Care Home: Filsham Lodge Residential Care Home

What the care home does well There is a detailed and informative Statement of Purpose and Service Users Guide that gives prospective residents the information required to enable them to make an informed choice about where they live. There are robust admission processes to the home which include a full needs assessment by a competent person and they are then assured in writing that their needs will be met. Some residents were able to confirm that they were visited by the manager prior to admission to the home and two relatives said they they were involved in the admission process. The menus evidence a well thought out balanced diet with a varied choice of food in line with residents preferences. Comments recieved from residents included: ` Very good food, plenty of it` `They know my favourite yogurt and make sure i get one everyday` `Nice food`. Quality assurance systems are in place which enables the service to monitor and improve their service and ensure that the home is run in the best interests of residents. A visitor said ` They are very good at following suggestions we have made`. There is an open-house policy which welcomes visitors at all reasonable times. Visitors confirmed that they are made to feel welcome and are offered refreshments and a private place to chat. Satisfactory arrangements are in place to safeguard residents finances. Staff provision is well maintained with an appropriate number of suitably qualified staff working in the home to meet residents health, social and welfare needs. The atmosphere of the home is pleasant with good interaction seen between residents and staff. The Comments received from residents and families regarding the care received included ` The staff are very kind and helpful` `Caring and friendly` ` A lovely atmosphere and always around to tell us what my relative has been doing`. There is a robust recruitment process in place to protect the residents. The home provide daily activities and monthly events that ensures residents social needs are met. The home encourages and supports residents to make decisions and be involved as much as possible in their daily lives. Filsham Lodge provides a clean safe and well-maintained environment which is appreciated by the residents and their relatives. Comments regarding life in were generally positive and included `I have been here for quite a long time and like it` `I have been here ages, its quiet and peaceful` ` I am comfortable`.Surveys from staff included comments `High standard of care given, good food` ` Filsham Lodge is a nice place to work with a good manager, a relaxed atmosphere, but all the work gets done`. ` This home has a good team work The team is doing a excellent job` ` Homely atmosphere`. What has improved since the last inspection? There were no requirements made at the last key inspection. The AQAA stated that there had been improvements made to the environment which included a new wet room which residents make good use of, the dining area on Ash unit has been upgraded and the corridors redecorated. The training programme continues to be developed to ensure that staff have the necessary training to meet the changing needs of residents living in the home. What the care home could do better: There were no requirements made at this key inspection as the management of the home are pro active and have acknowledged the areas identified for developing and improving. These include: The care plans need to be developed to ensure that there is a person centred approach to meeting residents individual needs in a consistent manner. That daily records evidence the care actually given. That the manager and Head of Care recieve the training and updates that their staff recieve. One resident survey stated ` More outings needed`. Key inspection report Care homes for older people Name: Address: Filsham Lodge Residential Care Home 137 South Road Hailsham East Sussex BN27 3NN     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: Deborah Calveley     Date: 0 4 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 28 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 28 Information about the care home Name of care home: Address: Filsham Lodge Residential Care Home 137 South Road Hailsham East Sussex BN27 3NN 01323844008 01323844008 filshamlodge@tiscali.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Thuraisamy Ravichandran and Mrs Radha Ravichandran care home 53 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 53. 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). Date of last inspection Brief description of the care home Filsham Lodge is registered to provide personal care and support to people with dementia. It is not far from the centre of Hailsham. The building is on two floors with a passenger lift and one stair lift providing access to all parts of the home. There is a car parking area at the front of the building. There is level access to the front of the building with a garden to the rear. The rooms are all single and some have en suite facilities. Care Homes for Older People Page 4 of 28 Over 65 0 53 53 0 Brief description of the care home Information about the service including the latest report from the Commission for Social Inspection (CSCI) is made available to prospective residents and/or their relatives, on request. Care Homes for Older People Page 5 of 28 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 reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term service user to describe those living in care home settings. For the purpose of this report, those living at Filsham Lodge will be referred to as residents. This was a key inspection that included an unannounced visit to the home and follow up contact with residents representatives and visiting health and social care professionals. This unannounced inspection was carried out over 6.5 hours on the 04 June 