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Care Home: Exmouth House

  • 12 Long Causeway Exmouth Devon EX8 1TS
  • Tel: 01395275926
  • Fax: 01395269084
  • Planned feature Advertise here!

Exmouth House provides accommodation with personal care for up to 31 older people who may also have dementia. It is situated in a residential area of Exmouth close to the local health centre, hospital and schools. The registered provider is Somerset Redstone Trust. The property is a detached, extended building. Bedroom accommodation for people living at the home is on the ground, first and second floors. All rooms are single occupancy. There is a passenger lift to both floors. A communal lounge, conservatory and dining room are situated on the ground floor. There is an garden area to the rear of the building and a car park at the front. At the time of the inspection, fees were 595 pounds per week. 0 Over 65 31 care home 31

  • Latitude: 50.618999481201
    Longitude: -3.404000043869
  • Manager: Ms Elaine Brown
  • Price p/w: ~
  • UK
  • Total Capacity: 31
  • Type: Care home only
  • Provider: Somerset Redstone Trust
  • Ownership: Charity
  • Care Home ID: 6189
Residents Needs:
Dementia

Latest Inspection

This is the latest available inspection report for this service, carried out on 24th April 2009. CQC found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

For extracts, read the latest CQC inspection for Exmouth House.

What the care home does well The home has a good assessment procedure to help ensure that they can meet the needs of people moving to the home. Relatives feel they are well informed and this gives them reassurance about the move. There have been improvements to care planning, people`s health care needs are well met and medication is well managed to help keep people safe. People living at the home are supported to make day to day decisions, and are cared for in a manner to promote their dignity. There are a range of activities on offer and people visiting the home are welcomed by staff. Meals are provided in a calm and caring manner with choices being offered. Complaints are well managed and people feel listened to. The environment is generally well maintained and safe, clean and odour free, and there is an accessible garden. Staff are well trained and supported by a strong management team. Records are well maintained, including the management of personal allowances. What has improved since the last inspection? Generally care planning is now up to date. The heating we saw during this inspection was appropriate and the home was clean and odour free. What the care home could do better: As a result of this inspection, no requirements have been made. However, we have made three recommendations to improve practice. The first links to guidance in people`s care plans as to when `as required` medication is administered to help ensure it is used appropriately. The second highlights that attention should be paid to the cleanliess of chairs in communal areas to maintian people`s dignity and comfort. And lastly, staff should receive refresher training to promote their knowledge of their safeguarding role to ensure that concerns are passed onto the manager in a timely manner. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Exmouth House 12 Long Causeway Exmouth Devon EX8 1TS     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: Louise Delacroix     Date: 2 4 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 27 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 27 Information about the care home Name of care home: Address: Exmouth House 12 Long Causeway Exmouth Devon EX8 1TS 01395275926 01395269084 angela.till@somersetredstonetrust.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Somerset Redstone Trust Name of registered manager (if applicable) Ms Elaine Brown Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: Date of last inspection Brief description of the care home Exmouth House provides accommodation with personal care for up to 31 older people who may also have dementia. It is situated in a residential area of Exmouth close to the local health centre, hospital and schools. The registered provider is Somerset Redstone Trust. The property is a detached, extended building. Bedroom accommodation for people living at the home is on the ground, first and second floors. All rooms are single occupancy. There is a passenger lift to both floors. A communal lounge, conservatory and dining room are situated on the ground floor. There is an garden area to the rear of the building and a car park at the front. At the time of the inspection, fees were 595 pounds per week. 0 Over 65 31 care home 31 Care Homes for Older People Page 4 of 27 Care Homes for Older People Page 5 of 27 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 key inspection was unannounced and took place over nine hours. Prior to the inspection, the home completed an Annual Quality Assurance Assessment (AQAA), which tells us about how the service is run and improvements that have been made and the homes plans for the future. Information from this document has been included in the report. We also sent out surveys to people living and working at the home, and to people visiting the home, and the responses from these have been incorporated into the report. During the inspection, we spoke to people living at the home and observed their care in communal areas. During the inspection, we carried out a Short Observational Framework for Inspection (SOFI). This helps us measure the well-being of people who are unable to comment directly on the care they receive. It also enables Care Homes for Older People Page 6 of 27 us to make judgments about how people occupy themselves during the day and the skills of the staff who support them. 