Care Home: Fairholme House

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What the care home does well The home provides a friendly, comfortable and welcoming environment for the people living here and their families and visitors. Comments we received included `Fairholme House is nice and clean. The staff are friendly making a nice atmosphere at all times`. `Fairholme is an open, friendly community. The staff are very caring and the atmosphere at the home is marvellous. The conditions are good in each room. The caring is also superb. The staff go out of their way to care for the residents` `The place is so clean and tidy, it is home from home, pleasant surroundings. Beautiful food and all the residents clean and cared for. The very best home` What has improved since the last inspection? Extensive decoration and re-carpeting has further improved the appearance of the home and people`s living space. The garden has been improved and accessed made easier for by widening the ramped path and adding a handrail, so that more people can enjoy the outdoor facilities. Landscaping one corner of the garden has provided another attractive view. The home has taken action on the requirements and recommendations we made at the last inspection about records kept in the home so that the assessment of people`s needs before they move into the home is more detailed. Care plans have more information and guidance for staff to follow so that resident`s preferences and individual needs are known by staff to make sure their care is `person-centred`. Staff have access to more training through an external training organisation as well as local colleges and health and social care organisations. The proportion of staff who have a nationally recognised qualification in care, such as the National Vocational Qualification (NVQ) at Level 2 or above, has increased. The homes commitment to the training and development of its staff means that the people living here are cared for and supported by skilled and knowledgeable staff. What the care home could do better: We found that the home has met the requirements and recommendations made at our last inspection. Though the recruitment and screening of new staff is generally safe and thorough, we found that there was one example where the home had not had not requested the full police and CRB check that it should have, before allowing the person to start work in the home. This was discussed with the homes manager who said that this would be followed up and the correct information requested in future. It is important that services providing care and support for vulnerable people ensure that they have all the required references and information about new workers in place in order to protect people living here from potential harm. Key inspection report Care homes for older people Name: Address: Fairholme House Church Street Bodicote Banbury Oxfordshire OX15 4DW     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: Delia Styles     Date: 0 3 0 6 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: Fairholme House Church Street Bodicote Banbury Oxfordshire OX15 4DW 01295266852 01295266954 jacquiemoss@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Oxford Care Homes Limited care home 22 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users to be accommodated is 22. The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - OP Dementia - DE Physical disability - PD Date of last inspection Brief description of the care home The home is situated in a village location on the outskirts of Banbury. The village has a post office, church and a public house. The home has 7 single bedrooms with en-suite facilities on the ground floor; upstairs, there are 13 single bedrooms, and one double bedroom all with en-suite facilities of toilet and washbasin. There are also three separate bathrooms. Stairs and a lift provide access to the first floor. Care Homes for Older People Page 4 of 30 Over 65 0 22 0 22 0 22 Brief description of the care home There are two lounges, a dining room and two conservatories on the ground floor providing comfortable communal accommodation. The home provides entertainment and activities for those wishing to take part. There is a pleasant garden at the back of the home for residents to use. The fees for this home currently range from 700.00 to 850.00 pounds per week. 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: The inspection visit took place over 6 hours and was a thorough look at how well the service is doing. We took into account detailed information provided by the homes registered manager in the form of the Annual Quality Assurance Assessment (AQAA) a self-assessment and summary of services questionnaire that all registered homes and agencies must submit to the Commission each year. We also looked at any information that the Commission had received about Fairholme House since the last inspection. A tour of the building, and inspection of a sample of the records and documents about the care of the residents and the recruitment and training of staff, were part of the inspection. Talking with a number of residents and staff gave us information about the home and peoples opinions about what it is like to live here. Some of the Commissions comment cards (surveys) were left at the home for Care Homes for Older People Page 6 of 30 residents, staff, relatives, and visiting health and social care workers to have an opportunity to have their say about the home. We received completed surveys from 3 residents, 5 relatives or advocates, and 2 health care professionals and their opinions are included in the report. We would like to thank all the residents, staff, and manager for their welcome and the time taken to help us with the inspection process. 