Care Home: Doulton Court Care Home

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What the care home does well People living in the home told us they were well cared for by a committed and competent care team. They were very satisfied with the care, approach of staff and the overall service provided by the home. The management take care to ensure that each persons needs are assessed before entering the home. The people live in clean, well decorated and maintained comfortable accommodation. Each person is encouraged and supported to be independent and take part in meaningful activities. They are also offered choices about what they wish to do and to make decisions about how they spend their lives. Staff communicate well with them and respect their choices and decisions.Doulton Court Care HomeDS0000068350.V375342.R01.S.docVersion 5.2There is a programme of education and training provided for the staff which ensures that staff know how to care and support the people who live at the home. People told us that they are cared for by a team of staff who meet their individual health and personal care needs in a sensitive manner. They are lead by an experienced manager who has knowledge about management, the care and support for people. The staff told us they felt valued by the manager and feel part of a team to improve, help and support the people living in the home. What has improved since the last inspection? There has been a programme of redecoration and refurbishment of the home over the last year. This has resulted in. New carpets provided throughout the home in corridors and stairways. New carpets and floor covering in the reception, offices, dining rooms, lounges as well as 15 bedrooms. Seven bedrooms had been redecorated. New furniture has been provided in the ground floor lounge as well as new TV and DVD. New bedding had also been provided. The people told us they liked the improvements and found the home comfortable and clean throughout. They have provided 19 special beds which are adjustable to suit the needs of each person and have been provided to improve the quality of life for people in bed and the make it easier and safer for staff to care and support them. A bathroom has been converted into a large, disabled access shower room. What the care home could do better: There were no requirements or recommendations as a result of this inspection. We discussed with the manager about ensuring that our new name was in their complaints procedure and all information referred to our Cambridge office. This was acted upon by the manager during our visit. Where there are improvements this was being addressed either by the manager and her staff or the company using their established quality assurance system. Key inspection report CARE HOMES FOR OLDER PEOPLE Doulton Court Care Home Alford Road Sutton on Sea Lincolnshire LN12 2HF Lead Inspector Tobias Payne Key Unannounced Inspection 13th May 2009 08:20 DS0000068350.V375342.R01.S.do c Version 5.2 Page 1 This report is a review of the 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. 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. Doulton Court Care Home DS0000068350.V375342.R01.S.doc Version 5.2 Page 2 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 Doulton Court Care Home DS0000068350.V375342.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Doulton Court Care Home Address Alford Road Sutton on Sea Lincolnshire LN12 2HF Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01507 441026 01507 442815 doulton.court@fshc.co.uk www.fsh.co.uk Doulton Court Limited Mrs Lynda Cunnington Care Home 41 Category(ies) of Dementia (41), Old age, not falling within any registration, with number other category (41), Physical disability (41) of places Doulton Court Care Home DS0000068350.V375342.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered provider may provide the following category of service only: Care home only - Code N 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 Physical disability - Code PD Dementia - Code DE The maximum number of service users who can be accommodated is : 41 25th May 2007 2. Date of last inspection Brief Description of the Service: Doulton Court Lodge is a purpose built care home which provides nursing and personal care. This includes care for older people, people with a physical disability and people who have a dementia. The home is situated on the outskirts of the town of Sutton-on-Sea. Public transport is available and the shops and local facilities in the town are about 100 metres away. The two-storey building provides accommodation for 41 people. There are 35 single rooms, 4 of which are en-suite, 5 double bedrooms, 4 of which are also en-suite. Access to the first floor is by stairs or a passenger lift. In the grounds are also two self-contained bungalows, which can house up to two people in each. There is a large lounge and dining room as well as smaller sitting rooms on both floors. There are various bathrooms and toilets throughout the home and a new shower room has been provided for the increasing number of people who prefer a shower to a bath. Outside, there is an enclosed central courtyard with a fishpond and a grassed area, where people can sit out in good weather. To the front of the building is a large car park for visitors and staff. The philosophy of care is to provide an atmosphere in which all people in their care, whatever their physical, psychological & spirit needs, feel able to live their lives contentedly in a pleasant and safe environment. Doulton Court Care Home DS0000068350.V375342.R01.S.doc Version 5.2 Page 5 The fees on the day of the inspection visit ranged from £360 to £683 - 01p each week depending on the room occupied and the person’s care needs. Extra charges were for chiropody which ranged from £10 to £12, hairdressing which ranged from £6 to £25, personal newspapers and magazines. Information about the home including the statement of purpose, service user’s guide and a copy of the last inspection report can be obtained from the manager or administrator. This information together with leaflets can also be found in the reception area of the home. Doulton Court Care Home DS0000068350.V375342.