Care Home: Cleveland House Nursing Home

Similar services:

• Snydale Care Home
• Abbey The
• Larchfield Manor
• Hawkhills
• Beeches The - North Yorkshire County Council
• Staveley Birk Leas Nursing Home
• Carentan House

What the care home does well People`s needs are assessed prior to them moving into the home and are able to visit the home to establish whether or not it is the right place for them. Staff were observed being friendly, polite with cheerful dialogue between themselves and people using the service. There are three areas outside of the home for sitting in warmer weather and this includes a secure area with access from the patio doors in the extension to the main house. The areas were well maintained and user friendly. The dining room was well presented and all tables had linen tablecloths, napkins and fresh flowers. A menu was available on each table and offered a variety/ choice of food taking into consideration the food preferences and likes and dislikes of people living in the home. Comments from people living in the home about the food include: "The staff let us choose what we want." "I can`t always remember what I`ve ordered the day before, but I can change my mind." "I enjoyed my dinner." "I enjoy my food especially when it is fish." People who use the service are able to maintain contact with their family and friends. What has improved since the last inspection? When a drug administration sheet states one or two tablets, accurate records are now maintained to show the amount of medication given. What the care home could do better: The care plan must clearly identify the person`s mental health needs and show how those needs are to be met. This is to ensure that the person receives the care that they need and there is continuity of care. When carrying out a wound assessment staff should clearly record their findings and the action to be taken. This is to ensure that it can be clearly seen if the wound is healing or not, the staff know how to care for the person and they receive continuity of care. To promote choice and ensure that the lifestyle of people living in the home matches their expectations, people must be consulted about the programme of activities arranged on their behalf. The activities that the person is involved in on a daily basis should also be recorded in more detail to show that they have taken part. Staff must ensure that people who are at risk are not left unsupervised and that they are deployed around the home to meet people`s needs. This is to ensure that people`s well-being, health and safety are protected and people`s needs are met. The manager should have a level 4 NVQ in management or equivalent qualification, and 50% of care staff should have an NVQ level 2 or above as trained staff have a better understanding of people`s needs. Key inspection report Care homes for older people Name: Address: Cleveland House Nursing Home 2 Cleveland Road Edgerton Huddersfield West Yorkshire HD1 4PN     The quality rating for this care home is:   one star adequate 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: Karen Summers     Date: 1 6 1 1 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 31 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 31 Information about the care home Name of care home: Address: Cleveland House Nursing Home 2 Cleveland Road Edgerton Huddersfield West Yorkshire HD1 4PN 01484512323 01484548043 waltonjo@bupa.com www.bupa.co.uk BUPA Care Homes (GL) Ltd care home 45 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) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability terminally ill Additional conditions: Can accommodate one named service user under 65 years of age - category LD Date of last inspection Brief description of the care home Cleveland House provides personal care and nursing for up to 45 older people. The home is a large stone built, converted residence with two purpose built extensions. It is approximately half a mile from Marsh and 1 mile from Lindley with all their local amenities. Huddersfield centre is about 2 miles away with the bus stop at the end of the road. There are spacious gardens for people to use and there is ample car parking. Care Homes for Older People Page 4 of 31 Over 65 45 0 0 0 5 5 Brief description of the care home The provider informed the Care Quality Commission on the 17.11.09 that the fees range from £400.18 to £675.00 per week. There are additional charges for private chiropody, hairdressing, newspapers, and magazines. Information about the home and the services provided are available from the home in the statement of purpose and service users guide. Care Homes for Older People Page 5 of 31 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: one star adequate 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 report refers to an inspection, which included an unannounced visit by one inspector on the 16th and 17th November 2009, and the length of the inspection was approximately 11.5 hours. The last inspection visit of this service was carried out on 6th November 2007, and an Annual Service Review was carried out on the 4th November 2008, where the information received indicated that the service continued to provide good outcomes for the people living there. Since then we have received a number of concerns about the service. The purpose of this inspection was to look at how the needs of people living in the home are being met and we focused on the outcomes of the key standards. We did this inspection with an expert by experience who spoke to people who are Care Homes for Older People Page 6 of 31 using this service. An expert by experience is a person who either has a shared experience of using services or understands how people in this service communicate. They visited the service with us to help us get a picture of what it is like to live in or use the service. This is important because the views and experiences of people who use services are central to helping us make a judgment about the quality of care. During the visit we spoke to people living in the home, visitors, staff and management. We looked at various records including peoples care plans and staff files. We looked around some of the building and we observed staff while they carried out their duties. To enable people who use the service to comment on the care it provides, we sent surveys to people living at the home, two of which were returned and had been completed by their relatives, ten to staff, two were returned, and other Social and Health care professionals involved with people living at the home, one was returned. Comments from these surveys have been included in this report. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Older People Page 7 of 31 What the care home does well: What has improved since the last inspection? What they could do better: The care plan must clearly identify the persons mental health needs and show how those needs are to be met. This is to ensure that the person receives the care that they need and there is continuity of care. When carrying out a wound assessment staff should clearly record their findings and the action to be taken. This is to ensure that it can be clearly seen if the wound is healing or not, the staff know how to care for the person and they receive continuity of care. To promote choice and ensure that the lifestyle of people living in the home matches their expectations, people must be consulted about the programme of activities arranged on their behalf. The activities that the person is involved in on a daily basis should also be recorded in more detail to show that they have taken part. Staff must ensure that people who are at risk are not left unsupervised and that they are deployed around the home to meet peoples needs. This is to ensure that peoples well-being, health and safety are protected and peoples needs are met. The manager should have a level 4 NVQ in management or equivalent qualification, Care Homes for Older People Page 8 of 31 and 50 of care staff should have an NVQ level 2 or above as trained staff have a better understanding of peoples needs. 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 9 of 31 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assessed prior to them moving into the home and are able to visit the home to establish whether or not it is the right place for them. Evidence: The care records of three people who use the service were looked at, all of which contained a Community Care Assessment carried out by the funding local authority. Each assessment contained detailed information about the persons current needs, and in addition to this there was evidence that the home had also carried out an assessment of the persons needs. This was also confirmed by staff and the deputy manager at the time of the visit. The information in the annual quality assessment document confirmed that all prospective people undergo a pre-admission assessment to ensure the home can meet any identified need and the placement will be appropriate. The deputy manager also said that people were encouraged to visit the home and spend some time there before Care Homes for Older People Page 11 of 31 Evidence: making a decision to move in. One person who completed a surveys was not sure if their relative had been given information about the home before they decided to move in and a second relative said that they had not received enough information about the home. The survey returned from the health care professional said that the care service assessment arrangements ensure that accurate information is gathered and that the right service is planned for people. Care Homes for Older People Page 12 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples care plans do not outline the level of support and care each person requires in ensuring that all their needs will be met. The recording and administration of medication is satisfactory. Evidence: Staff were observed being friendly, polite with cheerful dialogue between themselves and people using the service. Three peoples care records were looked at in detail and the pre printed documentation was of a good standard and identified the care needs, risk assessments, movement and handling assessments, nutritional assessment, social interests and the likes and dislikes of the people living at the home. There was also evidence that the care plans are updated monthly or as the needs of the person change. However there was not sufficient information as to how the mental health needs of people would be met and to ensure that there was continuity of care. Care Homes for Older People Page 13 of 31 Evidence: The daily record was generally an account of the persons day, however one persons needs had been identified that they had episodes of mild memory impairment, and the daily record said that the person looked tired and sleepy at times and wanted to stay in bed. On another occasion staff had observed that the same person looked tired and weak. There was insufficient information as to what action should or had been taken in relation to these findings. Another person had a pressure sore, and although this had been identified in the care plan, the nurse recording the assessment had referred to the wound as Maximum width depth 1. There was also little information as to how often the wound should be redressed. The assessment and record of the wound and how often it should be redressed should be clearly recorded so that it can be clearly seen if the wound is healing or not, so the staff know how to care for the person and they receive continuity of care. One person made the comment in relation to their care. I dont like a man helping me to get dressed. So that peoples dignity is protected their wishes regarding their personal care needs should include whether they prefer a male of female carer. These issues were discussed in detail with the managers and they said that they would ensure that the care plans were updated to address these issues and reflect in detail all the persons needs and the action taken to meet those needs. A survey received from a member of staff said, We need to be trained to utilise care plans. One person said that their relative usually receives the care and support they need and another person said that their relative sometimes receives the care and support that they need. A person living in the home said, They are all good to me. There was evidence in peoples care records that they are able to access health care services, such as the dentist, chiropodist, optician and people confirmed that they receive the medical care that they need. Feedback from doctors said, An excellent standard of patient care. For many years, this nursing home has consistently provided high quality care delivered with a caring personal approach. Care Homes for Older People Page 14 of 31 Evidence: Staff were seen using the hoist when assisting to move people which was