Care Home: Glenkindie Lodge

What the care home does well Health and personal care is managed well, all of the people who live there have an individualised plan of care that sets out their health, personal and social care needs. These are being further developed to ensure that they are more detailed and individualised. The service ensures that the people who live there have access to the right health care professionals at the right time . This means that the service ensure good outcomes for the people who live there. We noted that staff interacted well with the people who live there being inclusive and having good interpersonal skills. Staff were also seen to be respectful and mindful of the need to protect peoples privacy. Daily Life and social activity is managed well, people are able to make choices about how to spend their time and have access to a varied menu which is in keeping with their culture and preferences. The management are proactive in their response to verbal complaints addressing concerns as soon as they arise which means that formal written complaints are avoided. The recruitment, training and supervision of staff is managed well ensuring that staff have the right skills to care for people properly. The management of the home is proactive, they have complied with nine outstanding requirements form the last inspection. They have robust Quality Assurance procedures in place that are used to inform service development. They have also responded swiftly to put things right as they were identified during this current inspection. What has improved since the last inspection? The service has improved the way that it manages admissions to the home, all new admissions have a detailed preadmission assessments conducted by a senior member of staff to ensure that the service is able to meet the needs of the individual before a place is offered. All of the people who live at Glenkindie Lodge have an appropriate contract in place that sets out their terms and conditions of residence. The management have complied with a requirement that was made at the last inspection about the need to keep appropriate record for specific medication and this has now been done. The service have reviewed the use of the premises, there are now three areas where people are able to dine and there are four dedicated areas where people can spend their time such as a separate TV room and quiet room. Accident records are now being completed as necessary, these are collated and reviewed by the management to ensure that any hazards are identified and removed. What the care home could do better: During the inspection we identified that dental cleansing agents were not being securely stored, the management took immediate action to rectify this during the inspection. There are now specific risk assessments in place for people who choose to use this method of cleansing. We also identified that risk assessments for the use of bed rails were not specific to the individual and the use of protectors, this also was rectified by the management during the course of the inspection. We identified that the storage arrangements for controlled drugs may not meet new guidelines, the management have agreed to obtain a certified medication storage cupboard that complies with current legislation. We also noted that some of the people have prescribed creams that are kept in their bedrooms , these were not dated at the time of opening to ensure that the maximum benefit was obtained from preparations that were still in date. The management took immediate action to address this during the inspection. We also identified that one person had not been given their medication on two occasions due to a misunderstanding, however the management determined what remedial action that they were going to take during the inspection to prevent this from happening again. The management need to seek advice from the Safeguarding team when there something occurs that may comprise elements of abuse. The standard of the environment needs to be reviewed to make sure that equipment and stock is stored appropriately and that any potential hazards are dealt with. Key inspection report Care homes for older people Name: Address: Glenkindie Lodge 27 Harborough Road Desborough Northants NN14 2QX     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: Stephanie Vaughan     Date: 0 1 0 2 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 31 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 31 Information about the care home Name of care home: Address: Glenkindie Lodge 27 Harborough Road Desborough Northants NN14 2QX 01536762919 01536762919 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Premedic Limited care home 33 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 33 The registered person may provide the following categories of service only: Care Home only - code 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 - Code OP, maximum number of places: 33 Dementia - Code DE, maximum number of places: 33 Mental Disorder, excluding learning disability or dementia - Code MD, maximum number of places: 1 Date of last inspection Brief description of the care home Glenkindie Lodge is a privately owned care home providing personal care and accommodation for up to 33 People. The Home is situated in the outskirts of Desborough close to local shops and the towns amenities. The premises consist of a two-storey house with an extension. The People living in the home are provided with Care Homes for Older People Page 4 of 31 Over 65 0 0 33 33 1 0 Brief description of the care home single bedrooms with en suite facilities throughout the accommodation. The Homes charges range from GBP381.00 to GBP479.99. Thre are additional charges at variable rates for Hairdressing, Chiropody, clothing, toiletries, newspapers and other personal items. These charges are paid from the peoples own funds. Any charges incurred for private Dentistry or Ophthalmic services are the responsibility of the people living in the home. Care Homes for Older People Page 5 of 31 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: Before this inspection we spent five hours in preparation. This included looking at the Annual Quality Assessment which is a document sent to us by the management, the previous inspection reports, associated requirements, the service history and other