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. The inspection which was unannounced took place over 6½ hours. The registered manager was present throughout the inspection and was given feedback at the end of the inspection as well as the regional manager for the company who came to the home at the end of this inspection visit. The main method of inspection used was called ‘case tracking’ which involved selecting 2 people and tracking the care they receive through the checking of their records, discussion with them, the staff and observation of how the staff and people living in the home related to one another and care practices in the home. We looked at a sample of care records and walked around the home to see the quality of accommodation and visited some of the bedrooms with the permission of the people living in the home. We spoke with 7 people living in the home, a community nurse, 2 visiting tissue viability nurses, 5 visitors as well as 6 members of staff. An (AQAA) Annual quality assurance assessment was completed by the manager and sent to us before our inspection. This is a self- assessment document completed by the manager of the care home. It sets out evidence from the provider to demonstrate that they are meeting the Care Home Regulations. Before this inspection we sent out 10 questionnaires to the people living in the home and 5 to staff to obtain their views about the home. Their opinions are reflected within this inspection report. What the service does well: People living in the home told us they were well cared for by a committed and competent care team. They were very satisfied with the care, approach of staff and the overall service provided by the home. The management take care to ensure that each persons needs are assessed before entering the home. The people live in clean, well decorated and maintained comfortable accommodation. Each person is encouraged and supported to be independent and take part in meaningful activities. They are also offered choices about what they wish to do and to make decisions about how they spend their lives. Staff communicate well with them and respect their choices and decisions. Doulton Court Care Home DS0000068350.V375342.R01.S.doc Version 5.2 Page 7 There is a programme of education and training provided for the staff which ensures that staff know how to care and support the people who live at the home. People told us that they are cared for by a team of staff who meet their individual health and personal care needs in a sensitive manner. They are lead by an experienced manager who has knowledge about management, the care and support for people. The staff told us they felt valued by the manager and feel part of a team to improve, help and support the people living in the home. 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. 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. Doulton Court Care Home DS0000068350.V375342.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Doulton Court Care Home DS0000068350.V375342.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 2, 3, 4 and 6 People using the 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 coming in to the home receive information in various forms to meet their needs and support to help them make an informed choice of where to live. There are assessment processes in place, which ensure that individual needs can be met within the home. EVIDENCE: There was a detailed statement of purpose and service user’s guide in the form of a “welcome pack” together with a copy of our last inspection report in the reception area to the home which had comfortable seating. There were 2 service user’s guides one of which had pictures to aid understanding for those people who have a dementia. We noticed that our new name needed to be added to the statement of purpose and complaints procedure. We also asked that all information now referred to our Cambridge Regional office. The manager acted on this during our visit. The manager told us that where a referral was made she would visit each person and make a thorough Doulton Court Care Home DS0000068350.V375342.R01.S.doc Version 5.2 Page 10 assessment of their needs involving the person and any other person involved in their care and support. Once this was done written confirmation was sent to them that based on the assessment the home could meet their needs. Through case tracking we looked at records for a person who had recently been admitted to the home. We could see that a detailed pre admission assessment had taken place and that the person had received a letter confirming they could meet their needs. The manager told us that that all prospective people are encouraged to visit the home at least once before deciding if they would like to stay. We saw that each person had a contract which outlined what was covered in the fee and their terms and conditions of occupancy. The service does not offer intermediate care. Doulton Court Care Home DS0000068350.V375342.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person had a detailed care plan giving details about their care and support. This had been produced wherever possible with the involvement of the person, their family/advocate and other relevant people. Medication was safely given by staff who knew what they were doing. EVIDENCE: Each person had detailed care records giving details about their care and support. We saw a new detailed assessment document called a Care and Health Assessment Profile which is provided for each person and includes an assessment of each person’s needs. This includes, nutrition, mobility, personal hygiene, medication, communication, orientation, sleep and consent and capacity. From this detailed assessment a care plan is produced which outlined each person’s care and support needs. We saw records for 2 people one of whom had complex needs. Each person had a separate file with a photograph, the above mentioned admission information, moving and handling assessment, risk