Care Home: Glendale Lodge Residental Care Home

What the care home does well The people living in the home comment: `They organise entertainment well. I am content with daily living and care. I can not think of anything the home could do better`. `Look after me, seeing to everyone`s wants and needs`. `The home is very pleasant with friendly staff. Good food and the home is nice and fresh`. `I am very pleased with all aspects of the home`. `They take care of residents needs`. `I would recommend this home`. Relatives comments: `Glendale Lodge provides a safe, warm, happy and caring facility. All the staff are so friendly and welcoming both to residents, family and friends. The building is modern, light and always smells so nice! The views are beautiful. It has a feeling of a country hotel! My relatives bedroom is lovely, it is always clean, warm and very comfortable`. `They take good care of all residents needs with care and compassion`. `Overall I am extremely pleased with all aspects of my relatives care. She admits that if she can`t be in her own home Glendale is right for her`. `The team should be highly commended for walking to work on more than one occasion due to the heavy snow. Well done!` Health Care Professionals comments: `It is a good residential home`. `I am always impressed when I visit this residential home. The staff know what is going on and they know the residents. They appear kind and show respect. It is a residential home where I would be happy to place one of my relatives`. `They have a sensible approach, responsible and follow through issues. It is a clean and organised service with care and interest shown. I would be happy to be a resident there`. `As a visiting health professional I have always found the staff at Glendale Lodge to be very organised and courteous to both myself and the residents. If I have any queries they are promptly dealt with, and my observations of the staff dealing with the resident has always been very positive. They provide a caring service tailored to the individual needs. they also provide a team approach, connect well as carers to those in their care. They ensure training and support is given to their staff. Glendale Lodge has a well motivated and caring team. The home is well situated and the place is well kept. Carers seem to know their clients well and `go the extra mile`. Staff comments: `We provide a safe, caring environment for service users. We will always try to meet individual needs by adapting procedures. We maintain a high level of cleanliness, and the home always smells clean`. `All of the residents are generally happy and healthy. All concerns are properly dealt with`. `Staff and management are kept up to date on all Health and Safety issues. We are given regular supervisions. We are sent on various courses, e.g. fire, manual handling etc. In general, they provide us with any information and training needed in order for us to do our job well`. What has improved since the last inspection? The Deputy Manager has completed the management NVQ Level 4 award. The extension of the home is now complete and seven new en suite bedrooms have been completely furnished, with under floor heating. Internet connection is also available. There is a new laundry room and wet room has been installed. As a result of the extension more space is also available in the communal areas. The garden has been landscaped with decking so that it is more accessible for wheelchair users and the people can safely use the garden. Further details of the extension have been included in this report. What the care home could do better: The assessment and care planning system is in the process of being reviewed. This will make sure that the shortfalls in recording are addressed and written guidelines for staff are in place of how to move people safely. The recording of the temperature in the medication room will make sure the drugs are stored at the correct temperature. The counter signing of the hand written information in the mediation administration sheets will reduce the risk of error. When asked what the home could do better the people who use comment: `It would be nice if staff were able to give you a little more time`. `Some meals could be improved`. A staff member comments: We could provide a mini bus/people carrier to enable staff to take residents out more. We have a very good day centre locally which many of our residents would have visited whilst living in their own home. If transport could be provided they would maintain regular contact whilst living at Glendale Lodge. Provide a more varied menu`. `More training courses and more staff on Sunday as there are the same amount of residents and work to do but sometimes less staff`. Key inspection report Care homes for older people Name: Address: Glendale Lodge Residental Care Home Glen Road Kingsdown Deal Kent CT14 8BS     The quality rating for this care home is:   three star excellent 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: Penny McMullan     Date: 2 9 0 1 2 0 1 0 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 29 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 29 Information about the care home Name of care home: Address: Glendale Lodge Residental Care Home Glen Road Kingsdown Deal Kent CT14 8BS 01304363449 01304363449 glendale1@tiscali.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Extrafriend Limited care home 32 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 32 The registered person may provide the following category 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 category: Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Glendale Lodge is a purpose built residential care home, registered for thirty two older people. The property has 30 single bedrooms and one double bedroom. Twenty seven bedrooms have en suite facilities. There are twenty nine bedrooms situated on the ground floor, with one single and one double bedroom on the first floor. A staircase with chair lift is in situ to access the first floor. On the ground floor there are communal lounge areas, which provide pleasant surroundings to relax and eat in. The home is situated in the village of Kingsdown, Care Homes for Older People Page 4 of 29 Over 65 32 0 Brief description of the care home Deal; the village bus stop is a short walk away. The home also has impressive rural views and the garden is well maintained. There are ample parking facilities at the front of the home. The home is owned by Extrafriend Limited and is managed on a daily basis by Mrs Carole McNamara, the Registered Manager, with the assistance of a deputy manager; an administrator, chef, two domestics and care staff. The current fees for the service at the time of the visit are £338 to £525 per week. