Care Home: Earlfield Lodge

Similar services:

• Fairfields Country Rest Home
• Poldhu
• Queensmount
• Trevaylor Manor
• Didsbury Court Rest Home
• Belma
• Hunters Care Centre
• Manor Lodge

What the care home does well Residents needs are overall being well met and staff support people well. Residents and visitors are overall very satisfied with the quality of care and the service that they receive. Residents take part in a really good variety of social and therapeutic activities. This helps residents to enjoy a good quality of life at the home. Residents meals are of a good quality and are varied. Meals are nutritionally well balanced and well presented. There continues to be a good emphasis placed on improving staff training and making sure staff do a range of training to better understand residents needs. The home is well run and is run in the best interests of the residents. Mr Butcher and the deputy manager work well together. They both ensure that the needs and wishes of the residents are at the centre of the management of the home. What has improved since the last inspection? Residents care plans show what actions must be taken to meet the persons range of needs. Care plans and assessment records are reviewed on a consistently regular basis. This demonstrates residents needs can still be met. If regular medication is not given a reason is now recorded. This is to show that medicines are given safely. The home now make sure all new staff have had a `POVA first` check before they start work. All staff also have a completed criminal records check carried out on them before they begin work. What the care home could do better: Ensure fire doors are safe and used properly and are not wedged open with items of furniture. There must be records kept of all medication given to residents,to ensure this has been given correctly to them. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Earlfield Lodge 29 Trewartha Park Weston Super Mare North Somerset BS23 2RR     The quality rating for this care home is:   two star good 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: Melanie Edwards     Date: 2 3 0 4 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 31 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 31 Information about the care home Name of care home: Address: Earlfield Lodge 29 Trewartha Park Weston Super Mare North Somerset BS23 2RR 01934417934 01934622491 earlfieldcare@btopenworld.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) : Mr Gerald William Butcher care home 65 Number of places (if applicable): Under 65 Over 65 65 old age, not falling within any other category Additional conditions: 0 The maximum number of service users who can be accommodated is 65 The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home Earlfield Lodge offers personal care to older people over the age of 65. Mr Butcher has owned the home for many years and is also the registered manager. The home is situated in a quiet residential area on the hillside of Weston-Super-Mare. Over the years the accommodation has been altered and refurbished. It now offers 57 single rooms, and 4 that may be shared. The majority of these rooms have en suite facilities. Residents have access to a number of lounges and dining rooms, as well as a small cinema and private chapel. The gardens are attractively laid out, and offer a range of quiet places to sit. Mr Butcher takes residents on regular trips out in the homes minibus. Care Homes for Older People Page 4 of 31 Brief description of the care home The fees to stay at the home are around three hundred and seventy eight pounds a week. Care Homes for Older People Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We did the inspection over three days with two inspectors. Sue Fuller our pharmacist inspector inspected the handling of medication in the home on one day. We met thirty five of the residents at the home. We also met a number of visitors. We met Mr Butcher who is the owner as well as the registered manager. We also met the deputy manager who takes responsibility for the day-to-day running of the home. We spoke to eight care assistants and one of the cooks. We talked with them about roles, responsibilities, training needs and how they help the residents. We saw staff helping residents with their needs. Care Homes for Older People Page 6 of 31 We saw the lunchtime meals being served and we sampled lunch. We looked at a number of records relating to the running and management of the home. These included five care plans, five assessment records, four staff training records,staff duty records,accident records, fire records and menus. We saw most of the environment. The only parts that were not checked were a small number of bedrooms. The home was operating within the required conditions of registration set down by us. The conditions of registration set out the type of care, the needs of residents and the numbers of residents who may stay at the home. 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 printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 Care Homes for Older People Page 8 of 31 7535. Care Homes for Older People Page 9 of 31 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 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The needs of residents are assessed when they come to the home and are being met. People have access to enough information to make an informed choice about the home. The home does not provide intermediate care for residents. Evidence: We read a copy of the service users guide and the statement of purpose to see what sort of information there is for people to find out about the home. Each resident is given their own copy of the service users guide and statement of purpose so they can get hold of useful information about life in the home. We also saw the homes brochure that has colour photographs of the home and of staff and residents to show what daily Care Homes for Older People Page 11 of 31 Evidence: life is