Care Home: Courtfield

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What the care home does well The manager and staff team continue to provide a good standard of care. The Registered Manager is proactive in all areas of the management of the home resulting in a positive attitude throughout the home. Feedback from people living at the home is very complimentary. These are some of the comments made, " The staff couldn`t be nicer" " The staff are always there when I need them" "I can`t praise them enough" "The food is always excellent" One relative commented: My relative is so well looked after here, she has everything she needs" The care records are up to date and well maintained by the staff and peoples` health care needs are met. There are a range of interesting activities arranged for people to participate in and people are encouraged to pursue their own interests and their choices are respected. People live in a very comfortable home with good quality furnishings and decor throughout. The home is well maintained. Recruitment of staff at the home is done in a responsible way with checks being undertaken to make sure that people are safe to work at the home, this further protects people in the home by making sure the right staff are recruited. Staff are well trained and are positive about their work within the home, they also feel well supported by the management of the home. What has improved since the last inspection? Records of all medications brought into the home are now well recorded, this is to make sure people remain safe. A new controlled drugs cabinet has been fitted to comply with the regulations. This means that people`s medication is more secure in the home. What the care home could do better: There are no requirements from this visits. There are however two recommendations for developing the quality of care further in the home. The first is to have an activities coordinator to further promote activities in the home. The second to increase opportunities for people to express their opinion with more frequent "residents", meetings and introduce a suggestions box for residents and their relatives. Key inspection report Care homes for older people Name: Address: Courtfield 3 St James Drive Harrogate North Yorkshire HG2 8HT     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: Linda Trenouth     Date: 0 7 1 0 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 30 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 30 Information about the care home Name of care home: Address: Courtfield 3 St James Drive Harrogate North Yorkshire HG2 8HT 01423509277 01423701559 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: RBS Care Homes Foundation care home 24 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 24 The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category - Code OP, maximum number of places: 24 Date of last inspection Brief description of the care home Courtfield is registered for personal care for 24 older people. The home is owned by RBS Care Homes Foundation, and run by a board of trustees. People living there have all either worked for the group, or are dependants of those who have or still do, work for the group. The home is a large detached house set in its own grounds. It is close to Harrogate town centre and provides good access to the towns services and amenities. Fees on the day of the site visit ranged from £475 to £570 based on a banding system relating to peoples needs. Additional charges are made for hairdressing, newspapers and Care Homes for Older People Page 4 of 30 Over 65 24 0 Brief description of the care home private chiropody. A copy of the last inspection report is available to people. The service user guide is available at reception. This contains a summary of the services the home provides. Care Homes for Older People Page 5 of 30 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 of Courtfield. The site visit was completed on the 7th October 2009 by an inspector who was also accompanied by an Expert by Experience. This unannounced visit was done in one day over 7.5 hours. We looked at a selection of records, observed care practice and meal times, looked around the building and talked to people who live at the home, the staff and management. Before our inspection visit we reviewed all of the information we had received about the service since the last inspection and we asked the home to complete a self assessment. This was completed and returned to us on time. It provided the information we had asked for and told us what the home did well and what could be improved. We also sent a selection of surveys to the home, for the manager to hand out and ask people to complete and return to us. All comments received are positive and are Care Homes for Older People Page 6 of 30 included in this report. Information from the self-assessment is also included. The care of three people was tracked to help gain evidence as to what its like to live in the home. Various records were viewed during the inspection. 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. Feedback was given to the Manager at the end of the visit. The recommendations made during this visit can be found at the end of the report. Care Homes for Older People Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. Care Homes for Older People Page 8 of 30 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 30 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 30 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 have good information and are well assessed before they move into the home. Evidence: People are told what the service can provide and have their needs fully assessed. People who use the service told us that they were encouraged to visit the home and had been given good information, helping them decide if the home is right for them. The service ensures that care assessments are undertaken before someone is admitted to the home. From this information the service can decide if they are able to meet a persons needs. Relatives say that they felt that the assessments were thorough and this reassured them the home would be able to meet their relatives care needs. People have the opportunity to have a trial stay in the home and many individuals have experienced the care by having short stays at the home. Staff said how Care Homes for Older People Page 11 of 30 Evidence: important this is to make sure people get a feel for the home and that the decision to move in is right for them. Care Homes for Older People Page 12 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health care needs are continually assessed and met to make sure people have the best health they can living at the home. Evidence: Each person living at the home is registered with a GP. People receive support from staff in meeting their health care needs such as dental, optical and chiropody. People