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 27 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 27 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. Exmouth House has a good admissions procedure, which helps ensure that they can meet the needs of the people living at the home. Evidence: As part of the inspection, we looked to see how staff ensured that it could meet the needs of people considering moving to the home. In the homes AQAA, the manager describes a robust admission process, which includes a visit to the person and the completion of a questionnaire. Discussion with the manager confirmed that they were clear about the skills of their team of staff and recognised when the home could not meet the needs of people. We saw evidence that information is collected from the health and social care professionals who may be involved in the prospective residents care. Before moving to Exmouth House, people are assessed by the home by gathering information from them and the people important to them i.e. family, which was confirmed by peoples responses in their surveys. A family member gave an example Care Homes for Older People Page 10 of 27 Evidence: to show how the assessment process is on-going and recognises change, they said bed changed to prevent accident/falls after first week of stay. People are encouraged to visit the home, and in their survey a person said I was invited to visit, met with manager and had a tour of the home. Also given a copy of the service user guide. Another person commented we have always been given plenty of information. Help is given to explain fees and contracts. In response to our question, Have you received a contract?, all of the seven respondents said they had. A relative said that the contract was well explained by the manager, Elaine Brown. Staff told us they took a pride in providing a positive welcome to people moving to the home, which includes ensuring people have their preferred type of bedding and flowers in their room. In the homes quality assurance surveys, relatives spoke postively about the standard of welcome to new people moving to the home. Four staff told us in their surveys that they always receive up to date information about the needs of people they care for. One person commented before any new service user moves into Exmouth House a few days before we have the initial assessment, so we can read to know a little about the person before moving into Exmouth House. The home does not provide intermediate care. Care Homes for Older People Page 11 of 27 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 living at the home have their care and health needs met in a way which respects their privacy and dignity, and generally medication is well managed to help keep people safe. Evidence: We looked to see how peoples health,personal and social care needs are set out in an individual plan. We looked at three in detail, and where possible met the people they related to. In the homes AQQA, it states that there is on-going work to update the care plans and this work in progress status is reflected in the comment from one visiting social care professional that the records were disorganised and staff could not find the information I was asking for. However, generally the information that we saw was up to date, reviewed, and when we spoke with staff they were clear about peoples individual needs, which we saw reflected in staff practice during our time in the communal areas of the home. Staff were very clear about the role of care plans to inform their practice and Care Homes for Older People Page 12 of 27 Evidence: confirmed they had regular access to them. One person said care plans and policies and procedures give us guidelines to follow. And we promote this in the home and another said the care plans are always updated and we are well informed from it, as this is very vital in order for us to be aware what has changed or added in the care needs of our service users. Staff also told us about regular handovers before they start their shift, which also keep them updated about peoples changing needs. The care plans promote peoples individual needs, such as likes and dislikes and preferences and normal routines and show how people living at the home are consulted about their personal preferences. A GP said that the home treats people as people. While we spent time in the communal areas , we saw people following the routines described in their care plans, and being supported to maintain friendships, which had been recorded in their care plans. We spoke with the manager about changing the wording of the forms in line with promoting equality and diversity. We saw an example of where a risk had been identified for one person living at the home and the action taken to help reduce it, which included clear records and seeking a health professionals advice. But for one person there had been a change in their care needs, which had not been fully updated in their care plan after they had been discharged from hospital, which the manager said would be addressed. There are good examples that health and social care professionals are consulted appropriately, and there are clear records of health interventions. This includes contact with the chiropodist, optician, dentist, audiologist, district nurses and doctors. Two health care professionals told us in our surveys that individuals care needs are usually or always met by the care service, and that the care service seeks advice and acts upon it to manage and improve individuals care needs. Staff could give us examples of when advice had been sought and acted upon. A relative said we are totally happy with the care given to (our relative). We couldnt wish for a better home ...than Exmouth House. We are impressed by all the staff and the care they give to each person. We are always kept fully informed of (their) health etc. Six visitors said that their relatives always receive the medical support they need and two felt this was usually the case, although one person said that hearing aid batteries