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent 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 key inspection was carried out over a period of time and concluded with a visit to the home on 28th January 2010 between 09.30am and 4pm. The last key inspection was carried out on 13th March 2007. Postal surveys were forwarded to the home to distribute to the people who use the service, staff and health care professionals. We sent ten surveys to the people who use the service, ten to the staff and five to health care professionals. Four surveys were received from the people who use the service, three from staff three from relatives and four from social care professionals. Comments made in all of the surveys have been included in this report. The care of two people was tracked to help gain evidence as to what it is like to live in the home. A partial tour of the home was made and we also looked at care plans, risk assessments, training records, staff files, quality assurance and complaint records. Care Homes for Older People Page 6 of 29 Three members of staff were also involved in the inspection. The Annual Quality Assurance Assessment (AQAA) that was sent to us by the service was clear and comprehensive. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. The home returned the Annual Quality Assurance Assessment (AQAA) within the required timescale. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? The Deputy Manager has completed the management NVQ Level 4 award. The extension of the home is now complete and seven new en suite bedrooms have been completely furnished, with under floor heating. Internet connection is also available. There is a new laundry room and wet room has been installed. As a result of the extension more space is also available in the communal areas. The garden has Care Homes for Older People Page 8 of 29 been landscaped with decking so that it is more accessible for wheelchair users and the people can safely use the garden. Further details of the extension have been included in this report. 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 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Improvements are required to make sure that full information is recorded in the care needs assessments so that people moving into the home can be confident their full care needs will be met. Intermediate care is not provided in this home. Evidence: We looked at the information provided to people before they decided to move into the home. We spoke to the people living at Glendale Lodge and they told us that they or their family were given information about the home before they moved in. The Registered Manager or Deputy Manager carries out a thorough care needs assessment to make sure the home can meet the needs of the person. The people are invited to visit the home prior to moving in. Care Homes for Older People Page 11 of 29 Evidence: In general there is detailed information recorded to make sure that staff have the details they need to care for the individual person. However there were gaps in recording personal details, such as date of birth and social background. The Registered Manager told us that she also takes written notes and some of the information is recorded directly on to the care plan. Only one assessment had been signed by the next of kin to confirm agreement. Improvements are therefore required to make sure that the assessments are fully completed and a detailed record is in place. The Registered Manager told us that the assessment format is under review and these issues will be addressed to make sure that full information is recorded and it is clear that the assessment has been agreed. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that a person receives is based on their care plan. Written guidelines for staff will ensure that all staff are consistently moving people safely. People can be sure they will receive their medication safely and on time. People living in the home are treated with respect and their dignity is upheld. Evidence: Each person at the home has a care plan. We looked at two plans and found that some of the details were personlised to the individual, for example how to position pillows and what each person prefers to wear. Sleeping patterns are also recorded. The plans also told us what the person could do for themselves and how staff should support them to do this. However, there were gaps in how to move the people safely as there are no written guidelines for staff to follow. The risks are minimised as the staff spoken with told us how they move people safely and they have all received moving and handling training. The Registered Manager is also a moving and handing assessor and is on hand to support the staff if there are any moving and handling issues. Care Homes for Older People Page 13 of 29 Evidence: The daily notes are initialled by staff but full signatures are required to make sure the home has recorded clearly who provided the care at that time. The Registered Manager took immediate action to implement this and told the staff to sign their full names at the end of the shift. The recording in the daily notes is not detailed enough to know exactly what care has been given, for example Mrs X had her usual care. Improvements are therefore required in the recording of information in the plans. The plans do not show that the person living in the home, or their relative/representative, has agreed with the plan. The Registered Manager is aware of these shortfalls and is in the process of reviewing the care planning system. She told us that all of the shortfalls raised will be addressed, including providing written instructions for staff to follow in the moving and handling risk assessments. Although there are some shortfalls in the information recorded in the care plans this