Care Home: Dovecote Nursing Home

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What the care home does well During our inspection we were told many good things about the service offered, the staff and the food. The people living here, and their relatives, told us that they are well cared for and that they are kept up to date about matters affecting the home and their care. Clear information is sought and obtained about each persons needs before they come here. This ensures that Dovecote can meet their needs. Mealtimes are a pleasant and everyone we spoke to commented positively about the food on offer. Dining tables are well presented and there is always a choice of main meal and pudding. Catering staff are knowledgeable about peoples dietary preferences and particular needs, for example if they have an allergy or are diabetic. The building is a purpose built care home. It is clean and well maintained. There is little turnover in staff. This means that staff have time to get to know the needs of the people living here, and therefore are able to provide continuity of care. Staff are safely recruited and well qualified. There are regular checks by the manager to make sure the good standard is kept up. The people living here and their relatives are asked for comments and suggestions about the service they receive. The people we spoke to all knew who to speak to if they had a concern or were unhappy with any aspect of the service. They told us that they were confident any such concerns would be properly dealt with. What has improved since the last inspection? The manager and his team have worked to make improvements to the areas highlighted at the last inspection. This has included: Improving the storage of records. Continuing to improve the accommodation where this is needed. Ensuring fire exits are kept clear. Updating the homes procedure for protecting people. What the care home could do better: Overall the home operates at a high standard however, some areas need attention. These include: - The need to repair or replace the sluice disinfectors. - The provision of improved ventilation to the first floor. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Dovecote Nursing Home Hugar Road High Spen Rowlands Gill Tyne & Wear NE39 2BQ     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Lee Bennett     Date: 1 3 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Dovecote Nursing Home Hugar Road High Spen Rowlands Gill Tyne & Wear NE39 2BQ 01207544441 01207544171 dc1europeancare@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : European Care (UK) Limited care home 61 Number of places (if applicable): Under 65 Over 65 34 61 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 0 0 Dovecote Care Home has 61 places for older people. The home is split into two separate units. On the first floor nursing and personal care is provided for people with dementia. On the ground floor general nursing and personal care is offered. The home is purpose built. The bathrooms and shared toilets have handrails and appropriate lifting equipment for people with a disability. Each bedroom has an en-suite toilet. The home is constructed in a traditional style of brick and tile and has a variety of lounge / dining areas. There is passenger lift access to the first floor. The access is level from the ground floor entrance. It stands in its own grounds. There is a generous amount of parking space. The home is located in a village, in a rural area. It is a quiet setting with local facilities close to the home including shops and a pub. Care Homes for Older People Page 4 of 30 Brief description of the care home The home does not provide intermediate care. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The visit; Before the visit: We looked at: - Information we have received since the last visit in June 2008. - How the service dealt with any complaints & concerns since the last visit. - Any changes to how the home is run. Care Homes for Older People Page 6 of 30 - The providers view of how well they care for people. - The views of people who use the service & their relatives, staff & other professionals. The Visit: An unannounced visit was made on the 11th May 2009. A further announced visit was made on 13th May 2009. During the visit we: - Talked with people who use the service, their relatives, staff and the manager. - Observed life in the home. - Looked at information about the people who use the service & how well their needs are met. - Looked at other records, which must be kept. - Checked that staff had the knowledge, skills & training to meet the needs of the people they care for. - Looked around parts of the building to make sure it was clean, safe & comfortable. - Checked what improvements had been made since the last visit. After the visit: We told the manager what we had found. Previous Requirements: We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use the service are not put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get Care Homes for Older People Page 8 of 30 printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are assessed before moving here. Obtaining information about a persons needs is important in ensuring that everyone concerned is confident that this is a suitable place to live, and that everything is in place to make people comfortable. Evidence: Before a person moves to a care home they are entitled to have an assessment of their needs carried out, either by social services or a health care worker, such as a nurse assessor. Even when a person pays for their own care, they are still entitled to such an assessment. Most people moving here have their care arranged by Social Services, but some will come here by private arrangement. The manager of a care home must also obtain information about those