should be checked more regularly. We observed two occasions when members of staff gave people their medication. On the first occasion, the staff member was calm and caring, providing explanations and reassurance when necessary. We saw records were well kept, updated, and with explanations recorded when people chose not to take their medication. Written amendments were also double signed which is good practice. A visitor said that staff have been excellent in ensuring that their relative took their medication and that their Care Homes for Older People Page 13 of 27 Evidence: relative remained active. However, on the second time later in the day, the staff member was constantly interrupted by the needs of people in the communal area, which made their task more difficult. Other staff members were busy in other areas of the lounge. We saw from the medication charts that one person was prescribed medication which is as required but there was no guidance in the care plan as to what might trigger the administration and the records in the daily nights were unclear why it had been given. We were told it was to help the person to sleep. Throughout our visit, we saw numerous examples of how staff maintain peoples privacy and dignity . For example, during our visit one person slipped onto the floor from their chair, and the senior inparticular was calm in her approach, making sure their dignity was protected by placing a screen around them while they were hoisted whilst reassuring them so that they became less anxious. Unfortunately, the transfer by hoist was delayed by the first battery on the hoist not working. Staff were courteous, listened to people and acted upon their requests. This was still the case when one persons behaviour was repetitive and needed constant attention to prevent their behaviour impacting negatively on other people living at the home. People were discreetly supported with their meals, protective clothing was removed as soon as it was no longer necessary, and support to find the toilet was given quietly without drawing attention to the person. However, a few staff members overly used endearments, which sometimes came across as patronising and inappropriate, including describing someone as like a baby. Relatives told us that staff listen to people living at the home, and that they are able to support them, with one person saying very impressed with the ability of the staff in supporting (my relative) emotionally, having dementia has been traumatic for (them). We saw staff reassuring people when they became anxious and acknowledging their view of the world by responding to their concerns, which help them feel valued and listened to. We also heard people being called by their preferred name as documented in their care plans, and staff gently approaching people so as not to alarm them when they were sleepy. Care Homes for Older People Page 14 of 27 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 living at the home benefit from both organised and spontaneous activities in a welcoming environment. Choice is promoted and peoples individual nutritional needs are catered for. Evidence: We looked to see how people living at the home are supported to live the life they choose. One person told us that they got up when they wanted to and that they enjoyed using the garden, and we saw records in peoples daily notes showing a flexible routine at the home. Another person is supported to go out for regular walks, which includes a back up plan if they became disorientated. A third person told us they enjoyed using the computer and we saw them using it. A fourth person told us about the importance of friendships, and we saw staff helping them to maintain them, which was reflected in their care plan. We saw that people are supported to maintain their spiritual beliefs, and to carry on with previous skills and interests, such as drawing. One person told us that this was very important to them. We saw from records and photos that people have access to one to one support, as well as group activities, and external trips. Care Homes for Older People Page 15 of 27 Evidence: One relative was concerned that people were encouraged to stay in the lounge in order to make it easier for staff to care for them. However, on the day of the inspection people moved freely around the building, and we met people going to and from their rooms. The home employs a dedicated staff member to provide activities who works Monday Friday, and we saw a number of people being encouraged to join in with a group activity in the afternoon, which led to much laughter and banter. Some people looked at magazines and newspapers. Others were supported to see the hairdresser who was visiting, while other people looked comfortable walking around and talking to people in passing. Two people had less contact with staff than others, but did not appear distressed by this. The home organises trips out, and encourages people to use the garden. Staff showed throughout the day their awareness of peoples individual backgrounds and the local history i.e. previous shops in the area and who used to work in them. The home has no set visiting times and we saw relatives and friends coming and going. Staff were friendly and relaxed with relatives, and the atmosphere welcoming with people being supplied with drinks. Throughout the day, we saw that choice was promoted by the staff group; they listen to people and try to respond to their requests. Care planning supports this practice, and discussion with staff reflected the ethos of supporting people to make decisions. Mealtimes are managed in a calm manner with a number of staff on duty so they were able to support people on an individual basis in a reassuring and courteous manner. We received positive feedback about the quality of the meals, both from surveys and in conversation. People who looked as if they were enjoying their meal describing it as lovely. People