Care Home: Grange-Lea Residential Care Home

What the care home does well People told us the home was a nice place to live. They said or wrote that "Takes care of me really well. I am very happy here" "Couldn`t be happier" "I looked around a lot before choosing this home, and I can`t find fault with them" "I am very well looked after- the staff are kind and always cheerful" "The home provides residents choices at all times, like there is always two different menus for lunches and supper or they can request anything they wish. The home provides activities for residents, and for staff the home provides training to ensure we provide the highest standard of care for our residents" "The home is always bright and clean. We get offered a wide range of food and activities and also get to go out shopping with Kat. The home has a dog called Roxie who I love so much and look forward to seeing every day." "I have a lovely room which is always clean. My family can come when they want and can even have meals with me. If I am ever sick the girls make me better. Activities are always on." "They let me keep my cat here. They provide good food and wine every day. If I ask for anytihng I get it." "I have only been here a few months and I have already settled. The firls here have improved my mobility and I have lots of new friends. I don`t feel I live in a prison I feel like i`m at home and i wouldn`t want to be anywhere else" "I feel safe living here and am very happy and never want to leave this home" Relatives we spoke to said the home had exceeded their expectations. The home has clear policies and procedures to make sure that care is delivered well and people are kept safe as far as possible" The home has regular visits from students from the local College, who spend time reminiscing with people living at the home or observing activities. The home has a stable staff group who are well qualified. Some people have worked at the home for many years and have built up good relationships with the people who live there. The building is large with several small lounges so people can have a choice of where to sit. A new conservatory has been added so that people have an additional area for activities and more room in the dining room.People`s private accommodation is all en suite and many rooms are well above required sizes. Many also have patio doors overlooking a garden or picture windows with sea views. Considerable investment has been made in the last year on upgrading the premises. What has improved since the last inspection? Since the last inspection the home has redecorated all corridors and communal areas; redecorated ten bedrooms; purchased new flat screen televisions and new Hoovers; increased the amount of fire equipment available; renewed membership with the National Association of providers of activities for older people; painted the exterior of the home; replaced the fascias, guttering and downpipes; purchased new bedding, napkins and placements; upgraded the lift installation; purchased new activities DVD and new chairs for the lounges; purchased new garden furniture; upgraded the lift installation; purchased a Nintendo Wii; completed the Essential Steps programme for infection control; obtained new slide sheets; increased the trips out and activities provided; and increased the training provided for staff including more NVQ`s. What the care home could do better: Care plans would benefit from additional information being gathered in relation to people`s lifestyle choice and making care plans more person centred. This might mean including more information about how each individual likes to live their life and how they would like their care to be delivered.The home should also carry out a first aid risk assessment. This helps to identify the level of first aid cover needed at the home. Key inspection report Care homes for older people Name: Address: Grange-Lea Residential Care Home 38 Preston Down Road Preston Paignton Devon TQ3 2RL     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: Michelle Finniear     Date: 0 3 0 3 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) © 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 29 Information about the care home Name of care home: Address: Grange-Lea Residential Care Home 38 Preston Down Road Preston Paignton Devon TQ3 2RL 01803522342 01803408901 info@grange-lea.co.uk www.grange-lea.co.uk Mrs Michelle Andrea Baker,Mr Alan Ralph Albert Baker Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Katrina Maria Green Type of registration: Number of places registered: 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 who can be accommodated is 32. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home Grange-Lea is a detached extended building which stands in its own grounds and offers 24-hour residential care for up to 32 persons in the category of old age. The home has three lounge areas and meals are taken in a separate dining room. All the bedrooms at the home are single occupancy and have on suite facilities available. The home is Care Homes for Older People Page 4 of 29 Over 65 32 0 Brief description of the care home surrounded by well-tended gardens and a hard standing car park is provided. There is good level access into the home; a vertical lift is available and appropriate aids for persons that have mobility issues. Because the home is built on the side of a hill it has extensive views of the surrounding Torbay area. The fees payable at Grange-Lea are: Lowest £341.22 and the highest £520.00 payable weekly. 