people who would like to come here. This will include a copy of the assessment, and a summary care plan, which explains how each persons needs are to be addressed. This is to Care Homes for Older People Page 11 of 30 Evidence: make sure their needs are looked at and then can be properly met. The manager has obtained a care managers care plans for all of the people whose files we looked at. However, care managers did not supply copies of each persons assessment (from which the care plan is generated). To make up for the lack of information provided by care managers, the homes own nursing staff conduct their own pre admission assessments. This can help ensure that appropriate equipment, such as pressure relieving and manual handling aid are in place. The nursing staff use an effective assessment document which is designed to give the team information about the needs of the people who are considering moving into the home or staying for a short period. The assessment tool assists the staff to find out about all of the aspects of peoples lives and needs. The lead nurse is confident that it gives them the information they need to make the judgment about offering a place. The document is also used for residents returning to the home from hospital if their needs have changed. Potential residents can visit the home and spend time in the communal areas prior to making the decision to move in, but those people spoken to on the day of our inspection had relied on their relatives to make the choice for them. Care Homes for Older People Page 12 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living here receive the right level of care and support to meet their health and personal care in a well-planned way. Evidence: FIRST FLOOR: To help guide the practice of staff, after a person has been admitted here a plan of care is written up. This is so that important areas of need, such as those around personal care, diet and social interests, can be clearly identified, and the support that staff are to provide is clearly explained. Everyone living here has a care plan file in place, and for the people whose files we looked at, the care plans themselves are generally relevant to the needs observed and that have been assessed by the social worker and nursing staff. For the people living on the first floor (who have needs relating to dementia and their mental health) there are no care plans specific to these aspects. Care Homes for Older People Page 13 of 30 Evidence: Staff keep regular notes about each persons welfare and any care that they have provided. These records are clear, factual and relate to each persons health and personal care needs. Where people have medical needs, evidence is kept of appointments attended, nursing care provided, and other visits by healthcare professionals. This can help ensure peoples health needs are regularly monitored and met, and proper advice and intervention sought. Furthermore, where personal care is needed this is written down in a care plan. During the inspection, there were no instances where personal care was carried out in the public areas of the home, which shows that staff are conscious of peoples privacy and dignity. The support offered by staff was carried out in a friendly, and pleasant manner. Everyone was well dressed, and provided with clean, well laundered clothes. Each persons personal tastes and dress appeared to be promoted. The people we spoke to told us that they are cared for in a good manner. The comments we heard from service users and relatives included: - Its the best we can get, other than home. - Its great, we couldn t get better. - Mothers always well looked after. - Yes, they keep us well informed about what is going on. A common area where staff help people with their health care is in the way medicines are administered. All of the people here have their medicines looked after for them. To keep them safe, medicines are stored in a secure way and the room where they are kept is at a safe storage temperature. Staff check the temperature of the medicine room and the medicine fridge to make sure that these are correct for the medication being stored. This will make sure the medicines concerned remain safe and effective. When staff administer medication they tell the person concerned what medication they are receiving, and also follow good hygiene practices. There are clear records kept of the medicines administered by staff. The stocks held for all medicines we checked corresponded to the stock records. Medicine records are accurate, and the reasons for medicines being missed is clearly recorded. To help ensure staff are aware of the importance of good record keeping, along with other aspects of medication management, they have been trained on this topic as part of their nursing qualification. Competency checks are also carried out. All medicines are administered from the manufacturers original containers, and all stocks are regularly counted to make sure errors dont occur. GROUND FLOOR: Care Homes for Older People Page 14 of 30 Evidence: Each person living in the home has an individual care plan which is developed from the admission assessment and added to throughout their stay. These care plans show that the personal and health care needs of the resident are being met and how that is being achieved. The staff could describe the needs of the residents and were clear about the way that they had to record the care given and the need to report any relevant issues to senior staff. Care plans are in place around both the physical needs and the social care needs of the people living in the home. Necessary risk assessments are completed for a selection of areas including falls, nutrition and deterioration in skin condition. These were being reviewed and the reviews were detailed and up