like at the home. The service users guide is written in plain english, is easy to follow and contains a good range of usefull information about the home. We saw information about the service provided the qualifications of the staff employed and the accommodation. The philosophy of the home and how the service aim to meet residents needs is included. The complaints procedure is in the service users guide to help residents to know how to complain if they need to. In the AQAA document there is some really usefull information about how the home help residents to move in and make an informed choice about the home: An up to date service user guides incorporating the statement of purpose are available in each bedroom. A full assessment of prospective residents is carried out by the deputy manager. Relevant information is sought from other professionals and family and friends where needed. A social services assessment is also sought for all social services funded residents before they are admitted. Individuals being assessed are only offered a placement after the assessment indicates that the home can meet their holistic needs. This is fully explained to the individual and or their representatives and how we are able to meet their needs. All assessments are done in the environment the individual is currently living in. All placements offered are subject to a trial period of normally four weeks or longer if the individual requests. Earlfield recognise that transition to a care setting is an emotional and unsettling step. All staff are made aware of the assessment outcome before admission. All individuals are encouraged to bring their own furnishings and belongings as far as risk management allows. Part time liason officer who ensures that the new resident has all they require within their room and if not, then arranges for it to be in place. She also provides information on services within the home. We were told a lot of really positive comments by residents about the care they receive and how they feel their needs are being met. One resident said,you ask and the staff always do what you want, another comment made was, the service is quiet but efficient and on the whole the home is excellent. We read five residents assessment records to find out how well residents needs are assessed. The assessment records had a satisfactory level of information in them. They showed that an assessment had been made of what the person needs were and the ways the home could help them to meet their different range of physical, mental and social needs. We saw information that showed us that staff are reviewing in good detail what sort of help, care and support people need and if the home can still give residents the care to meet their needs. Residents are not provided with intermediate care at the home. Care Homes for Older People Page 12 of 31 Evidence: Care Homes for Older People Page 13 of 31 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 home are meeting residents needs well and care plans help to demonstrate how they are met. Residents are treated with respect and their privacy is being kept. Evidence: We read in detail five residents care plans to find out how residents are supported to meet their personal care needs. We found the care plans were reasonably informative and they explained how to meet the care needs of the person. The care plans stated what must be done to assist the resident to meet their needs. We found the care plans to be reasonably informative and they showed us how to meet the care needs of the person. We saw in each care plan that residents are been asked about what their needs are. We saw in four of the care plans some useful information about the persons life and what matters to them, including important family and friends. We saw that care plans had been reviewed and updated regularly. Care Homes for Older People Page 14 of 31 Evidence: We saw the staff on duty on both days of the inspection help residents in a polite and friendly manner. The residents told us some really positive comments about the staff and how they are helped by them comments made included, I find the staff very helpful when there was trouble with my eyes and I needed an extra light, the next day it was in my room, I feel part of a family, the staff always talk to you and the staff are really helpful. These comments show us that residents feel really satisfied with how their needs are met and they feel very well supported. We saw some detailed information in care plans that showed residents are well supported with their physical health care needs by the GP, the dentist and the chiropodist. The deputy manager told us that the home are well supported by the local community nurses who come to the home regularly, to see some residents who have identified nursing care needs. On the second day of the inspection the nurses visited to attend to the needs of one of the residents. The deputy manager talked with us about how the home assess residents needs. We were told that the home has now introduced a key worker system. They told us a member of staff will be allocated to take specific responsibility for building up a really good relationship with the resident. One resident we met told us they have now been allocated a keyworker of their own and they said this was very useful. In the AQAA document there is really useful information about how the home help to meet residents health and personal care needs: All residents have an individual person centred care plan generated within the first few days of admission. this allows for adaption to a care setting and monitoring of the initial assessment. All activities of daily living are recorded. Falls risk assessments have been carried out on majority of residents and any risks identified are referred to the appropriate professional. Waterlow ,(skin pressure risk assessments) assessments are carried out on residents.Care plans are reviewed monthly or earlier by the individuals key