Care Home: Frith House

What the care home does well The home has been purpose built and the environment is excellent. All areas are bright, airy, well maintained, nicely decorated and clean. The gardens are pleasant and provide seating areas for people who live at the home. Bedrooms were nicely personalised to reflect people`s individual interests and tastes. One person who lives at the home said "`I was able to bring my own bits and pieces and it`s really helped me to settle in`. Social and health care professionals who visit the home told us they were happy with the service being provided at the home. Comments included `I visit every week..the care is exemplary in every way`, `people are always welcomed into Frith House`, `a friendly and respectful service that gives service users choice`, and `Frith House have a motivated team, who work tirelessly to ensure all the residents in their care have their needs met and have the best quality of life they can`. A relative commented `the staff are good, I`m made to feel welcome. I am able to stay for a meal which is nice. Everyone calls you by my Christian name. It`s very nice and I am very happy with the care my relative is receiving`. People who live at the home told us `from the management right through to the staff they are very caring and make sure your individual needs are being looked after`, `I am satisfied here, there`s a lot to be thankful for`, `I have no complaints whatsoever, can`t fault it`, and `if you don`t like the food they`ll find you something else`, People who live at the home were keen to name the individual members of staff who make a difference to their lives. Comments included `very good, lovely, nothing`s too much trouble` and `she`s marvellous`. The management team are continually identifying areas for improvement and it is evident that people who live at the home have benefited as a result. What has improved since the last inspection? The home has recently introduced `Have Your Say` sessions on a monthly basis with the Manager and Deputy. This provides the opportunity for informal discussion about what is happening at the home and people are offered refreshments. The home has made improvements to the `Petals` unit which provides specialist dementia care. Bedroom doors are currently being painted in bright colours so that people can identify their bedroom more easily. The staff at the home had noticed that people prefer to sit in the middle area of the unit. As a result, the home has recently carried out work to provide a larger lounge area for the people who live there. Pictures, items from the past and ornaments have been placed in the unit to prompt memories. The home has started to make the bathrooms feel more homely by introducing, pictures, plants and rubber ducks. The home now employs a housekeeper to ensure that a high standard of cleanliness is maintained. The home has recently appointed a second deputy manager to enable the management team to make further improvements. The home now carries out an audit of accidents to identify patterns and minimise the risk of further incidents and injury to people. What the care home could do better: The home should ensure that staff are aware of special instructions relating to moving & handling within peoples` care plans to protect them from risk of harm. The home should review whether staffing levels are sufficient to meet peoples` assessed needs. This is to ensure that there are sufficient staff on duty at all times to meet the dependency needs of the people living at the home. Key inspection report Care homes for older people Name: Address: Frith House Steart Drive Burnham-on-sea Somerset TA8 1AA     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: Alison Philpott     Date: 2 1 0 7 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 26 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 26 Information about the care home Name of care home: Address: Frith House Steart Drive Burnham-on-sea Somerset TA8 1AA 01278782537 01278782537 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Somerset Care Limited care home 80 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: One named person under the age of 65 years within the registered number of 80 beds Up to three persons between the ages of 55 - 65 years within the registered numbers of 80 beds. Within the maximum registered numbers of 80, the home may accommodate up to 22 service users in the category of DE(E). Date of last inspection Brief description of the care home Frith House is situated in a quiet residential area of Burnham-on-Sea, near the sea front and town centre. It is registered with the Commission to provide care for 80 people over the age of 65 requiring personal care, including 22 persons with dementia care needs. The home is not registered to provide nursing care. Somerset Care Ltd own Frith House; the Registered Manager is Mr Paul Cullis. The home is purpose built and has accommodation on two floors, accessed by a passenger lift. Each bedroom has an emergency call system and a vanity unit (in the older part of the building) - all Care Homes for Older People Page 4 of 26 Over 65 22 80 0 0 Brief description of the care home rooms in the new part of the building have en-suite facilities. There is a separate unit, Petals within the home to accommodate up to 22 people who have dementia. The home has the capacity for 80 people. Frith House offers a respite care service within the registration and has a day care provision for up to ten people. Somerset Social Services has a contract for all the dementia care places to provide a Specialist Dementia Care (SRC) unit. Also contracted are 30 places in the main unit for older persons residential care, plus one Step up/ Step down bed which is used for short term rehabilitative care. There are lounges and sitting areas on both floors. There are dining areas on the ground floor and the first floor of the new part of the building. The home has a bar/ lounge where service users may smoke if they wish to do so. The home has a pay phone near the entrance foyer for residents to use. The homes current fee range is from £402.95 to £614.00 per week. Additional charges include; newspapers/magazines, hairdressing, mini-bus trips, holidays, chiropody, continence products, toiletries and transport for appointments. Care Homes for Older People Page 5 of 26 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: This unannounced key inspection was conducted over two days (14 hours) by one inspector. On the day of the inspection, 62 people were living at the home and people were attending for day care. Paul Cullis, Registered Manager was available throughout the inspection. We were given unrestricted access to all parts of the home and all records requested for this inspection, were made available to us. We were able to meet with people using the service, staff and a visitor to the home. Further to the last key inspection on 16th July 2007, we carried out two random inspections. During the random inspection on 23rd November 2007, we observed mealtime on the dementia care unit and reviewed peoples weights. During the random Care Homes for Older People Page 6 of 26 inspection on 9th April 2009, we looked at the quality of care delivery. No requirements or recommendations were made at these visits. The home completed its Annual Quality Assurance Assessment (AQAA) and this was received by the Commission within agreed timescales. The AQAA is a self assessment which focuses on how well outcomes are being met for people using the service. It also provides us with some numerical information. We received completed surveys as follows; eight from people who live at the home; four from staff who work at the home; and seven from social and health care professionals. Extracts have been included in this report where appropriate. The term we, used throughout this report, refers to we the Commission. We would like to thank all involved for their time and cooperation with the inspection process. The following is a summary of the inspection findings and should be read in conjunction with the whole of the report. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? The home has recently introduced Have Your Say sessions on a monthly basis with the Manager and Deputy. This provides the opportunity for informal discussion about what is happening at the home and people are offered refreshments. The home has made improvements to the Petals unit which provides specialist dementia care. Bedroom doors are currently being painted in bright colours so that people can identify their bedroom more easily. The staff at the home had noticed that people prefer to sit in the middle area of the unit. As a result, the home has recently carried out work to provide a larger lounge area for the people who live there. Pictures, items from the past and ornaments have been placed in the unit to prompt memories. The home has started to make the bathrooms feel more homely by introducing, pictures, plants and rubber ducks. The home now employs a housekeeper to ensure that a high standard of cleanliness is maintained. The home has recently appointed a second deputy manager to enable the management Care Homes for Older People Page 8 of 26 team to make further improvements. The home now carries out an audit of accidents to identify patterns and minimise the risk of further incidents and injury to people. 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 26 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 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive sufficient information so that they can make an informed decision about the home. The home carries out detailed assessments to ensure that it can meet the individual needs of people before they move in to the home. Evidence: The home told us on their AQAA all information is made available to prospective residents and families... The home has a Statement of Purpose, Service Users Guide and brochures which contain information about the home. People who live at the home and completed surveys told us they received enough information to help them decide that the home was the right place for them before they moved in. The home told us on their AQAA the home takes all appropriate steps to ensure that the home is able to meet the assessed needs of prospective residents..and is in the Care Homes for Older People Page 11 of 26 Evidence: best interests of the individual. We looked at the information that the home had obtained about a new person living at the home. The home had carried out a pre admission assessment to identify the persons needs. Information had also been obtained from the placing authority. The home encourages people to visit the home and look around to help them decide if its the right place for them. We spoke with one person who had moved to the home recently. They told us I stayed for respite a few times and knew this was where I would like to live. Care Homes for Older People Page 12 of 26 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. Care plans look at all areas of the individuals life. People receive personal and healthcare support using a person centred approach. Medication and records relating to medicines are well managed and protect people