Care Home: Cumbria House

Similar services:

• The Shelley
• Springfield House
• Sutton Lodge Nursing Home
• St Helier`s Residential Hotel
• St Joseph`s
• Ridgemount
• Wingham Court
• Old Hastings House

What the care home does well It is evident that the Registered Provider is committed to providing a high standard of accommodation. People who live in the home comment: `Well in a sense I am happy here but it is not my own home`. `Staff are always polite and I have no complaints`. `We had a real good time yesterday, dancing and singing with the entertainer`. `I like my bedroom, I can go into the garden when I like and I am quite happy here`. Care Managers comment: `They are very kind to clients and the clients are happy`. `They treat people as an individual, responding to care needs appropriately and sensitively`. `Excellent at communication`. `The Registered Manager responds well to emergencies, in particular with a situation where I needed to make a placement. She and her team communicated well with the client and her family extremely well, and under difficult circumstances`. Relatives comment: `Just to say thank you for all you have done for my relative, it was very much appreciated`. `A very big thank you for your care of my granddad. I know the he was very happy living at Cumbria House`. `With many thanks for taking care of my relative. The staff are helpful, patient and polite`. `Overall I am happy with the care being provided to my relative`. A GP comments: `The staff are very approachable and helpful. They are dedicated to the residents and their care and make them feel as at home as it is possible. The staff have taken appropriate steps to safeguard themselves and their residents during the flu outbreak`. Staff comments: `I feel that the home does well in all aspects of caring for the elderly, training of the staff, and has a high standard of quality management. I feel all the residents at Cumbria House are content and happy. All of the staff work well together as a team to produce a healthy and relaxed environment`. `I am very happy in my choice of profession and feel that Cumbria House has a warming and inviting atmosphere. It is a well respected residential home`. `We look after clients well, keeping them happy and giving them what they need`. `We promote independence of all the residents within their capabilities. The home is always clean, fresh and tidy. We have an `open door` policy and everyone is made to feel welcome`. `Residents are well cared for`. What has improved since the last inspection? The major refurbishment and redecoration of the home has been completed and the garden has been landscaped. All of the care plans and risk assessments have been reviewed with the people and their relative or representative. The home`s brochure has been amended to make it more user friendly and examples of menu choices and activities have been included. The home has modernised the laundry, installed a sluice and purchased new kitchen equipment. What the care home could do better: People living in the home comment: `Sometimes I have to wait for the staff to come, there is not enough on duty`. Some care plans and risk assessments do not contain full details of care to meet the needs of the people. The risk assessments do not give staff guidelines of how to move people safely. The activities in the home do not give everyone the opportunity to be socially stimulated. Handwritten information on the medical administration sheets is not countersigned to reduce the risk of error. People who use the service, relatives and staff told us that there is not enough staff on duty. The lack of staff will not ensure that the needs of the people living in the home are fully met. To make sure that all new staff have a thorough induction and are provided with the mandatory training to move people safely. To update the supervision programme. Key inspection report Care homes for older people Name: Address: Cumbria House 84/86 Shorncliffe Road Folkestone Kent CT20 2PG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Penny McMullan     Date: 2 0 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Cumbria House 84/86 Shorncliffe Road Folkestone Kent CT20 2PG 01303254019 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: cumbriahouse@ashwoodhealthcare.co.uk Cumbria House care home 32 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 to be accommodated is 32 The registered person may provide the following categorY of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Cumbria House is a detached property in Folkestone, situated within easy walking distance of local amenities and public transport. A major refurbishment has been completed with improved accommodation, such as en suite facilities, and a safer and more comfortable environment. All rooms are now being used for single accommodation and there is a shaft lift, enabling access for people to all parts of the home. There are communal lounges and a separate dining room. There are mature, well maintained gardens, which have ramps for easy access for wheelchair users. There is a large patio area where service users can sit and relax. Care Homes for Older People Page 4 of 28 Over 65 32 0 2 8 0 1 2 0 0 9 Brief description of the care home The current fees for the home are £475 to £525, according to the assessed needs of the person. A copy of the latest inspection report is available to view in the foyer of the home. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection was carried out over a period of time and concluded with a visit to the home on 20th August 2009, between 09.30am and 6pm. The last key inspection was carried out on 24 October 2007. The Registered Manager assisted with the inspection from 12.30 pm and the Registered Provider arrived later in the afternoon. Postal surveys were forwarded to the home to distribute to the people who use the service, staff and health care professionals. We sent ten surveys to the people who use the service, ten to the staff and five to health care professionals. No surveys were received from the people who use the service, three were received from staff and four from social care professionals. Feedback from all of the surveys and any comments have been included in this report. The care of three people was tracked to help gain evidence as to what it is like to live in the home. A partial tour of the home was made and we also looked at care plans, Care Homes for Older People Page 6 of 28 risk assessments, training records, staff files, quality assurance and complaint records. Three members of staff were also involved in the inspection. The Annual Quality Assurance Assessment (AQAA) that was sent to us by the service was clear and comprehensive. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. The home returned the Annual Quality Assurance Assessment (AQAA) within the required timescale. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? The major refurbishment and redecoration of the home has been completed and the garden has been landscaped. All of the care plans and risk assessments have been reviewed with the people and their relative or representative. The homes brochure has been amended to make it more user friendly and examples of menu choices and activities have been included. The home has modernised the laundry, installed a sluice and purchased new kitchen Care Homes for Older People Page 8 of 28 equipment. 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. 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 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service and their relatives are given the information they need before moving into the home. Care needs assessments are carried out to make sure that the home can meet individual agreed care needs. Evidence: We looked at the information provided to people before they decided to move into the home. We spoke to the people living at Cumbria House and they told us that they, or their family, were given information about the home before they moved in. Two people confirmed that they had had the opportunity to visit the home prior to admission. A person living in the home comments: They came to see me and I visited the home with my relatives before I came in. The Registered Manager carries out a care needs assessment to make sure the home Care Homes for Older People Page 11 of 28 Evidence: can meet individual needs. Three assessments were looked at and contained sufficient information. Information and assessments are also in place if the people are placed by the local authority. Intermediate care is not provided in this home. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Improvements are required in the care plans and risk assessments to provide sufficient detail to meet individual needs. People are supported to take their medication safely. The people in the home feel they are treated with respect and their dignity is upheld. Evidence: Each person has a care plan outlining their health, personal and social care needs. The plans are reviewed on a regular basis and the people have signed to agree with the care to be provided. We looked at three care plans. Two of the plans were very detailed with specific individual care needs and preferences, outlining what the person could do for themselves. For example Mrs X is able to wash her face and hands and prefers to sit down when having a wash. Another plan showed how to support an individual to improve her nutrition by giving small portions at meal times and offering drinks and snacks at different times of the day. However, one plan did not contain the full information required. The information was not detailed enough to make sure individual preferences and outcomes for the person Care Homes for Older People Page 13 of 28 Evidence: is in place. The registered Manager told us that the company had just introduced this format. On speaking to the Registered Provider he told us that the format would now be reviewed to include the relevant information. The plans also contain a variety of risk assessments, for example nutrition, moving and handling and behaviour. The moving and handling risk assessments do not inform staff of what manoeuvres to carry out to make sure everyone is consistently moving the person in a safe way. For example, one assessment states: Use the hoist when needing to transfer to chair, bed, and commode with two carers. Make sure Mrs X listens to instructions. In the special considerations section it states: Mrs X is refusing to use her right arm a lot of the time. There are no guidelines for staff to follow as to how to move the person or how to encourage and support her to move her arm. The assessment does not show what is in place to minimise the risks if a different move is required, when the person is unable to move her arm. Improvements are required in this area. We are confident that the new format of care plans will be reviewed and that moving and handling risk assessments will be developed to include the full details. Therefore no requirement will be made in this report. The people told us that they are happy with the care being provided and said the staff always do their best to make sure they are well cared for. The atmosphere in the home was calm and friendly. The health care needs of the people are monitored through the care pan. This includes their nutrition, skin integrity and continence care. All appointments with health care professionals are recorded. Carers were seen putting pressure relief cushions in the lounge chairs and wheelchairs to assist in the prevention of pressure sores. If required the District Nurse or community Psychiatric Nurse also visit the home. Regular visits from the chiropodist, visiting dentist and optician are also