carried out in a dignified manner; however they did not always explain to the person what they were going to do. This was discussed on the day and the managers said that they would ensure that these issues were addressed. We observed that one person chose not to wear all their clothing whilst moving around the home and although it is the persons choice, other peoples privacy and dignity should always be taken into consideration. This was discussed with the deputy manager and she said that the person usually stays in their own room when not fully dressed, however she would take steps to ensure the situation does not continue. A sample of three peoples medication were checked, and included an audit of the controlled drugs medication as there had been errors reported which had resulted in safeguarding referrals. The storage, administration and recording of the medication were done correctly. Medication was seen to be reviewed monthly and the manager confirmed this. There were also risk assessments and documentation for people who wished to look after and take their own medication. Care Homes for Older People Page 15 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Not all people experience lifestyles in the home which match their expectations in relation to their social and recreational interests and needs. Evidence: On the day of the visit people were seen to be in various parts of the home, either in their own rooms, in one of the lounges watching television or in another lounge reading. One of the people living in the home who was dressed to go outside, walked into one of the lounge. They said that they were having their morning walk, but due to the bad weather had decided not to go out. A member of staff passed the time of day with the person and asked that if rhey did decide to go out, then they would take care as the ground might be slippery due to the rain. Later that morning there were more people who came into the lounges, and although a number of people as part of their illness were disorientated, they sat talking to each other having cups of tea and passing the time of day. Care Homes for Older People Page 16 of 31 Evidence: A number of people had their televisions on loud, and the one in the main lounge was also loud. However we did ask people in the main lounge if they would like the channel changing or would they like the sound turning down. Everyone at that time said that they were happy with what was on the television and that the sound was alright. In one of the more quiet lounges items of memorabilia and large print books were available for people to look at. There was also a list of charges for the hairdresser who visits twice a week and the hair dresser was visiting on the day of our inspection. The home employs an activities person who works Monday to Friday, 30 hours a week. Unfortunately the activities person was on holiday and we were shown a list of activities that took place the following week; however there was nothing scheduled whilst she was away. In the early afternoon music was playing in one of the lounges and people were asked if they would like to watch a film. The social and recreational preferences of people are recorded in their care records, and an activities record sheet which is held in a file is used daily to record the activities that take place and who has been involved. Activities include, Karaoke, baking, dominos, bingo, quiz, weekend board games and reading the newspapers, watching films, and reminiscence. Not everyone had a record of taking part or declining an activity, and for those whose names were seen there was very little record of their involvement or enjoyment of the activity. The activities record also included the visits of the hairdresser, and the 2 minutes silence that took place on Remembrance Day. We discussed that not everyone would think that hairdressing or the two minutes silence were an activitie. Not everyone choose to pay for their hair doing therefore when this was taking place people might feel excluded from an activity or see the activity as personal care. We also discussed that people must be consulted about the programme of activities arranged on their behalf, taking into consideration their needs whilst ensuring that the activities match their expectations. People who completed the surveys and who use the service were asked, Are there Care Homes for Older People Page 17 of 31 Evidence: activities arranged by the home that you can take part in? One person said usually, and one person did not make a comment. Comments on the day from people who use the service include: I like to watch the old films. This television is good we can see it because it is so big. Theres nothing much to do in the mornings. I dont always join in the activities. Theres nothing that interests me, I like to stay in my room. A member of staff said, All the staff like to get involved in the activities, even the kitchen staff, its not just the job of the activities coordinator. There were a number of visitors visiting at the time, and the record in the visitors book confirmed that people visit the home at various times throughout the day. The dining room was well presented and all tables had linen tablecloths and napkins. A menu was available on each table and offered a variety/ choice of food taking into consideration the food preferences and likes and dislikes of people living in the home. People said that they were asked to choose their preference of lunch and tea time meal the day before and staff confirmed that if someone was unable to choose for themselves, they would refer to the persons care plan for their likes and dislikes. Tureens of vegetables were taken to each person asking them their choice and how much they would prefer, and the meal time was carried out in a relaxed and unhurried manner. With the exception of one person who we informed staff that they might need assistance, people were been assisted where appropriate and in a dignified manner. Clothing protective were used at meal times and in many instances were not removed when the meal had been finished. We discussed this with the managers and to protect peoples dignity the protectors should be removed when not in use. Comments from people using the service include: I enjoy my food, especially when its fish. This rice puddings lovely. There is always enough food for us to eat. The staff let us choose what we want. I cant remember what Ive ordered the day before, but