assessment, family and social background as well as Doulton Court Care Home DS0000068350.V375342.R01.S.doc Version 5.2 Page 12 a detailed care plan. There were also risk assessments in all files for the use of bed safety rails and all people had signed to give consent for these to be used if necessary. The company had also introduced monthly comprehensive audits to ensure bed rails were safe. Each person had their own key worker or in the case of those needing nursing care a named nurse and each bedroom had a notice giving this information. The care plans were hand written and detailed their assessed needs and expected outcomes and how the care and support would be provided. Records were signed and dated. We could see that considerable effort had been made to include a detailed mental capacity assessment for each person. Throughout our visit we saw staff respecting the peoples wishes and choices in the way they made contact with the people living in the home and their response. We also spoke with staff who showed good knowledge about the particular needs of the people living in the home. Where required, people living in the home were referred to GPs, Community Nurse, Community Psychiatric Nurse, Tissue Viability Nurse, Continence Nurse, Physiotherapist, Opticians, Dentist, Chiropodist and other specialists. We spoke to a Community Nurse and 2 Tissue Viability Nurses who were visiting the home during our visit. They told us that they found the staff to be very friendly and welcoming. There comments included, “I have been very satisfied with the professional approach from the staff. They communicate well with us, carry out our instructions and work well with us”. The home had also had Link nurses who specialise in various aspects of care including tissue viability, continence and palliative care and meet up with other nurses and staff from NHS Lincolnshire to promote good practise. The home also achieved the Gold Standard Framework for terminal care and after care which was assessed by the Macmillan Nursing Service. Nurses and senior care assistants administered medication. There was a policy and procedure for this and the manager assessed each person before they were considered safe to administer medication. Records we saw were clear and well maintained with a good audit trail. The manager told us that the people were encouraged by the staff team to self medicate but only one person did so, the other people needed a degree of assistance in order to ensure they took their medication safely. People we spoke with were satisfied with the way staff cared for them and had confidence in the staff. We saw throughout our inspection staff attended to the people in a warm, friendly and kind manner, knocking on doors before entering their bedrooms and asking whether they needed any help. The people told us,” they always listen to any requests I have. Carers discuss my needs with my family. The care provided is always a high standard which I feel happy with”, “the carers at this home care and love my wife and do everything to make her happy and well cared for. I also have the respect of Doulton Court Care Home DS0000068350.V375342.R01.S.doc Version 5.2 Page 13 them and go into see my wife two times a day and if I have anything to talk about they are available to see me on any matter not only about my wife but also about myself” and “they provide good care. It is a lovely home with very good staff who are all very helpful”. Doulton Court Care Home DS0000068350.V375342.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15 People using the 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 able and supported to make their own choices about how they want to live their lives, and what they want to do. Social activities are varied and provide stimulation and interest for people living in the home. People enjoy varied and nutritious meals. Visitors are made to feel welcome and supported. EVIDENCE: On admission to the home details were obtained about each person’s interests and life history and this information was contained in their care records. Information about activities was also included in the “welcome pack”. There was a written activities programme and the weeks programme was displayed on notice boards throughout the home. The activities included hairdressing, manicures, outdoor activities, painting and drawing, creative crafts, cake decorating, gardening and visits from outside people to the home. An activities co-ordinator provided activities 25 to 30 hours a week. There were photographs around the home of various entertainment evenings and activities. There were also reminiscence post cards and folders on display. Doulton Court Care Home DS0000068350.V375342.R01.S.doc Version 5.2 Page 15 These were used as prompts to engage with the people. This showed us that the home had an understanding of the various needs and abilities of the people living in the home. The people we spoke with told us they could attend local churches and that people from local churches could also visit them in the home. Visitors were welcomed into the home at all times. All the 5 visitors we spoke with were very complimentary about the staff and home. Comments included, “I visit daily and always receive a warm and friendly welcome. I find the staff are very good, loving and respectful and very friendly “, “we have been kept fully informed about how my father is, even when we have been away” and “the staff take time and always ensure the door is closed when they are attending to his needs”. The people living in the home were offered 3 main meals a day plus snacks. Menus were on a four-week rota. There was a set menu with a choice and an alternative could be arranged to suit the needs of the person. East Lindsey District Council awarded the home 3 stars (excellent) on the 29/9/2008 following an inspection, in recognition of the catering service provided. The report required the home to provide new flooring in the food preparation area and replace the freezer. The manager told us all this had been done. We examined the records for food temperatures, menus