Care Home: Clovelly House

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What the care home does well The service users were evidently well care for and expressed only positive comments about the home, registered provider and staff. We were told by service users either during the visit or within surveys; `the staff are very kind and helpful`, `I have no complaints and I am treated and cared for very well`, `they cater for all my needs`, `I have nothing but praise for them all, I could not fault a thing here` and `nothing is ever too much trouble`. One relative said `From the 1st day that we looked around we found it was a warm and friendly home with fantastic caring staff. June and Rick [the registered provider and her husband] can`t do enough for the residents and it really is home from home. As a family it gives us peace of mind that our relative is so well looked after, but most of all she is so happy here`. One of the community nursing team commented `The residents of Clovelly are always pleased to see us and I have never heard of any problems from them regarding any aspect of their care over the past 20 years. They provide good care and service for all aspects of the residents daily living and they telephone the district nurse team for any problems or concerns they have for any of their residents`. We found that people receive individualised care that meets their assessed needs. The privacy and dignity of service users is respected and they are treated with respect. The food provided is nutritious and plentiful with good choices offered to the service users. The home is well maintained and attractively decorated and furnished. The overall effect is of a comfortable and welcoming home and staff team. The grounds, whilst compact at the rear of the home, offer a pleasant and attractive seating area. The rear garden area is attractively planted with colourful and fragrant flowers and shrubs that are well maintained. The location of the home is central to the town and local amenities. The staff team work hard to make the most of the location and service users often go out for trips on the mini bus or for walks to local venues. What has improved since the last inspection? There were 2 requirements made at the last unannounced key inspection regarding staff training and maintenance of equipment, both of which have been met. 1 recommendation was made regarding the qualifications of the main cook. The main cook at the present time has considerable experience and qualifications within the catering industry. The home now offers service users the opportunity to attend meetings in the home to give their view of the way in which the home is run and voice any changes they would like to be made. What the care home could do better: The registered provider must ensure that the controlled drugs are recorded correctly. Care plans should be developed to be informative to staff and reflect the service users wishes and preferences. The infection control policy and procedure should include guidance on the cleaning ofcommodes within the home. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Clovelly House 18 St Michaels Road Newquay Cornwall TR7 1RA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Melanie Hutton     Date: 0 9 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Clovelly House 18 St Michaels Road Newquay Cornwall TR7 1RA 01637876668 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) : Mrs June Anastasia Hartigan care home 19 Number of places (if applicable): Under 65 Over 65 19 old age, not falling within any other category Additional conditions: 0 Service users to include up to 19 adults of old age (OP) Total number of service users not to exceed a maximum of 19 Date of last inspection Brief description of the care home Clovelly House is a registered care home, which offers accommodation and personal care for to up to 19 older people. It is located close to the centre of the town of Newquay. The home is situated with easy access to shops, transport and all the amenities of a small town. It is sited in its own gardens, slightly off the road, with a small parking area to the rear of the property. The home is located across two floors. The upper floor is accessible by lift. All the bedrooms are occupied as single rooms and most of them have en suite bathroom facilities. All are provided with sink units. In addition there is a spacious lounge/dining room, a quiet/smoking room and two conservatories. Several of the rooms have views across the town and to the sea beyond. Care Homes for Older People Page 4 of 29 Brief description of the care home The Registered Provider lives near to the home and manages the home on a day-today basis, with the support of the family. The current fees for this home are 289 - 380 pounds per week, additional charges are made for toiletries, papers, magazines, transport and hairdressing. Care Homes for Older People Page 5 of 29 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 was an unannounced key inspection that was undertaken on 9 July 2009, with 1 inspector visiting the care home and spending 7.5 hours at the home. We spent time in discussion with the service users, staff and registered and deputy managers and looked at paperwork including care planning, assessment information, staff recruitment and training records, policies, procedures and maintenance and health and safety documentation. We received a completed Annual Quality Assurance Assessment from the provider when requested, that contained detailed information about the home. Prior to this inspection visit, we sent out quality surveys to service users, care staff and external social and health care professionals. We received 3 completed surveys from service users and / or their representatives and 4 from health professionals including Care Homes for Older People Page 6 of 29 community nurses and general practitioners. What the care home does well: What has improved since the last inspection? What they could do better: The registered provider must ensure that the controlled drugs are recorded correctly. Care plans should be developed to be informative to staff and reflect the service users wishes and preferences. The infection control policy and procedure should include guidance on the cleaning of Care Homes for Older People Page 8 of 29 commodes within the home. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 29 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 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users care needs are assessed fully to ensure that the home can meet those needs. Service users and / or their relatives are welcomed to the home prior to admission to assess the quality, facilities and suitability of the home. Evidence: All service users admitted to the home are fully assessed by the registered provider or the deputy manager. We were able to see information gathered pre admission and a full assessment is undertaken place on admission to the home. One service user has been recently admitted to the home following a referral from Social Services out of county. A full care needs assessment was obtained from the referring body and further information gathered from family members who visited the home on the service users behalf. It is recommended that this information is included within the written pre admission assessment information. This assessment information forms the basis of the Care Homes for Older People Page 11 of 29 Evidence: care plan and ensures that the home is able to meet prospective service users needs. Service users and their relatives / representatives are encouraged to visit the home before making a decision whether they wish to move in. We were told by 2 service users that they or their representatives did indeed visit the home and were impressed by the warm welcome and family feel of the home during that initial visit. Another service user told us that they knew that it was a good home from their local knowledge. We saw a relative of a prospective service user visiting the home on the day of inspection and observed that they were provided with written documentation in the form of the service users guide and last Commission for Social Care Inspection (CSCI) now the Care Quality Commission (CQC) inspection report. We also observed that they were shown around the home and into the proposed bedroom by the registered provider. Care Homes for Older People Page 12 of 29 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. Service users receive individualised care and all have a written care plan. Care plans do not always inform the reader of the service users preferences and choices. The health care needs of service users are met. The home has previously had a good record of compliance with the receipt, administration, safekeeping and disposal of medication including controlled drugs. Evidence: All service users have a care plan which is generated from the initial assessment, some of which are signed by the service user or their representative and are reviewed monthly. These should now be developed to consistently provide staff with clear instruction on the action they must take to meet the service users assessed care needs. Some care plans that we inspected were task orientated and did not fully reflect the service users preferences and choices. Service users were very positive during discussions about the care and support that they receive from the registered provider and staff. The daily records are informative and provide detail about the service users day and choices they make. Care Homes for Older People Page 13 of 29 Evidence: The daily recording also provides information about the service users health needs and any input from external professionals e.g general practitioner (GP), community nurses, chiropodist and optician. Specialist equipment was observed throughout the home for individual service users and nursing support is provided by the community nurses. The registered provider is a registered nurse and the deputy manager has recently completed her registered nurse training. The nursing knowledge and experience of the management of the home ensures that prompt referrals are made to the appropriate professionals if a service users health deteriorates. We were able to see that service users are registered with a general practitioner of their choice as there are 6 different GPs who visit the home. Risk assessments relating to moving and handling, tissue viability and nutrition are available within the care planning information. It was noted that not all of these are fully completed, 1 of which was a nutritional risk assessment for a service user with diabetes. Further evidence supported that this person was receiving the correct diet but it is recommended that assessments are completed fully where necessary. A policy and procedure regarding medication is available to staff. Medication was observed to be stored securely within the locked medication trolley that is fastened to the wall. Medication that requires refrigeration was stored in an unlocked fridge, that is also at times used for the storage of food, and located within the kitchen. A seperate medication storage fridge that is lockable has been ordered and delivery is awaited. The local pharmacist visits the home regularly and the registered provider said that this had taken place recently, although no report was available. All staff have completed safe handling of medication training, with the exception of 2 staff who have been recently recruited. We observed the medication administration over the lunch time period and were able to see that this is administered safely and in line with the homes policies and procedures. Medication Administration Records (MAR) are recorded fully. A record is held of medication arriving and leaving the home - we did not inspect this fully on the day of inspection. Service users are able to self administer their medication if they wish, although this is subject to a risk assessment. Locked facilities are provided in each bedroom for this purpose. On the day of this unannounced inspection we conducted an audit of the controlled drugs held in the home. It was noted that there were 2 errors in the recording of the drugs, with the drugs held, not in accordance with the numbers recorded in the register. The registered provider and deputy manager realise the seriousness of this and immediately investigated the discrepancies. A full report of this investigation with the explanation for the mistake in recording / outcome and the measures put into place was received by us the day after the inspection. The preferred form of address is recorded within the care plan documentation