Care Home: Estherene House

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What the care home does well The interaction between the staff and people that lived at the home was observed to be caring, respectful and professional. People`s care plans that were viewed clearly showed the support that people were provided with to meet their assessed needs and preferences. People were provided with a good choice of meals, which were provided to them at their preferred times. What has improved since the last inspection? The staff recruitment records included the checks that were required to ensure that people were protected by the home`s recruitment procedures. An activities coordinator had been employed at the home and people were provided with the opportunity to participate in activities which were of interest to them. The bathrooms in the `old build` of the home had been provided with new flooring. A summary of people`s care plans, which was called a `dependency proforma` was available in people`s bedrooms, which provided staff with information of the support that people required in areas such as their mobility and personal care. What the care home could do better: The complaints procedure needed to be updated to show the current CQC (Care Quality Commission) contact details, should people wish to contact us. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Estherene House 35 Kirkley Park Road Lowestoft Suffolk NR33 0LQ     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: Julie Small     Date: 0 3 0 8 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 29 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 29 Information about the care home Name of care home: Address: Estherene House 35 Kirkley Park Road Lowestoft Suffolk NR33 0LQ 01502572805 01502580444 yvonne@estherenehouse.co.uk 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) : Estherene House Limited care home 29 Number of places (if applicable): Under 65 Over 65 0 29 dementia old age, not falling within any other category Additional conditions: 29 0 The maximum number of service users who can be accommodated is 29 The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE Date of last inspection Brief description of the care home Estherene House is a privately owned care home providing personal care and accommodation to a maximum of 29 older people, situated in a residential area of Lowestoft, near to shops and other amenities. Service users are accommodated on the ground and first floors of the building. There is a chair lift linking the two floors used by residents. Bathrooms and WCs have been adapted to assist people with mobility problems. The home provides a comfortable and caring environment for older people, and benefits from being a small scale, family-run establishment, with the owners on site on a daily basis. Care Homes for Older People Page 4 of 29 Brief description of the care home The homes fees range from £362.00 to £550.00 but do not include the cost of items such as newspapers, sweets and snacks from the homes shop, toiletries and hairdressing. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: The unannounced inspection took place Monday 3rd August 2009 from 10:00 to 17:05. The inspection was a key inspection, which focused on the core standards relating to older people and was undertaken by regulatory inspector Julie Small. The report has been written using accumulated evidence gained prior to and during the inspection. The manager and provider were present during the inspection and the requested information was provided promptly and in an open manner. During the inspection health and safety records, staff training records and the recruitment records for three staff were viewed. The care records of four people that lived at the home were tracked, which included care plans and medication records. Further records viewed are detailed in the main body of this report. Observation of Care Homes for Older People Page 6 of 29 work practice was undertaken and five staff members and seven people who lived at the home were spoken with. Prior to the inspection an Annual Quality Assurance Assessment (AQAA) was sent to the home and it was returned to us. Since the last key inspection an extension had been built, which housed up to ten people with dementia. There was further work being undertaken at the home, which would provide seven more bedrooms. There were also plans to make the shared rooms single and to improve the kitchen, laundry and medication rooms. 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 7535. Care Homes for Older People Page 8 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service can expect to have their needs assessed before they move into the home and to have their needs met. The home does not provide an intermediate care service. Evidence: The care records of four people that lived at the home were viewed and each held a detailed needs assessment, which identified their specific care and social needs and preferences, such as with their communication, health history, continence and mobility. The records also held a forty eight hour assessment, which identified observations of the person made by the staff at the home and how they had settled into the home over the forty eight hour period from when they had moved in. The AQAA stated each resident is assessed by the manager while they are in their home, hospital etc. before they are accepted by the homes manager to be offered a Care Homes for Older People Page 10 of 29 Evidence: placement. Peoples care records held detailed care plans, which showed how their assessed needs and preferences were met. Care Homes for Older People Page 11 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service can expect to have their needs and preferences set out in an individual care