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: 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. Care Homes for Older People Page 8 of 30 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. Prospective residents and their families and representatives have sufficient information about the home before they come to stay, to make an informed decision about whether it is likely to suit them. Since our last inspection, the home has improved the way in which it records the assessment of peoples care needs so that prospective residents and their families and representatives can be confident that the home can provide the appropriate care and support. Evidence: The home has reviewed the information it provides to people in the form of the Statement of Purpose and Service User guide. A brochure and service user guide are provided to prospective residents prior to their admission, and there is also a website. The homes own quality assurance questionnaire asks specifically about whether people felt they had good information provided before and at the time of admission. All five of our surveys we received from residents stated that they received enough information to help them decide if Fairholme House was the right place for them Care Homes for Older People Page 11 of 30 Evidence: before they moved in. People are given an opportunity to visit the home and spend time there, perhaps staying for lunch or taking part in the activities, so that they can get to talk to other residents and staff informally. People have a four week settling in period after which the home and resident are able to reassess whether the home is meeting the persons assessed needs and suits them. The homes Annual Quality Assurance Assessment (AQAA) tells us that the home plans to improve the information available further, by including some comments from current residents to give prospective residents some insight and opinions about their experiences of the home. They also plan to provide the pre-admission documents in large print and on audio tape to help those with visual impairment access the information. The standard of the pre-admission assessments seen in a sample of three peoples care records was good and shows that the home has acted on the recommendations made at our last inspection. The assessments now also include information about peoples mood, motivation, spiritual support needs and falls risk assessment. The registered manager confirmed that the initial assessment of prospective residents includes information from the individual, their family and any other professional health and social care who have had an input in their care and support. For people referred through a social services care management service the home ensures it has copies of the care managers assessment for the prospective service user and of their care plan. This helps the home to know whether the care and facilities they can offer is likely to match the expectations and needs of the individual. The surveys we received from GPs who provide medical care at the home showed that they feel the homes assessment arrangements ensure that accurate information is gathered and the right service is planned for people who come to live at Fairholme House. 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. Residents health care needs are well met and there is evidence of good communication between the home and health and social care professionals about ways to improve peoples health and wellbeing. Personal support is offered in such a way that promotes and protects residents privacy and dignity. Evidence: A sample of 3 residents care records was examined. The care plans seen were much improved from those we looked at last year and showed that the manager and staff have worked hard and acted on the recommendations we made. For example, the care plans include more information about peoples social and recreational care needs and their individual preferences about the pattern of their day and how they like to be cared for and supported. The care plans are arranged methodically and have numbered care needs and proposed actions for staff to follow to meet those needs. However, one of the sampled care plans did not include specific instructions for staff about the individuals personal care needs and what level of assistance they needed. There was no written information about how effective this persons pain relief Care Homes for Older People Page 13 of 30 Evidence: medication was for them, either. It is important that peoples records of care accurately show the level of care and support they need and how staff are to provide this. If someone experiences pain, the care plans should show what is effective in relieving their pain. If medication has been prescribed, the doctor will need to know if it is working, or need to be reviewed. The care records should contain written comments by staff to show whether the care they have given has met the residents care effectively and if not, what changes have been made. This was discussed with the manager. The two staff survey responses we received showed that they were not always confident that they receive enough information the needs of the people they are looking after, especially if they are part-time. One person wrote sometimes you dont have time to go through all the care plans. There are verbal hand overs between staff during each shift but the staff surveys indicate that they would like more brief summaries of care and changes in writing that they can see at a glance where there have been significant changes to someones care. The answers we received from the surveys we sent out for some of the residents to complete showed that all 5 felt they always receive the care, support and medical care they need. Of the 5 relatives. carers and advocates surveys completed, 2 stated that the home always meets the needs of their relative or friend, and 3 that this is usually the case. The responses from 2 GP surveys we received were very positive about the care provided at this home and the ways in which staff work with them to meet peoples health care needs. One wrote