each had a health care plan, which clearly recorded their individual health care needs. All health care needs are monitored in the care plan, a separate health care sheet is completed for all appointments, including doctors visits, hospital appointments, chiropody and optician. The appropriate equipment is being used to promote skin integrity and records are in place when individuals need regular turning to prevent pressure sores. People spoken to at the time of the inspection feel the staff respect their privacy and dignity. They said The staff are very good at supporting me the way I like and Care Homes for Older People Page 13 of 30 Evidence: always knock on the door before entering my room, they are always very polite and friendly Staff spoken to gave many examples of how they ensure peoples personal dignity when they are supporting them. People are regularly reviewed this make sure that any changes in their care needs are met properly. The reviews are kept up-to-date by the staff at the home. Staff had good knowledge of Peoples health care needs. The staff handover was observed and found to be very thorough. This is to make sure that all the information to support people is properly passed on. Staff were observed acting promptly to any health concerns that people have and liaise regularly with the surgery to ensure people were dealt with as soon as possible. The home has a good relationship with the local GP and district nursing teams. The home also has good links with the local health care facilities in the community. Regular visitors to the home are the GP, district nurse, chiropody, dentist and physiotherapist. Relatives felt communication in the home was good and they were kept informed. The care is good, they let you know of any changes and they always contact us. We are looked after by the staff, theyre always asking if Im comfortable and checking if Im all right. Its hard decision to leave your home but the staff have made it as pleasant as possible. The home operates a monitored dosage system. There is a policy in place for the storage and administration of medication for all staff working in the home to follow. The medication administration records show that everyone receives their medication as prescribed. Records were up to date and well maintained. The medication in the home was securely stored in a locked drugs cabinet. All used medication is returned to the pharmacy. No controlled drugs are currently held and a new controlled drugs cabinet has been fitted to comply with legislation. There has been an independent medication audit undertaken by the pharmacy advisor Care Homes for Older People Page 14 of 30 Evidence: who felt that the medication was well managed. All staff that administer medication have completed the necessary medication training. People are able to take their medication if they wish once a risk assessment is completed. This helps decide the best way to support individuals. Care Homes for Older People Page 15 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The recreational and social needs of people are well catered for, which enables them to make daily choices and promotes independence. Evidence: This is what the expert by experience said after speaking to people living at the home. People are able to make their own choices in the home. They can get up and go to bed when they want. They can watch TV, listen to music in their rooms or sit in the lounge. People can also have their meals in their room. Some people are able to go out on their own. The grounds surrounding the home are very quiet and rural. When the weather permits people can go outside and enjoy the gardens. The hairdresser visits once a week. There is a Coffee morning every second Wednesday of the month. A computer is available in one of the lounges for anyone who feels they would like to use it, but unfortunately no one, as yet has taken up this offer, even with the help of a carer to show them what to do. Staff seemed happy and relaxed in the home and carried out their tasks diligently. It was good to see people nicely dressed. All of them looked clean, smart and tidy. Some Care Homes for Older People Page 16 of 30 Evidence: of the ladies looked especially presentable through just having their hair done that morning. I observed staff being friendly and respectful towards people, addressing them by their first name and making contact by either touch or eye to eye level when communicating. I saw good practice by a member of staff in the Dining Room when he came to administer medication to two people; he gave them their tablets and respectfully stood back from them; whilst at the same time ensuring their medication was taken. Their medication was given in an unhurried, caring manner. I saw a member of staff sat in conversation with a resident who was having her morning cup of tea; this resident looked happy and comfortable. All members of staff I saw were polite and friendly towards people. The manager informed me that there are activities on offer such as bingo, quizzes, board games, dominoes and an organist comes in to play once a month. A mini bus can be hired by the home and booked in advance and this is usually once a month. Outings are to local attractions, the longer journeys are not as popular due to people not wanting to travel too far. There is a monthly service of Holy Communion along with visits by other clergy. Chair exercises take place in the blue lounge. The call bell system is in peoples rooms, in all communal areas, or if they wish they can wear a pendant around their neck. I found the advantage to this system is that there are no alarms or bells continually making a noise in the home, instead the call is diverted to a pager which the staff wear. This makes the home peaceful. There is a library/book case in the dining room. People are asked what books they would like and these are requested from the Library in Harrogate. Talking books are available also from the Blind Society along with large print books. Whilst I was there I heard the chair activities taking place in the blue lounge. I saw relatives visiting the home and they are made welcome at all times and are able to have lunch with their own relative if they wish. The manager informed me that there is a Residents Group meeting twice a year, when everyone is encouraged to participate and put their points of view or suggestions forward. There was no notice board with activities on offer. I asked the manager if there was an activities coordinator employed by the Home. She said that they had not had one but she was going to advertise for one. The activities had always been carried out by the staff. From observations and feedback from the people there I feel that the Care Homes for Older People Page 17 of 30 Evidence: Manager needs to explore this issue further. For as much as there were activities on offer these