plan, to have their health care needs met, to be treated with respect and to be protected by the homes medication procedures. Evidence: The care records of four people that lived at the home were viewed and each held a care plan, which detailed the support that people required to meet their assessed social and health care needs and preferences. The care plans identified support that people needed in areas such as with personal care, communication and mobility. They detailed how people should be treated with respect and how their dignity was to be respected, for example, the care plans identified peoples preferred form of address, how they styled their hair and one care plan identified how they took pride in their appearance and liked to check their reflection in the mirror. The care plans were regularly updated to reflect peoples changing needs and preferences. People that lived at the home who were spoken with told us that they felt that their needs were met. A staff member was spoken with and they told us that the care plans provided the Care Homes for Older People Page 12 of 29 Evidence: details that they needed to enable them to support people in ways that met their needs and preferences. A summary of peoples care plans (dependency proforma) was kept in peoples bedrooms that summarised the support, in areas such as personal care and mobility, that people required and preferred. The documents provided an easily accessible reference to staff when they were supporting people. Two staff members that were spoken with told us that they found the dependency proforma useful, which they could use as a checklist when supporting people. We had received a concern from an anonymous source which stated that people were not appropriately supported with their personal care when their pads were changed. We spoke with the homes management and staff that worked at the home and they assured us that personal care was undertaken appropriately. Peoples care plans detailed the personal care support that they were provided with, which included the arrangements for continence care. It was noted that people were clean and tidy during the inspection and there were no unpleasant smells. Daily records were viewed which identified the support that was provided to people on a daily basis, the staff observations of peoples well being and the choices that people had made, such as activities that they had participated in. The care plans included risk assessments, which identified the methods of minimising the assessed risks in peoples daily living. The risk assessments included areas such as manual handling, skin viability, mobility and nutrition. The AQAA asked what the service did well and it stated assessed Waterlow assessments and care plans including risk assessments. Peoples records included the details and outcomes of the medical support that they had been provided with, such as from a district nurse or doctor. People that were spoken with told us that their health care needs were met and if they felt unwell and doctor would always be called. During the inspection we observed a staff member supporting a person who complained of painful feet. The staff member listened to the person, offered them a wheelchair to sit in, looked at their feet and offered to make an appointment with the doctor. It was noted that the staff treated the person with kindness and respect. The interaction between staff and people who lived at the home was observed to be caring, respectful and professional. We observed people chatting with staff and it was noted that they laughed and smiled with each other. We observed two staff members supporting people with their mobility, using a stand aid. It was noted that the staff Care Homes for Older People Page 13 of 29 Evidence: used good manual handling practices and their interaction was very good. They clearly explained their actions and checked that the people were comfortable and felt safe. People that lived at the home who were spoken with told us that they were always treated with respect by the staff who worked at the home. People were complimentary about the approach of the staff and the homes management, one person told us that the staff are lovely. We observed staff knock on bedroom and bathroom doors before entering, and the manager asked for peoples permission for us to look at their bedrooms. The shared rooms in the home provided screens, which ensured that peoples privacy was respected. People that were spoken with told us that the staff always respected their privacy and they confirmed that their bedroom doors were knocked on before staff entered. During the inspection we observed a staff member working with a person who had asked for support with their personal care, the staff member promptly supported the person and they ensured that the bathroom door was closed. The homes medication procedure was viewed and it detailed the arrangements for the safe handling, storage, administration and disposal of medication. Part of the lunchtime medication administration was observed and it was noted that people were asked if they wanted their medication, the staff member signed the MAR (medication administration records) charts when the people had taken their medication and they used appropriate codes to show if they had refused their medication, such as for pain relief. The staff member was observed to use good infection control procedures when administering the medication, which included wearing a disposable apron and they transferred the tablets from the MDS (Monitored Dosage System) blister packs into clean pots. The staff member explained the procedures for medication administration and they told us that they had been provided with medication training, which was confirmed in the training records that were viewed. The MAR charts for four