I am very happy to provide a medical input in this home. I have great faith in the staff. The home uses a blister pack system for residents medication, provided by a large high street chemist. There are appropriate procedures in place to manage the storage, recording and distribution of medication. The manager said that senior care staff receive training in safe handling and administration of medicines from an external training agency. She confirmed that the training meets the standard required for those care staff who are authorised to give out residents prescribed medicines. The manager also confirmed that if a resident wishes to, and is able to manage their own medication, they are supported to do so. A self-medication risk assessment is now in place so that residents who keep their own medicines in their rooms, do so safely. From the survey comments and observations and conversation with the manager, 3 residents, 2 visitors and 2 staff during the inspection we think that the staff are very Care Homes for Older People Page 14 of 30 Evidence: good at treating the people who live here with respect and dignity. Some additional comments we received in surveys about what the home does well included, Communication and respect as a person Everyone is so kind and welcoming, nothing is too much trouble. They all work very hard, answer all questions asked There is a very friendly and caring attitude. As is the case in many care homes and NHS health care facilities, there is a wider range of racial, ethnic and faith backgrounds represented within the staff group compared with the current residents. From the evidence seen and comments received, we consider that this home would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. Residents have single rooms (the shared room is used by one occupant) and staff were seen to knock and await an answer before going into residents rooms. Residents spoken with and who completed comment cards considered that staff listened to them and acted on what they said, though one person felt this was not always the case because the water is too cold for washing and bed times. The manager acknowledged that there has been a problem with the hot water supply in some rooms but that this was being resolved. 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. The home continues to improve the frequency and range of activities available for residents so that people have more opportunities to participate in stimulating and motivating pursuits. The meals are good offering both choice and variety and catering for special dietary needs. Residents opinions about the meals and activities are sought and acted upon. Evidence: The home employs someone as an activities coordinator for 20 hours a week and the scope of activities for residents is improving. The AQAA describes the different activities that are organised every afternoon for example, quizzes, Beetle Drive, Bingo, crossword puzzles, board games, painting and film afternoons. Hand and nail care are included with the weekly visits from the hairdresser. There is also a weekly music and movement session led by a visiting therapist. The manager and activities coordinator have worked to develop activities that are more suitable to those residents who are mentally frail - for example, they have purchased different quiz materials and games items. Responses given by residents to our survey questions showed that 4 of the 5 felt that the home always arranges activities that they can take part in if they want to, with Care Homes for Older People Page 16 of 30 Evidence: one person stating this is usually so. The home tries to meet the different range of needs and abilities when planning activities and this was evident from talking to people and looking at the activities calendar. Since our last inspection the home has carried out the work they planned to improve the access to the rear garden. The garden now has a wider ramped path and hand rail and additional landscaped corner bed. This makes a very attractive outdoor space for residents and their visitors to enjoy. The conservatory area overlooking the garden has also been improved with the addition of washable flooring and provides space for people who want to do arts and crafts activities and gardening jobs, such as planting up seedlings and bulbs. Visitors spoken with during the inspection said they are always made to feel welcome. One person said I love the staff here - they really make you feel at home. Residents family or friends are welcome to join them for lunch and to go out for special events and are always offered refreshments when they come. The dining room is a light and attractive room. Fresh vegetables and seasonal products are used whenever possible, and the menus showed a varied and nutritious diet is provided. All 5 of the residents who completed our surveys stated that they always like the meals at the home. Some additional comments reflected that meals and choice of food are things that the home does well - for example, feed me well, such a good variety of food choices and beautiful food. However, one staff members survey responses gave a different opinion, stating that the menus are unimaginative and food portions are too large so that some residents do not feel able to eat what is offered and that this can lead to a poor diet. The homes AQAA tells us that they hold regular informal residents forums and in these groups people are able to make decisions about what they would like to see on the menus and the activities programme. The home aims to provide person centred care, treating service users as unique individuals - we try to make the routines of daily living as flexible as possible for example breakfast in bed, staggered sleep times, tea, coffee, juices, and snacks served when requested. Care Homes for Older People Page 17 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. Residents, relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. There