Care Home: Cleeve Court

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What the care home does well Care plans accurately reflect the individuals` needs and how they will be met. People who live in the home and their families are involved in this process wherever possible. Systems are in place to help ensure that there is consistency in assessing, planning, implementing and evaluating the care when required. We saw people making choices about how they choose to live their lives, this is detailed in the care documentation and staff we spoke with told us about the people living in the home, their likes and dislikes and their preferred routines. Safe, effective systems of practice are in place in receiving, storing, administering, and disposing of drugs which will help protect the health and wellbeing of people living in the home. Staff have a good awareness of individuals` needs and treat people in a warm and respectful manner, which means that they can expect to receive care and support in a sensitive way. Mealtimes were dignified and unhurried. The dining experience was a sociable occasion and people were given adequate support where needed. The complaints policy and procedure in the home is effective and all concerns are taken seriously and acted upon efficiently. People can be sure that they will be listened to and that their thoughts and feelings are taken into account. Recruitment procedures have meant that vacancies have been filled with people that are suited to the job with the right skills, this will also help ensure more continuity of care to the people who use the service. The home encourages and supports staff with training in order for them to develop their knowledge so that they have the required skills to meet the needs of the people. What has improved since the last inspection? The home is well organised and managed by an effective, stable management team that promotes the views and interests of all people who use the service. The home has continued to improve following the last inspection and further examples are detailed throughout this report. What the care home could do better: All of the National Minimum Standards assessed at this inspection were met. No statutory requirements have been made as a result of this inspection. We would like to thank everyone who took part in the inspection, their enthusiasm and support was greatly appreciated. Key inspection report Care homes for older people Name: Address: Cleeve Court 62 Main Road Cleeve North Somerset BS49 4PE     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Wendy Kirby     Date: 2 2 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Cleeve Court 62 Main Road Cleeve North Somerset BS49 4PE 01934876494 01934830626 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Cleeve Rest Limited care home 29 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Manager must be a RN on parts 1 or 12 of the NMC register May accommodate up to 29 persons aged 50 years and over requiring nursing care Staffing Notice dated 08/11/1999 applies Date of last inspection Brief description of the care home Cleeve Court provides nursing care for up to twenty nine people. The home is situated in the village of Cleeve, and can be accessed by car or public transport. This would be required for easy access to local shops and social venues. The home is a converted older property, set within large, attractive grounds. The fees range from £578 to £672. 0 Over 65 29 Care Homes for Older People Page 4 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced Key Inspection which included a visit to the home. The visit was completed by one inspector and lasted approximately nine hours. Prior to the inspection we (The Commission) looked at various pieces of information to gather evidence in preparation for our visit, which included the following: The previous inspection report. The inspection was conducted in December 2006 and resulted in a 3 star rating The homes inspection record, which gives us an account of any information we have received about the home since the last inspection. The Annual Quality Assurance Assessment, known as an AQAA. The home is requested annually to complete and return this assessment to us by a specified time. We received Care Homes for Older People Page 5 of 28 the AQAA on time, which contained information about what the home considers it does well and what plans they have for further improvements in the coming year. During our visit we spoke with some of the people who live in the home, visitors, the registered provider, the management team, and other staff members who were on duty. We also looked at how effectively staff engage with people in the home and how they were interacting and communicating with each other. We looked at four individuals care files, which included, pre admission assessments, care plans and risk assessments. We also looked at a number of records and files relating to the day to day running and management of the home. We spent time in all communal areas of the home and some of the bedrooms. Feedback was provided to the management team throughout the inspection. 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: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 7 of 28 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. Peoples needs are assessed prior to admission to determine the suitability of placement. They can be confident that staff will have the resources and skills to meet their assessed needs. Evidence: We looked at the pre admission assessments, these were comprehensive covering all activities of daily living, a full health screen and personal history background. The information gathered pre admission should provide a sound benchmark of the persons ability, state of health prior to admission and subsequent needs when they move into the home. The manager is looking at changing the format slightly and will include sections that relate to The Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). People wishing to live in the home, family and carers are involved in the pre admission assessment wherever possible and all information is used to determine the suitability Care Homes for Older People Page 10 of 28 Evidence: of the placement. Where possible the manager also obtains comprehensive assessments and care plans from other health and social care professionals involved, for example, social workers and hospital staff. We spoke with the manager who clearly demonstrated the importance of preadmission assessments in order to ensure that the home can meet individuals identified needs. People are encouraged to visit the home either for the day or perhaps for lunch dependent on their wishes. 