to date. Generally the care plans are person centered although there are plans to develop this further. The staff work hard to make sure that they communicate well within the team and with outside primary care team advisors. The records of food and fluids given to those residents who are at risk of not maintaining their intake were being completed in sufficient detail. Residents are supported to access NHS services and facilities as and when they need to. The care plans showed that the specialist advisors are used for individual people living in the home and their advice is followed closely. Examples of this being Dietitians, the Dysphasia service and tissue viability nurses. The home have also recently asked a specialist ulcer care nurse to visit to give advice for an individual. The home has appropriate equipment to minimise the risk of people developing pressure ulcers including nursing care beds which can be adjusted up and down to assist when staff are delivering care and pressure relieving mattresses and seat cushions. The residents and their representatives are supported to take part in the review of their care. A number of residents were positive about the care they were being given and were complementary about the staff. Residents said that they felt well cared for by the staff and an example of this was the staff are lovely and the staff are around to help me when I need it, and nothing is too much trouble for them. Residents were dressed for the activities they were undertaking and looked comfortable and tidy. Care was given in a discreet manner taking into account the individual residents previous lifestyles and the way they want to spend their time. They were being kind and polite with cheerful banter taking place throughout the day. Care Homes for Older People Page 15 of 30 Care Homes for Older People Page 16 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living here are offered regular opportunities to participate in activities, and are well supported to maintain friendships and family contacts. People are enabled to express choice and control in their lives and receive varied, wholesome and wellpresented meals. Evidence: At the time of the inspection there was a team of activities worker employed here. We spoke to one of these, who was very enthusiastic, and engaged people well. There is clear evidence of regular in-house activities. There are also regular outings, and entertainers are occasionally booked. There are links with local church and religious groups. The staff are knowledgeable about the social and recreational care needs of the people living in the home. This was shown in the care plans where there is an individual social activity sheet, and was confirmed by residents. There are regular activities for the service users. One service user described some of the opportunities they had been offered and although they felt that this was enough they did not always want to take part. There are also regular visits by entertainers. Residents confirmed that they are Care Homes for Older People Page 17 of 30 Evidence: free to join in social activities if they wish and that they are not made to join in activities if they do not want to. The residents are supported to continue their religious practices and there are opportunities for residents to participate in services which are appropriate to their particular faith and beliefs. A relative commented that they are aware of the activities that the staff organises for the service users. The home supports the relatives to make positive contribution to the care provided in the home. Visits from relatives form an important part of many peoples day. Visitors can come and go freely, and those visitors we spoke with were all complimentary about the staff and care offered. The residents are encouraged to maintain contact with their families, friends and visitors and can use either their own rooms or the communal areas. The relatives are given good assistance to help them to be as involved in the care as they feel comfortable. One visitor in particular said that they were positive about the way he had been supported in assisting to provide care to their relative. There is a good system for making sure that residents who are unable to visit the home are kept informed. This involves the nurse completing a monthly review of the residents, health, welfare and what has been happening in their lives. It is sent to the next of kin / representative, with the residents permission, and also includes a statement of the status of their personal finances. People also commented positively to us about the food on offer, and we heard many compliments about this. A choice of main meal and pudding is always offered. Staff were noted to be helpful at meal times, and took the time to sit down with those who need help with eating, supporting people in a dignified way. Routines are flexible here, and if someone wants to have a lie-in they can have their breakfast later in the day, to suit them. The dining tables here are nicely presented, and condiments are provided so that people can help themselves. A lunchtime meal was shared with several of the people living here. Staff were courteous, encouraging people to be independent. A choice of dilute juice or water, with tea or coffee was offered. The residents were complementary about the food and they were being supported to choose between the two main courses on offer. Residents are asked the day before the meal. However, when they did not seem to want or be enjoying the choice they made they were offered the alternative. There was a very good emphasis on residents being offered choice and this ranged from the drink they had with the meal and the condiments they used. All staff were very careful to ask the residents if they wanted assistance