Care Home: Davlyn House

Similar services:

• Maple Lodge
• Heathlands
• Aston Court Nursing Home
• Breme
• Ravenhurst
• Bank House
• Inspirations
• Westmead

What the care home does well Care planning is person centred and provides very comprehensive information about all aspects of the care and support needed to meet health and personal care needs. There is also detailed information about the background and social care needs of people, ensuring their chosen lifestyles are known and met. This is a small home providing an exceptionally high standard of care in a comfortable, homely setting. Individual relationships are strong between staff, people using the service and their relatives. The atmosphere is very relaxed and visitors clearly feel comfortable and quite at home when visiting. There is a good daily working relationship between staff and the District Nursing Service. This was confirmed in discussions with a visiting nurse, also seen on previous inspections. She again confirmed that there was strong commitment from staff to the needs of people using the service and any concerns were referred at an early stage and managed in an atmosphere of teamwork. People resident at Davlyn House, relatives and other visitors have consistently given a positive view of care in this home over a long period of time. Activities are provided by two members of staff who lead on activities, but supported well by all other staff. Individual activity programmes, whether 1:1 or on a small group basis are provided with input from social history information and discussions with people individually. The result is a programme of stimulating activity to meet the social and recreational needs of all people using the service. Routines are geared to the needs of people in the home. Changes to staffing routines are ongoing to accommodate the changing needs and choices of people in the service the service is person and not staff driven. What has improved since the last inspection? The range of activities has been extended and also the contacts with community groups. Apart from the activities co-ordinator already providing a range of options, another member of staff with particular interest in activities has been allocated time to further increase/strenghen this area of service provision that the home feels is an integral part of total care provision. A wider range of activities has been provided. Policies and procedures have been reviewed and updated and so have the statement of purpose and service users guide. The service have worked with the dietitian and district nurses to further improve the health care of people using the service. This has taken the form of joint discussions, training and advice. The AQAA states "The Community Matron has made a contribution in areas specific to the client group for whom we care". The home have looked at issues regarding restraints in the home and their relevance to the Deprivation of Liberties Standards. This has reviewed the protection of people in the service. Ongoing refurbishment and redecoration has continued as usual, with many areas further upgraded with new furniture, fittings, equipment and redecoration. The providers continue to provide a well presented environment for people to live in. The garden has been completely landscaped with greatly improved access for wheelchairs and with handrails, allowing people easy and safe access to this very pleasant area. The new summerhouse ensures people can gain enjoyment of the garden area throughout the year. Targets have been met to ensure more than 80% of staff hold the NVQ qualification. Further changes to the flexible shift patterns have ensured that staff are available at crucial peak times of need. Staff training has taken place in many areas of both mandatory and additional care value training including: Infection control, moving and handling, dementia care, first aid appointed persons, diabetes awareness, bowel care, pressure area care, epilepsy awareness and medication training. Some improvements identified in the last report required in relation to medication were actioned and there were no shortfalls in relation to medication administration identified during this inspection. What the care home could do better: Some improvements could be made in the recording of daily notes of people using the service. Some records are good, others brief and not very informative. It is important to provide more information to substantiate the high standards of care being provided. Two written references should be obtained for all new staff prior to employment. This ensures people are fully protected. Training is needed for staff in the administration of rectal diazepam prescribed for one person. Assessments of competence are part of this process. It is also important to obtain a clear protocol from the prescriber for the administration of this medication. This should include timings, position, repeat dose and the point at which the 999 service is called. Key inspection report Care homes for older people Name: Address: Davlyn House 41 Bull Lane Brindley Ford Stoke-on-trent Staffordshire ST8 7QL     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: Peter Dawson     Date: 2 8 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 29 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 29 Information about the care home Name of care home: Address: Davlyn House 41 Bull Lane Brindley Ford Stoke-on-trent Staffordshire ST8 7QL 01782512269 01782517645 lesleyflatley@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Heath,Mr David Heath care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 20 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 categories: Old age, not falling within any other category (OP) 20 Dementia (DE) 20 Physical Disability - over 65 years of age - (PD(E)) 2 Date of last inspection Brief description of the care home Davlyn House is a detached modern building situated in the village of Brindley Ford, surrounded by countryside. The garden has recently been landscaped and covers an area of half an acrea of land, with excellent access for people. The home can accommodate up to 20 elderly people - some of whom may require dementia care and Care Homes for Older People Page 4 of 29 Over 65 0 20 0 20 0 2 Brief description of the care home some may have a physical disability. There is one shared bedroom the remainder are for single use. There are three lounge areas, conservatory and separate dining area. There are two assisted bathrooms and a shower facility on the ground floor. There are no en-suite facilities but adequate number of toilet areas throughout the building Furnishings, fittings and equipment are to a high standard and there has been a very commendable improvement and replacement programme over recent years, providing a comfortable, homely environment. Davlyn House provides a very personalised and individualistic service for people, reflected in the consistent 100 occupancy of the home. 