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: To carry out this inspection we sent the home an Annual Quality Assurance assessment or AQAA for them to complete. This tells us information about the home and how it is run, as well as any changes that have been made since we last visited. We sent questionnaires to the people who live at the home and other stakeholders; We sent questionnaires to the staff who work at the home; we looked at all the information we have received about the service since our last inspection; We made a visit to the home without telling them when we were coming. We spent a day there looking at the records the home keeps, and talking to the people who live and work there; Care Homes for Older People Page 6 of 29 We spoke to the owner and the manager; we spoke to the staff on duty and we tracked the care given to some people from their admission to the present day. We spoke to them about their care and spoke to the staff about how they met their needs. This helps to give us a good idea about how the home is being run. Care Homes for Older People Page 7 of 29 What the care home does well: People told us the home was a nice place to live. They said or wrote that Takes care of me really well. I am very happy here Couldnt be happier I looked around a lot before choosing this home, and I cant find fault with them I am very well looked after- the staff are kind and always cheerful The home provides residents choices at all times, like there is always two different menus for lunches and supper or they can request anything they wish. The home provides activities for residents, and for staff the home provides training to ensure we provide the highest standard of care for our residents The home is always bright and clean. We get offered a wide range of food and activities and also get to go out shopping with Kat. The home has a dog called Roxie who I love so much and look forward to seeing every day. I have a lovely room which is always clean. My family can come when they want and can even have meals with me. If I am ever sick the girls make me better. Activities are always on. They let me keep my cat here. They provide good food and wine every day. If I ask for anytihng I get it. I have only been here a few months and I have already settled. The firls here have improved my mobility and I have lots of new friends. I dont feel I live in a prison I feel like im at home and i wouldnt want to be anywhere else I feel safe living here and am very happy and never want to leave this home Relatives we spoke to said the home had exceeded their expectations. The home has clear policies and procedures to make sure that care is delivered well and people are kept safe as far as possible The home has regular visits from students from the local College, who spend time reminiscing with people living at the home or observing activities. The home has a stable staff group who are well qualified. Some people have worked at the home for many years and have built up good relationships with the people who live there. The building is large with several small lounges so people can have a choice of where to sit. A new conservatory has been added so that people have an additional area for activities and more room in the dining room. Care Homes for Older People Page 8 of 29 Peoples private accommodation is all en suite and many rooms are well above required sizes. Many also have patio doors overlooking a garden or picture windows with sea views. Considerable investment has been made in the last year on upgrading the premises. What has improved since the last inspection? What they could do better: Care plans would benefit from additional information being gathered in relation to peoples lifestyle choice and making care plans more person centred. This might mean including more information about how each individual likes to live their life and how they would like their care to be delivered. Care Homes for Older People Page 9 of 29 The home should also carry out a first aid risk assessment. This helps to identify the level of first aid cover needed at the home. 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 10 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 11 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. Information is available to help people make a decision about whether Grange-lea is the right home for them. People are fully assessed before a decision is made to offer them a place. Evidence: The home has a service user guide available for people considering moving in. This contains a copy of the homes statement of purpose and information about the services and facilities available. It also includes a copy of the homes contract which gives information about any rules and restrictions about living at the home, peoples rights and what they can expect to receive for the fees they are paying. This for example includes information about Insurance cover and the homes policy on pets. This information helps people make a decision about whether Grange- Lea is the right home for them. We looked at the care files for three people who had recently moved into the home. Care Homes for Older People Page 12 of 29 Evidence: The files showed that people had been assessed before a decision was made to offer them a place at the home. A full pre-admission assessment helps to ensure that the home can meet the persons needs before they move in, and also that they will be compatible with people who already live at and use the service. The home manager or senior staff will visit people to complete this assessment and have done so in other areas of the country to ensure they can meet peoples needs appropriately. People are offered opportunities to visit the home and stay over night if they wish to do so. People also come to the home on