are procedures in place to protect residents from abuse. Evidence: There is a copy of the homes complaints procedure is displayed in the corridor and the homes complaints procedure is clearly set out in the Statement of Purpose and Service User Guide information. The manager said she has reviewed the homes policies and procedures since our last inspection, including those about recognising suspected abuse and how to respond, and the complaints procedure. Neither the manager, nor CQC, has received information about any formal complaint about the service since the last inspection. Replies to our surveys and conversation with some of the residents and visitors during the inspection showed that people are confident about raising any concerns with the manager or the home owner and that these would be followed up and resolved. Four out of the 5 residents who completed our survey indicated that they know how to raise a formal complaint and all 5 state yes to the question about having someone with whom they can speak to informally if they are unhappy. The manager has a copy of the Oxfordshire multi-agency codes of practice for the Care Homes for Older People Page 18 of 30 Evidence: protection of all vulnerable adults from abuse, exploitation and mistreatment. These codes are discussed with new staff during induction. National Vocational Qualification NVQ training includes a core topic on the protection of vulnerable adults and new carers have undertaken this training. The manager confirmed that there are annual updates for staff in adult safeguarding issues provided through an external training company. Care Homes for Older People Page 19 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The standard of decor in the home is good with evidence of improvement through maintenance and future planning. The home provides residents with an attractive, comfortable and homely place in which to live. Evidence: The standard of decor and furnishings is good. The home is an old building, with conservation listed status in parts and with interesting original features in many of the rooms. Residents and relatives comment cards indicated that they felt the home is kept clean and fresh and this was seen to be the case on the day of the inspection. Since our last visit the home has continued to improve the appearance of individual rooms through a programme of redecoration and re-carpeting. A new call bell system has been fitted to all residents rooms and staff have pagers to help them locate and respond to call bells promptly. Extensive work has been undertaken on the plumbing system in the home and to comply with modern water supply standards. A problem with low water pressure and flow in some first floor en-suite rooms has meant that some residents have not had a sufficient or consistent flow of hot water. A plumber was at the home continuing work to resolve this problem at the time of the inspection. Care Homes for Older People Page 20 of 30 Evidence: The home has a small laundry room with modern laundry equipment. The area was noted to be clean and tidy and supplied with gloves, hand hygiene gel and red alginate bags for soiled laundry to provide the necessary protection for staff from infection and contamination Care Homes for Older People Page 21 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. Staff are skilled and attentive so that residents health and welfare needs are met in a competent, caring and friendly way. The homes recruitment and assessment procedures for prospective new staff are satisfactory and protect the people who live here from harm. Evidence: The completed surveys we received from residents and relatives showed that staffing numbers in the home appear to meet residents needs. Four out of 5 residents surveys showed that they felt staff are always available when they need them, though one person added that the home could improve by having a few more staff. Of the two staff surveys received, one person commented that the use of assistants to care staff at weekends effectively reduced the number of staff available. The young people who work as assistants to the carers are not permitted to provide personal care for residents, but can do general tasks like making beds. Four out of the 5 relatives, carers and advocates surveys answered that the care staff usually have the right skills and experience to look after people properly. One relatives survey included the statement that there has been a big turnover in staff recently and in their view this had affected the consistency of care provided. The AQAA , completed in March 2009, tells us that 8 staff have left in the last 12 months and that staff retention has affected the training and development programme for staff. However, 16 of the total of 21 permanent staff have National Vocational Qualification (NVQ) at Level 2 or above and Care Homes for Older People Page 22 of 30 Evidence: so that the home has exceeded the recommended percentage of 50 with an NVQ Level 2 qualification or above. The manager said that they have tried to reduce the impact of occasional staff shortages by using one accredited agency to provide staff and requesting the same workers to ensure the best continuity of care for the residents. She said that the staff are supportive and work well together as a team and will often work additional hours to cover their colleagues absences. Feedback about the staff was very positive, both from survey comments and made by residents and visitors on the day of the visit to the home. Some of the comments were - Fantastic and caring The staff are friendly, making a nice atmosphere at all times There is a very friendly and caring attitude. A sample of 3 staff files was examined. There was evidence that for 2 out of 3 files seen, the required checks had been obtained in relation to Criminal Records Bureau (CRB) and including checks against the list held for individuals barred from