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: 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: The last Key Inspection of this service was on 22nd January 2007. An Annual Service Review of the service was completed on 14th April 2008 and confirmed that excellent services continued to be provided for people using the service. This unannounced Key Inspection was carried out by one inspector on one day from 08:30 - 17:00. The service completed the AQAA (Annual Quality Assurance Assessment) and this was returned to us prior to the inspection. This is a legally required self-assessment that every service has to complete annually. It contains information about what the service think they do well, what progress they have made over the past year, what they think they could do better and their plans for improving the service over the next year. The information given was comprehensive with supporting evidence of the statements Care Homes for Older People Page 6 of 29 made. We found at the inspection that the service operated to the level described. Some information from the AQAA is included in this report. During the inspection most people were seen and many spoken with together and separately. It was possible to speak to small groups in the lounge areas and we saw and spoke with 5 visiting relatives throughout the day. We also met and spoke in detail to a visiting District Nurse who was seen twice during the inspection having visited to give insulin. Comments from people using the service, relatives and the visiting District Nurse are included in the body of this report. The views expressed showed that people were satisfied with the high standards of service provided at Davlyn House. There were 20 people in residence at the time of this inspection - the maximum number. The home runs consistently at 100 occupancy and there is a small waiting list of people prepared to wait for a place. The Registered Manager was present during the inspection and called (usual practice) the Deputy to assist whilst the inspection took place. At the end of our inspection a summary feedback was given to the Manager outlining our findings. The basis used for the assessment of the service was the National Minimum Standards for Older People. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? The range of activities has been extended and also the contacts with community groups. Apart from the activities co-ordinator already providing a range of options, another member of staff with particular interest in activities has been allocated time to further increase/strenghen this area of service provision that the home feels is an integral part of total care provision. A wider range of activities has been provided. Policies and procedures have been reviewed and updated and so have the statement of purpose and service users guide. The service have worked with the dietitian and district nurses to further improve the health care of people using the service. This has taken the form of joint discussions, training and advice. The AQAA states The Community Matron has made a contribution in areas specific to the client group for whom we care. The home have looked at issues regarding restraints in the home and their relevance to the Deprivation of Liberties Standards. This has reviewed the protection of people in the service. Care Homes for Older People Page 8 of 29 Ongoing refurbishment and redecoration has continued as usual, with many areas further upgraded with new furniture, fittings, equipment and redecoration. The providers continue to provide a well presented environment for people to live in. The garden has been completely landscaped with greatly improved access for wheelchairs and with handrails, allowing people easy and safe access to this very pleasant area. The new summerhouse ensures people can gain enjoyment of the garden area throughout the year. Targets have been met to ensure more than 80 of staff hold the NVQ qualification. Further changes to the flexible shift patterns have ensured that staff are available at crucial peak times of need. Staff training has taken place in many areas of both mandatory and additional care value training including: Infection control, moving and handling, dementia care, first aid appointed persons, diabetes awareness, bowel care, pressure area care, epilepsy awareness and medication training. Some improvements identified in the last report required in relation to medication were actioned and there were no shortfalls in relation to medication administration identified during this 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. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Pre-admission procedures ensure people have adequate information and opportunity to make an informed choice about the suitability of the home for them. Evidence: The Statement of Purpose/Service Users Guide is updated annually and contains all required information to inform people about the service provided, allowing them to make an informed decision about the suitability of the home. All have pre-admission assessments to ascertain if their needs can be met, if the home is unable to meet needs, explanations are given for those reasons. In the sample of care plans seen all 3 people were assessed by the homes staff in their current environment prior to admission and a multi-agency assessment completed by the social worker. People who are privately funded are also encouraged to seek an assessment from a social worker. Care Homes for Older People Page 11 of 29 Evidence: People are encouraged to visit the home prior to making a decision about suitability and families are part of this process. People can visit for a day or overnight stay. Staff feel it is important for people to meet others using the service to speak with them and seek their views, this also provides a more pertinent assessment that will ensure the persons needs can be fully met. All are given a contract to which they have agreed, giving clear information about fees and extra charges and details of their rights and more detailed terms of contract. The AQAA states Review follows after 6 weeks whether local authority funded resident or privately funded. This ensures people are totally happy about their choice of home before committing themselves to more permanent care. 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. The health and social care needs of people are clearly identified and are fully met. Evidence: A sample of care plans were seen for both recently admitted and people in longerterm care. The home have their own care planning format that is flexible and has been amended and added-to, producing a person centred approach based upon the principles of dignity, equality, fairness, autonomy and respect. We saw care plans that identified health care needs such as nutritional care, continence, mobility and identifying those at risk of weight loss or pressure damage with risk assessments to support people to reduce those risks. An example was a person with high dependency health care needs who had a nutritional guide based upon Dietician input and a Speech and Language Assessment. Defined inputs included liquidised diet, fortisips, fortijuice, yoghurts, pureed fruit and prescribed thickening agent for drinks. This person was cared for mainly in bed on an airwave mattress provided by the District Nursing Service and visited regularly by them. The home has a proven record over the years of meeting particularly high dependency needs such as Care Homes for Older People Page 13 of 29 Evidence: these. Care plans included social histories outlining a background of family, work, interests, hobbies and social support. These are used in providing support and input to meet peoples recreational and social needs within the home. We spoke with the District Nurse who visits twice daily to administer insulin. We have met her before on inspections at Davlyn House. She is very comfortable in the home and integrates well with the homes staff. She again confirmed that there is an excellent open working relationship with care staff and there was the usual relaxed but important dialogue about peoples health care needs. Staff can refer or ask her advice about health care concerns for any person using the service. We saw good and detailed care plans for the support needs of people having respite care and for those staying permanently. All care plans were reviewed on a monthly basis together with risk assessments for daily living. People are weighed regularly and those with nutritional deficits, more often. An example was a person with dementia care needs, constantly moving around the home and refusing to have lunch is given food on the move - that she can choose and take with her - her weight is closely monitored. The AQAA states: We use a nutritional guide and work with dietiican at the local hospital to ensure people with diet related problems have the best advice and care We saw samples of daily notes where staff summarise the care provided for the day. Some entries were good, others were short and brief and did not do justice to the total care the home is providing. Some improvements could be made in this area. Staff have good knowledge of individual needs and have had person-specific training in areas such as wound care, diabetes, epilepsy, catheter care, dementia care, palliative care and equality and diversity training. End of life care is an important part of care provision at Davlyn House the AQAA states We aim to provide a home for life and will support residents to remain with us until end of life, despite any changes in needs as long as we are able to meet those changing needs. This may be with the support of the District Nurse and GP services or on occasions the Douglas McMillan Community Nurses We looked at the medication system in place in the home. There is no self-medication apart from inhalers and sprays. All staff have completed medication training, whether they administer medication or not. Records seen for the receipt, storage, Care Homes for Older People Page 14 of 29 Evidence: administration and disposal of medication were completed correctly and accurately, there were no omissions. One person is prescribed rectal diazepam for seizures. Her seizures are severe. Staff have not had training in administering rectal diazepam, although this has been administered on at least one occasion. Training must be provided by the nursing service and competencies assessed. Only trained and named staff should administer this medication. It is also important to have a written protocol signed by the prescriber to state the timings, repeat dose, position and also the timing of 999 calls. 