Care Home: Elroi Manor Residential and Nursing Home

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What the care home does well Each person we spoke with, and those who wrote to us, said they liked living in the home and always receive the care and support they need. There are many positive comments from people which are included in this report. The social care professional we spoke with said the home meets individuals` health care needs and respects their privacy and dignity. They were complimentary about this home and their comments are included in this report. The staff we spoke with, and those we saw working, enjoy working at the home, they now work well as a team and are provided with the training they need to enable them to support people properly. People have their needs thoroughly assessed before they are given the opportunity to move into the home; there is continued use of tools to assess if people are at risk of malnutrition, falls or skin conditions. People continue to be very happy with the quality and variety of meals served in the home. There is a very homely atmosphere; staff were seen to offer care and support in a respectful and professional way. There is a genuine commitment to continuing to improve the care and support provided to the people who live in the home; the expectations placed upon staff are greater and they have been given more responsibilities. What has improved since the last inspection? The management of the home has been significantly improved. This ensures people that live in the home are provided with a safe and accountable service. The home`s recruitment practice has now been improved. This helps to ensure the welfare and safety of people who live in the home. Person centered care and person centered care planning has been introduced. This ensures peoples` current and changing needs can be met. Staff supervision has now been improved. This helps to ensure staff have the right support to provide a good service to the people who live in the home. All meals and snacks are now served in the home by staff following best practice. This promotes the dignity of people who live in the home. The environment has been developed and improved to ensure this meets peoples` needs. What the care home could do better: The Registered Person must ensure that records of falls are used in the review process. This will ensure that care plans remain up to date and that the risks posed to people who are prone to falls are effectively managed. The Registered Person should ensure that guidelines for medicines taken `as and when required` are included in care plans as well as in medication records. This would help to ensure all care records for people are contained in one, up to date, plan. The Registered Person should update our contact details on the home`s complaints policy. This will ensure people have the correct infomation should they wish to make a complaint. Key inspection report Care homes for older people Name: Address: Elroi Manor Residential and Nursing Home West Hill Wincanton Somerset BA9 8BP     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: David Smith     Date: 1 6 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Elroi Manor Residential and Nursing Home West Hill Wincanton Somerset BA9 8BP 0196333577 0196331175 suddon.house@virgin.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Deverill Holdings Limited care home 43 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: Persons, not less than 60 years, who require nursing care by reason of progressive mental disorder. Registered for a total of 43 places in categories DE, MD, DE(E) and MD(E) Room 10Q must only be occupied by a person who is independently mobile, has a low risk of falls and can manage their personal care needs independently. The person admitted to this room must meet this criteria when they move in. This must be evidenced through the pre-admission assessment and monthly reviews. Should the person`s needs change during their stay a multi-professional and service user/representative review must be held to determine the adequacy of the accommodation to meet their needs. Up to 14 places for personal care DE(E) Up to 29 places for nursing care only in the categories DE, MD, DE(E) and MD(E) Up to five persons in the range 50-60 years, who require nursing care by reason of a progressive mental disorder. Care Homes for Older People Page 4 of 30 Over 65 43 29 29 29 Date of last inspection Brief description of the care home 0 8 0 1 2 0 0 9 Suddon House is a care home registered to accommodate and provide personal and nursing care services for up to forty-three people. Up to thirty-eight over the age of sixty years. Conditions have been agreed to enable up to five persons over the age of fifty years to be admitted depending on their care needs. The first floor is currently closed for refurbishment and repairs. Bedroom accommodation is therefore provided on the ground floor only at present. This reduces the maximum number that can be accomodated. Suddon house is approximately one mile from Wincanton town centre set in its own grounds with pleasant views onto surrounding farmers fields. The home is approached by a long private drive off the main road in West Hill. The home has two entrances with the main entrance to the front of the property. The second entrance is to the side. There is ample car parking to the front and side of the home. The main entrances are kept locked at all times for security of the home and the people who live there. The home has ample communal space and outside areas that can be accessed with the support of staff. The home provides nursing and personal care for older people with dementia and other mental health needs; care is provided by registered nurses who are experienced in mental health and general nursing. Care staff are experienced in delivering personal 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: 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: These were unannounced visits to the home to enable us to complete a Key Inspection of this service. We spent approximately 11 hours in the home over the two days of our visit. The inspection was carried out by one inspector, but the term we is used in this report. This is because the report, and the judgements within it, are on behalf of the Care Quality Commission. The pre-inspection planning involved reviewing the report of the last Key Inspection completed in January 2009. We looked at the last annual quality assurance