working with vulnerable adults (PoVA) before new workers started work in the home. However, one persons file did not have the required full CRB because the manager said she thought that the supplying agency screening, and a local police clearance statement from the persons country of origin, was sufficient. The home must be satisfied that they have the full information required about each prospective employee before the person starts work in the home. The manager confirmed that all new staff receive induction training to the standard set out by the national training organisation, Skills for Care. Evidence of induction training and regular mandatory training in moving and handling, fire safety, food hygiene, first aid and adult safeguarding updates each year. The home now uses a training consultancy organisation to run courses at the home. They have also accessed training for staff at a local college of further education. Care Homes for Older People Page 23 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. The home promotes person-centred care and works in partnership with families and other representatives to support the best interests of the people who live here. The home continues to develop the ways in which it gets the views of service users and their representatives so that the service and facilities are improved in line with peoples suggestions. The safety and well-being of the people who work and live here are protected by the policies and procedures in place. Evidence: The manager has considerable management experience and has worked with older people for a number of years. She has the Registered Managers Award (level 4 NVQ in management) and has completed Level 4 NVQ in care. Comments received in writing and during conversations during the inspection were positive about the way the home is organised and the manager and home proprietors availability to discuss any aspects of the care and facilities with residents, their families and representatives. The home has a system for getting relatives and residents views about the quality of Care Homes for Older People Page 24 of 30 Evidence: the service through sending out questionnaires every year. Responses seen during the inspection showed that people were generally very positive about the welcome, communication between the homes staff and families, and food. There are also comment cards for visitors to complete in the reception area. The homes AQAA tells us that they plan to simplify the questionnaires to make them easier for residents to complete. Since our last inspection the home has also introduced a system to check that the homes policies and practices are consistently followed by staff. For example, quality assurance audits of the care plans and medication systems are regularly done to make sure that the information and records are correct and and accurately record residents health needs and any medication that they take. At this inspection the providers monthly reports (required under Regulation 26 of the Care Home Act) were available. These showed that the provider regularly talks to residents and staff about their opinions of the home and takes action wherever possible to make changes and act on peoples suggestions for improvements. Residents are involved as much as possible in decisions about changes made in the home -for example, choosing colour schemes for their own rooms and the decor for communal areas and suggesting new menu choices. Residents are encouraged to manage their own finances for as long as they can before involving the help of a representative. The manager arranges for day-to-day incidental expenses to be paid out of a float provided by the owner and residents are invoiced monthly for payment. Staff are not permitted to be involved with residents finances and this is made clear in the Service User Guide for the home. If a resident does not want to manage their finances or are no longer able to do so, the home encourages them to appoint a lasting power of attorney to make sure they have an independent person to deal with their affairs on their behalf. The home employs a contract cleaning and maintenance service, with local contractors to carry out any plumbing and electrical work that is required. Staff list any repairs and maintenance jobs that need doing in a workbook that is checked and signed when the work has been completed. On the day of this inspection, a plumber was working to improve the hot water supply to some upstairs rooms. Some residents have complained that the water is not hot enough. Work on the homes plumbing system has included making sure that the water supply and fittings meets with current water regulations. Legionella testing is Care Homes for Older People Page 25 of 30 Evidence: carried out every year by an independent laboratory. Someone was also on site to check a fault on the new call bell system that has been fitted to all residents rooms since our last inspection. A Health and Safety inspector visited the home recently and required that window opening limiters were fitted to all first floor windows and the home has now completed this work. Care Homes for Older People Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 29 19 The home must have full 28/08/2009 and satisfactory information about prospective workers at the home in realtion to each of the matters specified in Schedule 2, 7 All new staff can only be confirmed in post after the home has received a satisfactory police check and satisfactory check of the Protection of Children and Vulnerable Adults register. This is to protect people living at the home from potential abuse by workers who are banned from working with vulnerable people. Care Homes for Older People Page 28 of 30 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 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. 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. 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