2009. There were forty eight residents living in the home on the day of which five were case tracked and spoken with. During the tour of the premises eight other residents both male and female were also spoken with. The purpose of the inspection was to check that the requirements of previous inspections had been met and inspect all other key Care Homes for Older People Page 6 of 28 standards. A tour of the premises was undertaken and a range of documentation was viewed including the Service Users Guide, Statement of Purpose, care plans, medication records and recruitment files. Four members of care staff and the cook were spoken with in addition to discussion with the Manager,maintenance person and head of care. Telephone contact was made with visiting professionals following the visit and six relatives were spoken with during the inspection visit. The information received verbally has been incorporated into this report. Prior to the site visit twenty two surveys were recieved back, 11 from staff and 11 from residents. The comments recieved have been included in to the report. An Annual Quality Assurance Assessment (AQAA) was received from Mrs Dunfold the registered Manager completed competently and in full prior to this key inspection. The information received in the AQAA was measured against the information gathered on the site visit. The fees charged from April 01 2009 range from 500 pounds to 680 pounds weekly. This does not include toiletries, newspapers, hairdressing or chiropody. Care Homes for Older People Page 7 of 28 What the care home does well: There is a detailed and informative Statement of Purpose and Service Users Guide that gives prospective residents the information required to enable them to make an informed choice about where they live. There are robust admission processes to the home which include a full needs assessment by a competent person and they are then assured in writing that their needs will be met. Some residents were able to confirm that they were visited by the manager prior to admission to the home and two relatives said they they were involved in the admission process. The menus evidence a well thought out balanced diet with a varied choice of food in line with residents preferences. Comments recieved from residents included: Very good food, plenty of it They know my favourite yogurt and make sure i get one everyday Nice food. Quality assurance systems are in place which enables the service to monitor and improve their service and ensure that the home is run in the best interests of residents. A visitor said They are very good at following suggestions we have made. There is an open-house policy which welcomes visitors at all reasonable times. Visitors confirmed that they are made to feel welcome and are offered refreshments and a private place to chat. Satisfactory arrangements are in place to safeguard residents finances. Staff provision is well maintained with an appropriate number of suitably qualified staff working in the home to meet residents health, social and welfare needs. The atmosphere of the home is pleasant with good interaction seen between residents and staff. The Comments received from residents and families regarding the care received included The staff are very kind and helpful Caring and friendly A lovely atmosphere and always around to tell us what my relative has been doing. There is a robust recruitment process in place to protect the residents. The home provide daily activities and monthly events that ensures residents social needs are met. The home encourages and supports residents to make decisions and be involved as much as possible in their daily lives. Filsham Lodge provides a clean safe and well-maintained environment which is appreciated by the residents and their relatives. Comments regarding life in were generally positive and included I have been here for quite a long time and like it I have been here ages, its quiet and peaceful I am comfortable. Care Homes for Older People Page 8 of 28 Surveys from staff included comments High standard of care given, good food Filsham Lodge is a nice place to work with a good manager, a relaxed atmosphere, but all the work gets done. This home has a good team work The team is doing a excellent job Homely atmosphere. 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. 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 28 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 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides prospective residents and relatives with a good level of information about the home, its facilities, services and the costs involved. The admission procedures allow for the needs of prospective residents to be assessed by a competent person before admission and people are then assured in writing that their needs will be met. Evidence: There is a comprehensive Statement of Purpose and Service Users Guide in place which contains clear information about the home, the range of fees charged and the services it provides. In discussions with various members of staff it was said that the majority of residents no longer read and therefore the residents handbook would be more beneficial/useful for the residents if a different or pictorial format was also available. Care Homes for Older People Page 11 of 28 Evidence: The terms and conditions of residency are clear and written in clear English. The document contains the information regarding the room to be occupied and is accompanied by an introduction to the home. References to the commissioning body need to be updated. The care plans for five residents were reviewed as part of the inspection process. These evidenced that a comprehensive assessment is carried out by the manager before a decision is made that the home will be able to meet the needs of the resident. This includes gathering vital and personal information about the prospective resident including