for most Care Homes for Older People Page 14 of 29 Evidence: service users and staff were observed to use this when speaking with the person. We observed staff knocking on bedroom, toilet and bathroom doors prior to entering the room. All bedrooms and bathrooms have locks fitted to afford the service users privacy. There is 1 registered double room at the home, we were told this is always used as a single room. Most bedrooms have ensuite toilets. It was noted that 1 ensuite toilet did not have a door in place and was immediately opposite the bedroom door, this could compromise the service users dignity if they were sat on the toilet and a visitor entered. The registered provider informed us that this was the personal choice of the service user to avoid problems with opening the door. owever, the registered provider may wish to explore other ways in which privacy and dignity may be provided e.g. screening. Individual records relating to the service users are now stored securely in the office. Care Homes for Older People Page 15 of 29 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 able to make choices about how they live their lives and their autonomy is respected. The registered provider and care staff are clearly committed to service user comfort and quality of life. Service users were positive about all aspects of life at Clovelly House, with particular comment made regarding the meals that are provided to them. Evidence: A time table of social activities is made available on the notice board in the hallway. This included keep fit, visit to a local blind club, flower show visit, musical entertainment, piano playing, bingo, quiz, mini bus trips and walks to local areas. The Roman Catholic and Church of England Ministers visit the home regularly. We observed one minister visiting service users on the day of inspection. Service users told us that they are supported to attend and continue their preferred activities. One person told us that the home provides reading material for them. We also saw that the hairdresser visited the home on the day of inspection and service users told us that they enjoy these visits regularly. A friendly and welcoming atmosphere is experienced in the home, with service users observed to socialise with each other. 1 service user told us Care Homes for Older People Page 16 of 29 Evidence: that they prefer not to participate in the activities held within the home and that her choice is respected by the staff. Another said that often they enjoy watching the activity but they do not want to join in and again this is respected by the staff. There are no restrictions on visits from families and friends of service users. We were told by 3 service users that their families visit often and are made to feel very welcome in the home. The visitors book evidences that several people a day come to the home. The communal areas of the home are arranged in such a way that service users can receive their visitors in private e.g. the dining area, small lounge and a choice of 2 conservatories as well as the garden during fine weather and the service users own bedroom. A monthly menu is planned and changed each month. The cook told us that service users choices are included in this menu. Service users told us that they have been asked if there is a particular meal they would like prepared. The menus show that there is a choice of both the main mid day meal and also the tea time meal. On the day of inspection all of the service users chose to have roast chicken with new potatoes. A selection of vegetables were available - broccoli, carrots, cauliflower and green beans. The cook said that a mixture of fresh and frozen vegetables are used. Desert on the day of inspection was home made sponge pudding and custard, ice cream or jelly. All of the service users we spoke with were complimentary about the food provided to them. We observed bowls of fruit available in the lounge areas, which service users were seen to enjoy. Additional drinks are provided with coffee and biscuits in the morning and tea and home made cakes in the afternoon. Jugs of squash and water were available in the lounge throughout the day and staff were observed encouraging service users to drink these additional fluids. We visited the cook in the kitchen during the day and observed that cleaning schedules and maintenance checks are in place. The kitchen was domestic in nature, clean and tidy. Care Homes for Older People Page 17 of 29 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. Service users are safe from harm and are able to raise concerns to the registered provider and staff. Evidence: The home has a written complaints procedure, which includes the required information. Further information should be included to inform service users and their represenatives that they may refer their complaint to the Department of Adult Care and Support (DACS) who have a responsibility to investigate complaints on behalf of service users. All of the service users we spoke with told us that they feel well cared for and have had no need to make a complaint. They also told us that they would feel very able to raise any concern with the registered provider. The deputy manager told us that the home has not received any complaints. CQC has not received any complaints in respect of this home. The home has a policy in relation to the Safeguarding of adults that is available to staff. A whistle blowing policy is also available. The registered provider told us that an overview summary is provided to staff to clearly advise them of their responsibilities should there be an alleged or suspected safe guarding issue raised. Training has been provided to staff regarding safeguarding adults, deprivation of liberties and the mental capacity act. This training was provided by Cornwall County Council training department. Care Homes for Older People Page 18 of 29 Evidence: No safeguarding referrals have been made in respect of service users at Clovelly House. Care Homes for Older People Page 19 of 29 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. Clovelly House is well maintained and decorated, offering comfortable, homely, safe accommodation for the service users. The home is clean, hygienic and free from odours. Evidence: The home is well maintained, attractively decorated and comfortable. It is easily accessible by public transport, with parking to the rear of the home, on the road or in nearby public car parks. There is evidence that the home is well maintained throughout. Staff and service users told us that maintenance is ongoing and that carpets have been replaced and rooms (both bedrooms and communal rooms) have recently been decorated. This ongoing maintenance is not always recorded in the maintenance log. The home has attractive grounds with a grass lawn at the front of the building and a courtyard area at the rear. Seating in the garden is plentiful with the provision of parasols to afford shade to the occupants. Service users were observed enjoying the garden in the warm weather on the day of inspection. 