does not seem to affect the outcomes for the people receiving the service. We are confident that these changes will be made therefore a requirement will not be made in this report at this time. The health care needs of the people are recorded in the care plan or a separate folder if required. When specialists appointments happen or when district nurses or doctors visit there are records about the outcome of the visit and what if anything needs to change in the care plan. If required fluid charts and body charts are used to make sure that peoples health care needs are monitored. The home works closely with health care professionals to support the people who wish to remain in the home with appropriate medical support. Some people had special mattresses on their beds and they were sat on cushions that help prevent the skin from breaking down. There is a separate medication room in the home and we looked at the medication procedures. Temperature records are in place to monitor the temperature of the medication fridge, however we found that the temperature of the medication room is currently not recorded. The Registered Manager told us that she would address this issue to make sure that all of the drugs are stored at the appropriate temperature. The majority of the medication is dispensed using blister packs, which are made up at the pharmacy. This system reduces the risks of errors when giving out medication. Only senior staff administer medication and they have all received appropriate training. We found that hand written entries on the medical administration (MAR) sheets are not countersigned to reduce the risk of error. The Registered Manager told us that she would implement this as soon as possible. She audits the medication on a regular basis to make sure that people in the home are receiving their medication safely. Care Homes for Older People Page 14 of 29 Evidence: At the time of the visit the care plans were locked in the medication room. The medication room is for storing and administering medication only and should not be used to store care plans or as a staff hand over room. The Registered Manager told us that the plans would be moved and staff hand overs will be carried out in a different area. During the visit she was taking action to address this issue. The people living in the home told us that the staff treat them with respect, and always knock before entering their room. Staff were seen to be polite and supporting the people with their daily life. There was a calm, relaxed atmosphere in the home. When asked if the staff respect their privacy and dignity four people said yes definitely. Always, the staff are very good. Yes, they are wonderful to me and the staff are a bunch of nice people, they help and treat us with respect. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are supported well to make some choices about their lifestyle. The people are given the opportunity to participate in appropriate social, cultural and recreational activities of their choice. People enjoy the food and have a varied diet. Evidence: We looked at what was happening in the home to make sure people are supported to take part in activities of their choice. We saw that a bingo session was being held and some people were taking part. One person said that she knew bingo was taking place but preferred to read her book instead. There are planned activities listed on a white board in the dining room to make sure that the people in the home can see what, if any, activity they would like to join in with. These include art and craft sessions, exercise classes, visits from the local churches, hairdressing, beauty sessions, and a film afternoon. The Registered Manager told us that small personalised outings are also arranged, for example, taking some residents to the shops or to the library. People are also supported to go to the local church if they wish. There is a selection of books, DVDs and videos in the corner of the dining room and people were seen using this facility. There is currently no Care Homes for Older People Page 16 of 29 Evidence: dedicated staff to provide activities. The Registered Manager told us that within three months a post will be advertised to recruit a part time activities co-ordinator. Every person in the home is encouraged to participate in a hobby of their choice and one person, whose hobby is flower arranging, arranges the flowers in the dining room. The home has a Wii console and the Registered Manager told us that staff join in with the games, which promotes social interaction with all of the people in the home. The people told us that they use the garden in the summer, especially since the new decking has been finished. They said that they enjoyed having their tea outside and were looking forward to the summer. There are large doors and windows facing the countryside and garden and the people told us how nice it is to sit in the lounge and enjoy the wonderful view. All of the new rooms have internet access and wireless connection is available. Two people who stayed in the home for a short period brought their lap tops in with them. Some families email the home to keep contact with their relatives. If required the home will print the emails in large print for the individual to read. Relatives and friends visit the home on a regular basis and people living in the home are encouraged to ask their relatives for lunch at any time. During the Christmas period, people living in the home invited their relatives for lunch and over seventy two people were served. A relative comments: As a visitor I am made welcome at any time of day. I visit every day and it is a delight. The home has a system of key workers who support the people with their individual shopping, for example buying birthday cards for relatives or toiletries of their choice. One person asked if she could bring an organ in the home when she moved in and the home made a space for this in the lounge. The people living in the home told us that they are able to come and go as they please. They choose when to go to bed or get up, what to wear and eat. Before Christmas the people living in the home decided that they wanted more than one Christmas tree. It was therefore agreed that they would have two in the home and two outside. Most