept in a good state of repair externally and internally and are kept clean and reasonably decorated. The shower room requires full upgrading and bathrooms in use should be made more domestic looking.One bath requires resurfacing. 31/03/2010 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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