3 service users told us that they enjoyed the well maintained grounds, both to view and sit in. The environment is clean and well maintained, offering good access throughout for service users. The communal areas are comfortably decorated and furnished in a homely way. There is a choice of communal seating areas throughout the home Care Homes for Older People Page 20 of 29 Evidence: including; 2 conservatories, lounge, dining area, quiet seating area and if necessary a smoking area (currently none of the service users smoke). The home feels light and airy throughout. Artificial lighting is domestic in nature and additional lamps are in place within communal areas and the bedrooms to assist with reading and activities e.g. knitting. Wheelchair access is available to the side of the property, the main entrance is reached by steps. The bedrooms are all personalised and attractively decorated. A group of 3 service users told us that they liked their rooms and that they were comfortable. It is recommended that a record of service users personal possessions be consistently maintained. All have the provision of hand basins, most have ensuite toilets. One room is registered as a double room although we were told this is always used as single accommodation. All rooms are provided with a lockable storage space for valuables and / or medication and all bedroom doors can be locked by the service user. The registered provider told us that while keys are available for each room, only 1 person chooses to hold their key. We were also told that a key would only be given to a service user following a satisfactory risk assessment. The home has provided grab rails and hand rails where necessary to assist service users to mobilise throughout the home. There is an 8 person shaft lift to allow access between the 2 floors. All rooms have a call bell facility, but we noted that some call bells would not be accessible to the service user if sat in their chair in their bedroom. The registered provider advised us of the procedure that is followed in such cases and we were able to see this in action with 1 service user who was in their room. Equipment was observed throughout the home to ensure that service users needs can be met safely e.g. hoists, wheelchairs, raised toilet seats, pressure relieving equipment. There are 3 bathrooms, 2 of which provide assisted bathing and 1 bathroom also has the provision of a shower over the bath. 1 bath is marked as being out of order - the registered provider told us that this will be mended by the plumber when he is available. The hot water outlets in the baths appear to deliver hot water close to 43 degrees centigrade. The registered provider told us that thermostatic valves are fitted to the hot water taps on the baths and the temperatures checked regularly by the staff. Hand basins do not appear to have these valves fitted. Additional toilets are located throughout the home and are close to the lounge and dining room on the ground floor and bedrooms that do not have ensuite toilets on the 1st floor. The home was clean, tidy and free of unpleasant odours on the day of the unannounced inspection. There are domestic staff employed by the home who are supported in keeping the home clean by the care staff. Service users told us that the home is always clean and tidy and that very good care is taken of their rooms and personal posessions. Laundry facilities are situated in a separate building at the rear of the home. There are Care Homes for Older People Page 21 of 29 Evidence: 2 washing machines. These do not provide a sluicing wash but can wash at 95 degrees centigrade. Dispersible bags are used to wash soiled laundry. The laundry floor is impermeable and the walls painted to allow easy cleaning. The infection control policy and procedure provides guidance for staff on reducing the risk of infection. It is recommended that this identify the procedure to be followed when cleaning commodes as there is no sluice facility within the home. Personal protective equipment including gloves and aprons is available throughout the home and staff were observed to use these. Sanitising hand gel is available throughout the home along with liquid soap and paper towels in communal areas and areas used by the staff. The registered provider told us that the hot water has been tested for legionella, but was unable to find the certificate that demonstrates this. regular checks and cleaning is undertaken to reduce the risk form legionella e.g. in depth cleaning of the shower heads. Care Homes for Older People Page 22 of 29 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 needs of service users are met by trained and competent staff who are employed in sufficient numbers. Evidence: Service users, staff and the management team of the home all told us that there is a reliable and dependable staff team within the home. The data information in the AQAA informed us that no staff have left the home in the last 12 months and that 14 care staff are employed along with 4 ancillary staff members. On the day of inspection the duty rota showed that there were 2 carers on duty during the morning, 2 in the afternoon and 1 waking and 1 sleeping member of the night staff. The duty rota was observed to be up to date and accurate. The registered provider and deputy manager were also on duty during the day. There was also a cook and domestic member of staff on duty. We were told that this is the normal staffing for the home. Service users told us that the staff are always available to meet their needs and if they ring their bell for assistance, the staff respond