who live at the home. Staff treat people who live at the home with respect. Evidence: We looked at five care plans. These were person centred, contained a good level of detail about what the person could do independently and support needed, and included peoples preferences. People who live at the home told us very good personal care,look after me very well. When we asked people who completed surveys do you receive the care and support you need?; five people said always and three people said usually. A relative who was visiting the home on the day of inspection told us they are very happy with Care Homes for Older People Page 13 of 26 Evidence: the care at the home. We looked at risk assessments relating to diabetes and falls. The home has moving and handling assessments in place for staff to follow. We found that one moving and handling assessment stated in event of a fall due to recent fracture it would be advisable to call for paramedics. When the person fell, staff on duty did not follow this advice and moved the person with the assistance of a hoist. This was discussed with the Deputy Manager who confirmed that action was being taken to ensure that this does not happen again. People have access to a wide range of health care professionals including GP, Dentist, Chiropodist, Optician, Dietary Nurse, and District Nurse. Social and health care professionals who completed surveys comments included I visit every week.. the care is exemplary in every way, person centred, friendly, respectful service gives service users choiceand staff are always available to discuss problems and discuss residents at reviews. We looked at medicines and records. Medicines are stored securely. The home records daily temperatures of the medicine fridge and room to ensure medicines are stored at a safe temperature. The home uses a monitored dosage system. We looked at Medication Administration Record (MAR) Sheets. These were fully completed and well organised. For people who are prescribed warfarin, the home had included the GPs instructions with the MAR Sheets. Some people who live at the home are prescribed creams. We asked the home where they record the application of creams. They told us applications are recorded on the computerised care planning systems but this was not being recorded consistently, so there are plans to introduce a paper record. We checked a stock of controlled drugs, these were found to be correct. Where medicines are taken as required, the home had recorded the reason for administration and action that staff should take if the desired outcome was not achieved. The home told us they do not keep a homely remedies stock. Some of the people who live at the home manage their own medication. The home had completed a risk assessment relating to this. People have a lockable space in their bedroom to store their medicines. People who live at the home told us that staff respect their privacy and dignity. Staff are currently undertaking training, 10 Steps to Dignity. There are plans for staff to sign up to be Dignity Champions. Care Homes for Older People Page 14 of 26 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 offers a range of activities for people who live at the home. The meals at the home are balanced and nutritious. People are generally very happy with the quality and choice of food available. Evidence: The home employs activities co-ordinators to organise group activities. We spoke with one of the activities co-ordinators who told us they have completed a qualification in creative activities. People have weekly activity planners in their bedrooms so that they can plan their days. We observed people taking part in potato painting and skittles. People told us other activities include baking, indoor gardening, bingo, games,quizzes, and sing songs. People were observed chatting, reading, listening to music, and knitting. Some of the people we spoke with told us they had recently been on an outing to an Animal Farm. We asked people does the home arrange activities that you can take part in if you want?; six people said always and two people said usually. We observed that some people have life history books in their bedrooms. The home Care Homes for Older People Page 15 of 26 Evidence: told us on their AQAA so that we may understand the individual more fully. The home has a church service on the first Wednesday of each month. The home also has contacts with the community. The local War Veterans Society and Neighbourhood Watch Schemes hold meetings at the home. Several ladies were looking forward to visiting the hairdresser who works in the homes hairdressing salon. The home produces a quarterly newsletter called The Messenger. This includes information about whats happening at the home; photos, dates for the diary, peoples birthdays and events that have taken place. A relative told us they are always made to feel welcome, I stay for a meal, everyone calls me by my Christian name and its very nice. The home told us on their AQAA they have recently introduced Have Your Say sessions on a monthly basis with the Manager/Deputy for all residents to sit and have refreshments with us and chat about anything they wish to discuss. We observed lunch being served in the large dining room, small dining room and Petals unit. The tables were nicely laid with flowers. A menu was available on each table. People were offered a choice of drinks. Staff in Petals unit were observed showing people the dishes on offer so that they could choose the one they wanted. One person told us the chefs ask is there anything you would like thats not on the menu. People told us if