and did not impose their help without permission. Care Homes for Older People Page 18 of 30 Care Homes for Older People Page 19 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are suitable arrangements in place here to protect people form abuse, and this enables people to make their views heard, and to raise any concerns or complaints they have. Evidence: A complaints procedure is available within the home with a copy placed on display. This informs the people here that they can contact the Commission if they wish regarding complaints. A record book for complaints and suggestions is maintained, and a review of these indicated that there has been one since the last inspection. The complaint has been clearly documented, investigated, and the outcome logged. No complaints have been referred to the Commission since the last inspection. We were told by the people living here, and their relatives, that they know how to complain and that they are confident that this would be looked into. Staff have received training on Adult Protection from the local Social Services Department. This training was to help explain the role of adult protection, and to offer guidance to staff. The care provider has adult protection procedures, which are available in the home, should staff need guidance in this area. Care Homes for Older People Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The accommodation here suits peoples physical and personal care needs, is clean throughout, well maintained and personalised to suite individual tastes. Evidence: Dovecote is a purpose built care home. It is kept clean throughout and re-decoration and refurbishment has taken place to Keep the home clean and fresh looking. Many people have brought in personal items to make their rooms more homely. Shared lounges are large, but attempts have been made to make them more domestic in appearance. The building has underfloor heating, however, we were told this makes the first floor of the home too hot. There is also limited ventilation (as windows have to be restricted to ensure the safety and security of the people living here). All bedrooms have en-suite toilets, and bathrooms and shared toilets have been located throughout the home to be near all of the living areas and bedrooms. Four new adapted baths have been provided this year, and there is a range of equipment (such as profiling beds and air flow mattresses) to meet peoples health and personal care needs. There were no physical hazards observed during the inspection, although there is little storage, which means staff have to be mindful to ensure mobile hoists and stand aids Care Homes for Older People Page 21 of 30 Evidence: do not form obstructions or trip hazards. The building is sited in a mainly residential area. The ground floor accommodates those people who have physical care needs and the first floor provides care for those people with dementia. It is appropriately maintained and access into, and within it, is good and it meets the needs of those people who have mobility difficulties or have use of walking aids or wheelchairs. There are assisted bathing facilities for residents who have moving and handling needs and require assistance from staff to bath safely. All bedrooms and toilets have suitable locks on the door to ensure privacy. This provides the opportunity for residents to remain independent and to enjoy good levels of privacy. There are sufficient numbers of communal areas for people living in the home to choose from. These include a range of lounges, dining rooms and communal spaces that residents can use, these are well decorated and clean. The bedrooms are of varied shapes and sizes and they were well decorated, furnished and were personalised to the taste of the occupant. There has been a programme of redecoration and replacement of the bedroom furniture. Residents were asked how they felt about their rooms and all were happy with the level of cleanliness. The clinical lead nurse and the manager have a good understanding of Health and Safety issues and he is responsible for facilitating good practices that safeguard the people living there. It is well decorated and furnished and there were no unpleasant odors anywhere in the home. Safety checks are carried out in line with the homes policies. The staff are trained in control of infection procedures, and were using these practices throughout the day, to minimise the risk of cross infection. There are two sluice disinfectors in the home, however neither of them is working. This presents a potential health hazard as staff are having to clean equipment by hand, involving the use of hazardous chemicals and being less effective at minimising the risk of cross infection. Care Homes for Older People Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff working here are safely recruited, qualified and competent. They are well trained, and deployed in sufficient numbers to meet peoples needs. Evidence: Before staff start working here they have to undergo a series of checks. This is to ensure they have the right skills, experience and approach for the job. There are also checks carried out to help make sure they are physically fit for the work they have to do, and do not have a criminal history that would make them unsuitable to work here. We looked at a sample of the staff recruited here since the last inspection. We found that suitable pre-employment checks, including the receipt of a Criminal Record Bureau Disclosure and two, or more, references have been obtained before they started duty. Overall there are 13 nurses, 38 care workers, 3 activity coordinators and a large number of ancillary and bank staff employed here. They are deployed in sufficient numbers to ensure peoples needs are being met. The home maintains very good staffing levels. On