documentation. We sent surveys to some of the people who live at Glenkindie Lodge, we also sent some to the staff who work there and a local GP. In general the responses were all favourable specific comments have been used to inform our inspection activity and are also included in the body of the report. We have received no concerns or complaints about this service however we have received two safeguarding allegations about this service, the service has responded in the right way to these allegations and ensured that these are referred to the local authority for investigation. The outcome of both of these investigations are as yet Care Homes for Older People Page 6 of 31 unknown. However a third alert was raised by another agency and the investigation into this allegation concluded that there was no evidence to support this allegation and that the service had responded to the needs of the individual appropriately. The Commission have a focus on Equality and Diversity and issues relating to this are included in the main body of the report. The site visit was conducted over a period of seven and three quarter hours during which we made observations, spoke to some the people who live there and some of the staff. A limited tour of the premises was conducted which unloved reviewing the communal areas and some of the bedrooms. Case tracking is the method used during the inspection where a sample of four people were selected and aspects of their care and experiences were reviewed, including the individual plans of care and associated documentation. The service specialises in the care of people with Dementia as such some of the people who live there have limited ability to recall and communicate their experiences. In these circumstances observations are used to inform the inspection activity. The Registered Manager was present throughout this inspection Care Homes for Older People Page 7 of 31 What the care home does well: What has improved since the last inspection? The service has improved the way that it manages admissions to the home, all new admissions have a detailed preadmission assessments conducted by a senior member of staff to ensure that the service is able to meet the needs of the individual before a place is offered. All of the people who live at Glenkindie Lodge have an appropriate contract in place that sets out their terms and conditions of residence. The management have complied with a requirement that was made at the last inspection about the need to keep appropriate record for specific medication and this has now been done. The service have reviewed the use of the premises, there are now three areas where people are able to dine and there are four dedicated areas where people can spend their time such as a separate TV room and quiet room. Accident records are now being completed as necessary, these are collated and reviewed by the management to ensure that any hazards are identified and removed. Care Homes for Older People Page 8 of 31 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 31 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 31 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 people who live at Glenkindie Lodge receive clear information and have opportunity to visit the home enabling them to make a choice about whether they might like to live there. Evidence: The service provides people with information about the home so that they can make an informed an decision about whether they would like to live at Glenkindie Lodge. Arrangements are also in place so that people can visit the home, meet the people who already live there, the staff and see what it is like to live there. We looked at the care plan of one of the people who had recently come to live at the home. This contained a detailed preadmission assessment which had been conducted by the Registered Manger before a place was offered. This means that the service was able to determine whether they could meet the needs of the individual concerned. Care Homes for Older People Page 11 of 31 Evidence: This means that the service have complied with the requirement made at the last inspection. We also case tracked three other people and saw that the service has issued all of the people who live at Glenkindie Lodge with a contract which sets out their terms and conditions of residence. This means that the service have also complied with the requirement that was made about contracts in the last inspection report. The people who use the service told us The staff are friendly and they care about the residents Staff comments included The home does well in providing training for the staff so that they are able to meet the needs of the residents. Glenkindie Lodge offers a safe, loving and caring home for the elderly, we are like one big happy family Glenkindie is a very nice friendly home, we are like one big family Care Homes for Older People Page 12 of 31 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have a detailed plan of care which ensures that they are treated as individuals and that their health care needs are met. Evidence: The standard of the individual plans of care is good and these are being further developed so that they are more individualised and reflect the needs, wishes and lifestyles of the people who live there. There is also evidence that the people who use the service or their representative are involved in the care planning process and regular review. The care plans cover all aspects of health, personal and social care including information about choice, preferred routines and activities. We noted that the care plans for dental care contained reference to the use of dental cleansing agents, we also identified that these containers were being stored in the en suite facilities that are accessible to the people who live there. We asked that these be secured because of the risks associated with accidental ingestion. During the Care Homes for Older People Page 13 of 31 Evidence: inspection the management developed appropriate risk assessemnst for each person who has chosen to use dental cleansing agents and arranged for their safe storage. Arrangements are in place to ensure that consent for the use of bed rails is obtained and that individual risk assessemnst are conducted regarding the associated risk of entrapment and the use of protectors. Care plans also contain detailed