assessment (AQAA) that was sent to us by the home. The AQAA is a self-assessment that focuses on how well outcomes are being met for people living at Suddon House. It also gave us some numerical information about the service. We also looked at the service history, which details all other contact with, or about, the home. Care Homes for Older People Page 6 of 30 We sent surveys to some of the individuals living in the home; most were completed with the help of peoples relatives. The views of each person who wrote to us have been included in this report. Time was spent speaking with people who are living in the home and we observed staff interacting and supporting them at various times during both days of our visit. We gathered additional information for this report by speaking with the Manager, his Deputy, three relatives and a social care professional who were visiting and some members of staff who were working in the home. We looked at a number of records such as individuals care records, risk assessments, accident records, medication storage and administration, staff records, complaints and compliments and some health and safety procedures. We viewed all communal areas of the home and some of the bedrooms used by the people who live here. Care Homes for Older People Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: The Registered Person must ensure that records of falls are used in the review process. This will ensure that care plans remain up to date and that the risks posed to people Care Homes for Older People Page 8 of 30 who are prone to falls are effectively managed. The Registered Person should ensure that guidelines for medicines taken as and when required are included in care plans as well as in medication records. This would help to ensure all care records for people are contained in one, up to date, plan. The Registered Person should update our contact details on the homes complaints policy. This will ensure people have the correct infomation should they wish to make a complaint. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 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. Individuals are given the information they need about the home to enable them to make an informed choice about whether they wish to live here. People are confident the home can support them as their needs are thoroughly assessed before they are given the opportunity to move in. Evidence: The home has a Statement of Purpose and people are also given a guide to the service. The people who wrote to us, those living in the home and relatives we spoke with said they did have enough information to decide if it was the right place for them or their relative to live. One relative said I visited some 15 care homes; to me this was the most caring and seemed to be the only one genuinely interested in caring for [my relative]. The Manager or his Deputy ensures comprehensive assessments are carried for each Care Homes for Older People Page 11 of 30 Evidence: person interested in moving to the home to determine whether Suddon House could meet their needs; they are assisted by a competent member of the staff team. The assessment includes what personal or medical care people may need, their hobbies and interests, how they communicate, how mobile they are and family involvement; any potential risks to each person are also identified. If any assessments or reports have been completed by other social or health care professionals, copies are obtained and used as part of the assessment process. We looked at the care records of four people who had moved into the home since our last visit; each contained a detailed assessment which had been used to form the initial plan of care when the person first moved in. 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. Peoples health, personal and social care needs are met. Each person has a plan of care that they, and people close to them, has been involved in making. Peoples right to privacy is respected and they are supported with their medicines in a safe way. Evidence: Each person who lives in the home has their own plan of care; these are currently being developed and improved to make them more person centred. The Deputy Manager told us they have completed seven peoples plans; other plans are being worked on although they may take some time to complete due to their number. Care plans are developed with each persons involvement where possible, but this very much depends on the level of the persons skills, ability and awareness; relatives, and other people close to the people who live in the home, are also involved in planning and reviewing care. We looked at six peoples plans in detail; these contain clear guidance for staff in relation to the care and support each person needs to Care Homes for Older People Page 13 of 30 Evidence: support their health and personal care. They also contain health care risk assessments such as assessments for the likelihood of a pressure sore developing, for the prevention of falls, how to move and transfer safely and nutritional assessments. Whilst these assessments are reviewed regularly, the home must make better use of other records in the review process. For example, we looked at records of falls within the home; two people were focused upon. The falls were clearly recorded and an audit of these reports is carried out each month. However, this audit does not currently link to an update of care plans; when these two people had fallen it was not recorded in their risk assessment review nor was it clear if the risks had changed due to these falls. This issue was discussed with the Manager during our visit who agreed to look at how this system could be improved. People we spoke with and those who wrote to us said they do receive the care and support they need and staff are available when they need them. One person said they look after [my relatives] personal and mental care; they are much better at talking and more alert than when they came here. Other comments included: I have always been very happy with the care here; [my relative] seems very happy here and is well cared for and the home has done everything to support us and my relative. Everyone we spoke with felt that privacy was respected in the home. We saw that people were able to choose to spend time in their own rooms or in communal areas; staff knew them well and always addressed them using their names. Staff always knocked on peoples doors and waited for a response before going into them; one