and cleaning rotas and found them well maintained and up to date. The manager told us that each of the catering staff had received food hygiene training. Meals were served in the dining rooms on the ground and first floors or in their bedrooms on a tray. Food was taken to the two dining areas in heated trolleys and served from them. The menus which were also displayed on notice boards showed us that there was a varied menu with fresh fruit and vegetables. The two dining rooms had been redecorated and refurbished with dining tables with clean table cloths and table mats. We saw staff were assisting those people who needed assistance in a dignified and sensitive manner. All the people we spoke with were complimentary about the food. Comments included, “the food is very good with a good choice” and “if I do not want what is on the menu they go out of their way to find me an alternative”. Doulton Court Care Home DS0000068350.V375342.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 People using the 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 know how to make a complaint and feel that staff will listen to their views. The care team know how to respond to a complaint and how to act in order to protect people from abuse. They are protected from abuse by correct and safe recruitment procedures. EVIDENCE: Each person received a copy of the complaints procedure in their “welcome pack” and this was also on the notice board at the reception and also in the statement of purpose. We noticed it did not contain our new name. The manager however acted on this during our visit. None of the people living in the home, visitors or the staff had any complaints about the home and felt they could discuss any concerns with staff or the manager. Staff also knew what to do if they received a complaint from a person living in the home. Staff records showed and discussion with staff confirmed that safeguarding adults training has taken place. All staff were correctly recruited including a check by the criminal records bureau (CRB). During their induction each member of staff received information about abuse. We asked 3 staff what abuse was and they showed knowledge about their role and what they would do if abuse was suspected. Staff told us they received regular refresher training to ensure their knowledge was up to date. Doulton Court Care Home DS0000068350.V375342.R01.S.doc Version 5.2 Page 17 We and the home had received no complaints or safe guarding adults’ issues since the last inspection. Doulton Court Care Home DS0000068350.V375342.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 20, 21, 22, 23, 24, 25 and 26 People using the 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 clean, comfortable, safe and well maintained accommodation. The infection control policy is followed and a safe environment is maintained. EVIDENCE: The home was well maintained throughout. The manager told us that many areas throughout the home had been redecorated with new carpets, floor coverings, new special “profile” beds, bedding and other improvements. During our visit we walked around the home and found all areas of the home were clean, tidy and odour free. People we spoke with told us they were satisfied with the decoration and cleanliness of the home. They also spoke of how they liked their bedrooms. They were encouraged to bring into the home small items of furniture, television, pictures and personal items. People told us Doulton Court Care Home DS0000068350.V375342.R01.S.doc Version 5.2 Page 19 I am very comfortable here”, “the home is lovely and clean” and “my clothes are washed well and looked after”. There were grab rails and raised toilet seats and bathrooms and toilets were wheelchair accessible and had thermostatic valves fitted to basins and baths to prevent the people from scalding. There were a variety of pressure relieving mattresses, special profiling beds and a variety of mobile hoists with a variety of slings and other moving and handling equipment. In shared rooms there were privacy screens. There were clear signs throughout the home which showed where toilets, bathrooms and other rooms were, in order to make it easier for the people to find their way around the home. The home is set around a landscaped internal courtyard, which was well maintained. All footpaths were clear from hazards and furniture was available for the people to use so they can sit outside in warmer weather. There was a very attractive and welcoming reception area with comfortable chairs and information about the home. Communal areas were spacious with sufficient space for those people who use wheelchairs to move around freely. Doulton Court Care Home DS0000068350.V375342.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a safely recruited, well-trained, supported staff team available who have the skills to meet the varying needs of the people living in the home. A wide range of in-house training and National Vocational Qualification training is provided. Separate staff are provided for nursing/care, housekeeping, catering, administration, maintenance and activities EVIDENCE: People we spoke with felt the home was adequately staffed with staff who were experienced and competent to care for the people living in the home. People we spoke with did not express any worries about the level or availability of staff. During our inspection visit we saw staff attended to the needs of the people promptly and in a calm and friendly manner. The home employs registered nurses, care assistants, chambermaids, laundry, administrator, catering staff, activities co-ordinator and a maintenance person. The people commented, “I am very comfortable and the staff are very kind”. The manager told us she monitored the dependency and varying needs of the people. We examined the files for 2 new members of staff. Records were clear, detailed and showed that staff were safely recruited in accordance with the Doulton Court Care Home DS0000068350.V375342.R01.S.doc Version 5.2 Page 21 regulations. This included a check by the Criminal Records Bureau (CRB). When new staff