promptly. Service users were very positive regarding the care that they are provided with and told us that staff are kind and helpful, caring and nothing is too much trouble for them and the staff are all very good and so very kind and helpful. We looked at recruitment records for 4 members of staff. These all evidenced that a Care Homes for Older People Page 23 of 29 Evidence: Criminal Records Bureau (CRB) check, POVA first check, 2 written references had been obtained. The completed application form identifies any gaps in employment history and a declaration of medical fitness by the applicant. Each applicant is required to attend a face to face interview of which a record is held. The registered provider is clearly committed to staff training. Staff told us that they are encouraged to attend regular training including NVQ training to level 3. The AQAA data information informed us that 13 members of staff are qualified to NVQ level 2 or above. The registered provider and deputy manager have completed the registered managers award. New staff complete an induction training that complies with the Skills For care Induction Foundation Standards. Written evidence of this is held on staff files with records signed by both the registered provider and the member of staff. Training is provided during induction with ongoing refresher and specialist training provided as necessary. Certificates held on staff files evidenced attendance at the training sessions including ; first aid, health and safety, moving and handling, safeguarding adults, mental capacity act training, deprivation of liberties, medication, fire safety, food hygiene. Staff were positive during conversation with us about the training and support provided by the registered provider and deputy manager. Care Homes for Older People Page 24 of 29 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 registered provider demonstrates clear leadership, knows the service users well and the home has functioned effectively for many years. The management and administrative systems are well organised and able to respond promptly to the needs of service users. Evidence: The registered provider who manages the home on a day to day basis is a qualified nurse and is registered with the Nursing and Midwifery Council. The deputy manager has also recently completed her registered nurse training. Both the registered manager and the deputy manager have successfully completed their registered manager awards. The home has a pleasant restful atmosphere. There is evidence of clear direction and leadership with both service users and staff very positive about the manner in which the home is run. Everybody we talked with spoke very highly of the provider and the family. Care Homes for Older People Page 25 of 29 Evidence: Quality assurance information has been gathered through discussion with service users and their representatives. Last years annual quality survey has been audited, this years is currently in progress. Surveys have been sent out to service users, their representatives and professionals who visit the home. It is recommended that the audit also contain information of any action that the registered provider intends to take as a result of the survey. Service user meetings are held every 2 months with minutes maintained of the content. All service users are invited to give their views of the way in which the home is managed and run, 9 service users attended the last meeting held in June 2009. The registered provider keeps the handling of service user money to a minimum, no monies are held on behalf of service users. The registered provider does arrange for the collection of pension for 2 service users, who have given their written permission for this to take place. Arrangements are in place with some service users and their representative for the home to pay for services such as chiropody and hairdressing, with the representative then invoiced by the home. A policy and procedure is in place for staff regarding the handling of service users monies and receipt of gifts. Records are maintained and seen to be up to date. The accident book complies with data protection, although records completed for individuals should now be stored in the persons personal file. Environmental risk assessments have been completed for individual rooms and other risks within the home. Staff are provided with appropriate health and safety training that includes moving and handling, basic food hygiene, first aid and infection control. General health and safety training has been commenced and 4 staff have completed this, with others completing the health and safety module within their NVQ level 2. Fire safety policies, procedures, checks and training for staff in in place with records available for inspection. We were able to evidence maintenance and servicing information for equipment within the home e.g. the lift, hoists, bath chairs, fire extinguishers, electricity and gas. The security of service users is promoted by the main door to the home being kept locked and visitors pressing the bell to be admitted. The door may be opened from the inside without the need for a key. Care Homes for Older People Page 26 of 29 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 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 3 It is recommended that a written record be maintained of service users care needs, where this has been provided verbally by relatives / representatives or the commissioning agent prior to admission. It is recommended that care plans are consistently detailed and provide detailed guidance to staff to inform them of the action they must take to ensure the service users assessed care needs are met. It is recommended that relevant risk / care needs assessments are completed e.g. moving and handling and nutritional. It is recommended that a record of service users personal possessions be consistently maintained. It is recommended that the quality audit of the home, contain information of any action that the registered provider intends to take as a result of the survey. It is recommended that records referring to individuals should be stored in the persons personal file in accordance with the Data Protection Act. 2 7 3 8 4 5 24 33 6 37 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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