worker.Reviews are done with the resident and or their representative and a signature recorded from either and the keyworker. The care plan is generated by the care staff and discussed with the resident. This ensures that it is recorded in plain english to allow for resident and other staff to understand All residents are encouraged to be as independent as possible to maintain and promote dignity and selfworth. All staff are aware of pressure management and report any change in a residents skin condition to the district nursing team without delay. The home owns two air wave mattresses and these are assigned to residents who require them until the need is no longer present. The district nurses order pressure relieving mattresses and cushions as required. One of the senior carers has taken the role of continence lead and refers all residents identified with continence problems to the continence service. residents identified with Care Homes for Older People Page 15 of 31 Evidence: Blood pressure problems have their blood pressure regularly. Tai Chi lessons are held once weekly to promote gentle exercise. All residents are weighed fortnightly by two lead carers responsible for this task. Records are kept in individual care plans. All residents are encouraged to remain with a GP of their choice. We ensure referral to other specialist professionals as required. Vision call provide eye testing within the home yearly or as required. Visioncall have also carried out hearing screaning on majority of residents. The AQAA document goes on to explain that : The deputy manager has designed a care handbook which clearly explains how to carry out certain personal care tasks, the right to respect and dignity and the importance of choice and autonomy. these books have been given to all existing care staff and will form part of an induction pack for new starters. All bedrooms have personal telephones which can be used for internal and external calls. A designated resident phone number which requires an extension number specific to the resident allows for residents to receive calls direct to their room without the need to be transferred via the office. Staff are aware for the need for privacy, respect and dignity in death. The home is currently in the process off completing end of life care plans for all residents to ensure personal wishes are respected and adhered to. The staff keep relatives and friends updated with deteriating conditions with residents permission. Family and friends are welcome to stay with their dying relative at all times. Resting and welfare facilities will be provided. The home will not call the funeral directors until the family have had time to say their goodbyes. within reason. Staff ensure that a dying resident is made comfortable, pain management is sought from GP, registered nurses or hospice team and that a member of staff remains with the resident in their final moments if no other family present. The pharmacy supplies medicines to Earlfield Lodge using a monthly blister pack system. The manager told us that the pharmacist had recently visited. They reviewed peoples medicines and the systems in place for handling medicines in the home. She is waiting for a report from this visit. Several people living in the home are able to look after their own medication. Two people we spoke to said they were happy with looking after their medication. Staff look after and give medicines to most of the people living in the home. One person commented that that they are very efficient referring to staff giving out medicines and another told us My medicines are always available. We saw staff giving out some medicines at lunch time using safe practice. Medicine policies are available for staff, however we noted that some comments in the policies were not applicable to this home. Action is needed to make sure that the policies alway reflect the procedures used at Earlfield Lodge. Care Homes for Older People Page 16 of 31 Evidence: The pharmacy provides printed medicines administration record sheets for staff to complete. Generally these showed that medicines had been given as prescribed by the doctor. However records for some ointments, creams and eyedrops had not always been completed. Action is needed to make sure that a record is kept of all prescribed medicines given by staff. Records are kept of medicines received into the home and of all medicines disposed of from the home. This means that there is an audit trail to show that medicines have been used safely. We could not find a record for the disposal of some medicines and asked the manager to investigate this and ensure that these medicines had been safely disposed of. Medicines are safely stored in the home and transported around the home using medicine trolleys. A large medicine fridge is available and records show that temperatures are in the safe range for storing medicines. An Oxygen cylinder, no longer prescribed for anyone living in the home, needs to be returned to the supplier. Additional storage and a register is available for medicines needing additional security. We saw some excess supplies of medicines particularly eyedrops and inhalers. Action is needed to make sure that these medicines are not over ordered because this can lead to waste. Staff must ensure that eyedrops are labelled with the date they are opened and thrown away 28 days after opening to avoid the risk of infection. We looked at four peoples care plans. There was little information about medicines in these plans. The manager told us that she is intending to introduce medicine care plans to address this. Care Homes for Older People Page 17 of 31 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. Residents are well supported to do different social and therapeutic activities that they enjoy. Residents are being provided with a satisfactory and well cooked diet. Residents can have visits from family and friends. Residents are helped to keep some control in their daily