started work at the home they received a supported induction programme during which time they learnt about the policies and procedures of the home and how to provide the necessary care and support to the people living in the home. There continued to be a wide range of training provided. This included formal training in care to National Vocational Qualification standards (50 of the staff had achieved NVQ level 2 and one person had achieved NVQ level 3). In addition 2 staff were waiting to start NVQ level 2 and 2 for NVQ level 3. We saw records and staff confirmed that training over the last year had included, care of people with a tracheostomy, diabetes, dignity in care, dementia awareness, nutrition and health, palliative care, safe handling of medication, reducing falls, health and safety, fire prevention and moving and handling. The manager told us she was to arrange in the near future training for staff about the Mental Capacity Act 2005) and their role. Staff told us they received regular supervision and an annual appraisal. We spoke with 6 members of staff who told us, “If I have any worries or concerns I can always discuss these with the nurses or managers”, “I enjoy what I do”, “I feel it is rewarding work” and “I feel I have done a good job when I go home at the end of each day. The manager gives me thanks for what I do and we work well together”. Staff we spoke with were clear about their job role and knew about the needs of the people. We also received comment cards from staff with the following comments, “care is based on an holistic approach to each person’s individual needs by promoting health and independence. All people can enjoy the company of others. We work as a team and provide dignity and choice” and “I feel the home is doing well and always make sure we work together”. Doulton Court Care Home DS0000068350.V375342.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 32, 33, 35, 36, 37 and 38 People using the 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 and staff benefit from the positive leadership of the management team. Management record systems show that the peoples’ health, welfare, safety and choices are promoted. The management team ensures that the people living in the home have the opportunity to voice their views and opinions. The management uses feedback from questionnaires from a number of sources and quality assurance systems to make improvements. EVIDENCE: The registered manager had worked at Doulton Court for 13 years and had been the manager for 6 years. She was a registered nurse with many years experience in delivering care for older people. She also had a management qualification. She had extensive knowledge of age related conditions and how Doulton Court Care Home DS0000068350.V375342.R01.S.doc Version 5.2 Page 23 they could affect people, equality and diversity issues, good interpersonal and leadership skills and had kept her learning up to date. She was assisted by a deputy manager who also was an experienced registered nurse with extensive knowledge. Staff we spoke with told us they had a good relationship with the management team and felt they were open and supportive. People and visitors we spoke with echoed these views. Comments were, “I feel I can discuss any concerns or worries I might have” and “any problems are soon sorted out”. Relatives managed personal allowances for some of the people. The home held monies for others. We looked at the records for 2 peoples personal allowances. Recording and accounting systems were appropriate and balances correct and we were told they were audited by the company every 3 months. The company had comprehensive quality assurance procedures. These consisted of a comprehensive internal audit every 6 months which involved all departments in the home and covered infection control, activities, training, care documentation, medicines, maintenance, domestic, catering and laundry. As a result an action plan would be produced by the manager to identify any areas which required improvements and sent to the regional manager for the company. The manager also carried out monthly internal quality audits which covered care records and medication. The company also carried out an annual survey of peoples views of the service provided. The regional manager also made unannounced monthly monitoring visits to the home and produced reports for each visit which we looked at during our visit and found no concerns. Again, we found very clear records were being kept. The manager told us that she had meetings with people living in the home every 4 months and the staff told us they had staff meetings. There was a range of policies and procedures including clinical procedures which were regularly reviewed and updated. There were comprehensive health and safety policies, which also included detailed and up to date risk assessments and a fire risk assessment. There were regular tests of the fire system as well as regular fire drills and monthly monitoring of hot water temperatures. There were also infection control policies and staff made use of alcohol hand rub bottles throughout the home to further prevent infection. These were also placed at the entrance to the home and in the visitor’s toilet with clear instructions for visitors to the home to use. Records we looked at showed that equipment was regularly checked and serviced and there were systems to monitor any maintenance issues. We found records throughout our visit were available, well maintained and up to date. There were also 10 staff with an up to date first aid certificate. Doulton Court Care Home DS0000068350.V375342.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 3 Doulton Court Care Home DS0000068350.V375342.R01.S.doc Version 5.2 Page 25 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Doulton Court Care Home DS0000068350.V375342.R01.S.doc Version 5.2 Page 26 Care Quality Commission East Midlands Region Citygate Gallowgate Newcastle upon Tyne NE1 4PA National Enquiry Line: 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. 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