Care Home: Glentworth House Nursing Home

What the care home does well The home has information available for prospective residents/representatives on the facilities and services provided to make an informed decision if their needs can be met at the home. The admission process ensures that only residents whose needs can be met are admitted to the home. Residents are safeguarded by the medication practices within the home. Resident`s routines are to their own choice and preference and are provided with sufficient stimulation to fulfil their interests. Residents` choice and preferences are catered for with meals. Visitors are welcomed at the home and no restrictions are imposed. Residents privacy and dignity are respected. Complaints are dealt with by the home and action taken where necessary, ensuring those who raise complaints that they are listened to. Safeguarding Adults procedures ensure residents are safeguarded. Residents are provided with comfortable indoor communal facilities. Residents` needs are currently being met with the number and skill mix of staff on duty and staff are kept up to date with all relevant training. Feedback from residents showed they were overall happy residing at the home and some comments received were: `very happy here`, `my room is nice and comfortable`, `satisfied here` and `staff are very nice and helpful`. What has improved since the last inspection? Work has been done to address the three requirements made at the last inspection. Written confirmation is provided to prospective residents confirming to them that following an assessment, the care home is suitable for the purpose of meeting their needs in respect of their health and welfare. Improvements have been made in the care planning system to ensure clear, accurate and up to date information is maintained, evidencing that the home is meeting the needs of residents. We were informed that a new recruitment pack has been implemented. Shortfalls in recruitment practices noted at the last inspection have been addressed. The AQAA identifies areas that the home has improved within the last 12 months and some examples given of changes they have made as a result of listening to residents are: established community presence through networking with colleges and local schools, have provided a dining table to encourage social interaction between the residents and staff, a menu board is on display to remind the residents of the food that is on offer and a monthly newsletter has been implemented keeping people informed of current and future events within the service. What the care home could do better: No requirements have been made as a result of this inspection. Some recommendations were made to the Responsible Individual at the site visit and are reflected throughout the content of this report. We are confident that these shortfalls will be addressed. The Responsible Individual has previously demonstrated the services commitment to ensuring outcomes for residents is improved. The reader is advised to read the report for full details. Whilst the overall outcome for residents is good, work must be done to improve the information provided in the AQAA when we next ask for it. All key standards must be addressed and clearer evidence be provided. It is in the homes best interest to demonstrate clearly that they continue to provide good outcomes when we next use their AQAA to assess the services they are providing. The Responsible Individual demonstrates a willingness to continue to improve the service and ensures any requirements made are complied with. The AQAA did not provide us with any information on what the service has identified in what they could do better, however identifies some plans for improvements in the next 12 months. Key inspection report Care homes for older people Name: Address: Glentworth House Nursing Home 40-42 Pembroke Avenue Hove East Sussex BN3 5DB     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: Jennie Williams     Date: 2 5 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 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Glentworth House Nursing Home 40-42 Pembroke Avenue Hove East Sussex BN3 5DB 01273720044 01273723660 manager@glentworth-house.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Whytecliffe Limited Name of registered manager (if applicable) Manager post vacant Type of registration: Number of places registered: care home 33 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users to be accommodated is 33. The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) Physical disability (PD). Date of last inspection Brief description of the care home Glentworth House is a large detached nursing home with a purpose built extension, registered with the above listed conditions of registration. It is situated in a quiet residential area of Hove, close to local shops and public transport. There is no parking available at the home and restricted paid parking in adjacent streets. Parking time is restricted to a maximum of two hours, although residents and visitors are entitled to Care Homes for Older People Page 4 of 26 Over 65 0 0 0 0 Brief description of the care home visitor parking permits, which are available on request from the home. Residents accommodation is located over two floors. The third floor is used for management and administration duties. There is a passenger shaft lift at the home that assists residents to access all residential areas of the home. There are twenty-one 21 rooms for single occupancy and six 6 shared rooms. All bedrooms, except one, are provided with en suite facilities. The local authority has contracted seven beds for Transitional and Interim Care. The purpose of this is to offer nursing support and rehabilitation to residents for up to a maximum of eight weeks usually following discharge from hospital prior to returning home. The local authority provides specialist support such as physiotherapy. Specific rooms have been designated for this care. There is a loungedining room and conservatory for use by the residents. There are suitable numbers of toilet and bathing facilities located throughout the home to meet the needs of residents. The home has a well-maintained rear garden, which is easily accessed from the ground floor lounge. Fees range from £502 to £700 per week. Additional fees are for hairdressing, chiropody, toiletries, newspapers/magazines and private physiotherapy. Full information on additional costs is available from the home. This information was provided to us on the 25 January 2010. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: It should be noted that service users prefer to be called people who use services. It was confirmed that the home uses the term residents. For the purpose of this report, people who use the service will be referred to as residents. This inspection was facilitated by the Responsible Individual, who is currently also undertaking the role of the appointed manager. For the purpose of this report, she will be referred to as the Responsible Individual. This unannounced site visit took place on the 25 January 2010 over seven and half hours. Evidence obtained at this site visit, previous information regarding this service and information that we have received since the last inspection forms this key inspection report. An annual quality assurance assessment (AQAA) was sent to us by the service, completed by the home on the 03 November 2009. 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 last key inspection was undertaken on the 21 January 2009. Care Homes for Older People Page 6 of 26 Six residents were spoken with throughout the site visit, whilst others were involved in the process via observation. One care plan was viewed in detail and specific areas of care viewed in a further four care plans. Three visitors were spoken with throughout the site visit. Two staff members were spoken with and other staff were invovled via our observations. Four staff files were inspected. Discussions were held with the Responsible Individual throughout the site visit. Medication procedures were viewed. A brief tour of the environment was undertaken and some individual rooms were viewed. The quality assurance system, complaint records and quality monitoring checks in place were viewed/discussed. There were thirty-one (31) residents residing at the home on the day of the site visit. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: No requirements have been made as a result of this inspection. Some recommendations were made to the Responsible Individual at the site visit and are reflected throughout the content of this report. We are confident that these shortfalls will be addressed. The Responsible Individual has previously demonstrated the services Care Homes for Older People Page 8 of 26 commitment to ensuring outcomes for residents is improved. The reader is advised to read the report for full details. Whilst the overall outcome for residents is good, work must be done to improve the information provided in the AQAA when we next ask for it. All key standards must be addressed and clearer evidence be provided. It is in the homes best interest to demonstrate clearly that they continue to provide good outcomes when we next use their AQAA to assess the services they are providing. The Responsible Individual demonstrates a willingness to continue to improve the service and ensures any requirements made are complied with. The AQAA did not provide us with any information on what the service has identified in what they could do better, however identifies some plans for improvements in the next 12 months. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has information available for prospective residents/representatives on the facilities and services provided to make an informed decision if their needs can be met at the home. The pre admission process generally ensures that only residents whose needs can be met at the home are admitted. Evidence: The Responsible Individual confirmed that there has been no changes made to the Statement of Purpose and Service Users Guide since the last inspection. Copies of these documents are located in the residents room. A resident confirmed that they had the choice to reside at this service or not. There was evidence that a newly admitted resident had been assessed prior to admission. The information recorded at these assessments includes information obtained from other health professionals wherever possible. Care Homes for Older People Page 11 of 26 Evidence: A staff member confirmed that they felt all residents were appropriately placed at the service and that management takes action if someones needs can no longer be met at the home. We were told that written confirmation is provided to prospective residents that following an assessment the home is able to meet their needs. The home does not have dedicated accommodation to provide intermediate care, however there are seven dedicated rooms to provide transitional care. These individuals are referred to the home via the local authority Care Matching Team. The Responsible Individual confirmed that the home undertakes their own assessment of these individuals, encourages family members to visit the service prior to moving in and takes information about the service to the individual prior to their admission. Respite care is available if there is a spare room. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs are being met with the information provided in the care plans on the assessed needs of individuals. Residents are safeguarded by the medication procedures in place. Evidence: Work has been done to improve the information recorded in care plans since the last inspection. The providers have employed a Senior Manager Clinical Governance Lead to work within both their services to provide guidance and support to staff and ensure good practices are followed. A care plan was viewed along with specific areas of care in a further four care plans. There was evidence that care plans provide guidance to staff on how to meet the needs of residents and that individuals have agreed with their plan of care. Some minor shortfalls in the documentation were noted of which management assured us would be addressed. We are confident this will be done. Examples are: improvements could be made in relation to wound dressing care plans and to ensure guidance is provided to staff if an individual displays aggressive behaviour. Care Homes for Older People Page 13 of 26 Evidence: Of the residents that were asked, all confirmed that they have viewed their care plans and staff discuss care with them. A staff member told us that care plans are now clear and straight to the point and can be easily understood. Risk assessments are in place and the home proposes to review these every three months or earlier if the needs of an individual changes. We were informed that a new risk assessment format has been implemented. Other additional assessments/care plans have been implemented since the last inspection to improve the quality of information recorded as guidance for staff. A quality review nurse from the local Primary Care Trust (PCT) last visited the home in February 2009. This is to audit documentation and to undertake a clinical audit of the service. These reports are available for viewing on the local authority website. The Responsible Individual confirmed that any shortfalls noted during the last audit had been addressed and another review was due to take place in the near future. The home accesses input from other health professionals when the need arises. There was evidence of multi-disciplinary health professionals visiting the service; ensuring residents health care needs are met. There was evidence that robust medication procedures are in place to ensure residents and staff are safeguarded. Medicines are stored within individual locked cupboards within individual rooms. Separate MAR charts are in place for regular prescribed medicines, as needed (PRN), controlled drugs and prescribed creams for all individuals. It was confirmed that records are maintained of all medicines entering and leaving the home and unused medicines are disposed of through a licensed company. There were accurate records being maintained of controlled drugs. Residents are provided with a choice to self administer, if they wish and a risk assessment identifies it is safe for them to do so. Staff were observed to have a good professional rapport with residents and were heard calling them by their preferred term. A resident spoken with felt that their privacy and dignity are respected. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents lifestyle within the home is their own choice and residents are provided with sufficient stimulation to fulfil their interests and needs. Residents are provided with choice in relation to food to ensure their preferences are catered for. Evidence: Residents spoken with confirmed that their routines of daily living are to their own choice and preference. It was observed on the day of the site visit that there was a relaxed homely environment and residents were seen to move freely around the home. A resident commented that they choose what to do during the day. Of the residents that were asked, all confirmed that there were enough activities provided at the home if they choose to be involved. One resident confirmed that they had been on outings. We were informed that every two to three months activities are arranged at the home where relatives/representatives/visitors are invited to attend. There is a person employed for 12 hours a week to spend time talking with individual residents, take people out into the community and arrange other activities. Outside entertainers continue to visit the home. One resident attends a local church and the Responsible Individual confirmed that residents would be encouraged and supported Care Homes for Older People Page 15 of 26 Evidence: to continue with any activities/groups they are involved in prior to admission to the service. A trolley with sweets etc has been implemented for residents. This enables those who are unable to visit nearby shops to still purchase small items for themselves. We were informed that a monthly newsletter and been implemented, of which staff and residents are able to input into. We were informed that this has been welcomed within the service. Residents and visitors all confirmed that they are welcomed at the home and that no visiting restrictions are imposed. No concerns were expressed to us at the last inspection in relation to the provision of food. We were informed that it is the still the same cook working at the home and residents are still provided with a choice in meals. Comments received from residents in relation to food were: lovely, cordon bleau, overall very very nice and am offered an alternative if I dont like whats on the menu. We were also offered a variety of sandwich fillings and given options of white or brown bread etc for lunch. This also demonstrated that there is always a choice available at the service. The Responsible Individual confirmed that they have introduced taster days. Samples of different cultural food are provided to residents and if there is positive feedback, these are introduced into the menu. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints are dealt with by the home and action taken where necessary, ensuring those who raise complaints that they are listened to. Residents and staff are safeguarded by the Safeguarding Adults procedures in place. Evidence: The home has a complaints procedure available to all people. A resident confirmed that they would feel comfortable to raise any concerns they may have with staff/management. One resident told us that they would raise concerns depending on what the issue was, however did not know who they would speak to. A staff member confirmed that they would know what to do should any concerns/complaints be raised with them. The AQAA identifies that there has been three complaints made to the service in the last 12 months with none being upheld and all resolved within 28 days. Records viewed identified that complaints are dealt with in a non biased manner and action taken is recorded. The AQAA identifies that there has been two Safeguarding Adults investigations in the last 12 months. One was referred by the service and the other referred by professionals within a hospital. The Responsible Individual confirmed that both allegations were unsubstantiated. The home co-operates with any investigations. The AQAA identifies that they have improved in the last 12 months by adopting an open Care Homes for Older People Page 17 of 26 Evidence: culture to the reporting of abuse where staff and residents feel safe to report any instances and are confident that the matter will be dealt with competently and confidentially. The Responsible Individual confirmed that staff receive Safeguarding Adults training on an annual basis. A staff member spoken with confirmed that they are familiar with the processes to take should an allegation of abuse be raised with them. Care Homes for Older People Page 18 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a clean and homely environment and are provided with comfortable indoor and outdoor communal facilities. Evidence: The last report identified that this outcome area for residents was good. The Responsible Individual confirmed that there had been no major changes made to the environment since our last site visit and no significant changes within the environment that they wished to bring to our attention. There has been general upgrading of areas and decorating. The environment was not inspected in detail, however we viewed specific areas as we were walking around the home. The AQAA identifies that some improvements they have made within the environment in the last 12 months are: commenced monthly auditing of the cleanliness of the home, housekeeping staff are now trained in infection control and a dedicated Infection Control Champion has been appointed with a remit for all infection control issues. A new television was observed to have been purchased and the reception for this was improved. Any minor shortfalls noted at the site visit was discussed at the time of which the service will address. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs are being met with the number and skill mix of staff on duty. Implementing more robust recruitment procedures will better safeguard residents. Evidence: Residents spoken with were complimentary about the staff working at the home and the majority felt there were enough on duty. Some residents commented that they felt at times there was a shortage of staff and they often had to wait for a long time to be assisted to the toilet etc. A staff member confirmed that there is generally enough staff on duty. The time they may be short staffed is when someone may ring in sick at short notice. We were informed that management has commenced reviewing weekly dependency levels of residents to ensure sufficient staff are on duty at all times. This newly implemented monitoring will assist them in identifying and making changes if required. No requirement has been made in relation to staffing levels as the home demonstrated that they are taking action to address this. We were informed that there is always a registered nurse on duty at all times, along with seven carers in the morning, five carers in the afternoon and two carers at night. Management is not included in these figures. Comments received from residents regarding the staff were: very nice, helpful, very good and excellent. The AQAA identifies that there is 27 permanent care workers at the home, of which 12 Care Homes for Older People Page 20 of 26 Evidence: have National Vocation Qualification (NVQ) level 2 or above. We were informed on the day of the site visit that there are now 26 permanent care workers and 13 with NVQ level 2 or above. There are plans for a further two care staff to undertake these studies. The AQAA identified that there had been 21 care staff/registered nurses that had left employment in the last 12 months. This seemed a very high turn over of staff. We asked the Responsible Individual at the site visit why there was such a high turnover. These figures were double checked and it was found that only 11 had left employment. The Responsible Individual confirmed that most had left for genuine reasons and some did not pass their probationary period. Four staff files were viewed that demonstrated more robust recruitment procedures could be implemented to further safeguard residents. Whilst all relevant recruitment checks are undertaken, there was no evidence of the authenticity of references obtained or information in what capacity the person was known to the referee. One file had no evidence of a valid permit for the individual to be working in the UK. We were informed by the individual that they are still able to work whilst an application is being processed. The Responsible Individual demonstrated that she was pro active and tried obtaining information from the home office whilst we were still at the home. The experience gained written by an individual did not correspond with written previous work experience. Shortfalls were discussed with Responsible Individual, who was open and honest with us, realising that she will need to ensure further monitoring of recruitment files needs to be implemented by management. This responsibility had previously been with someone else. Shortfalls noted were not consistent in all files. Following robust recruitment procedures has not been reflected as an outstanding requirements as improvements have been made and the Responsible Individual will ensure thorough monitoring takes place. This will continue to be monitored during our inspection process. The Responsible Individual confirmed that all staff are kept up to date with mandatory training. A staff member commented to us that there is good teamwork within the home and that training is coming out of our eyeballs. They confirmed that mandatory training is kept up to date and other training being offered relevant to their roles. It was confirmed that all new staff undertake the Common Induction Standards as set by Skills for Care. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is generally run in the best interest of residents. The health, safety and welfare of residents and staff are promoted and protected so far as is reasonably practicable. Evidence: The Responsible Individual has previously been registered with us as the Registered Manager for another service. She is currently in the process of completing an application for registration with us for this service. She has undertaken the Registered Manager Award (RMA) and has current registration with the Nursing and Midwifery Council (NMC). Since commencing at this service, she has demonstrated a commitment to improving outcomes for residents within the service and ensures these improvements are sustained. When asked regarding management within the service, a service commented that the Responsible Individual is supportive, approachable, feels there is better structure within the service with clearer roles and responsibilities and commented its miles and Care Homes for Older People Page 22 of 26 Evidence: miles better than what it has been. We were informed that all staff have attended Mental Capacity Act (MCA) and Deprivation of Liberty Safeguard (DOLS) training. The Responsible Individual confirmed that there has been no application made and no application for authorisation being processed for any resident at this time. Whilst no information was provided in the AQAA in relation to the homes quality assurance and quality monitoring system, the Responsible Individual confirmed that annual surveys are provided to residents and formal meetings take place at least annually with relatives/representatives. There quality monitoring is an ongoing process and surveys are kept by the front door for people to complete when they wish. Verbal feedback is provided by visiting health professionals. Consideration should be given to obtain written feedback. Any changes/results are shared with staff and residents via the monthly newsletter. Whilst the overall outcome for residents is good, work must be done to improve the information provided in the AQAA when we next ask for it. All key standards must be addressed and clearer evidence be provided. It is in the homes best interest to demonstrate clearly that they continue to provide good outcomes when we next use their AQAA to assess the services they are providing. Discussions were had with the Responsible Individual and Senior Manager Clincial Governance Lead on ways this document must be improved. There was no information written in what they thought they could do better. The home does not hold any personal allowance for residents. Residents either manage their own money or have relatives/representatives assist them. Invoices are sent to the relevant representative where needed for hairdressing, chiropody and personal toiletries etc. There are other monitoring systems within the home to ensure the health and safety of residents, staff and visitors are protected. The AQAA identifies that equipment in use has been tested or serviced as recommended by the manufacturer or other regulatory body and that all relevant policies and procedures are in place. We were informed that policies and procedures are currently in the process of being reviewed. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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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