a trial period, which is reviewed to ensure they have settled well. People are encouraged to bring personal items and belongings with them to make them feel at home, and people we spoke to said that the home had been very welcoming when they moved in. One person said they really made me feel welcome. A relative we spoke to told us they had looked at a number of homes before choosing Grange-Lea, and had felt as soon as they walked in it was the right place for them. The home does not provide for intermediate care. This means they do not provide specialist programmes of rehabilitation with an aim of returning someone to their own home. Care Homes for Older People Page 13 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. Peoples health care needs are identified and addressed. Evidence: On the site visit to the home we looked at a number of care plans for individuals living there, and related these to the person themselves and discussed their care needs with staff on duty. We looked at the assessments and past medical histories in relation to medication people were currently receiving, and tracked their care from their admission. This helps to give us a good idea about how well plans are working. This told us that the plans were accurate and reflected well peoples needs and the care they were recieving. The manager agreed to rview one set of information with the GP. Discussions with people living at the home and their relatives told us that they were very happy with the level of care and support they received. Typical comments from people were they look after me better than my mother did, I cant find any fault with them and couldnt be better. Care Homes for Older People Page 14 of 29 Evidence: Each person living at the home has an individual plan indicating the care and support that they need based upon the assessment. Plans are being reviewed regularly and discussions with staff indicated that they had a clear understanding of the support people needed. Plans included assessments of physical, emotional, psychological needs as well as risk assessments in relation to making sure that the care could be delivered safely. Plans would benefit from being more person centred, including more information about peoples individual lifestyle choices and ways in which they liked their care to be delivered. Plans showed clear evidence of the health care support people need, and during the tour of the home and in discussions with management we could see the level of equipment which is provided to support people, for example with moving and handling or to relieve pressure areas. The home has good working relationships with district nurses, and has spent considerable time recently working on local policy and development initiatives in the areas of palliative care and infection control. The home has recently completed a full nationally recognised government audit on infection control which shows they have the skills and information available to provide a high level of support. Files also contained information on assessments made under the Mental Capacity Act to ensure that peoples rights are being protected. In some cases seen this has included information from relatives regarding lasting power of attorney, and discussion was held on the home approaching an IMCA, who is an independent practitioner to support a person with limited capacity and ensure their rights are protected. We looked at the way in which the home manages medication, including controlled medication which requires special handling and recording due to its effects. The home has a controlled drugs book where medication is signed for by two members of staff. All staff who administer medication have received specific training to do so. Medication is issued to the home in a series of blister packs preprepared by the supplying pharmacist. This helps to ensure that the risk of errors is reduced and staff can easily verify whether medication has been administered. Medication is stored and transported safely around the home. All medication given to people is signed for, and a review of the medication administration sheets showed that staff were signing appropriately to record medication had been given out. One prescription was discussed with the manager and she is to seek clarification from the prescribing general practitioner. Care Homes for Older People Page 15 of 29 Evidence: Some people living at the home deal with their own medication and this is addressed through a risk assessment completed by the homes management to ensure that people are safe and competent to do so. Care Homes for Older People Page 16 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 have opportunities to follow a chosen lifestyle. Meals provided are of a high quality with choices available. Evidence: On the site visit we spoke to a number of people living at the home and their relatives to gather information about what it was like to live at the home. The home has daily plans of activities provided to people and links to an organisation which provides, develops and supports activities for older people within care homes. There are a number of resources available to staff including a recently purchased WII which people have enjoyed. On the day of the visit people were playing word games and a group of students attended from the local college to support people reminiscing. Some people we spoke to on the visit said that they chose to spend time in their rooms or on their own, but they were busy and active and did not feel that they were isolated in any way. There are a number of lounge areas throughout the home so people can spend time either with lots of people in an active