in place. We also saw that people were taken to their rooms for private consultations when the doctor came. Currently all of the people in the home are supported to take their medication. There is a small medication room with a refrigerator for cold storage. The storage and medication administration sheets (MAR sheets) are in good order. Hand written entries in the MAR sheets are not being countersigned to reduce the risk of error. The MAR sheets are audited by the manager on a regular basis and all staff administering the medication have been trained to do so. . On the day of the visit the medication round did not start until 09:30 as there was only three members of staff on duty, helping people to get up and providing personal care. The round did not finish until 11 am. This does not make sure that the people who use the service are receiving their medication at the time prescribed. The Registered Manager told us that this does not Care Homes for Older People Page 14 of 28 Evidence: happen on a regular basis and the issue of timing will be addressed to make sure people receive their medication at the right time. The people told us that the staff always knock on their bedroom doors before entering and they treat them with respect. They said the staff are polite and happy to help. The staff was observed talking to the people and making sure they were given the choice of where to sit or what they wished to do. Most of the staff were polite and respectful in their approach and conversation with people. However, there was one concern at the time of the visit when a new carer was trying to move a person and did not communicate with her in a sensitive, caring manner. The inspector requested the Registered Manager to help the carer. The Registered Manager took control of the situation and supported the carer to move the person safely. We also saw another carer reassuring and moving a person from a wheelchair to a chair in the lounge. The person was encouraged to choose where to sit and the carer made sure that a pressure relieving cushion was in place so that the person would be as comfortable as possible. Care Homes for Older People Page 15 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service are supported to make daily choices about their lifestyle. The lack of planned activities does not give all of the people the opportunity to exercise their choice in leisure and social activities. People enjoy the food and have a varied diet. Evidence: The people told us how much they enjoyed an entertainer who had been to the home the previous day. They said they had a good sing along and some people enjoyed a dance. The home does not have a formal activity programme in place, although bingo is played once a week and the home has purchased board games such as dominoes, snakes and ladders, indoor ten pin bowling, card games and ludo. There is no dedicated person to provide the activities and organise such events. Two of the people said they were bored although they did a lot of reading and watched television. One person said that he did, on occasions, play draughts but this has stopped now. The home does provide outside entertainment such as Music for Health Workshop, which enables the people to sing, dance, do some exercise, and take part in musical quizzes. Two of the people said how much they enjoyed these sessions. The home has a volunteer who accompanies people to the hospital and arranges for some of the people to go to the theatre. Last week there was a barbeque with relatives and Care Homes for Older People Page 16 of 28 Evidence: friends. Hobbies are recorded in the care plan so that each person has the opportunity to say what they would wish to do. The lack of staff to organise the activities does not give all of the people the opportunity to receive stimulating social care activities. The main lounge is laid out with a small number of chairs in different areas. One person said that she could not always watch the television as there are only a few chairs in front of it. She told us that this was not really a problem as she preferred to read and said she could watch her own television in her room if she wished. The main lounge has fixed staff call bells in place, however, those people who are less able and need help to move out of their chairs are not able to reach the bells. Less able people do not, therefore, have the opportunity of ringing for staff, they can only call out and wait for staff to come. People are encouraged to maintain contact with family, friends and the local community. The people told us that there are regular church services and some people are able to go to the church of their choice on Sundays. They said that they regularly attend meetings at the local Salvation Army Hall. A relative told us that she visits every day at different times and is always made welcome by the staff. Staff were seen supporting the people to make their own decisions. For example where to sit and what they would like to drink. The people also told us that they are able to get up and go to bed when they wish and there is always a choice of food. One person is currently being supported by an advocate to help her make decisions. Several people said they had personalised their bedrooms with family photographs and their own bits and pieces. All of the people spoken with at the time of the visit told us that overall the food is good in the home. One person said it was not always to his personal choice but he could pick something else on the menu if required. People were seen enjoying their meal in a friendly and relaxed atmosphere in the dining room. The meal being served was varied to the choice of the person and they were individually offered a choice of drink with their meal. Staff were available to offer assistance if required. The meals looked appetising and the people told us that they were enjoying their meal. Nutritional needs are assessed and recorded in the care plan to make sure that a healthy diet is provided to individual choice. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service know their concerns would be taken seriously and any complaints will be listened to and acted upon. Arrangements are in place to make sure the people are protected from abuse. Evidence: There is a complaints procedure in place which records timescales and outcomes It is on display in the foyer of the home. The people told us that they would complain if they had any concerns. Some said they would tell their family whilst others said they would talk to the staff or the Manager. They all felt that their concerns would be listened to and action would be taken to resolve any issues raised. There has been two complaints since the previous inspection which were investigated within the required timescales. The Registered Manager has completed Stage 2 in Safeguarding for Adults training. She has provided the majority of staff with this training and they have also received Mental Capacity training. This makes sure that they are trained to recognise any signs of abuse. Staff spoken with at the time of the inspection are aware of safeguarding procedures and who to report such matters to, both in and outside of the home. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well maintained to make sure that the people live in a safe, comfortable, homely and pleasant environment. Evidence: Since the previous inspection the major refurbishment of the home has been completed and it is evident that the Registered Provider is committed to providing and maintaining a high standard of accommodation. All rooms now have en suite facilities and the home was completely refurbished and redecorated. The home has the necessary equipment in place to promote and support the people with their mobility. The home is furnished and decorated to a good standard and is well maintained with pleasant gardens for the people to enjoy. People were observed moving round the home, choosing where to sit, in the garden or smaller lounge or returning to their rooms if they wished. Bedrooms are personlised to individual wishes and there is a maintenance person who makes sure the home is in good order. A new cooker has been installed in the kitchen and there was a pleasant smell throughout the home. One relative comments: The home is always clean and has a pleasant odour. New washing machines have been installed in the laundry and there are procedures in place to control the risk of infection. A new sluice has been installed and all of the staff have received infection control training. To reduce the risk of infection there is antiCare Homes for Older People Page 19 of 28 Evidence: bacterial gel on the table in the foyer for visitors to use. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The current staffing levels do not ensure that the care needs of the people using the service will be fully met. The people who live in the home are protected from the recruitment process in place. Evidence: The Registered Manager told us that the home is in the process of recruiting staff. There is currently one Deputy Managers post, one senior carer and one carer vacancies. The additional vacant hours are being covered by existing staff who are working additional hours to cover the rota. Since the previous inspection the staffing levels were reviewed and additional shifts were introduced to cover at busy times. However, some staff have now left and the home is now managing with three staff on in the morning, three in the afternoon and two waking night staff. Although the Registered Manager is supporting the staff, and providing direct care, the needs of people recorded in care plans may not always be met by current staffing levels. People who live in the home comment: I suppose there is enough staff on duty but I am able, others that need more help need more staff but I have no complaints. I moved into the home over a year ago and I am happy with the care. Sometimes more carers are needed but they are always helpful and polite. The staff rotas indicate that the home is struggling to maintain staffing levels and Care Homes for Older People Page 21 of 28 Evidence: there will be additional pressure on the established staff team as the new recruits are employed. They will need to receive shadowing and induction training. At the time of the visit there were twenty six people living in the home and one being admitted. If further admissions take place the home will have to consider using agency staff to meet the needs of the people until the permanent vacant posts are filled. During the month of August there has been a total of nine falls, seven which occurred during the night time period and the Registered Manager told us that she will investigate these accidents and if required review night staffing levels. The people who use the service and relatives told us that there is not enough staff on duty and at times the residents have to wait for the staff to respond to their calls. They acknowledge that the home is doing everything to address these issues and told us that the staff do the best they can. The lack of staff is having an impact on the care being provided, for example, the late medication round and lack of a full programme of individual activities. The Registered Provider and Manager are aware of the shortfalls in this area and are actively recruiting to improve staffing levels, therefore a requirement will not be made at this time. The people who use the service are receiving care from staff that is qualified. Over fifty per cent of the staff have achieved NVQ 2 or above and there is an ongoing programme to make sure the staff have the right skills to do their jobs. Three staff files were looked at to make sure that the people are protected by the