expressing sexuality, particular physical needs and any special equipment required. The home then ensures it is in place on admission to the home. The pre admission process is person centred and time is taken to ensure that the individual will be welcomed into the home by the other people already using the service. A recommendation of good practice is to ensure that there is a clear process documented that evidences input from health professionals, family and friends and signed by the person performing the assessment. It was evidenced that the home confirms in writing that having regard to the assessment that the home can meet the assessed needs of the prospective resident. The manager and head of care were able to verbally demonstrate their knowledge and awareness of the different specialties required in the home and ensures that the carers employed have attended relevant courses to deal with the needs of the elderly and also specialised courses for dementia. The manager is pro active in ensuring that the physical and mental health needs of residents are closely monitored and seeking advice and support as required. There are also guidelines in place of when to arrange a move to specialist home if required and as observed, the family are involved in this important and delicate process. Trial visits to the home can be arranged this is clearly stated in the Statement of Purpose and in the statement of terms and conditions. Care Homes for Older People Page 12 of 28 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. Whilst care plans provide a good framework for the delivery of care they need further development to give clear guidance to care staff on meeting the care needs with a more person centred approach. The home was found to be meeting residents health and general needs with accessed additional specialist support when needed. Medication practices in the home promote and protect the health needs of residents and on the whole the privacy and dignity of residents are promoted. The homes practice at this time ensures that residents medicines are ordered stored and administered safely thus placing residents at potential risk Residents are treated with respect and have their privacy and dignity maintained Evidence: Five residents care plans were selected for review and included one or two from each unit low medium and high dependency. these residents were also met and spoken with and if possible the relatives were involved. The care plans seen contained a good level of personal information about each individual resident and evidenced regular review and involvement of the family. As discussed there are areas that need to be Care Homes for Older People Page 13 of 28 Evidence: developed to ensure that person centred care is delivered in a consistent manner by the staff e.g continence promotion. These shortfalls were acknowledged and the head of care said she would get to work immediately so a requirement has not been made at this time. The system of daily recording does not give a lot of information and if the other records are not completed, e.g personal care and bowel charts, this gives an incomplete picture of how the staff are meeting the needs of the residents. this was acknowledged and discussed in full. Residents are registered with a GP from local surgeries. Residents are supported to attend the GP surgery or if appropriate home visits are conducted. Referrals to the Optician, Occupational Therapist, Physiotherapist, Dietitian and Audiologist are made via the GP or the hospital. Residents access private dental surgeries where able and a domiciliary dentist will visit on request. A visiting Chiropodist attends residents six weekly with additional appointments being arranged if necessary. The clinical room is also the staff office and the medication trolley is appropriately attached to the wall for security reasons. The home has clear policies and procedures in place for staff to refer to regarding the safe administration, storage, disposal and recording of medication. The AQAA stated that they have recently been updated. There are systems in place for the recording and checking of controlled drugs when required. There is a clinical small fridge and temperatures are recorded daily, liquid antibiotics have a short life once opened and therefore the bottle needs to be dated on opening. Medication Administration Charts (MAR) were found to be competently completed. Staff signatures are in place to identify staff and thus providing an audit trail. The policies at Filsham lodge state that only senior staff give out medication and it was evidenced that staff have received appropriate training and receive regular refreshers. courses. By direct observation the medication practices were seen to be safe and therefore protect and promote the health and welfare of the residents. The staff on duty were seen to be respectful and considerate to all residents whilst attending to their needs and the interaction observed was open positive and friendly. There is a Privacy and Dignity policy in place and this is reviewed regularly. The protection of residents privacy and dignity is highlighted as one of the main aims of the home in its Statement of Purpose and Service User Guide. Each of the residents were addressed by their preferred term and dressed Care Homes for Older People Page 14 of 28 Evidence: appropriately in well-laundered clothing. Care Homes for Older People Page 15 of 28 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. Social activities and meals continue to be creative and provide daily variation and interest for people living in the home. Residents are enabled and supported to make a range of choices about their lives as well as maintaining links with friends and relatives. Evidence: Filsham Lodge employ an activities co-ordinator who works 40 hours per week. The records for the activities include a care plan that highlights individual