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. Peoples lifestyles reflect their preferences and choices and satisfy their social, cultural, religious and recreational interests and needs. Evidence: Flexibility of routines is a key factor in this home. The chosen lifestyles of people are known, recorded and met. This was clear from documentation, observation and discussions with people using the service, staff and visitors. Examples of chosen lifestyles were: A person who wishes to spend all time in her bedroom, where all care and meals are delivered. She is visited daily by her family (relative seen during the inspection) and receives all visitors there. Another person likes to walk long distances alone, sometimes in the evenings - this is recorded with a risk assessment and defines the length of time he is likely to be out and at what point actions should be taken if he does not return. He told us that this arrangement works well for him and that his time out walking alone is very important to him. The AQAA states We practice person centered care treating each individual as unique, routines remain flexible with people able to change routines as and when they wish Visiting is important and there are no restrictions. All visitors are well received, offered refreshments and move around the home in a very comfortable way. One person Care Homes for Older People Page 16 of 29 Evidence: dines daily with his wife another twice weekly - there are no charges and the quality time together is valued. Activities are provided to meet the diverse needs of people. Social histories (Life Books) are completed for all giving a summary of their family, work, interests, hobbies and preferences. These are used in tailoring care to their needs and choices and by staff to make positive engagement and ensure relevant recreational activity. Two members of staff lead on activities in the home on different days. They have a mixture of qualification, experience and specific interest, although all staff are involved in activities too as an integral part of care. Records are kept of all activities The AQAA states We use the skills of a qualified activities co-ordinator but also use skills of an existing staff member to complement the activities programme. Activities for residents have been improved overall. We continue to offer a wide range of activities and are always seeking new ideas to stimulate our residents. There is a large garden area that has been extensively re-planned recently, allowing easier and safer access. Handrails have been fitted, wheelchairs can easily access the area and a new summerhouse installed to provide a central area where people can sit an enjoy the garden area on cooler days. The whole area has been landscaped at considerable cost. People said they were using this area during the summer and enjoying this excellent facility. We spoke to people about food provision, looked at menus and observed food being served in the dining area. People were unanimous about the quality, quantity and varied choice summarised in comments such as excellent - we can have anything we wish The communal areas allow people to move between a choice of quiet, social or TV areas and this was seen during the inspection. Entertainment is provided from external sources regularly. People are able to enjoy a full and stimulating lifestyle with a variety of options. Routines reflect the diversity needs of individuals in the home. The AQAA states: Local community links are strong with local church and village and recently we have made links with local homes The home has 2 vehicles used to transport people to local community faciltiies. We saw and spoke with 5 visiting relatives during the inspection, all spoke highly of the service provided and the attitude and work of staff in supporting people. Care Homes for Older People Page 17 of 29 Evidence: Comments included The home provides excellent care, we have total confidence in the staff. If I have any concerns I can easily approach the Manager or other member of staff. One visitor did query the regularity of bathing for a person - at her request this was dealt with anonymously, but we found that regular chosen bathing times were recorded in care plans and had taken place for the person concerned and for other people. Their choice (Bath or shower) and times were recorded. The service actively supports people to be independent and to be involved in all areas of daily living in accordance with their preferences. The service is person-led. Care Homes for Older People Page 18 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. People can be sure that their views are sought and acted upon. They are protected from abuse with good procedures and training for staff. Evidence: There is a clear accessible complaints/concerns procedure in place outlining procedures and timescales for responding to complaints. Copies are included in the statement of purpose/service users guide that all people have and there is a copy in the reception area of the home for visitors. No complaints have been received by the service or by us since the last key inspection. Concerns are documented and relate to domestic type comments - an example was difficulty in extensively cleaning the bedroom of someone using the room at all times. This was dealt with by intense cleaning when the person has a bath. All staff have had training in Safeguarding Vulnerable Adults and a recent copy of the local Safeguarding procedures is available in the home. Staff had practical knowledge of the procedures. Staff have had training in the Mental Capacity Act and the Manager has had training in Deprivation of Liberty Safeguarding that she has cascaded to other staff. She is presently sourcing suitable training for all staff. The AQAA states: we assume that all residents have capacity to make all their decisions unless proved otherwise and staff Care Homes for Older People Page 19 of 29 Evidence: are aware that residents capacity can vary daily and they assess this on every occasion a decision is made In the past year the home have also Looked at issues regarding restraints in relation to the Deprivation of Liberty Standards. Care Homes for Older People Page 20 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. This is a high standard environment, exceptionally well maintained and providing a safe, homely place for people to live. Evidence: The majority of accommodation is on the ground floor - only 4 bedrooms and toilet area are located on the first floor - access is via stairs or stair-lift. People have a choice of 2 assisted baths and shower facilities on the ground floor. There are