risk assessments for the risks of falls, fractures, nutrition and the risks associated with pressure. These are all regularly reviewed and contain appropriate information so that staff can reduce the associated risks. Where high risk is identified the staff ensure that guidance and if required equipment is obtained from the appropriate professional such as the Community Psychiatric Nursing Service, District Nursing service and others such as the Dietician. Following a requirement made as a result of the last inspection the management have put in place systems to ensue that medication systems are appropriately checked. We checked the records for controlled medication and found them to be in good order and to be an accurate record with the amount administered corresponding with the remaining balance. However we were concerned that the existing storage arrangement for controlled drugs may not comply with the Guidelines Issued by the Royal British Pharmaceutical Society. This was discussed this with the management who have confirmed that they have now placed an order for a certified storage facility. We conducted a limited tour of the premises and noted that some of the rooms had prescribed creams that were not dated at the time of opening. Although there was a separate record for the staff to sign to show that the cream had been administered it was not being recorded on the the medication record on which it was prescribed. This was discussed with the management who arranged for all of the creams to be replaced and dated so that creams can be discarded after 3 months. A new system has also been introduced so that the Medication Administration Record can be signed directly to show that topical medication has been given. Most of the medication is dispensed in Monitored Dose Systems by a National Pharmacy. In general these systems were in good order with the exception that one persons medication record indicated that their medication had not been given on two occasions. Further discussion established the rational for this and the management have informed us of the action that they have taken to prevent a recurrence. Care Homes for Older People Page 14 of 31 Evidence: There are arrangements in place to ensure the privacy and dignity of the people who live there. We saw that the staff knock on people doors before entering, they interact well and in a way that they can be understood. The staff were seen to be attentive, respectful and speak to them using their chosen form of address. We have received completed surveys from four of the people who use the service, six from the staff who work there and one from a local GP. All of the responses were favourable, specific comments includedThe home recognises my disability and shows me dignity in all areas The personal care is fairly good The staff try to solve problems They keep me and my room clean at all times We keep the families informed and let them know how their relative is doing I feel that the home is friendly and that we are trying to deliver more person centred care The residents are well cared for and are always treated with respect and dignity The staff work well together as a team to ensure that the residents are cared for 100 The home provides a very good service, it provides good nutrition and medication. While we were there the people that we spoke to told us that they felt safe, that they were well looked after and that the staff were nice to them. Care Homes for Older People Page 15 of 31 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 people who live at Glenkindie Lodge have control over their lives which enables them to enjoy a lifestyle that promotes choice and independence. Evidence: People who live at Glenkindie Lodge are able to make decisions about their life styles and routines such as where they choose to spend their time and the activities in which they wish to participate. There is a formal activities programme that is produced on a monthly basis, the content is dynamic being regularly reviewed by the activities coordinator and management , this is based on the feedback and experiences of the people who live at the home. The service aims to provide various activities for two hours in the afternoon and one hours session in the evening with activities such as bingo, sing a longs, armchair exercises, arts and crafts sessions & quizzes. The service is developing ways of working with the people who live there by involving them in routine domestic tasks such as baking and laying the table. Arrangements are also in place for people to have one to one sessions in their rooms to just chat or to have hand massages or manicures. Care Homes for Older People Page 16 of 31 Evidence: Individual preferences are recorded in the individual plans of care which also include information about previous lifestyles and their family unit so that staff can support them to maintain their individuality. The activities are held in the conservatory so that people can opt out if they wish to do so. There is also a designated TV lounge, Reminiscent Lounge and quite Lounge so that people can make choices about where to spend their time. All of the existing people who live there are white European as such the predominant faith is Christian, people are able to choose whether they wish to participate in the arrangements that are available for religious observance. People are supported to maintain links with the local community, people are able to received their chosen visitors either in their own rooms or in the communal areas. Visiting times are flexible and visitors are made welcome by the staff. Some of the people who live there choose to spend time at a local day centre. The service aims to promote choice and this is evident form the individual plans of care and from observations that were made during the inspection. Examples include decisions about their personal care routines, clothing, where and how to spend their time, the food that they eat and who they spoke to. The service specialises in the care of people with dementia and the management and staff have received training in the Mental capacity Act and Deprivation of Liberty Standards, no applications have been made by this service for authorisation of Deprivation of Liberty to the local council. The dining arrangements have been improved since the last inspection there are now