recruitment procedures. The files evidenced that all appropriate checks are in place to make sure that staff are safe to provide care to the people in the home. Although proof of identity is in place a recent photograph of each member of staff is not on file. The Registered Manager told us that this would be put into place and all files would be updated. The majority of staff have received mandatory training and there are more courses booked for September to update their practice in moving and handling. There is a training matrix in place and each member of staff has a training form in their personal file. A new recruit who commenced in August did not have an induction in place. The carer had been working just over two weeks and although the rota showed she had shadowed senior staff, no induction or mandatory training had been provided. She was observed talking to a resident inappropriately whilst supporting the person with her mobility. This is not good practice and we called the the Registered Manager to Care Homes for Older People Page 22 of 28 Evidence: intervene. The Registered Manager told us that this person was recruited in her absence and she was not aware that mandatory training had not been provided. She told us that the carer would not be moving people and will work with another carer at all times, until the required training has been completed. A requirement will be made in this report to make sure that all staff receive induction training and are competent to move people in a safe and respectful manner Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed in the best interest of the people who live there. The health, safety and welfare of the residents is promoted and protected. Evidence: The manager of the home is qualified and experience. She has recently completed training in distance learning courses, for example, Level 3 in Dementia Care and Level 3 in Palliative Care. Staff spoke positively of the manager and feel she supports them well. She is aware of the shortfalls in the home and is taking action to address these issues, such as staffing levels. We are confident that, when staff are recruited, the home will improve the service to the people. The AQAA was completed with clear, relevant information to evidence the development of the service. The Registered Provider visits the home on a monthly basis to make sure the home is running smoothly. A quality assurance programme is in place and the results were displayed in the foyer of the home for everyone to see. The Registered Manager told us that she walks round the home daily to get feedback from the residents that Care Homes for Older People Page 24 of 28 Evidence: everything is satisfactory. The ethos of the home is an open door policy so that everyone is able to have their say on how the home should be run. The people who use the service told us that the manager talks to them on most days to ask how they are and if they have any concerns. There are systems in place to make sure that the people who use the service have their financial interests protected. The home supports some of the people with their financial affairs, whilst others are supported by their families or solicitors. All transactions are recorded, receipts filed and the records are audited by the Registered Manager. The Registered Manager told us that the programme of supervision is not fully up to date. There is evidence that some staff have received supervision this year, however without a Deputy Manager and a senior carer in place the programme has lapsed. The Registered Manager is aware of this shortfall and told us that this will be addressed when a full compliment of staff is in place. She is providing direct care to cover some shifts in the home and is able to observe and supervise staff at these times. Peoples health, welfare are generally promoted. There is a mandatory training programme in place. Improvements are required to make sure all staff receive induction training. As previously stated int he staffing outcome, a care was found to be working without starting her induction or mandatory training. Accidents are recorded and monitored for trends. During the first three weeks in August there were several falls. The Registered Manager was only made aware of this information this week as she has just returned to work after a two week period of absence. It is normal practice that the accidents are audited on a monthly basis to identify trends. It was found that the majority of the accidents happened during the night shifts, therefore, she told us that she will be assessing the needs of the people during the night to decide if additional staffing levels is required. The fire book was in good order, weekly tests and fire drills have been carried out to make sure staff and the people are aware of what to do in an emergency. Environmental and fire risk assessments are also in place. The home has thermostatic valves fitted to make sure that the water temperature is safe however the water is not currently tested or recorded. The Registered Manager implemented a recording process at the time of the inspection. She told us that the staff also take the temperature of the bath water to make sure the residents are safe. The information in the AQAA confirms that the appropriate servicing and checks of equipment is in place. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 30 12 The Registered Provider to make sure that all members of staff receive the common induction training developed by Skills for Care, including training on the principles of care and safe working practices To make sure that staff have the skills to do their jobs well and are competent and safe to move the people 30/09/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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 28 of 28 - 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!