people were viewed and it was noted that they were appropriately completed and all medication was accounted for. The controlled medication book was viewed and it showed that the administration of controlled drugs was witnessed by a second staff member and a running total of the medication was recorded, which showed that people were protected by the homes controlled medication procedures. The medication was stored in a secure medication cupboard in a secure medication room. The controlled medication was stored in a secured cabinet, which was stored inside the medication cupboard. A staff member told us that they were aware of the changes in legislation regarding the storage for controlled medication and that this would be addressed in the phased refurbishment of the home, which would provide a Care Homes for Older People Page 14 of 29 Evidence: new medication room and storage. This was confirmed by the homes manager, who told us that the work would be completed by the end of the year. The AQAA asked what the service did well and it stated all medication kept and administered, regular visits from pharmacy and pharmacist. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service can expect to be provided with the opportunity to participate in activities which are of interest to them, to be supported to maintain their chosen contacts and to be provided with a balanced diet. Evidence: People were provided with the opportunity to participate in activities which are of interest to them, which included group and individual activities, such as playing cards, dominoes, games, quizzes and art work. Since the last inspection an activities coordinator had been employed to ensure that people were provided with an activities programme which met with their social needs. The AQAA stated that they had improved in the last twelve months by employed someone to coordinate activities. Encourage residents to take part in various activities e.g. everyday things making their beds, laying up tables or more artistic things, making masks. The records of activities were viewed, which identified the activities provided and the people who had participated in them, such as cake baking, making face masks, painting picture frames and poetry. There were face masks and picture frames in the lounge, which people told us that they had painted. People that were spoken with told Care Homes for Older People Page 16 of 29 Evidence: us that there was plenty to keep them occupied and one person told us that they attended a local air show. Peoples care plans that were viewed identified they should be supported to do what they were interested in and enjoyed. For example a person regularly attended a church in the community and a person liked to help to keep their bedroom clean and their care plan explained how they should be supported to do so. The manager told us that visiting entertainers attended the home, such as singers and a person attended the home on a weekly basis who provided an movement and exercise activity. There were notices posted in the home which showed the dates of visiting entertainment. During the inspection we saw several things in the home, which people could use for their entertainment, such as a karaoke machine, a Wii games console, television, music centre, board games, jigsaws and books. During the morning of the inspection people were observed to be listening to music by Tom Jones and in the afternoon there was music playing from 1940s, which some people danced to. Peoples care plans that were viewed, showed how people maintained their chosen contacts with family and friends. One care plan detailed the support that staff should provide to a person to ensure that they were safeguarded during visits. During the inspection several people were observed to visit people in the home and it was noted that they were welcomed into the home by the staff that were on duty. People that were spoken with told us that their guests were always made welcome. The AQAA stated friends and family can visit at any time. The AQAA stated that they give residents choice about what they want to do/not to do during their daily lives. We had received a concern from an anonymous source which stated that peoples views were not listened to. However, people that were spoken with told us that the staff listened to what they said and that their choices were respected, which was confirmed in daily records that were viewed and observations made during the inspection. People chose what time they wished to get up in the morning, and we observed a late riser having breakfast, which showed that they were supported in their choices. The AQAA stated residents can sleep in until they prefer to rise, meals are worked around this. We viewed questionnaires, which had recently been undertaken by the people that lived at the home, in which they stated their satisfaction with the activities and meals that were provided at the home. The menu was viewed and it was noted that people were provided with a balanced and varied diet. There was an additional alternative menu, which people could choose from if they did not want what was offered on the main menu. The alternative menu offered thirty one choices of meals, which included eight soup varieties, eight vegetarian choices and food such as fish, meat and pies. People that were spoken with told us Care Homes for Older People Page 17 of 29 Evidence: that the food at the home was very good, they could choose what they wanted to eat and that they were provided with enough food. We observed people enjoying their lunch, in the dining room, which was cottage pie and vegetables. The meal looked and smelled appetising. We observed a staff member helping a person to eat their meal and it was noted that they remained with the person throughout their meal and they