I can change my mind. I enjoy my dinner. Care Homes for Older People Page 18 of 31 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be confident that their complaints will be listened to and taken seriously. People are protected from abuse. Evidence: The complaints procedure was located in the reception of the home and with the exception of one relative, the surveys received from people who live at the home and their relatives said that they knew how to make a complaint and who to complain to. One of the relatives and people who use the service when spoken with also said that if they had any concerns they knew who to speak to. The information received from the home prior to inspection states that the company are currently reviewing the complaints procedure, and that they also have a robust allegation of neglect and abuse policy, allowing staff to raise concerns to senior staff within or outside of the home. The home has the Kirklees Safeguarding Policy, and the homes complaints procedure reflect that policy. Training records showed that staff have had safeguarding training (protection of vulnerable adults training,) and when spoken with staff were aware of the procedure to follow. Care Homes for Older People Page 19 of 31 Evidence: The information received prior to inspection states that nine safeguarding referrals were made and eight were investigated. Where issues had been identified the homes is working with health and care professionals to ensure similar situation do not occur. Care Homes for Older People Page 20 of 31 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 home offers people a homely, comfortable and clean environment. Evidence: As part of the inspection a tour of the home was conducted this included the communal areas, a number of peoples bedrooms, and the laundry. The bedrooms were tastefully decorated, and there was evidence in peoples rooms that they had been able to bring small personal items of furniture with them. The three lounges in the main part of the house were clean and bright, and there is also a small conservatory where people are able to smoke. The corridors in a number of areas were showing signs of wear, and the Regional Manager said that they were aware of the issues and they would be addressed within the redecoration programme. In the majority of bedrooms the only cover on the bed was a sheet and although the rooms were warm, we did not feel that one sheet was sufficient to keep people warm. This was discussed with the deputy manager and she assured us that if someone wanted more bed clothes then they could have it. A linen store was seen which housed duvets and extra bed linen should anyone need them. We asked people if their bedrooms were cold at night and they said that they were not. Care Homes for Older People Page 21 of 31 Evidence: On entering the extension there was a slight unpleasant odour, and there was also an odour in one of the bedrooms. Staff said that the cleaner was aware that these areas needed to be cleaned and the cleaner confirmed this. A relative made the comment, The chair my mother sits in is always in need of a wash. I have to point it out several times whilst my mum has been in Cleveland House. At the time of the visit the chairs in the lounges looked clean. The laundry person was seen to be carrying linen draped over a large bin on wheels to peoples rooms. She said that she had been given a clothes rail but it was too long to fit in the lift. Consequently some peoples clothing was creased. Comments from people who live in the home and their relatives include: My washing is okay, its not always ironed but you cant always expect them to do that can you. My mothers dress and skirt went missing. We have had clothes go missing, we have received some compensation but not for everything that has been ruined. The Regional Manager said that he would ensure that these issues were addressed and that the company always replaces clothing that has been accidentally damaged. However, if he is not made aware that the items of clothing have been damaged then he is not able to replace them. Externally there are three areas outside of the home for sitting in warmer weather and this includes a secure area with access from the patio doors in the extension to the main house. The areas were well maintained, user friendly and a pleasant area for people and their visitors to sit. Care Homes for Older People Page 22 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from being supported by caring, competent staff that have had all the necessary checks before working with people so that they are kept safe. However staff are not always deployed appropriatley around the home to meet peoples needs. Evidence: During the morning of the first day of the inspection there were occasions where people who were disorientated as part of their illness, were left unsupervised in the lounges. A person living in the home was seen to be trying to help other people living in the home and they did not seem happy with the intrusion. A visitor also pressed the call bell in their relatives room and the delay in staff answering the call made the visitor go looking for them. One person said, They are slow in answering the buzzer; I once had to wait 20 minutes to be helped off the toilet. It seems to be getting a bit better now. Visitors were also looking for staff to open the coded lock to enable them to leave the home. A member of staff commented in a survey, We need more staff on the floor. When Care Homes for Older People Page 23 of 31 Evidence: asked what could the home do better. Comments include, To give more time spent with residents. A relative made the comment, Would like more contact with the staff, but having said this they are kept very busy, and I think they do a good job. The duty rota was looked at and there was evidence to suggest that there were sufficient staff on duty to look after people in their care and this was also confirmed by the Regional Manager and Quality Manager. The Regional Manager at the time took steps to make sure that the lounges were supervised and said that he would ensure that the call bell are answered. This is to make sure that no one is at risk and people are kept safe. On the second day of our visit staff were better deployed to supervise and meet the needs of people in their care and staff were seen and heard to answer call bells in a timely manner. Care practice observed during this visit, and the relationship