lives. Evidence: Residents can do a range of activities put on by the home. The owner of the home drives the homes minibus on a twice weekly basis into the town of weston for shopping trips for any residents who wish to go. Other events that are planned for the near further include drives to look at the sea, arts and crafts sessions, games, a visit from a therapeutic dog, musical afternoons and gentle exercise classes. Care Homes for Older People Page 18 of 31 Care Homes for Older People Page 19 of 31 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. Residents are well supported to make complaints and these are dealt with correctly. The home has good systems in place to protect residents from the risk of abuse and harm. Evidence: We saw a copy of the complaints procedure in the reception area. The procedure includes our details for anyone who needs to get in touch with us. There is also information explaining how to get in touch with Mr Butcher. Mr Butcher also lives on the premises and residents told us that they see him every day and that he is very approachable. In the AQAA document there is helpful information about how the home help residents to complain and to stay safe and free from the risk of abuse:We have a clear complaints procedure which is displayed within the home. All complaints are dealt with as promptly as possible. The majority of complaints are dealt with immediately and informally. Complaints of a serious nature are investigated fully by the deputy manager and those concerned are fully informed of the outcome. Complaints and compliments log kept within office. residents are encouraged to participate in political processes and their legal rights are respected. The home has a zero tolerance policy Care Homes for Older People Page 20 of 31 Evidence: on abuse. The new version of North Somersets No secrets policy is within the staff office. Procedures for reporting actual or suspected abuse are displayed throughout the home. The homes whistle blowing policy is made available to all staff in their staff handbooks and management encourage, respect and protect individuals who report abuse. The home has a clear policy on the receiving of gifts or money from residents and no member of staff is permitted to be involved in any financial dealings with residents. Dignity challenge cards distributed to all staff. Dignity challenge ten steps displayed in various parts of the home Deputy manager has attended formal deprivation of liberty training and mental capacity training.Six staff have attended a workshop on deprivation of liberty. Deputy manager has purchased codes of practise for mental capacity and deprivation of liberty. We saw in the staff training records information that showed the staff have done safeguarding training. This is to ensure they are up to date in their understanding of the principle of safeguarding residents from abuse. There is an up to date policy in place relating to the issue of protection of vulnerable adults from abuse. All of the staff have been issued with a staff handbook that includes a comprehensives range of employment information. There is a copy of the whistleblowing procedure in the handbook. This is so that all staff know what to do if they need to report another member of staff and if a resident is at risk. The staff knew of the policy and the actions they must take to protect the residents. Care Homes for Older People Page 21 of 31 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 home is well suitable for the needs of the residents who live there. Evidence: We have quoted some of this section from the last inspection report as it is still applicable Earfield Lodge is an older property that is in fact three large houses converted into one building. The home is near to private houses and a short distance from the town of Weston Super mare. This helps ensure residents can be a part of the community. The home is set in its own grounds. The garden was satisfactorily maintained and there are patio seats and a secure garden where residents can sit and walk safely. We saw residents spend time in the garden area. The residents that we saw looked very comfortable and relaxed in the surroundings. We saw that residents bedrooms have been made more personal to reflect residents tastes of residents with photographs, mementos and small items of furniture. The standard of furniture and fittings is satisfactory. We found the home to be clean and tidy in all of the areas that we saw. We saw the domestic staff working hard cleaning the home. Residents bedrooms are grouped in wings of up to half a dozen rooms. There are Care Homes for Older People Page 22 of 31 Evidence: toilets, bathrooms, and lounges within easy reach of each group of bedrooms. This arrangement helps to create a sense of living in a smaller community within this very large home. The home is considering creating an extra dining room upstairs so that residents can eat together in smaller groups closer to their own rooms. The majority of bedrooms have en-suite facilities most other bedrooms do. Since the last inspection the extra care wing has been refurbished and upgraded. The fixtures and fittings are very domestic and of a very good standard. There are hot water temperature regulators fitted to all hot water outlets to which residents have access and these are routinely tested. Radiators are fitted with low surface temperature covers. Windows are restricted and this all helps to make the environment safer for the residents. Care Homes for Older People Page 23 of 31 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. Residents needs are being met by enough competent trained staff. The homes recruitment procedures are safe and protect residents. Evidence: In the AQAA document there is some really usefull information about how the home help ensure staff are well trained and suitable to work in the home: A new deputy manager has been appointed with relevant experience and qualifications. She has National