relative said the staff treat everyone individually, knowing their needs. The home uses a monitored dosage system of medication administration and this is well managed. All medicines are stored securely in one room of the home; this room is large, well lit and has hand washing facilities available for staff. A medicine fridge is available; the temperature is checked every day. Some medicines require additional secure storage and this is provided together with a register to record their use. Should people need medicines as and when required there are guidelines in place, although these also need to be included in care plans as well as in medication records. The home ensures that peoples medicines are reviewed regularly; some people have been able to reduce their medication since moving to the home and this has benefited them. One relative told us they have sorted out [my relatives] medication so they are not so drowsy. Care Homes for Older People Page 14 of 30 Evidence: Medicines are only dispensed by senior members of the staff team who have had appropriate training. The home uses a trolley when medicines are dispensed. This ensures that all medicines are dispensed and then given to the person immediately to reduce the risk of errors or people not taking their medicines at the right time; the trolley is stored securely when not in use. The medication administration records we saw were well kept. Care Homes for Older People Page 15 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. Each person is treated as an individual and they make choices about their lives. People are part of their local community. They have a choice of activities and trips and are supported to keep in touch with family and friends. People have healthy, well presented meals which they choose. Evidence: People we spoke with, and those who wrote to us, said they are happy living at Suddon House. They are able to choose how to spend their time; staff always respect their wishes. Comments included: staff listen to what is said, they are very friendly. The home allows me space to walk about, they try to tailor things to [my relatives] needs; they seem very happy and the staff relate to people well and they take trouble with the residents on an individual basis. The home has developed a comprehensive activities programme since our last visit; this has been designed to suit the people who live in the home. We looked at the activities planned for December and these included a tea party, Christmas Bazaar, Mobile Library, making Christmas cards, a Christmas Party; there were also trips out Care Homes for Older People Page 16 of 30 Evidence: of the home planned such as shopping trips to Wincanton and Yeovil and attending the local Church service. They have formed good links with other organisations who also support some of the activities for people who live here. These include a weekly flexercise session (which is organised by Age Concern) and singing for the brain sessions (organised by the Alzheimers Society). The home now has a sensory room where people can relax or have therapies such as aromatherapy or massage; people were seen using this room when we visited. Some people were also supported to make Christmas cards when we visited; this activity was enjoyed by the people who chose to take part and was well organised by staff. There is a stronger focus on providing care for people with Dementia. Some people have a life history book so that staff know what interests the person may have even though they may not be able to communicate them. The homes AQAA says they are a great tool for one to one activities. There are areas where older pictures or items of interest are displayed; people were seen to walk freely around the home as they wished and many had soft toys for tactile comfort. Time is spent with people on a 1:1 basis, if this better suits their needs; people were seen to be supported in this way by staff at times during our visit. The home organises entertainers for peoples birthdays and other special events. They ensure peoples cultural and spiritual needs are supported; they celebrate Saints days and religious festivals such as Easter and Christmas. They have a communion service every month and are in the process of developing a prayer corner which people will be free to use when they wish. The Manager told us the home has provided a good service to people where their previous care provider had not been able to meet their needs; this was especially when people had Dementia. One social care professional told us people they have placed here are much happier as other homes could not meet their needs. There is a nice relaxed atmosphere here and they are keen to learn from good practice. Each person is supported to maintain contact with their families and friends. Visitors to the home are welcome and relatives are kept up to date about important issues. During our visit many people received visitors; those spoken with said they are always made welcome and were happy with the care and support provided to their relative. Comments included: the staff show care and patience, there are activities for mental Care Homes for Older People Page 17 of 30 Evidence: and physical stimulation, the home is open and welcoming; they try hard to involve all of the residents and I dont know what they are doing, but they are doing something right. [My relative] is much better since they moved in. They sit with others now, they didnt before and they are eating much better now. The home has a pictorial menu and people have a choice of meals. Should people have particular preferences or need their food to be prepared or served in a particular way, this is known to staff and acted upon. People told us meals and snacks in the home are very good. Relatives are able to have meals in the home if they wish; these can be in the dining rooms or in peoples own rooms if they decide they would like somewhere more private. We observed both breakfast and lunch being served. There was a very relaxed, informal atmosphere during mealtimes; they are an enjoyable social occasion. Staff supported people who need help at mealtimes in a sensitive and professional way; people chatted between themselves and with staff. There was a good rapport between people who live in the home and the staff team. Care Homes for Older People Page 18 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. 