three areas where meals are served. Breakfast is served in the kitchenette at flexible times according to the individuals preferred times of rising. All of the existing people who live at the home are White British and as such prefer traditional English food and this is reflected in the menus. The menu offers choice for the three meals during the day with the provision of hot food for lunch and supper. People can choose from either of the two menu options for each meal and there are also alternatives available if preferred. Drinks and snacks such a biscuits and fruit are available between meals. The service liaises with the Community Dietician when people require special diets. We have received comments from the people who live at Glenkindie Lodge and from Care Homes for Older People Page 17 of 31 Evidence: some of the staffThe meals are good Meal times are happy occasions and the residents are offered choice in what they would like to eat We could do with some more equipment for the activities sessions the home provides a family like atmosphere We always welcome relatives at any time Care Homes for Older People Page 18 of 31 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. A comprehensive procedure for the handling of complaints is in place so that people are able to voice their concerns. Evidence: The service has a complaints policy which is accessible to the people who live at Glenkindie Lodge, their friends and relatives. We looked at the complaints file, the service has has had no formal written complaints since the last inspection. However a record is made of any informal verbal compliant, the records indicate that all complaints are taken seriously, that they are responded to in a timely way and that corrective action is taken to put things right . People told us that they felt safe living at Glenkindie Lodge and that they felt able to express their views should they need to do so in confidence that they will be listened to and taken seriously. The management are now mindful of the occasions when guidance needs to be taken from the local Safeguarding Team about when to make referrals. There have been three Safeguarding Alerts made about this service, two having been submitted by the management of the home, the outcome of these referrals are as yet unknown. One other referral was made from the local hospital, this has been fully investigated by the Local Authority and there was no evidence found to support this Care Homes for Older People Page 19 of 31 Evidence: allegation. Staff have received training in the Safeguarding of Adults, the Mental Capacity Act, Deprivation of Liberty Standards, First Aid and NVQ training. People told us We look after our patients and report any concerns We care for the residents well and the residents seem happy We ensure that they have freedom of choice Care Homes for Older People Page 20 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The communal areas are in need of development and this needs to be addressed to ensure that they provide the people who live there with a pleasant, safe and comfortable place to live. Evidence: The service is a large house within a residential setting that has been extended for use as a residential care home. It has been fitted with ramps to the main entrance so that it is accessible for people in wheel chairs. The accommodation is arranged over two floors with management and support services being housed in the basement. There is a passenger lift so that people can access other floors. The use of the communal areas has been reviewed since the last inspection, there are now three areas that are used for dining purposes including a kitchen diner that can be used by relatives and the people who live there to access drinks and snacks. There are four lounges which have been designated for different uses such as a Quiet Lounge, a TV lounge, a Reminiscent lounge and the conservatory where people assemble to participate in group activities. Most of the bedrooms are for single occupancy, there is an ongoing refurbishment of fixtures, fittings and soft furnishings as rooms become available. All of the bedrooms Care Homes for Older People Page 21 of 31 Evidence: are fitted with privacy locks and most have lockable facility in which to keep any valuables . We viewed a selection of the bedrooms and found them to be fitted with safety equipment such as radiator guards, to have windows that were safe, access to call bells and en suite facilities and adequate supplies of hot water. Rooms were personalised with small pieces of furniture, photographs, pictures and other personal items uncling televisions. People also have access to mobile phones which can be loaned to them by the home. The entrance and communal areas are in need of decoration and refurbishment, carpets are worn in several areas and may soon present a trip hazard. In addition there is a lack of storage in the home, one of the en suites was seen to be being used for storage purposes which would make it difficult for the person to use independently. Some of the communal areas are cluttered which makes it difficult for staff to keep the home clean and tidy. In addition the Registered Manager and Head of care share an office in the basement, this means that they are not able to observe what is going on in the upper levels and are not directly accessible to the people who live there or their relatives. They strive to compensate for this by spending time out of the office whenever possible. All areas of the home appeared to be clean and hygienic, albeit untidy in some places. Staff are trained in Infection Control and there are sufficient hand washing and hand scrub facilities throughout the home. We were informed that the service has plans to commence a refurbishment of the communal areas in the near future. People told us They keep my room clean at all times The service has appropriate door security at the entrance The rooms are all well kept The home is in need of some redecoration The home could be improved by having some work done to make it look brighter and some new curtains and bed linen Care Homes for Older People Page 22 of 31 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 home employs appropriate numbers of inducted and trained staff to ensure that they are able to meet the needs of the people who live there. Evidence: The service ensures