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. Because they are consulted about their health and personal care needs people should be assured that their views and expectations will be considered. The health and personal care that people receive is based on individual needs. There are safe systems of practice are in place in receiving, storing, administering, and disposing of drugs which will help protect the health and wellbeing of people living in the home. People can be confident that staff have a good awareness of their needs and that they will be treated with dignity and respect. Evidence: From the pre admission assessments the staff are able to develop a set of care plans based on identified needs. During the first months trial period the plans are reviewed weekly and developed accordingly. Care plans were completed with regards to health Care Homes for Older People Page 12 of 28 Evidence: and social needs including, psychological, emotional, and cultural needs which demonstrates that the home takes an holistic approach to the provision of care. The plans that we looked at were detailed and fairly person centered, including personal preferences and like and dislikes. Plans told us that people had specific requests and routines, this is very good practice and helps demonstrate that people are involved in deciding how they wish to receive care. The manager told us that training in the MCA and DoLS will further support staff in understanding about empowering people to make choices about how they want to receive care, which in turn will help staff develop more person centered care plans. The plans showed consistency in assessing, planning and evaluating care as required. Regular care reviews take place for people living in the home, which can include family members and Key Workers wherever possible. This allows the opportunity to discuss and evaluate care and any issues or concerns people might have. The manager audits the care files on a monthly basis and gives written feedback and any action required to staff members. We were told that the home is reviewing the paper work in care files so that it is streamlined and more user friendly. Health care needs are monitored and documented in peoples care files. Nutritional assessments are completed on admission and reviewed monthly, people are weighed as part of this review. Care plans are written for people who are nutritionally at risk and how this is to be managed. Specialist health care support is often sought and referrals are made to community dietitians and the speech and language therapists. Records of General Practitioner (GP) visits and the outcomes were recorded. Specialist referrals and visits from other professional including, Chiropodists, Dentists and Opticians were also seen. We spoke with and observed staff who demonstrated very good relationships with individuals and were knowledgeable about the care needs of those living in the home. The AQAA tells us about future plans in maintaining and monitoring health care needs, We want to access more staff training around wound care management, we want to devise a more comprehensive wound assessment tool and then ongoing wound management care plans. Our aim is to empower and involve senior care assistants in this process to encourage a greater understanding regards wound healing and the importance of maintaining adequate nutrition and fluids and encouraging mobility. We want staff to understand more about the healing process, types of wounds and why certain dressings are being used. Care Homes for Older People Page 13 of 28 Evidence: We are currently looking at a teaching programme to cover disease processes and the impact these have on a persons abilities to function, how to personalise care and understand the limitations for the carers and the people they are looking after. We want to include topics to discuss at meetings which will increase staff understanding and allow for open conversation, these will include chronic diseases, the medication used to treat and why. The side effects and interactions of some medications will also be addressed. We also want to look at all policies and procedures for Peg feeds, tissue viability and diabetic care and develop a champion or link carer for these different areas. This will help develop staff knowledge and expertise and bring a better understanding within the team as to why certain aspects of care are important and how they are all interlinked. Policies and procedures for receiving, storing, administering and disposing of medications were examined and discussed with the trained nurses. All systems in place are effective, well managed and audited. Fridge temperatures are recorded daily, the administration charts were legible and continuity of administration was shown with a signature from the person dispensing. Staff responsible for the medication have appropriate and accredited training and take in house competency assessments. The home promotes privacy and dignity to all people who use the home. Staff attend training on induction, which covers aspects such as closing doors and pulling curtains when delivering personal care and knocking on doors and waiting for an invitation to enter before going in to their bedrooms. We saw staff knocking on peoples doors before entering, members of staff spoke respectfully about individuals needs and referred to them in the term of address that they preferred, this information was also recorded in the care files. 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. People benefit from a varied activities programme, which is both enjoyable, stimulating and meets individual preferences and expectations. People maintain family contact and staff encourage family and friends to join in with activities and any outings. The home actively promotes individuals to exercise choice and control over the lives they choose to live. Evidence: People receive a varied and wholesome diet that they are able to influence. There does not appear to be any unnecessary rules and it seemed that daily routines are flexible within the home. We saw evidence that people can get up and go to bed when they like, have their meals in their bedrooms, they can go out when they wish and participate in activities they have a particular interest in. This was confirmed in discussion with individuals and through observation during our visit. We met with the activity coordinator who was very enthusiastic about her role. She was very knowledgeable about the people in her care, including their