the day of the visit the staffing on the ground floor was the lead nurse, one qualified nurse and five care staff. These levels are above that which would be expected in a similar home with the numbers and Care Homes for Older People Page 23 of 30 Evidence: level of dependency with one extra carer on duty. The manager is confident that these numbers make sure that people living in the home have their personal and health care needs met in a way which maximises their independence while maintaining their dignity and values them as individuals. The homes management structure gives good leadership to the nurses, carers, and domestic staff. There are sufficient numbers of qualified nurses employed and the clinical lead nurses have periods of time when they are supernumery giving them the opportunity to consider the more complex issues and to consider the way to develop practice in the best interests of the people living in the home. There were sufficient numbers of domestic and catering staff on duty all of which have appropriate training in using chemicals safely. Once employed, staff receive an induction and regular training, although this has been variable over the last year. Training has, in the past, included topics relevant to peoples needs in the home. An extensive range of training has been scheduled for the forthcoming year. The staff here initially attend induction training if they are new to care work. Following this they will also be offered periodic training opportunities. Furthermore, those not already qualified will be supported to attain a vocational qualification in care. The vast majority of the staff here have achieved such an award, at NVQ level 2 or higher. Those who don t have this are working to attain an NVQ in care. Care Homes for Older People Page 24 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people here benefit from living in a well managed home. This can help make sure their views are sought and acknowledged, and that their health and safety is promoted. Evidence: The manager has many years experience at a senior level within health and social care. He is a qualified nurse, and holds relevant management qualifications as well. The manager provides very good leadership in the home and has appropriate qualifications, experience and skills to make sure that the home is managed in the best interest of the people living there. He has worked hard with the team to make improvements and is continuing to make sure that he is always aware of any current best practice so that it can be incorporated in the way they provide care. The manager is supported by two lead nurses (one a General Nurse, the other a nurse specialising in Mental Health). They are responsible for the day to day care of Care Homes for Older People Page 25 of 30 Evidence: the residents. They work closely with the manager to ensure that any resources needed are identified and obtained. There are clear lines of accountability within the home. To ensure the home is well managed there are several quality checks that are carried out in areas such as equipment and the building. There is a record kept of service users views. Satisfaction questionnaires have been used to gain the views of the people living here and their relatives. This involves sending a survey to all of the relatives, these are then analysed centrally with anonymous information given to the home so that they can make changes if necessary. The last one was carried out in January 2009. The records kept at the home, were up to date, detailed, and held in a safe and secure manner. Financial records are subject to the scrutiny of the area manager. Staff in the home do not usually hold or manage service users finances, but where these are left with staff for safe keeping they are securely stored, with clear records in place. Individuals money is kept separately and the records are maintained well. There are receipts kept for any purchases made on behalf of the residents and there are systems in place to make sure that people in the home are provided with money for them to have the items they need. The records are audited. The manager arranges residents meetings and there is a newsletter which is currently published seasonally. There is a very comprehensive relative surveys carried out by the company to elicit their views. During the visit the home was tidy and there were no health and safety issues evident, there is a good system for making sure that all of the equipment and services are safe and well maintained. There is also a series of checks carried out and the records of these were up to date. Care Homes for Older People Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 19 23 The registered person must ensure there is suitable and sufficient ventilation to the first floor of the home. This is to ensure service users, staff and visitors remain comfortable. 28/08/2009 2 26 23 The registered person must repair or replace sluice disinfectors. to ensure that the risk of cross infection can be minimised and residents and staff are protected from harm. This is to ensure that the risk of cross infection can be minimised and residents and staff are protected from harm. 28/06/2009 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 28 of 30 1 2 The registered manager should always seek to obtain the care managers assessment before a person moves here. This is so the manager is clear what each persons needs are, and that they can be met here. The registered manager should ensure that care plans are developed relevant to each persons needs, including those relating to dementia, mental health and behaviours that challenge the service. 2 7 Care Homes for Older People Page 29 of 30 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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