needs and preferences and include some residents past interests. The records evidenced that there are group activities and individual activities structured to meet the varying needs of the residents. The morning activity was held in the lounge area and was well attended and the atmosphere was positive and residents were clearly enjoying themselves. In the afternoon a swinging sixties part was being held and a visiting entertainer was booked to play music, the catering team were providing a special tea and family and friends had been invited to attend. From direct observation the staff were seen to be interacting positively with the residents who do not participate in group activities. The residents religious views are explored on admission to the home and there is a Care Homes for Older People Page 16 of 28 Evidence: monthly interdenominational church services. The Salvation Army continue to visit regularly and a local religious group visit monthly to sing hymns and other songs with and for residents. From discussion with staff and visitors it was confirmed that there are no restrictions on visiting as long as consideration is shown to all the residents. Residents who wished to were able to move freely around the building and sit in any communal areas. From direct observation the residents were supported in choosing where they spent their time with staff supervising them supportively. The staff also support residents in choosing everyday activities including clothes and jewelery and making everyday decisions. The home have a choice of dining areas and these are used according to the residents individual needs taking all residents differing capabilities in to consideration. All dining areas are well furnished with plenty of natural light. Staff were observed offering support or assistance to residents in a discreet and dignified manner. The mid day meal was observed and the food served demonstrated two options of meat dishes, a vegetarian and a salad choice and three sweet dishes. The staff offered each resident a choice of beverages as well, during and after the meal. All the meals were attractively presented and were nutritionally balanced and enjoyed by the residents. The kitchen team have a good understanding and knowledge of those residents who have special requirements such as diabetic, vegetarian and soft diets. It was also confirmed that they could provide dietary provision for differing religious and cultural needs. The kitchen was inspected by the Wealden District Council inspector for food safety in June 2008 and was positive with some recommendations which have been implemented. The safer food better business book has since been commenced and is completed daily. The menus rotate on a 4 weekly basis and were devised taking into account the changing seasons and residents preferences, likes and dislikes. The feedback from the site visit and from surveys were in the main positive and included Care Homes for Older People Page 17 of 28 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. Practice in the home ensures that complaints are responded to with residents and their representatives being confident that they are listened to and demonstrated that robust procedures are followed. Practice in the home ensures that adult protection issues are responded to when identified Evidence: The complaint policy and procedure is clear and uncomplicated and a copy of this is readily available in the home and the Service Users Guide. As previously identified an alternative format would beneficial for those residents who have difficulties in reading text. The home operate an open door policy and the open and transparent culture within in the home enables families, staff and residents to voice any concerns as they occur. The system of recording complaints demonstrated that all complaints are recorded with the investigation, outcome and action taken included. The home has received two complaints since the last inspection and they were responded to within the stated timescales. One is still unresolved at this time. Residents and relatives spoken with confirmed that they were confident that any complaints or concerns that they had would be listened to and responded to effectively The home has relevant guidelines on the protection of vulnerable adults and staff have received appropriate training. The management team has a clear understanding of Care Homes for Older People Page 18 of 28 Evidence: adult protection guidelines and are aware of how to initiate an investigation if required. There have been no safeguarding referrals since the last key inspection. The home operate a robust recruitment procedure to protect the residents safety and well being, which includes ensuring all staff have a Protection Of Vulnerable Adults (POVA) and Criminal Record Bureau (CRB) check before commencing work and these are then updated two yearly. Care Homes for Older People Page 19 of 28 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. Filsham Lodge provides a comfortable clean and safe environment for those living there and visiting. Residents and their families are enabled and encouraged to personalise their room and rooms are homely and reflect the residents personalities and interests. Evidence: Filsham Lodge is well maintained and comfortable and the decor within the home is pleasant and attractive. The Philosophy of Care states that the home aim to enhance the quality of life by providing a safe secure comfortable and supportive environment. The emphasis being on homely and welcoming. There is a full time maintenance person who works very closely with the manager and staff team. There were no outstanding requirements from the local environmental health department or the fire safety officer. The management team of the home have a rolling plan of redecoration and improvement in place, improvements since the last inspection include a wet room upgraded