area or quietly. There are attractive garden areas with seating which are fully accessible to people with mobility problems. The owner has plans to develop the garden areas further and discussion Care Homes for Older People Page 17 of 29 Evidence: was held on raised beds to support people with gardening projects. Discussion was held on gathering more information wherever possible on peoples previous lifestyle choices so that the home can endeavour to support people to maintain them as far as possible rather than expecting them to fit within routines supported by the home. People told us there was a lot of flexibility; that they could get up when they wished, spend time where they wished and take meals where they wanted. Five people spoken to told us how they chose to spend their time, and told us they were very happy at the home. We also spoke to people about the meals provided. Without exception people told us the food was of a very high quality and that choices were always available. One person said if I dont like the meals on offer I only have to ask and the staff will get me whatever I want. The meal being served on the day of the unannounced visit was minced beef cobbler with fresh vegetables or macaroni cheese followed by stewed apple and custard. 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. People are protected by the homes policies on complaints management and safeguarding stop staff have an understanding of legislation in regards to capacity Evidence: The home has a complaints procedure and the home tells us that any complaints are taken seriously and addressed with all feedback being given to the complainant about what action has been taken as a result. The home tell us they have not received any complaints in the last year about the service, and feel that they react quickly to any small issues of concern raised before they become a problem. People have opportunities to express any concerns or problems that they have and the people that we spoke to said they would absolutely feel free to do so if they had a problem. One person told us I would complain to the management if there was anything I didnt like but I have yet to find something I dont like. Staff at the home have all received training in prevention and identification of abuse and the home has policies and procedures in place to support staff whistle blowing or raising concerns about anything they have seen during their work. Staff have also received training in the Mental Capacity Act and the Deprivation of liberty safeguards and assessments were fully recorded throughout the care planning process. People told us they were treated with dignity and respect by staff. Training of staff and providing policies should help to ensure that staff understand their role in an adult Care Homes for Older People Page 19 of 29 Evidence: protection process. 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 home is comfortable warm and attractive with a variety of places for people to spend their time. Evidence: During the site visit we toured some areas of the home, but did not look in all the bedrooms. All areas of the home that we saw were clean, warm and comfortable. Peoples bedrooms were all above standard sizes, and many have patio doors to the garden or sea views. People we spoke to said they had been able personalise their own rooms with items of furniture, pictures and other belongings, which had made it feel more like home. Communal areas are situated throughout throughout the building, and although not large were being well used during the inspection visit. The dining room conservatory can also be used for activities. The people that we spoke to told us that staff kept their rooms clean but they could help out if they wanted by tidying and making their own beds. Some people enjoyed doing this. Evidence could be seen of aids and adaptations for people including raised toilet seats, grab rails, mobile and bath hoists where needed. The gardens outside of the home are now much more accessible to people and include Care Homes for Older People Page 21 of 29 Evidence: areas of decking, planting and seating areas. There is parking to the front of the home, and this is currently being extended. the service areas we looked at such as the laundry and kitchen were being well used. It is understood the home has recently had an Environmental health assessment and as a result is updating some of the shelving in the storage areas. It is also understood that the laundry is to be repainted to ensure that the surfaces can easily be cleanable and disinfected. The laundry area was clear and free from obstruction and provides opportunities for clean clothing to be kept separate from dirty or soiled items awaiting laundering. The homes washing machines are capable of achieving a sluicing cycle, which means they are suitable for controlling any risk of cross infection. The home is well maintained and attractive. Considerable investment has been made in the last year, in particular to the fire systems, refurbishment of 10 bedrooms and repainting of the outside with new fascias and guttering. A new conservatory has also been provided which has increased the dining space and provided a space for crafts and cooking. 