explained what was on the plate and fork. We visited a person in their bedroom and they had soup for lunch, they told us that they preferred a light lunch and a main meal in the evening. They told us that their choices were catered for. The care plans that were viewed showed peoples specific dietary requirements, such as diabetes. The cook was spoken with and they told us that they were informed of all dietary requirements by the manager and that they ensured that they were met. Choices of hot and cold drinks were provided throughout the day of the inspection and it was noted that there were water coolers in the lounges, which people could help themselves to. Care Homes for Older People Page 18 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service can expect to be protected from abuse and to have their complaints listened to and acted upon. Evidence: The complaints procedure was viewed and detailed the arrangements for dealing with complaints. The procedure provided CQC (Care Quality Commission) contact details, which needed to be updated to show the current address, should people wish to contact us. The AQAA said that there had been no complaints made in the last twelve months, which was confirmed in the complaints book that was viewed. People that were spoken with told us that they knew how to make a formal complaint and who to speak to if they were not happy. The AQAA stated we deal with complaints immediately, the manager is always available to speak to residents, families or friends with any concerns they may have. Compliments, which included letters and cards thanking the staff for the support that they had provided, were viewed and they were displayed in the entrance hall to the home. There had been no safeguarding alerts made in the last twelve months. The safeguarding procedure was viewed and clearly identified the actions that should be taken if there were concerns about a persons well being. Staff that were spoken with Care Homes for Older People Page 19 of 29 Evidence: had a good understanding of their roles and responsibilities regarding safeguarding and they all said that they had been provided with safeguarding training, which was confirmed in the training records that were viewed. Care Homes for Older People Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service can expect to be provided with a clean, hygienic and comfortable home to live in. Evidence: Since the last key inspection there had been an extension unit to the home, which provided support for ten people with dementia. The unit was clean, tidy and attractively decorated and furnished. It provided bedrooms with an en suite facility, a communal lounge/dining area and a small courtyard in which people could sit. The original building provided a communal lounge, dining room, bathrooms and toilets. Throughout was clean and well maintained and it was noted that there were no unpleasant smells. The AQAA stated we have been making improvements to the home. We have an ongoing development plan, which phases 1 and 2 are now completed and we are waiting for contractors to start phase 3, which is a 7 bedded unit with day room and dining room, new laundry and kitchen facilities. During the inspection it was noted that phase three was underway, and people told us that they enjoyed watching the progress and that they were not disturbed by the work. The provider told us that the work was due to be completed by the end of the year. The AQAA stated that they had Care Homes for Older People Page 21 of 29 Evidence: improved in the last twelve months by new floors have been put in toilets and bathrooms, residents all have call bells in their rooms and personal call bell if they would like them. We had received a concern from an anonymous source which stated that the kitchen was dirty. We viewed the kitchen and found that it was clean. The manager explained that a new kitchen was to be built during the phase three development of the building. Peoples bedrooms that were viewed included items of personal memorabilia and reflected their choices and individuality. The manager told us that people could furnish their bedroom with items that they wished to bring from their previous home, which was confirmed by a person that lived at the home who was spoken with. The laundry was viewed and it was clean and tidy. The manager told us that a new laundry would be built in the phase three of the development of the home, which would be larger and incorporate clean and dirty areas. There was a drying machine, two washing machines, one of which provided a sluice facility and hand washing facilities in the laundry. It was noted that the risks of cross infection was minimised by the provision of hand wash liquid and paper towels in bathrooms, toilets and the laundry. Staff were observed to use good infection control procedures, such as wearing protective clothing and gloves when supporting people with personal care, working with food and medication. A staff training matrix that was viewed showed that staff had been provided with infection control training. Care Homes for Older People Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service can expect to be supported by staff who are trained to meet their needs and to be protected by the homes recruitment procedures. Evidence: The manager told us that there were three staff that worked in the main unit and two in the extension unit each shift during the day and there were two waking night in the original building and one in the extension during the night. This was confirmed by the rota that was viewed and our observations of the staffing arrangements on the day of the inspection. Staff that were spoken with told us that there was enough staff on duty to meet peoples needs. People that lived at the home were complimentary about the approach