they didnt like the choices on the menu, an alternative would be offered. On the first day of the inspection lunch was a choice of cottage pie or salmon & broccoli bake. The food was well presented and smelt appetising. Potatoes and vegetables were offered in separate serving dishes so that people could help themselves. Where people required assistance this was done in an unhurried way. Staff were observed chatting and encouraging people to eat. Some people chose to eat their lunch in their bedroom. Care Homes for Older People Page 16 of 26 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. The home has an open culture that allows people to express their views and concerns. The homes policies relating to abuse and whistleblowing protect people from the risk of harm. Evidence: The home has a complaints procedure in place. People who live at the home knew what to do if they had any concerns. The home has received seven complaints since the last key inspection in July 2007. We saw evidence that the complaints had been investigated and action taken where necessary. The home had responded to the complainant and followed this up to check they were satisfied with the outcome. The home has a whistleblowing policy and staff spoken with knew what to do if they suspected or witnessed abuse. We found that staff recruitment files contained all of the required checks to protect people from risk of abuse. The home told us on their AQAA I have continued to progress our relationship with the local Neighbourhood Police..I also receive up to date information on patterns..which could impact on the safety of people in this unit. Care Homes for Older People Page 17 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean, well maintained, decorated to a high standard and provides a comfortable environment for the people who live there. Peoples bedrooms are personalised to reflect their individual tastes and interests. Evidence: Frith House has benefited from major re-development, building work and modernisation to a high standard in 2006. The home is registered with the Commission to provide personal care for up to 80 people. Within the 80 beds, the home has a specialist dementia care unit, named Petals which can accommodate up to 22 people. The home has allocated step up/step down, respite care places and day care provision. The home told us that they are currently in the process of applying to increase the number of beds within Petals. The accommodation is provided over two floors. There are two passenger lifts available for access to all areas of the home. The home has a number of communal lounges and dining rooms. There is an activities room, hairdressing salon, shop, and bar area. A designated smoking area is available for people who live at the home and Care Homes for Older People Page 18 of 26 Evidence: wish to smoke. We looked around the home. The environment is light, spacious and airy. The home provides comfortable furnishings and all areas are well maintained. On the day of the inspection, bedroom doors were being painted and areas in need of touch up were being attended to. The Petals unit which provides specialist dementia care has been designed to meet the environmental needs of the people who live there. Signs and symbols are used to help orientate people. Bedroom doors are currently being painted in bright colours so that people can identify their bedroom more easily. The staff at the home had noticed that people prefer to sit in the middle area of the unit. As a result, the home has recently carried out work to provide a larger lounge area for the people who live there. Peoples who live in Petals have taken part in art sessions and their work is displayed on the walls. Pictures, items from the past and ornaments have been placed in the unit to prompt memories. The home has started to make the bathrooms feel more homely by introducing, pictures, plants and rubber ducks. The home told us on their AQAA all bedrooms benefit from en-suite facilities and are for single occupancy. One person who lives on the ground floor was keen to show us their bedroom which has french doors leading onto the garden. Bedrooms were nicely personalised to reflect peoples individual interests and tastes. One person who recently moved to the home said I was able to bring my own bits and pieces and its really helped me to settle in. Health care professionals said the welcome area is very good and rooms are excellent. The gardens are well maintained, pleasant, well stocked with shrubs and provide seating areas so that people can enjoy spending time there. The home now employs a housekeeper in addition to domestic staff. We observed that all areas of the home are cleaned to a very high standard. People who live at the home told us that it is always clean and fresh. The home also employs laundry staff. The laundry contains a range of commercial washing machines. We observed that liquid soap and paper towels were available in all bathrooms and toilets. We observed staff wearing gloves and aprons to minimise the risk of spread of infection. Alcohol gel is available throughout the home. Care Homes for Older People Page 19 of 26 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. There are normally sufficient staff on duty to meet the needs of people who live at the home. Some people would like more staff on duty as sometimes they have to wait a short time for staff support and attention and then feel rushed. People who live at the home benefit from having caring, skilled and trained staff. The homes recruitment procedures protect people from risk of harm. Evidence: We looked at the