no ensuite bedrooms. All have wash-hand basins and commodes are provided as required for most people. There are 7 toilet areas on the ground floor and located near to the communal areas and bedrooms. All bedrooms are for single use with the exception of one where the people have consented to share. The provider and manager have ensue that the physical environment of the home provides for the individual requirements of the people using the service and is appropriate for particular lifestyle needs. The providers have a good record of improvements that have been made to most areas. The home is attractive and homely, standards of hygiene throughout are excellent. Additions and refurbishment since the last inspection include: New lounge furniture, bedroom furniture and upgrading of some rooms, large screen TVs to improve viewing experience, new central heating boiler and needed improvements to the laundry area. Care Homes for Older People Page 21 of 29 Evidence: The garden area has been landscaped providing improved access with handrails and ramps and a new summerhouse where people can sit central to the garden area on cooler days. The AQAA states: The garden room has been used by residents to enable them to get the most from the garden throughout the year. We noticed that the CCTV system, in use to alert visitors to the front door, still has cameras in the main corridor area that are not and have never been used. We suggest that they should be removed to remove any doubt about their use. Money is spent on the environment in the best way so that outcomes are improved and maximised for people using the service. 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 numbers and skill mix of staff ensure people are supported and that their needs can be met. Training and recruitment procedures ensure people are safe. Evidence: People and visitors expressed confidence in the staff. Rotas show well thought out ways of making sure the home is staffed efficiently, with particular attention given to busy times of the day and the changing needs of people using the service. The staffing structure is based around delivering outcomes for people and not led by staffing needs. Staff undertake all statutory training, evidenced by the training matrix but also undertake external courses and qualifications beyond the basic requirements. Of the 17 care staff only 3 have not completed NVQ training for particular reasons. Additional training is provided for individual person, or diagnosed particular conditions, ensuring a knowledgeable, skilled and experienced workforce. The AQAA states All staff work in a way that promotes the dignity and choice of residents, whilst ensuring their safety and security and promoting their independence. There was evidence to support this statement. We looked at a sample of 2 staff files. All required police checks had been carried out prior to employment and other documentation in place with the exception of one Care Homes for Older People Page 23 of 29 Evidence: instance, where only 1 reference had been obtained prior to employment. It is necessary to obtaine two written references prior to employment to ensure that people using the service are protected. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A well run and managed home, where a well trained and highly motivated staff group ensure people experience high quality care. Evidence: The Registered Manager has 8 years experience in that role and has obtain NVQ4 and the Registered Managers Award. The Deputy also has the NVQ4 in care. The Manager takes a positive lead in the home and is supported by an enthusiastic and caring staff team. Staff retention is excellent, many staff have more than 10 years service. The two owners play an active role in the home carrying out financial management and supporting staff in the daily running of the home were needed. There is an open and very positive relationship between owners, manager and staff and boundaries are clear - the Registered Manager has the autonomy to run the home and ensure high standards of care - the owners provide support financially, administratively and practically where needed. The result is well run and managed home. Dialogue at all levels is open with people in the home, managers and staff all Care Homes for Older People Page 25 of 29 Evidence: having direct access to the owners. This model works exceptionally well in this home. The Manager possesses a well developed awareness and understanding of equal opportunities issues, good people skills and is responsive to the needs of people using the service. Quality assurance is assessed with annual questionnaires sent to people in the home and also to GPs, District Nurses, Dietician and Pharmacist. Feeback from relatives is sought in day to day discussions with them, several told us that they would be comfortable raising any areas of concern with the Manager or staff. We saw records and in discussions established that all staff are supervised on a regular basis. There is a formal supervision plan for the year. The AQAA returned to us prior to the inspection contained excellent information, verified during this inspection, that indicated a high level of understanding about the importance of equality and diversity and there was a range of evidence showing how the service have listened to and responded to the views of people using the service. Policies, procedures and working practices are reviewed regularly to ensure that people are safe. All staff have a good understanding of risk assessment processes that underpin and promote independence, choice and autonomy. 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 9 Training is required for staff in the safe adminsitration of rectal diazepam. A clear protocol from the prescriber must be obtained. Two written references must be obtained for all staff prior to employment. This ensures maximum protection for people. 2 29 Care Homes for Older People Page 28 of 29 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 29 of 29 - 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!