Vocational Qualification in care awards two three and four and is currently working towards the registered manager awards. All senior staff either have or are working towards National Vocational Qualification in care award to level three. We looked at the staff recruitment records of three care staff who had started We looked in detail at the number of staff on duty to see if there is enough staff to meet the needs of residents. For the current number of residents forty seven there are a minimum of between seven and ten care staff on duty in the morning. There are six care staff in the afternoon,at night there are four care staff on duty. There are domestic staff on duty every day, cooks and kitchen assistants and a full time Care Homes for Older People Page 24 of 31 Evidence: maintenance person The home also have a full time administrator. Mr Butcher works in the home every day and the deputy manager work full time hours and carries out much of the day to day running of the home. We looked at the staff recruitment records of four care staff who had started work at the home since the last inspection. We did this to see if the home carry out the correct employment safety checks on staff before they start work. We saw two written references taken up for new staff before they start work as well as Criminal Records Bureau Disclosures checks and Protection of Vulnerable Adult POVA first checks. This demonstrates to us that residents are protected by the homes recruitment procedures. Care Homes for Older People Page 25 of 31 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a home that is well run and is run in their best interests The finances of residents are being looked after safely. The health and safety of residents staff and visitors is mostly being well looked after . However there needs to be an improvement in correct use of fire safety doors Evidence: In the AQAA document there is helpful information about how the home is managed in the best interests of the residents who live there: Mr Butcher has owned and managed the home for over forty years. He has gained the National Vocational Qualification in care award to level four. He is supported in his role by the deputy manager who was previously a registered manager of a sixteen bed home and who has seventeen years health and social care experience in various settings. There are Care Homes for Older People Page 26 of 31 Evidence: weekly care staff meetings are held by the deputy manager to discuss current care needs best practise, health and safety, performance, dignity in care and policies and procedures. The deputy manager aims to carry out monthly supervision of all staff.annual appraisals are carried out on all staff. There are annual resident surveys are carried out. liaison with the residents committee is carried out every four to six weeks. policies and procedures are constantly under review. The registered manager controls money for a minority of residents and this money is kept within safes within the home. We checked the finance records of three residents and we found that the records were satisfactorily maintained and in order. We saw receipts for things that residents had bought. We saw the Mr Butcher signs for all money taken out if the residents could not sign for it. The records relating to the management of the home were also satisfactorily maintained up to date and in order. We saw that residents records and the homes records were kept secure in the home and are available to staff when needed. We have referred to other records elsewhere in the report. This part of the report has been quoted from the last inspection report as it is still applies:The staff reported that staff meetings are held regularly. A sample of recent minutes were looked at that demonstrated staff are consulted and their views listened to by the managers. A residents committee has been sent up, involving residents and relatives.The committee discuss and make suggestions about daily life in the home. The home has its own format for monitoring the quality of the care and the overall service. We did not look at the paperwork that is used to audit the home on this inspection. We looked at a selection of recent accident forms to find out what action is taken after residents have an accident. The accident records showed the managers in detail the nature of the accidents and what may have caused it. They also monitor all follow up action taken by staff to assist the resident involved in the accident over a period of days after the event. Staff do training in health and safety matters including first aid food hygiene training and moving and handling practises. This should help protect residents health and safety. We checked the fire logbook records and these showed fire alarm tests are being carried out. There are also fire drills carried out on a regular basis to help protect the Care Homes for Older People Page 27 of 31 Evidence: health and safety of residents and staff. However we saw two fire doors being kept open with coffee tables against them. We advised that this could be a serious risk in the event of a fire,if fire doors cannot shut. Care Homes for Older People Page 28 of 31 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 29 of 31 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 1 9 13 The registered mananger 14/07/2009 must ensure that records are kept of all medicines administered by staff, including creams, ointments and eye drops. to protect peoples health and well being. 2 38 23 Fire safety doors must be 25/04/2009 able to shut in the event of a fire The use of a table to prop open fire safety doors - and the impact on peoples safety. 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 Care Homes for Older People Page 30 of 31 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). 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. Care Homes for Older People Page 31 of 31 - 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!