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. People are safeguarded from abuse and neglect and action is taken to follow up any allegations. Evidence: The home has clear policies and procedures on how to recognise and report abuse (known as safeguarding), making a complaint and whistle blowing, which staff can use in confidence to raise any issue or concern they have regarding poor practice or possible abuse. People we spoke with, and those who wrote to us, said they know who to speak with if they are unhappy about any aspect of the home and they know how to formally complain if they needed to. The homes complaints procedure is displayed in each persons room; our contact address and telephone number is now out of date and should be amended as soon as possible to direct people to our National Contact Centre. The staff are clear about the important role they have to ensure people are happy with their service and remain safe; they know what to do if an individual, family member or a friend is concerned about any aspect of the care and support they provide. One Care Homes for Older People Page 19 of 30 Evidence: social care professional said they do know who to speak to if they have any concerns regarding the care and support provided at the home; they feel their views would be listened to and taken seriously. The home has had one complaint since our last visit; this has been looked into in line with the homes policy and was upheld. They also keep a record of compliments; we saw that the home has had a number of compliments about the care and support offered to the people who live in the home. Most are from relatives; some are from social and health care professionals. Staff are provided with training in relation to safeguarding and are subject to safety checks such as enhanced Criminal Record Bureau disclosures (known as CRBs), before they start work in the home. The home maintains thorough records of each accident, incident or other significant event which occurs in the home. We are notified of significant events together with any other concerns regarding individuals who live in the home. 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. Suddon House provides a homely, clean and comfortable environment for people to live in. Evidence: Suddon House is situated approximately one mile from Wincanton town centre, set in its own grounds with pleasant views onto surrounding farmers fields. The home is approached by a long private drive off the main road in West Hill. It has two entrances with the main entrance to the front of the property; the second entrance is to the side. There is ample car parking to the front and side of the home. Accommodation is arranged over two floors and there is a lift for people who are not able to manage stairs. At present only the ground floor of the home is in use; the upper floor is closed for refurbishment which should be completed by the end of January 2010. We will visit the home again when this work is completed, prior to people occupying the first floor. There are 21 single room and five double rooms on the ground floor; nineteen have en-suite facilities. People have use of two shower rooms and a bathroom, equipped with a bath hoist and hand rails to help people with mobility problems. One of the ground floor bedrooms has been converted into the homes sensory room. The home Care Homes for Older People Page 21 of 30 Evidence: has a variety of communal space, but the large lounge adjacent to the dining room remains the hub of the home. The bedrooms we viewed on the ground floor had name boards on doors, some with pictures. Bedrooms were clean and comfortable; it is clear that much work has been done to make these more personal and homely and they now contain many personal items, pictures, ornaments, photographs and some people have some of their own furniture. Improvements have been made to meet the needs of people who have Dementia. There is use of colour contrast (for example each toilet and bathroom door is painted the same colour), there are areas of interest around the home (such as pictures of older forms of transport and work) and there are tactile items in the homes reminiscence corner such as an old camera, sewing machine, radio and books which may interest or stimulate people. All of the communal areas were clean and tidy; they are well lit and have hand rails to help people walk around the home independently if they are able to. Doors are now secured using either a keypad system or an alarm system; fire doors are also secured and the fire service have been informed and provided guidance to ensure this practice is safe. The home employs staff to keep the home clean; one member of staff was seen cleaning on both days of our visit. The home has laundry and sluice facilities; there are hand washing facilities and equipment, such as gloves and aprons, available for staff. We looked at the records relating to the risk of legionella infection, the monitoring the water temperatures and the management of waste; these were all up to date. The homes AQAA confirms they have an action plan to deliver best practice in the prevention and control of infection; all staff have been provided with relevant training. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have safe and appropriate support provided by a competent and well trained staff team. Thorough checks are carried out on new staff to ensure they are suitable to work in the home. Evidence: The home currently employs 24 members of staff; there are currently 16 members of the team who are classed as permanent care staff and six of these have attained a National Vocational Qualification (NVQ). There has been a number of changes in the staff team since our last visit and the home is continuing to recruit new staff. On both days of our visit there were sufficient staff working to make sure people were well cared for and supported. Those staff we observed supporting and interacting with people who live in the home had a good understanding of peoples needs and how to communicate effectively with them. Staff had a good rapport with individuals and always appeared to have time for them; there was a relaxed, homely atmosphere. People we spoke with, and those who wrote to us, said staff treat people well; they are available when they need them and they listen to them and act on what they say. One person told us all the staff are helpful and friendly; other comments were the Care Homes for Older People Page 23 of 30 Evidence: staff treat everyone individually knowing their needs, staff are always friendly when I visit and there