of the families deal with their relatives finances, however in some cases the home supports individuals to handle their financial affairs for as long as they wish. The Registered Manager told us that advocacy services are available if required. Care Homes for Older People Page 17 of 29 Evidence: There are some mixed comments from relatives and staff with regard to the standard of the food. One comment indicated that sometimes the meat was tough. The Registered Manager was aware of this comment and action has been taken to improve the cooking of the meat to make sure it is tender. Another comment by a relative was: imagination of the food is poor. The four weekly menus are discussed with the people on a four to six weekly basis when the Registered Manager audits the service. Menus are also discussed at the residents meetings and any suggestions and choices are incorporated into the menu. There is evidence that all of the people living in the home have an opportunity to have their say with regard to the choices on the menu. The people who live in the home are asked by the Chef or staff what they would like for dinner the next day; the menu clearly shows that different meals are being served in line with individual choice. The tea time menu showed all of the choices made, which varied from sandwiches to soup. There are several choices of drinks available in the dining room and a fridge for the people to use. Hot drinks and snacks are served by the staff from the kitchen and fresh fruit and sweets are available on the dresser. The meals looked appetising and the atmosphere in the dining room was relaxed. People living in the home comment: There is a good variety of food. The food is good, you can just ask for a snack or a sandwich if you want. The food is very good there is always a choice. There is always a choice and alternative. I am always satisfied and if you dont like what is on offer you can have what you like. Relative comments: The Chef has tried to meet my relatives needs; a new system has been devised to show her choice of menu for the next day, which I think is excellent. Care Homes for Older People Page 18 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service are confident complaints will be listened to and dealt with appropriately. People who use the service are protected from abuse. Evidence: All of the people spoken to at the time of the visit told us that they have no complaints. They are confident that if they had any concerns they would speak to the Registered Manager or the Deputy Manager and they would be listened to. There is a complaints procedure on display. Since the previous inspection one complaint has been received. This was when the service increased the number of people living in the home. There were issues over waiting for lunch to be served. The Registered Manager called a residents meeting to discuss the issue. The people living in the home discussed the issue and it was decided to have two sittings at lunch time. All of the people were happy with this decision and the system is working well. People living in the home comment: I have never had to complain but if I had something to say I would speak to the manager. No. I have no complaints, there are no faults with this place. There are safeguarding polices and procedures in place to make sure that the people using the service are protected. The policy was reviewed last year to make sure it was Care Homes for Older People Page 19 of 29 Evidence: up to date. Staff have received safeguarding training and told us what they would do if they had any concerns. They understand the importance of reporting issues and are clear what they must do if they have any concerns. The home has a robust recruitment procedure and checks are made on new members of staff to make sure that they are safe to work in the home. Care Homes for Older People Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has improved the environment to provide people with an excellent, comfortable, homely and safe place to live. The residents benefit from a clean and very well maintained environment. Evidence: The building provides a suitable range of facilities for the people who live there. These are in line with what the Registered Provider has committed itself to deliver in its Statement of Purpose. This is a legal document that describes in some detail the facilities and services that are available in Glendale Lodge; copies of which can be obtained from the home. Since the last inspection the home has completed an extension to increase the number of people living in the home to thirty two. Seven new bedrooms have en suite facilities and have new furnishings and fittings. All of the rooms have under floor heating with television and internet access. Three other bedrooms have also had en suite facilities installed. A married couple living in the home uses one room as their private lounge. The environment in the home is well maintained, clean, comfortable and homely. The existing communal area has been refurbished and the extension provided Care Homes for Older People Page 21 of 29 Evidence: additional space. A new wet room has been installed which gives people more bathing choices. Profile beds and pressure relieving equipment has been purchased to make sure people in the home have immediate access to this equipment. Grab rails are installed throughout the home and on the external doorways. The service employs a maintenance person. Daily maintenance jobs are recorded in a book and they are signed and dated to make sure that they have been completed. Chairs and lamps and some furniture in the bedrooms have been replaced. A new dishwasher has been purchased and staff have been provided with new uniforms. The garden has been landscaped and the people living in the home told us how they enjoyed the garden in the summer. There is an area of decking where people told us they enjoyed sitting and they had their meals served outside in the good weather. The new laundry room has all of the facilities required and sufficient space to iron and store clean clothes. There are systems in place to reduce the risk of infection. The fire officer has visited the home when the new extension was completed and a fire risk assessment is in place. The whole of the home was very