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 staffing arrangements meet peoples needs. Evidence: On the site visit we looked at the numbers of staff on duty, the ways in which the home recruits and employs their staff and the training and support they provide for them when working. We spoke to the staff on duty and looked at their working roles. We looked at records the home keeps about their staff and we spoke to the people living at the home about how well the staffing arrangements meet their needs. People we spoke to on the visit or who completed questionnaires for us told us that staff were able to usually respond quickly to their needs, and understood how they liked their care to be delivered. They said Theyre lovely, very good staff, always cheerful and couldnt be better. Staff were on duty in sufficient numbers to meet peoples needs and the manager works part time in a managerial role and part time delivering care which she said kept her in touch with how care was being delivered and on staff numbers needed. We looked at the staff files for three people employed by the home. These showed that the home follows a full recruitment procedure with references and criminal records bureau checks being taken up for staff employed. These help to ensure that Care Homes for Older People Page 23 of 29 Evidence: people are being cared for by staff who are suitable to be caring for potentially vulnerable people. Copies of contracts were available in peoples files, and information was available on preventative health care options or advice for example flu vaccinations. Counselling and support has been made available to staff in the past when needed. The home told us they do not discriminate against potential staff with disabilities, or by reason of age, faith, sexuality, race or gender. We looked at the training that staff receive while employed by the home. There is a programme of staff training and individual training profiles for each staff member detailing the training they have received and when updates are due. Staff receive an Induction programme when they start working at the home, which helps to ensure they work consistently and in accordance with the homes polices and procedures. The home told us they have high levels of staff with National Vocational Qualifications, which are a national award reflecting the competence of a worker in their role. The staff we spoke to all had or were working towards an NVQ level 3, which is a senior level award. The staff we spoke to were clear about their role at the home and could describe the ways in which they cared for people. Some had worked at the home for many years and this helps to provide consistency for people who live there. Staff turnover appears to be lower than in many homes. 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 home is being well managed. Evidence: On the site visit we looked at the way in which the home is managed; we spoke to the owner and manager; we sampled the records the home keeps and we looked at some of the systems in use for ensuring the home is run well. The manager has achieved a level 4 national vocational qualification (Management level) and is currently working on her management and leadership award. She has worked at the home for many years and works with the staff for part of the day which helps her have a clear grasp of what is occurring at the home. She has plans for further professional training to enhance her role. The home has systems for assuring the quality of care provided. There is a full quality assurance system in place which uses information from throughout the home and external audit to look at how well the home is meeting peoples needs and accept any Care Homes for Older People Page 25 of 29 Evidence: suggestions for the development of the service. The system in use may benefit from additional information being included from a series of internal audits. People living at the home or visiting are encouraged to express their opinions about the services provided. We sampled some of the health and safety systems at the home, looked at some of the risk assessments and management arrangements to help ensure people who live and work at the home are kept safe. For example we looked at some of the fire logs which showed that the home is undertaking regular tests of fire drills, practices and instructions. Since the last Inspection the home has had considerable work undertaken to the fire alarm system and is also working on the electrical safety of the building with a larger three phase electrical supply. Assessments have been undertaken for legionella, but not yet for Asbestos and the home does not yet have a first aid risk assessment. Service contract agreements were seen for lifts, hoists and for the testing of portable electrical appliances. Risk assessments were sampled for safe working practices, the environment and for specific reasons related to individuals living at the home, such as moving and handling arrangements. Risk assessments help to ensure that people are able to live and work safely at the home by attempting to minimise any foreseeable risks. Staff are supported through a programme of supervision, which is a system combining performance management and personal development. The home aims to engage staff in supervision about every six weeks. Discussion was held on ways of keeping this fresh and interesting for people, and the home has a rolling programme of involving staff in working through the National minimum standards. This helps to ensure staff are working consistently and to their full potential. 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 1 7 Care plans would benefit from additional information being gathered in relation to peoples lifestyle choice and making care plans more person centred. This might mean including more information about how each individual likes to live their life and how they would like their care to be delivered. A first aid risk assessment should be undertaken. 2 38 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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