of the staff and they told us that the staff were available when they needed them and answered call bells promptly. Staff were observed to be attentive to the needs of people that lived in the home and the interaction between staff and people was observed to be caring, respectful and professional. Staff training records that were viewed, which included a training matrix and certificates, showed that the staff were provided with the training which they needed to meet peoples needs. Training included a Common Induction Standards course, safeguarding, infection control, manual handling and dementia. Staff that were spoken with told us that they felt that the training provision was good and that they were Care Homes for Older People Page 23 of 29 Evidence: provided with training which supported them to meet and understand peoples needs. The manager explained how they monitored the effectiveness of the training that the staff had been provided with. They told us that the staff completed a quiz following training courses, which the manager used to identify any further training needs if needed and discussed their progress with them in supervision meetings. The AQAA stated we use the local authority induction programme, then new staff are expected to then go on and do a minimum of NVQ 2 in care. The home had met the target of a minimum of 50 staff to have achieved a minimum of NVQ (National Vocational Qualification) level 2 as identified in the National Minimum Standards relating to older people. The AQAA said that there were twenty seven care workers at the home and fifteen had achieved a minimum of NVQ level 2 in care or social care and health. The recruitment records of three staff members were viewed and it was noted that the appropriate checks had been undertaken to ensure that people were safeguarded. The records included an application form which detailed their work history, identification, CRB (Criminal Records Bureau) check and POVAfirst (Protection of Vulnerable Adults) check. Two of the records held two written references and one held one, however, there was evidence that the manager had chased up a second reference in writing and they had obtained a verbal reference. The AQAA stated we employ a cross section of people with different abilities, all have POVA, CRB checks and references taken up. Care Homes for Older People Page 24 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service can expect to live in a home which is managed in their best interests and to have their health, safety and wellbeing promoted and protected. Evidence: The manager was present during the inspection and it was noted that they were receptive to the inspection process and provided the information requested promptly and in an open manner. The manager had been successful in the CSCI (Commission for Social Care Inspection) registered manager application process and they had achieved an NVQ level 4 in management and an NVQ level 3 in care. The certificates for the managers training and qualifications were displayed in the entrance hall to the home. The manager had updated their knowledge and skills in attendance of various training courses, which included dementia care mapping, Deprivation of Liberty, Mental Capacity Act and was working on dementia training with Bradford University. The manager had a good knowledge of their roles and responsibilities of managing a care home. Care Homes for Older People Page 25 of 29 Evidence: People that were spoken with were complimentary about the approach of the manager and staff reported that the manager acted on concerns promptly. The AQAA stated manager is available 24/7 to see residents, staff and relatives, she updates policies and procedures regularly. The manager was also the responsible individual of the home, the manager and provider were on site on a daily basis and monitored the running of the home and the support that people were provided with. We viewed satisfaction surveys which had recently been completed by people that lived at the home, which stated their satisfaction and suggestions in areas such as food and activities. During the inspection staff were observed to be attentive to peoples needs, they asked people for their views and choices and acted upon them. People who lived in the home that were spoken with told us that the staff listened to them and acted upon what they said. Peoples finances were safeguarded and it was noted that details of forwarded to their representatives for payment. Where people kept for safekeeping, clear records were maintained of their spending. A they managed their own finances and that they were provided with place in their bedroom to keep their valuables. their spending was money in the home person told us that a safe and secure Peoples health and safety was monitored and protected. Staff were provided with information in their roles and responsibilities regarding health and safety in the homes health and safety procedures and training, such as safeguarding, fire safety, infection control and manual handling. The homes environmental risk assessments were viewed which identified the methods of minimising the assessed risks in areas such as fire, the use of cleaning materials and electrical appliances. The servicing certificates were viewed for the hoists, chair lift, electrical appliances, the nurse call and gas safety, which showed that appliances and aids were safe to use. People were safeguarding in case of a fire, the fire safety records were viewed and showed that checks were regularly undertaken and issues were reported and addressed promptly. Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 28 of 29 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 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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