clean and tidy, very well maintained with a pleasant smell throughout. Care Homes for Older People Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service can be sure that their care needs will be fully met at all times. People are receiving care from trained staff and they are protected by the recruitment policies and procedures of the home. Evidence: We looked at the staff rota to make sure that there was enough staff on duty to support the people living in the home. The people also told us that there is always enough staff on duty. From this information we were able to see that staffing levels throughout the day and night are sufficient to look after the people living in the home. When asked what the home could do better a member of staff comments: Provide more staff on Sunday as there are the same amount of residents and work to do but sometimes less staff. There was no evidence to confirm that staffing levels are reduced at the weekends and staff spoken with told us that there are four members of staff during the week and it is the same at the weekends. The Registered Manager also told us that staffing levels are consistent throughout the week. . People spoken with at the time of the visit told us: The staff are very, very good, I can not say a bad word about them. They are excellent and are always there when I need them. The staff are very pleasant, my family are very happy with this service. The people living in the home receive care from staff that is qualified. There are over fifty per cent of Care Homes for Older People Page 23 of 29 Evidence: staff who have achieved National Vocational Qualification (NVQ) level 2 or above. People are protected by the recruitment procedures. All of the staff have been checked to make sure that they are safe to provide care to the people living in the home. This includes criminal record checks, proof of identity and two written satisfactory references. There is a full training programme in place and the majority of staff have received core training, for example, health and safety, infection control, first aid awareness, food hygiene, fire and moving and handling. Some specialist training has been provided including Mental Capacity Act Training, Diabetes and MRSA. Two people have received training in Safer Business, Better Food. Senior staff have also attended the Deprivation of Liberty Training. New staff complete a full competency based induction. The service has purchased a complete training pack covering a variety of training courses. The Registered Manager told us that she will be trained to deliver this training to all staff. It is the homes intention to have a training suite built at the side of the home. There will also be a small office for the Registered Manager to carry out the supervision of staff. Care Homes for Older People Page 24 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The effective management of the home makes sure that it is well run and in the best interest of the people who live there. The health, safety and welfare of the people living in the home is promoted. Evidence: The Registered Manager, Carole McNamara, is qualified, experienced, and competent. She has clear leadership skills, identifies what is required to improve the home and continually monitors the service to make sure a high standard of care is delivered. The people who live in the home are constantly encouraged to get involved in the day to day running of the service. Comments from relatives, health care professionals and staff are complimentary to the management and staff. A relative comments: There is a core team headed by the Registered Manager and Deputy, which works well. The team have made me feel welcome. Care Homes for Older People Page 25 of 29 Evidence: A staff member comments: Glendale Lodge provides a home within a home for all residents with dedicated, friendly and efficient management and staff there to ensure all residents can lead as normal life as possible. The people in the home can be sure that their views and suggestions will be taken into consideration in the day to day running of the home. Residents meetings are held on a regular basis and the Registered Managers also speaks to the people every six to eight weeks. These audits also include observation of staffs care practice. Written records are in place to make sure that any concerns raised are actioned. Questionnaires are also sent to the people, relatives, health care professionals and visitors to monitor the standard of care being provided. The results are analysed and a newsletter is produced to make sure everyone is aware of the outcomes. The Registered Provider of the service visits the home every month to make sure the service is meeting the required standards. Most of the people living in the home are supported with their personal finances by their relatives. However, if required, the home has systems in place to make sure peoples finances are protected. Records of the system were seen to be in good order. Receipts of all transactions are in place and where possible people sign to confirm they have received their money. The staff receive regular supervision from the managers to make sure they are supported to do their jobs well. The Registered Manager also observes staff care practice as part of the quality audit programme. Staff spoken with at the time of the visit told us that they are supervised regularly and they feel that the management team is approachable if they have any concerns. The home has systems in place to make sure health and safety is promoted in the home. Core training is up to date and there is a thorough staff induction in place. All servicing and maintenance checks are carried out to make sure the building is maintained safely. There are environmental and personal risk assessments in place. Fire records are in good order; we saw that safety checks are done at the required intervals including the testing of fire bells and drills listing all members of staff on duty. The accident book was seen and information recorded was tracked through to the care plan to make sure that appropriate action had been taken. Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 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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