are provided with a range of utensils to support their individual needs, and peoples preferred method of eating i.e. using their fingers was not discouraged. Tables are attractively set with condiments provided, as well as a range of drinks. Meals were provided to meet peoples different needs, and alternatives were provided for people with a poor appetite. The atmospheres unhurried and staff adjusted their pace to the needs of the person they are supporting. Care Homes for Older People Page 16 of 27 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 living at the home benefit from a well managed complaints system, although safeguarding awareness for staff could be improved to help protect people living at the home further. Evidence: The Commission has not received any complaints about the service since the last annual service review. All of the relatives who responded to our surveys knew how to make a complaint, and one person was positive about how the service had responded when they had made a complaint. We discussed two complaints with the manager, and how she had responded quickly through letters and meetings, as well as ensuring the staff group were made aware of the concern so that it did not occur again. Staff were clear about their role if people had concerns about the home, and one person said I would discuss this first with my mentor or supervisor, and if I felt it wasnt dealt with correctly, I would speak to my manager. Health and social care professionals visiting the service said that generally their concerns were responded to appropriately, although one person felt that funding arrangements could be problematic. The manager has written in the homes AQQA that she is considering carer forums to include relatives and friends to try and encourage open and frank discussions about concerns. Care Homes for Older People Page 17 of 27 Evidence: There have been no safeguarding referrals linked to the home. Staff are provided with training in their responsibilities, as shown by the homes AQAA and training records, and we discussed their knowledge in this area with them. However, one example was seen in the homes records where staff had not shared a concern raised by a staff member with their manager in a timely manner. The homes AQAA states that Mental Capacity training has been provided to some staff and that the manager has attended Deprivation of Liberties training. Since the inspection, the manager has shown how she has alerted professionals to safeguard a persons best interests. Care Homes for Older People Page 18 of 27 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 living at the home benefit from a well maintained and clean home with accessible grounds but attention is needed to ensure the cleanliness of chairs in communal areas to help maintain peoples dignity. Evidence: The homes AQAA states that externally the home is well maintained, with contracted gardeners to attend to the front and rear garden. The garden looked well kept and people told us they enjoyed using it. We visited a number of bedrooms and saw that they were well maintained too. The manager told us that rooms were decorated as they became vacant, and re-carpeted as necessary. However, some of the furniture in the communal areas would benefit from cleaning because it is stained e.g. chairs in the conservatory area. A relative commented that the home was on the whole a very bright environment. Chairs are always an issue in a care home due to food and continence issues. The home was clean and odour free, this included bathrooms and toilets, although a relative raised a concern that communal toilets could be unclean, another said there could be an unpleasant odour, and a social care professional said the dining area could be malodorous. However, other people told us that the home was regularly fresh and clean. Care Homes for Older People Page 19 of 27 Evidence: We saw that the laundry was well organised and that staff were aware of the precautions needed to promote good infection control procedures, including the use of red bags for soiled laundry and colour coded cleaning equipment. The manager confirmed that the majority of staff have attended infection control training; we saw evidence of this training in one of the three training files we looked at. We also saw from staff meetings that infection control issues are highlighted to the team. Care Homes for Older People Page 20 of 27 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 living at the home benefit from a skilled and committed staff team who are able to respond to their care needs. Evidence: On the day of the inspection, there appeared to be adequate staffing levels to meet the needs of people living at the home, although staff were very busy in the early evening and the atmosphere was less calm. We saw in the early evening that some people became more restless and needed more one to one attention as the day passed. In their surveys, three of the four staff who completed them felt that staff levels were generally sufficient, although one person said the balance of the day could be upset if a person was unwell and needed extra care. We spoke to the manager about being able to provide flexible staffing levels at busier times. However, throughout the day we saw that staff were observant and picking up on peoples needs i.e. finding a blanket for someone to make them comfortable. Five people living at the home who completed surveys said that staff were always available, and three said that this was usually the case. On the day of the inspection, the manager and deputy manager were on a training day but there was a senior on duty both in the morning and evening with four carers working with them in the morning, afternoon and evening shifts. There is an overlap between the two seniors Care Homes for Older People Page 21 of 27 Evidence: shifts to allow for a handover, and the team are supported by the cook, a