rotas. The home usually has the following staffing levels; Residential; Mornings - supervisor; shift leader; 6 care staff and 1 day care staff Afternoons - supervisor; 5 care staff Petals; Morning and afternoon - supervisor and 4 care staff. At night, there are two supervisors and 4 night care assistants to cover the whole home. In addition to this, the home employs a housekeeper, domestics, handyperson, laundry assistants, kitchen staff, and activities staff. The home has recently employed Care Homes for Older People Page 20 of 26 Evidence: a second deputy manager. We carried out an Annual Service Review on 29/08/08; staff also felt there is an increasing dependency amongst the people they care for. This may mean that people require the assistance of two members of staff which in turn meant that call bells may not be answered straight away... When we asked people are staff available when you need them?; 4 people said always and 4 people said usually. We spoke with people who live at the home during the inspection. Comments included when I ring the bell for assistance, I sometimes have to wait, it depends how busy the staff are, staff dont have a lot of time, I rang the bell and was told I would have to wait and the bell is always answered. The home should review whether staffing levels are sufficient to meet peoples assessed needs. This is to ensure that there are sufficient staff on duty at all times to meet the dependency needs of the people living at the home. People who live at the home told us about the staff. Comments included, If I need help the staff are always pleased to help, reception staff are very good, supervisor is very good, lovely and nothings too much trouble, and some staff are better than others. We looked at three staff recruitment files. These contained all of the required checks and information. The home has a comprehensive training programme in place. This includes the following areas; induction; manual handling; fire; health & safety; health & hygiene; medication; creams; food hygiene; dementia awareness; the real meaning of person centred care; equality & diversity; palliative care; and creative activities. The deputy manager told us that there are plans to provide training in signs and symptoms. 40 of the 62 care staff employed at the home have completed an NVQ in care at level 2 or above. Staff spoken with told us they are very pleased with the training and career development opportunities available to them. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home benefit from a well managed service and an open and inclusive atmosphere. Effective quality assurance systems are in place. The homes health & safety policies and procedures generally protect peoples health, safety and welfare. Evidence: Paul Cullis is the registered manager. He has worked at Frith House for many years and has a good knowledge of the home. Mr Cullis has continued to identify areas for improvement and it is evident that people who live at the home have benefited as a result. A healthcare professional commented there is a good management structure and support. One person who lives at the home said from the management right through to the staff they are very caring and make sure your individual needs are being looked after. Staff said the manager and assistant manager are approachable Care Homes for Older People Page 22 of 26 Evidence: should any problems occur and I have a good team leader who I feel able to discuss anything with. During the inspection, we were told that the registered manager will be commencing a six month secondment, working away from the home, from 27th July 2009. The area manager told us they will send written confirmation of the management arrangements to the Commission. The registered manager is supported by an effective and experienced deputy manager. The home has recently appointed a second deputy manager to enable the management team to make further improvements. The area manager was visiting the home on the second day of the inspection. They carry out a monthly visit to the home to monitor quality and provide support. The homes quality system also includes surveys, a suggestion box, regular meetings, and quality audits. The home stores small amounts of personal monies for some of the people who live there. These are stored individually and securely. We checked the records and balance of monies for one person who lives at the home. The balance was found to be correct. We looked at health & safety records and checks for fire systems; electrical installation; food hygiene; and lifting equipment. These were all up-to-date. The gas safety certificate which lasts for 12 months was dated 01/07/08. The manager confirmed that he would look into this and ensure the check had been carried out. Chemicals were stored securely. We looked at accident records. The home now carries out an audit of accidents to identify patterns and minimise the risk of further incidents and injury to people. Care Homes for Older People Page 23 of 26 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 24 of 26 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 7 The home should ensure that staff are aware of special instructions relating to moving & handling within peoples care plans to protect them from risk of harm. The home should review whether staffing levels are sufficient to meet peoples assessed needs. This is to ensure that there are sufficient staff on duty at all times to meet the dependency needs of the people living at the home. 2 27 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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