dining area in Ash unit and redecoration of the main corridor. The home is fit for its stated purpose and provides with a comfortable, well maintained and safe environment for the people who use the service and those visiting. Care Homes for Older People Page 20 of 28 Evidence: Polices and procedures for infection control are in place and are updated regularly. The home was clean and free from offensive odours on the day of the inspection. Good practice by staff was observed during the day and there were gloves and aprons freely available in the home. Sluice and laundry areas were found clean and safe. The home provides a good laundry service. The have seperate staff teams for house keeping and laundry services. The laundry have appropriate laundry equipment to deal with foul linnen and infected items. There is an appropriately secured cupboard for storage in keeping with the Control of Substances Hazardous to Health Regulations and there are hand-washing facilities throughout the home. There are appropriate policies and procedures in place that guide staff in safe infection control measures. Care Homes for Older People Page 21 of 28 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. Robust recruitment procedures are in place to protect residents and staff training ensures they are aware of their roles and are able to provide the support and care the residents need. Evidence: The staffing rota was viewed and the staffing levels were seen to be sufficient to meet the needs of the residents at this time. It was confirmed by the manager that there is flexibility of the staffing levels and they are adjusted according to the changing needs of the residents. A selection of staff recruitment files were viewed and demonstrate that a robust recruitment process has been maintained to protect residents and contained all the relevant information required. There was evidence of health questionnaires, Criminal Record Bureau checks, two references, a resume of previous employment and work permits where necessary. All the paperwork is kept within a locked room. There is an induction programme is in place in line with Skills for Care and this has been introduced for all staff. The AQAA confirmed this. Staff spoken with said that training opportunities at the home are good and they are well supported by the senior staff and the manager. Staff and the training list seen confirmed that compulsory training such as manual Care Homes for Older People Page 22 of 28 Evidence: handling, adult protection, first aid and fire safety are being undertaken. The manager has introduced a training matrix which enables the management team to track the training needs and ensure that refresher courses are undertaken. This matrix however did not evidence that the manager and head of care were undertaking the training required. This was discussed and training will be undertaken. Staff are all encouraged National Vocational Qualification training (NVQ) at present 26 of the 37 permanent staff have a NVQ. Care Homes for Older People Page 23 of 28 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 residents living in Filsham Lodge benefit an experienced, competent and knowledgeable manager. The home is managed in an open and transparent manner with suitable quality monitoring systems in place. Residents financial interests are safeguarded. The health safety and welfare of residents and staff are generally well promoted and protected Evidence: Mrs Dunford is the registered manager of Filsham Lodge and has been in post for six years. She is a registered general nurse and has worked in the care industry for many years. Mrs Dunford has the necessary qualifications experience and competency to manage the home and ensure it meets the homes stated purpose, aims and objectives. She has completed a registered managers award. The working relationship between the registered providers, Mr and Mrs Ravichandran and the home manager is positive and works well for the benefit of the home. The staff team is strongly Care Homes for Older People Page 24 of 28 Evidence: supported by the manager, head of care and senior staff offering appropriate support and supervision which provides a good working environment which then impacts positively on the outcomes for people who use the service. The Providers carry out unannounced visits to home and provide reports under Regulation 26 of The Care Homes Regulations, which form part of the quality assurance systems in the home. The quality assurance systems in the home include questionnaires sent out to residents and relatives following admission to the home. The use of this formal quality assurance and quality monitoring systems has enabled the management to objectively evaluate the service and ensure it is run in the residents best interests. The quality assurance results are audited and action taken to address any suggestions of improvement and these are then made available to all stakeholders. Mrs Dunford confirmed that where the home has any involvement with any residents money that there are clear records maintained and robust policies and procedures followed to ensure that residents financial interests are safeguarded. The health safety and welfare of the residents are promoted and protected by the training programme which covers a range of aspects of health and safety such as first aid, infection control, food hygiene, manual handling and fire safety. The home keep records of the maintenance of all equipment, water temperatures and servicing of boilers and lifts. The risk assessments to promote the safety of residents are current and appropriate to the home environment. Care Homes for Older People Page 25 of 28 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 26 of 28 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 27 of 28 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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