between staff and people being cared for was positive. The information supplied by the home prior to inspection states that there are thirty six care staff employed by the home and eleven have achieved a level 2 NVQ (National Vocational Qualification) in care. The guidance is that fifty percent of staff achieves an NVQ level 2 or equivalent qualification, as trained staff have a better understanding of peoples needs. The information also supplied by the home states that there are comprehensive human resource policies to aid effective recruitment and staff management, and that the correct recruitment checks are carried out. A sample of three recruitment records were inspected and the correct information and check had been carried out. Evidence was also seen in the staff records, and staff confirmed that they had induction training. Training in palliative care, abuse awareness, fire, movement and handling. The Regional Manager also said that all care staff were to have training in understanding dementia, six had already completed the course and two staff spoken with on the day confirmed that they were going to do the training. Care Homes for Older People Page 24 of 31 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 is run by a competent management team who will ensure that it is run in the best interest of people. Evidence: The manager is a qualified nurse and has many years of experience in the care of older people, and is currently taking the Registered Managers Award. The manager is currently on leave and until her return managers from the company are based in the home to provide management support. Comments from relatives include: This place is not as good as it used to be, I have had serious issues with the management. Another relative said that the old manager was very good, but their only criticism now is that the new manager does not come out of her office. Care Homes for Older People Page 25 of 31 Evidence: Comments from staff include: The manager Spends most if not all of her day in her office. I feel we do not have support of the home manager. She is not apart of the team. Whereas if she was to speak to people, I think it would be much more effective. One person said that the staff need a manager that praises them for the excellent work that they do. The management issues were discussed with the Regional Manger of which he was well aware of the issues and had already taken steps to address the situation. As part of the inspection in order to provide information to help us form judgements about the quality of the service, the manager was asked to complete an annual quality assessment (AQAA) document. This she did, and the document provided the Care Quality Commission (CQC) with a lot of information about the way the home is run, and what they hope to achieve in the future. The information supplied by the home in the AQAA states that they continue to be accredited with the Investors in People award. The managers said that customer satisfaction surveys are sent out to people who use the service each year and an external company collates the results in the form of a report which is made available to everyone in the home. The surveys which are due to be sent out soon include information about the quality of care, privacy, dignity, respect, the internal and external environment etc. The results of previous surveys shows that each area is given a percentage, and the manager then has to write a written action plan as to how improvements will be made. In addition to this BUPA have comprehensive audits that take place annually and these include the management practices and the running of the home. Personal best initiative is an initiative used by BUPA to encourage staff to have commitment to their work, and through the nomination of people, staff are financially praised for. In the main part of the home there was a notice board displaying various letters nominating staff for the award, for their kindness and care whilst carrying out their duties. These letters came from relatives, people living in the home and also staff nominating other staff. All letters were very complimentary. The information in the Annual Quality Assurance Assessment said that the home have Health and Safety meetings, and there are dedicated Health and Safety staff within the Quality and Compliance directorate to assist the home, and this was confirmed by Care Homes for Older People Page 26 of 31 Evidence: staff on the day.The AQAA also provided information of the dates that equipment and systems within the home had been serviced and maintained and these were satisfactory. On the day of the visit staff were involved in fire lectures and appropriate records were maintained. Care Homes for Older People Page 27 of 31 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 28 of 31 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 7 15 The care plan must clearly identify the persons mental health needs and show how those needs are to be met. This is to ensure that the person receives the care that they need and there is continuity of care. 31/12/2009 2 12 16 People must be consulted about the programme of activities arranged on their behalf and take into consideration their needs. This will ensure that the activities match the expectations and needs of the people living at the home. 31/12/2009 3 27 18 Staff must ensure that people who are at risk are not left unsupervised and that they are deployed around the home to meet peoples needs. 31/12/2009 Care Homes for Older People Page 29 of 31 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 This is to ensure that peoples well-being, health and safety are protected and peoples needs are met. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 When carrying out a wound assessment staff should clearly record their findings and the action to be taken. This is to ensure that it can be clearly seen if the wound is healing or not, the staff know how to care for the person and they receive continuity of care. 2 3 28 31 50 of care staff should have an NVQ level 2 or above as trained staff have a better understanding of peoples needs. The manager should have a level 4 NVQ in management or equivalent qualification. Care Homes for Older People Page 30 of 31 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. 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. Care Homes for Older People Page 31 of 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!