were not at any regular times by regular staff, and people were not keen to join in. On the positive side, Courtfield are trying to make activities available and interesting. I think Courtfield would benefit from a regular activity coordinator who would be able to build relationships with individuals thereby encouraging them to join activities. These are some of the comments I received when I spoke to 5 people about their daily life at Courtfield. The staff are always kind to me and helpful I have been here two years and I am really happy Everything is lovely and clean, just what I would expect I cant think of anything to complain about I was able to come here for two weeks to see if I liked living here and so I stayed After lunch nearly everyone goes to their rooms, there is not a lot to do There are some activities but not everyone likes to join in I like to go on the mini bus trips, but sometimes it is cancelled because there are not enough people I am looking forward to visiting the garden centre this Christmas to see all the decorations I like to do my own washing, which I hang in my bathroom. I go out for a walk in the afternoon, it keeps me active, some of the activities dont appeal to me. I have been here 5 years and still enjoy living here. The whole experience of my visit to, Courtfield was a happy one. It was good to witness dignity given to people who were living in a clean and comfortable home with staff who displayed kindness and consideration and were attentive to their needs. The staff showed good caring and communication skills towards people in their care. The quality of food was very good and served appropriately in very pleasant surroundings. I found the Manager of the home an extremely conscientious and caring individual, who not only seemed excellent in her managerial role but who was also happy to work alongside her staff in meeting the needs of the people. I think that if further exploration of activities along with an activity coordinator is pursued as the Manager said it will be, then Courtfield will become even more successful in its duty of care towards people living there. Also perhaps to have more than one residents meeting per year. People are given choices of menus prior to mealtimes. However, if they change their mind at meal times they can usually be accommodated with their choice. I had the opportunity of having lunch with people living in the home. I was sat at a table with 5 other people. We enjoyed conversation whilst we were served our lunch in a professional and courteous manner by the staff. Staff were very efficient at getting the food to the table promptly. The carers gave help where needed, although everybody seemed to be able to help themselves. But those people who needed a bit of direction Care Homes for Older People Page 18 of 30 Evidence: were helped in a respectful manner. The food was very nutritious. On the day of inspection we had celery soup, beef cobbler with a selection of 3 vegetables in tureens followed by pureed apple and custard. Each course tasted freshly prepared and was just like a home cooked meal. People were given time to eat their meal, it was not rushed and was very relaxed. Morning Coffee and tea is served during the morning. The tea trolley comes round in the afternoon and there is always a drink and snack given during the evening at supper time. I asked 4 people their views on what they thought about their meals. These were their responses: The food is excellent The chef is very good, we always miss him when he goes on holiday, the food is not as good then. There is always plenty to eat The food is very good here, I have put weight on as a result I like my lunches, but not too keen on the teatime food. Sometimes I can have my meals in my room if I dont feel well enough to go to the dining room, its never a problem. We are given a choice of what to eat, and they always accommodate me if I dont like something. Care Homes for Older People Page 19 of 30 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 are protected from harm by staff training and robust policies and procedures. Evidence: There is a complaints procedure which is included in the service user guide, which is available in peoples rooms and on display in the home. All those spoken with felt confident that they could take their complaints to the manager, and that she would deal with them to their satisfaction. Relatives told me, the manager and the staff are very approachable, We feel we can say if we are not happy. We worked together for what is best for mum. Staff knew that if they had any complaints made to them that they should be reported to the registered manager. Staff have all completed training in the protection of vulnerable adults. Also during the visit the staff were attending a training session on the deprivation of liberty, this was to further develop their understanding of supporting vulnerable people. Staff say that they would refer any concerns brought to their attention to the Care Homes for Older People Page 20 of 30 Evidence: manager, who in turn would report the matter to the appropriate body for investigation. The care quality commission (CQC) has not received any complaints about the service since the last inspection. Care Homes for Older People Page 21 of 30 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. People live in a comfortable and well maintained home. Evidence: This is what the Expert by Experience said about the environment. Walking into Courtfield was a of breath of fresh air in comparison to other care homes I have visited. A keypad security is used to gain entry. The Manager said the code is changed on a regular basis. Courtfield is clean, spacious, has no unpleasant odours and gives a bright and cheerful appearance. Everything was in good condition, the carpets were clean and colourful. The corridors were spacious. I felt an atmosphere of stability and calm. Initially, I was shown around the home by the Manager. I saw peoples rooms which were clean and tidy, decorated to a good standard along with a complete en suite bathroom facility which had decorative tiling and grab handles and rails to assist people in their tasks. I also had the opportunity later that day of being invited by two people to view their rooms. These two rooms contained their own personal possessions which evidenced that people are allowed to make their room personalised to their taste. The corridors are very wide to benefit wheelchair users and also had Care Homes for Older People Page 22 of 30 Evidence: hand rails on the walls. The laundry facilities were organised and had a good system in place for peoples laundry needs. Shelves had peoples names on where their clothing was folded neatly. There are also systems in place to prevent risk of contamination of items. The bathroom and shower rooms are adequately adapted for those people who did