are always staff around and staff are really good at caring for a variety of people here. As far as Im concerned everything is fine. The staff we spoke with said they feel the home has really improved in the last year. The care for people who live in the home has improved and the team is now working consistently. One member of staff said we have a good team now. We have higher expectations now and higher standards; we are all here for the residents. Another staff member told us there is a much better atmosphere now, staff are much more settled and this shows. The social care professional we spoke with said they feel staff have the right skills and experience to support people. They have had very positive feedback from other health professionals in their team about the support provided by staff at the home. New staff complete a thorough induction training programme; staff are then provided with mandatory courses such as emergency aid, health and safety, how to move and handle people safely, fire safety and infection control. Staff are also given training in specific areas such as Dementia, diet and nutrition, how to support people who may be aggressive, medication administration, bereavement, independent living and safeguarding. Some staff still need to complete their training programme. The home has now improved its recruitment practice. The personnel records of staff who have recently joined the team contain copies of their application form, documents proving their identity and eligibility to work in the UK, a health declaration, two satisfactory references and an Enhanced Criminal Record Bureau Disclosure (CRB). All necessary safety checks are now carried out before staff start working in the home; one member of staff told us that they have people waiting to start work but they are not able to until their CRB is returned and checked to ensure it is satisfactory. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have growing confidence in Suddon House because it is now well managed; it is run appropriately, with an open approach which values and respects the people who live in the home, and those who are close to them. Staff are now well supported; the environment is safe for people and staff because health and safety practices are carried out. Evidence: The home is managed by Mr Bis Oozageer; he is one of the Directors of the limited company who own the home. Mr Oozageer is suitably qualified, has many years experience in the care sector and has applied to register with us as there has been no registered manager in the last four years. He is supported by one Deputy Manager and qualified members of the staff team who are on duty who offer support and guidance to less experienced staff. A manager from one of the organisations other homes has also been supporting the developments and Care Homes for Older People Page 25 of 30 Evidence: improvements at Suddon House. Mr Oozageer has an open door policy and knows people who live in the home, their friends and relatives and staff members well. During our visit people came into the office for help or advice and the Manager also spoke with people in communal parts of the home; he was seen to be very in touch with the day to day running as well as all the management of the home. People we spoke with and who wrote to us said they found managers and senior staff very approachable and they were happy to speak with them about any issue. People said they were always listened to and that they believed the home had improved significantly. One person said the management are constantly looking to improve all aspects of the home and to give a homely feel to the place. Other comments included: the general ambiance of the home has improved and they are open and welcoming, focusing on improving dementia care. The Quality Assurance process has now been formalised; people are asked to complete questionnaires and the results are then analised. We looked at the ones returned during August, September and October 2009; these showed that people are very happy with the care and support provided with the home. We also noted that social and health care professionals are also asked to complete questionnaires and their feedback was also very positive. The home has a number of policies and procedures, which are designed to ensure that both the people who live in the home and the staff team are safe, the service complies with the law and remains aware of best practice or new ways of working. Staff understand these policies as they are asked to read them and they sign to say they have done so. Staff are provided with regular supervision; a record is kept of each supervision session and any other more informal discussions which take place. The staff team meets regularly; the records we looked at show that attendance is usually good and that a variety of topics are discussed. The home is well maintained and there are systems in place to ensure the health and safety of people living and working at the home. The AQAA confirms that appropriate safety checks are carried out on the electrical wiring in the home, portable electrical appliances, the heating system, gas appliances and hoists. Care Homes for Older People Page 26 of 30 Evidence: We looked at the homes fire log book. This shows there is a current Fire Risk Assessment in place; regular checks are carried out on the fire alarm system and other fire fighting equipment. Staff take part in regular fire drills; they are also provided with fire safety training. Care Homes for Older People Page 27 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 28 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 7 13 The Registered Person must ensure that records of falls are used in the review process. This will ensure that care plans remain up to date and that the risks posed to people who are prone to falls are effectively managed. 16/02/2010 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 9 The Registered Person should ensure that guidelines for medicines taken as and when required are included in care plans as well as in medication records. This would help to ensure all care records for people are contained in one, up to date, plan. The Registered Person should update our contact details on the homes complaints policy. This will ensure people have the correct infomation should they wish to make a complaint. 2 16 Care Homes for Older People Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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