likes, dislikes, Care Homes for Older People Page 15 of 28 Evidence: communication needs, personal history, hobbies and interests. It was evident through discussion and observation that her skills and expertise ensures that activities are meaningful and valued for individuals. People decide what activities they want to take part in and are also supported to pursue personal hobbies. People were having a flower arranging class on the day of our visit and the enjoyment was obvious to see. The home recognises the importance and value for those people who prefer personal individual time with either the activity coordinator or staff members. This can include reading, playing games, painting, trips out, nail care and reminiscing. Various volunteers and entertainers visit the home throughout each month. People are supported to satisfy their religious preferences. Several denominations will visit the home on request and people can be taken to local places of worship when they wish to go. Lounges in the home provide good entertainment systems including televisions, videos, DVD players and musical systems. Many people living in the home have very large rooms with plenty of space for a lounge area. Many people told us that they enjoy spending private times in their rooms and the solitude and privacy it affords them. The AQAA tells us, The activity coordinator chairs meetings for people living in the home and relatives, these are minuted and kept on file, any action arising from the meeting are addressed. The meetings are an ideal opportunity for people to share news and information with families and friends. Other useful information is shared by having a notice board in the home and we also saw photographic displays of memorable events which provide topics of conversation and allows for people to reminisce. The home operates an open door policy for visitors and people are able to see visitors in the privacy of their own rooms and there are several semi private seating areas around the home and in the gardens. There is a portable telephone available for people to use so that they can stay in touch with family and friends. The size and layout of the dining room makes it possible for everyone to enjoy the social advantages of dining together. The dining room is light and spacious with good quality dining furniture. Staff members supported people that required assistance with eating their meals in a respectful sensitive manner. Staff sat at the same level and assisted them without rushing. We saw jugs of juices, beakers and glasses and these Care Homes for Older People Page 16 of 28 Evidence: were being handed to people whilst waiting for lunch. Later when we visited people in their rooms we saw that jugs of fluid had also been provided for individual use. The kitchen is well organised and runs efficiently and effectively, it was recently awarded four stars from Environmental Health. The chef and staff are able to demonstrate an awareness of individual requirements and needs including special dietary requirements and personal preferences. The food is home cooked offering various choices of hot and cold alternatives and fresh fruit is available at all times. The four week menu displays traditional meals and menus are reviewed to reflect seasonal trends and availability of produce. Extras are ordered on request for birthdays and special occasions. People told us that the food was very good. 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. There are good policies and procedures in place to manage complaints and people can be confident that their concerns will be listened to and acted upon. There are good arrangements in place for staff training and the awareness of protecting vulnerable adults so that people living in the home are further protected from abuse. Evidence: The complaints policy and procedure is detailed and contains all the relevant information required, this can be found in the service user guide and welcome pack, which is given to people on admission. It is also displayed on notice boards throughout the home. We would receive details from the home about any internal complaints investigations and safeguarding referrals. We know that any concerns raised are dealt with openly and effectively. The manager told us that she is committed to encourage an open culture within the home so that people feel comfortable and able to make a complaint or a suggestion without fear of reprisals. The AQAA tells us, The aim is for all complaints to be viewed in a positive way with the aim to improve and reflect on practice. She makes every effort to see people living in the home Monday to Friday. Being Care Homes for Older People Page 18 of 28 Evidence: available means that people can discuss any concerns or issues with the manager before they potentially escalate into complaints. Systems are in place at the home such as regular care reviews, key workers and holding meetings for people living in the home, relatives, and staff. This means that there is opportunity to communicate and share information. This further promotes people becoming less frustrated thus relieving anxieties and any potential complaint referrals. There are policies and procedures as well as a range of guidance information on the topic of protection of vulnerable adults from abuse. The availability of this information should increase staff awareness and the understanding of their role in protecting people who live at the home. Policies and procedures given to staff include, Whistle blowing, How to make a grievance and Harassment in the workplace. We were told that the home actively promotes staff training and education in the protection of vulnerable adults on induction and on an annual basis the staff receive an update. A number of staff have either completed or are enrolled on the National Vocational Qualification (NVQ) in care award and a component of the award addresses issues around the topic of the protection of vulnerable adults from abuse. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Cleeve Court is well maintained, decorated and furbished to a very high standard, providing a safe, homely, peaceful environment for everyone. The home meets, and in some areas, exceeds the standards. Evidence: Cleeve Court is a large detached regency house, which is approached up a long tree lined drive and provides parking for several cars. The house is surrounded by its own extensive gardens and adjoining fields, affording people in the home countryside views and plenty of wildlife. The home and its gardens are well maintained and the inside has been tastefully decorated throughout, it provides a safe peaceful home for people to live in. Both lounges and dining room are decorated, furnished and carpeted to a very high standard. They retain many original features lending character and homeliness, including ornate fireplaces, cornices and ceiling roses. People were sitting in these rooms throughout and the day, resting peacefully reading newspapers, and talking amongst friends. There are a number of aids and adaptations throughout the premises to enable physically disabled people to maximise their independence. This includes wide Care Homes for Older People Page 20 of 28 Evidence: corridors and pathways, passenger lifts, specialised bathing facilities, grab rails, and assisted toilet facilities. We walked around the inside of the home and viewed some of the bedrooms and bathrooms. People had been supported to personalise their bedrooms with pictures and ornaments and they are able to bring items of furniture should they wish. Rooms are lockable so that they can maintain their privacy and keep their personal possessions secure. Rooms have adjustable beds and good quality matching bedroom suites, soft furnishings, lounge chairs, and a small table. Some of the rooms provide people with en suite facilities. People have individual commodes should they require one and communal bathing areas, showers and toilet facilities are located throughout the home. The home has a housekeeper and domestic staff seven days a week. The house was spotless throughout. 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. The relationships between staff and people living in the home are good and create a warm positive environment to live in. People are supported and protected by the homes recruitment policy. The people are cared for by skilled staff that are trained, supported and supervised by management. Evidence: The manager told us that staffing levels are indicative of needs and the level of care required and confirmed that levels of staff would rise should dependency levels increase. We know that the home also increases the levels of staff at certain busy times of the day to ensure that needs are met. People living in the home and staff agreed that there were enough staff to meet their needs. When there have been staff vacancies regular agency or bank staff have been used to provide continuity and the permanent staff will often cover extra shifts. Staff rotas are developed to ensure an appropriate skill mix of staff is on duty. We know that the home follows a good recruitment procedure. This will help ensure that people living in the home will be further protected. Records contain completed application forms with a full employment history, two or more written references and Care Homes for Older People Page 22 of 28 Evidence: Criminal Records Bureau CRB disclosures. Staff confirmed that relevant checks had been completed before they started working in the home. There is an induction programme which covers all mandatory training. The home has a mentor system where all new staff are linked with and shadow a senior staff member during shifts to help with continued training throughout the induction process. The home provides the staff at the home with training and development opportunities tailored to individual needs. The manager and all staff are conscientious in attending training relevant to the care needs of the people they are caring for and those relevant to the roles they perform. The manager told us about her plans to support staff to professionally develop and wants to encourage innovation within the staff team. The manager is planning a growth program for senior staff consisting of agreed responsibilities, set projects to achieve, and devising and implementing new ideas. This will give staff an opportunity to sample management responsibilities in a controlled structure, promoting confidence and self belief and good team building skills. We saw that staff were respectful and sensitive towards the people they were caring for and the atmosphere was calm, happy and relaxed. The AQAA tells us, It is evident through our staff Quality Assurance Questionnaires that morale has improved significantly and it confirmed that staff are happier, the atmosphere is more relaxed and the interpersonal relationships between management, trained staff and care assistants has improved and is very good. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs and best interests are central to the management approach in the home. The health and safety of people who use this service should be protected by systems that are in place Evidence: At the time of the inspection the manager had been registered with the commission for three months. She demonstrated good management skills that relate to the aims and purpose of the home. The registered provider, manager and staff are very committed to the people living in the home and the roles and responsibilities expected of them. Staff are empowered by the manager to continually monitor and evaluate the services they provide to people. The ethos of the service is person centered with the views of service users actively being sought as part of this process. The home continues to monitor and assess the quality of services provided by giving Care Homes for Older People Page 24 of 28 Evidence: people questionnaires to complete, any weaknesses identified are put into an action plan. Regular audits are carried out in the home including health and safety care documentation, medication and other procedures in the home. Comments received from the questionnaires were very positive and included, The home provides high quality care, meets individual care needs and provides support for people living in the home, families and staff, I have always felt that Cleeve Court is a good nursing home that looks after people well. I would consider it for any relative of mine and The care is excellent. People who live in the home are supported to manage their own finances. The home has written policies and procedures in relation to the promotion of the health and safety for all people who use the service and associated training was provided for staff in all health and safety matters. Some of the Health and Safety records in the home were examined. Documentation showed that relevant checks were maintained correctly and at the required intervals including all fire alarms, equipment and emergency lighting. The homes records showed all necessary service contracts were up to date including, gas and electrical services and the passenger lift. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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