not feel secure in bathing in their own bathrooms. There are two reasonably sized lounges, one of them with a feature wood fireplace, both had comfortable seating and decorative arrangements by way of ornaments, pictures and flower arrangements. This gave the lounges a very homely feel. I was shown into the Hairdressing Salon, this was very authentic, a lady was having her hair styled. The dining room was very well set out with damask tablecloths and serviettes, along with place settings and flowers on the tables. There was a water dispenser in the corner of the room. The dining chairs were very user friendly, made so that they glided on the carpet making it easier for people to manoeuvre them, and were very stable. The kitchen was directly opposite the dining room giving everyone the advantage of receiving their food freshly cooked and hot. I asked three people their opinions on living in Courtfield. These are their comments: I enjoy the peace and tranquillity I can look out of my room window and watch the wildlife Everything is so clean I was able to choose my own curtains for my room, and I asked to have a power shower fitted We can always get assistance when we need it through the call system My bedroom has everything I need and I like having my own toilet The gardens are lovely in the summer It is very spacious; there is plenty of room to move about Care Homes for Older People Page 23 of 30 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. Staff are knowledgeable, skilled and on duty in sufficient numbers to meet the assessed needs of people who live at the home. Evidence: Robust recruitment practices are in place to ensure that people living at the home are fully protected.The recruitment files of three staff were examined. Application forms were completed appropriately and interview notes are kept on file. Two satisfactory references, proof of identification and Criminal Records Bureau (CRB) and Protection of Venerable Adult (POVA) checks are also on file. Recruitment of staff at the home is done in a responsible way with checks being undertaken to make sure that people are safe to work at the home, this further protects people of the home by making sure the right staff are recruited. Staffing levels at the home are good. The home has separate staff who are responsible for the catering in the home and use an agency for the cleaning of the home. People living at the home say, There are enough staff working here and they come quickly when I ring my bell. Although one individual felt that there could be more staff, A bit more one to one Care Homes for Older People Page 24 of 30 Evidence: would be nice to build up relationships Staff say that they do spend time chatting to people when they can, they feel it is an important part of the care they give. The staff all carry individual pagers to attend to people promptly. Relatives told us that they visited regularly and found the staffing levels good. There is a clear induction and training programme which meets the skills for care standard. Over 70 of the staff have completed National Vocational Qualifications (NVQ) level II or above. Staff have also attended specialist training in areas such as, palliative care, diabetes, dementia and on the day of the visit, deprivation of liberty, training. The home is clearly committed to staff training and making sure people who work at the home care for people safely. Staff say that they have regular supervision and feel supported by the management of the home. Care Homes for Older People Page 25 of 30 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. The manager is proactive in all areas of administration and management, and provides good leadership in the home. This means that the home is run in the best interests of the people living at the home. Evidence: The home is well managed. The registered manager is very experienced in care. Shes completed the right training to make sure she can do her job safely. The AQAA (Annual Quality is Assurance Assessment) was thoroughly completed and returned promptly. Health and safety is regularly monitored by the manager and the staff. Records were reviewed in areas such as gas, electrical and hoist safety. Health and safety records were well organised. The AQAA states that all equipment has been serviced and maintenance and safety checks are up to date. General training is being provided in areas such as health and safety, food hygiene and first aid. This ensures that everyone is in a safe environment. Care Homes for Older People Page 26 of 30 Evidence: The fire book is in good order and risk assessments are in place. There is clear evidence of staff on duty when fire drills are carried out. The accident book was completed satisfactorily and a record of any action taken was recorded in the individual care plan. The home works in full cooperation with other agencies and has completed work where recommended by both fire and environmental agency. All accidents are recorded as required in an accident book and maintained in line with data protection. The service makes sure that there are regular monthly visits to the home from their management representative who completes a report on their findings. This is to make sure the manager is well supported and the quality of the home is maintained. Relatives tell us that they have confidence in the manager and feel shes easy to approach and will deal with any concerns that they may have. People living at the home say the manager, Is lovely and she always has time to talk to us. Staff commented that they feel the home is well run and they feel well supported. People have their views taken into account there are twice yearly resident meetings and regular staff meetings. There are individual reviews with quality questionnaires sent to the staff, relatives and other stake holders. These views are taken into account in the future development of the home. The staff also have a comments box in the staff room to put forward their opinions and ideas. It was recommended at the inspection that the manager considers a similar comment/suggestion box for people living in the home and also consider increasing the frequency of residents meetings. This is to further develop opportunities for people to have their say and express their opinions in the home. Care Homes for Older People Page 27 of 30 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 30 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 14 The appointment of an activities coordinator would help improve the organisation of activities for people in the home. The service should seek further ways to encourage peoples opinions for instance a suggestions box and increasing the frequency of the residents meetings. 2 38 Care Homes for Older People Page 29 of 30 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). 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