kitchen assistant , and three domestic staff, as well as the activities organiser who works four hours a day, five days a week. There is also a maintenance person and an office manager. Currently, there are two night carers and in the homes AQAA it states that funding is being sought for a third. According to the homes AQQA, the majority of permanent staff have an NVQ 2 in care or above, which is good practice. Staff confirmed their training on the day of the inspection, and the manager told us that further funding has been provided for NVQ training. We looked at three recruitment files to ensure that staff are recruited in a robust manner to safeguard the people living at the home. We saw that key documents are in place, such as ID, references and POVA checks and CRBs. However, we advised that when verbal references are taken they should be documented, and that staff need to ensure that all documents are dated. Staff praised the ethos of the home to promote training and the quality of their induction with one person saying it was excellent. People visiting the home commented positively on the skills of the staff, and we saw this praise reflected in the practice of staff on the day of the inspection. For example, offering reassurance and kindness to someone who was anxious and restless. People who visit the home told us that staff are always hard working and busy, provide excellent support and helpful and caring. We observed that people living at the home appeared relaxed with staff and that many felt able to express their opinions and were listened to by staff. For example, somebody requested some jazz music and a staff member remembered their request and found appropriate music. Staff were positive about their work and demonstrated a strong commitment to person centred care. One person said it is a happy home and I have never enjoyed a job so much as this one. We saw that some staff members have good person centred skills to provide positive role models to less experienced staff. Training records reflect a range of current training, including mandatory training. The homes AQAA states that the home has adopted the Skills for Care induction of model, which includes equality and diversity elements. Staff told us that they had two weeks induction before they worked on their own, and we saw a new member of staff shadowing a staff member as part of their induction. Care Homes for Older People Page 22 of 27 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. The home is well run by an experienced manager, who encourages people using, working at and visiting the service to share their views. People living at the home benefit from a well run home, which help protects their safety and well-being. Evidence: The manager has been registered with the Commission, and has the experience and skills to met the needs of the people living at the home. Staff were positive about her leadership and the ethos of the home. One person said we were sad to lose our previous manager but her replacement has provided to be an excellent replacement. Another staff member said that the managers door was always open so they could go to her with concerns, and another felt their line manager also provided good support. The homes AQAA states that consideration is being given to incorporate the manager and office managers office into the main part of the home, and to provide a quiet area for people living at the home, which some visitors and staff have identified as a need for people living at the home. Care Homes for Older People Page 23 of 27 Evidence: We looked to see how the home enables people to influence the service. Staff told us during the inspection that they have regular meetings and this was confirmed in staff surveys, and that they felt there was good communication in the home, which we saw to be the case during the inspection. They told us this kept them up to date and enabled them to share their views. A staff member also told that that the visits by the responsible individual made them feel part of a team and they found the person open and friendly. We also looked at the homes surveys responses from staff, relatives and people living at the home, which were positive. The home told us in their AQAA that further work is planned to set up a carers form to improve links with the management team, and to have meetings that invite the views of all staff working at the home. We saw staff listening to peoples day to day decisions, and supporting people with these. We saw that peoples personal allowances are well managed and that there was a clear audit trail. We spot checked several accounts and saw that the money and receipts in them matched the records. The home is well maintained with safety measures in place such as call bells, restricted upper floor windows and covered radiators. Staff are clear about their role to maintain good infection control procedures. We were told that an external company had completed the homes fire risk assessment, and we spot checked maintenance records and saw that they were up to date i.e. services for hoists. Care Homes for Older People Page 24 of 27 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 25 of 27 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 1 9 There should be guidance in peoples care plans as to when as required medication is administered, and this should be reviewed to ensure that PRN medication is being used appropriately. Staff should receive refresher training to promote their knowledge of their safeguarding role to ensure that concerns are passed onto the manager in a timely manner. Attention should be paid to the cleanliness of chairs in communal areas to maintain peoples dignity and comfort. 2 18 3 19 Care Homes for Older People Page 26 of 27 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 27 of 27 - 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. 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