that there are good staffing levels in the home to cover all shifts. In addition to the care staff there are sufficient house keeping and domestic staff available to support the team. There is also a dedicated activities coordinator that works at times when the residents are most able to benefit from the stimulation that the activities provide. There is also a maintenance person who looks conducts routine checks and carries out maintains tasks. There are robust recruitment practices in place, the management make sure that they conduct all of the right checks on new staff before they start working in the home. They also make sure that they have the right training to do their jobs safety including training such as fire safety and first aid. Staff also have training to meet the specific needs of the people for whom they care such as care of people with diabetes or epilepsy. The service also encourages staff to obtain NVQ and other formal qualifications. People told us - Care Homes for Older People Page 23 of 31 Evidence: The staff are friendly and they care about the residents Everyone has in house training and external training is also offered we have lots of training both in house and external I have worked here for over year now and I am very happy in my job. Care Homes for Older People Page 24 of 31 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed so that the residents are well protected and their best interests are promoted. Evidence: The Registered Manager is an experienced nurse who has managed Genkindie Lodge of over three years. She is supported by a recently appointed Head of Care both work together well to ensure that the home is being run in the best interests of the people who live there. There are a range of Quality Assurance activities in place to ensure that the service meets the needs and expectations of the people who use it, this include formal surveys, a suggestion box and a range of regular audits. The management have complied with the nine outstanding requirements made at the last inspection, this shows that they work with us to improve outcome for the people who live there. Care Homes for Older People Page 25 of 31 Evidence: We looked at the management of residents money, this is being managed appropriately with safe storage and accurate documentation. Staff recruitment and training is robust and staff supervision is in place so that management can be sure that the staff have the skills to care for people properly. They have capacity to take action when something goes wrong to make sure that it does not happen again. Safe working practices are ensured by a range of risk assessments both general and individual to reduce and manage the identified risk. They also make sure that the right routine checks are conducted so that equipment is maintained in good and safe working order. People told us The Senior staff are always available The manager is very good and always helpful if we need advice or help. The communication between staff and management is very good I feel very supported by management, I can go to them with a problem or if I am not sure about something regarding work The home has improved a lot over the last few years, our residents are happy and well cared for The staff and management work very hard to meet the demands of the home, especially the residents. I see the joy and gratitude from the majority of residents for whom we provide care. Care Homes for Older People Page 26 of 31 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 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 8 13 The registered persons must 03/02/2010 ensure the safe storage of dental cleansing agents To ensure that the risks of accidental ingestion are reduced. 2 9 13 The registered persons must 03/02/2010 ensure that medication for local application such as creams are dated at the time of opening so that they are discarded after 3 months of use. To ensure that people receive the intended benefits of the prescribed medication 3 9 13 The registered persons must 01/03/2010 ensure that there is a certified facility for the storage of Controlled Drugs to comply with the Misue of Drugs Act ( Safe Custody) To ensure the safe sorage of medication. Care Homes for Older People Page 28 of 31 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 4 9 13 The registered persons must 03/02/2010 ensure that medication is given as prescribed at all times. To ensure the health and well being of the people who require the administration of medication. 5 9 13 The registered persons must 03/02/2010 ensure that individual risk assessments are in place for the people who use bed rails, that comply with the guidance issued by the HSE and include the risks of associated entrapment and potential restraint To reduce the risks associated with the use of bed rails 6 18 13 When there is concern that people have been abused harmed or neglected guidance must be sought from the local Safeguarding Team to determine whether the concern falls within the remit of safeguarding. To ensure that the people are protected from all forms of abuse. 04/02/2010 Care Homes for Older People Page 29 of 31 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 7 19 13 Stock and equipment must not be stored within the residents personal accommodation including the en suite facilities To ensure the health and safety of the people who use the service. 01/03/2010 8 19 13 Action must be taken to reduce the potential trip hazards associated with the worn and stretched carpets in the communal areas. To ensure the health and safety of the people who use the service. 01/03/2010 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 2 9 19 Where a person is assessed as needing the use of bed rails their consent for use should be obtained. The management should give consideration to the relocation of the managers office so that they can be easily accessible to the people who live there, their relatives and also the staff. Consideration should be given to the arrangements for the storage of stock and equipment to reduce the amount of clutter in the home. Senior staff should give consideration to obtaining a formal qualification in the care of people with dementia 3 19 4 31 Care Homes for Older People Page 30 of 31 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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