Care Home: Great Wyrley Community Support Unit

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What the care home does well The unit has been redecorated and soft furnishings and fittings replaced in some areas, to improve standards and facilities for the people using the service. This is ongoing and the decorator was in the unit at the time of this visit. People can be assured when moving into Great Wyrley Support Unit, that a thorough assessment has been carried out and the unit can meet their needs. People we talked to spoke very highly of the unit, and the care provided by the staff. People using the service said that health care needs are promptly met, the staff provide good quality care within a caring happy environment. There is a long standing nucleus of staff at the unit, all have received National Vocational Training. Now the unit has its own kitchen and cook, there is an excellant choice of food for any preferred diet. What has improved since the last inspection? The Head of Unit now has her own office, this has helped with confidentiality and given management more scope to deal with or delegate management issues. The Care Office is now a dedicated care office which works more efficiently. Housekeeping Staff have now been employed freeing up care staff to work on person centred planning Full management team of staff now employed Full occupancy most of the time due to their now being flexibilty of bed use, between respite and enablement. Electronic online booking system which has cut down on telephone calls. New person centred care plans to enable staff to see the persons journey through the unit from admission to discharge. Daily table menus are used, pictorial menus are in large print. Introduction of a quarterly newsletter to inform people using the service and their relatives of any changes, including the change to the Care Quality Commission. New up to date easy access information files in each persons bedroom. What the care home could do better: The staff are curently working towards a daily morning and afternoon activity programme, for people who want to be involved, over and above individual choices that are already made. Key inspection report Care homes for older people Name: Address: Great Wyrley Community Support Unit 156 Walsall Road Great Wyrley Near Walsall WS6 6NQ     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: User doesnt belongs to any group     Date: 0 7 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Great Wyrley Community Support Unit 156 Walsall Road Great Wyrley Near Walsall WS6 6NQ 01922419054 01922415763 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Staffordshire County Council Social Care And Health Directorate care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia learning disability mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: Age: Dementia (DE) age 50 and above. Mental disorder, excluding learning disability or dementia (MD) age 50 and above. Learning disability (LD) age 50 and above. Physical disability (PD) age 50 and above. The maximum number of service users who can be accommodated is: 16 The registered person may provide the following category 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: Dementia (DE) 16 Mental disorder, excluding learning disability or dementia (MD) 16 Learning disability (LD) 16 Old age, not falling within any other category (OP) 16 Physical disability (PD) 16 Care Homes for Older People Page 4 of 29 Over 65 0 0 0 16 0 16 16 16 0 16 Date of last inspection Brief description of the care home Great Wyrley community support unit is a purpose built facility that can accommodate sixteen short stay people using the service. All accommodation is provided on the ground floor and comprises of sixteen single en/suite bedrooms. All bedrooms are used for respite and enablement dependent on the need of the person using the service. There are two assisted bathrooms and a fully assisted shower room. There are four separate lounge and dining areas. The service provides respite and enablement beds for the length of stay required by the person using the service. The service also provides both physiotherapy and occupational therapy as part of the care being delivered. Health service professionals are accessed when required and local General Practitioners and a pharmacist service the home. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced inspection was carried out on Monday 7th September 2009 by one inspector, who used the National Minimum Standards for Older People as the basis for the inspection. The last Key Inspection on this service was 31st October 2007. On arrival for this inspection The Head of Unit, care shift leader, four care assistants, the cook and housekeeping staff were on duty. The Head of Unit provided written information regarding staffing, staff training, menu and dietary provision, that was observed to be in place at the home. We discussed with the Head of Unit arrangements for the day to avoid disruption to the people using the service, staff, and routines in the unit. We spoke to people using the service both in lounges and their bedrooms. Care Homes for Older People Page 6 of 29 Three peoples care records were examined, and the records of three staff, including recruitment and training records. We discussed the food with people staying at the unit, observed lunch being served, and talked to the cook. We also looked at the Annual Quality Assurance Assessment (AQAA) this is a self assessment tool. and had been very well completed with a lot of detail, and sent to us prior to the key inspection. Completion of the AQAA is a legal requirement and it enables the service to undertake a self assessment, which focuses on how well outcomes are being met for the people using the service. It also gave us some numerical information about the service. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: The staff are curently working towards a daily morning and afternoon activity programme, for people who want to be involved, over and above individual choices that are already made. Care Homes for Older People Page 8 of 29 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have the information they need to make an informed choice about staying at the unit for respite or enablement. Evidence: The AQAA we received prior to the Key Inspection told us that The service have developed a new Statement of Purpose, and a pictorial Service User Guide, which is specific to the client group, and considers different styles of support, treatment, specialist services and equipment required to meet the individual needs of the person. People who regularly use the service have given their comments. Information is available in large print if required. The service try to ensure people and families are given the opportunity to visit the unit, so they can actually see the unit and its facilities. A needs assessment is carried out by trained management staff before any admission, except in emergency admissions where we ask for the basic and relevant details. We obtain a summary of any assessments that have been undertaken through Care and Assessment social worker, and insist on a copy of persons care plan and Care Homes for Older People Page 11 of 29 Evidence: confirmation in writing of dates required for each stay. A letter is sent out to people re outcome of assessment. On each visit, the person receives a contract, giving clear information about fees for that particular stay. All contracts are signed by the person if possible, or carer on their behalf on each stay. Contracts are kept on care plans, and a copy of the full contract can be found in Easy Access Information Files located in all peoples bedrooms. A new electronic online booking system has been set up and is working really well. All area offices can browse the system to look for bed availability and management team can block out beds and record all relevant information. We saw a statement of purpose and service users guide in place, this gave detailed information about the care and services provided by the unit. The service users guide was also in pictorial format. We saw information on care records that told us families or carers had visited Great Wyrley Support Unit prior to the person staying at the unit. We talked to people using the service who told us their families had visited the unit, prior to their stay. We saw the care files of the last three people using the service and examined them in detail. Peoples records contained information collected by the Head of Unit, and management staff who carried out the assessment. We saw risk assessments in place that included manual handling, nutritional information, and mobility. Risk assessments were signed and dated. This means that peoples needs had been assessed, and the unit was satisfied it could meet peoples needs. We saw contracts on care files that are reviewed and updated, for each stay the person has at the unit. The unit does not provide intermediate care. We received completed surveys from six people using the service that told us: they received enough information about the service before moving into the unit Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care needs of people using the service are met, personal care is delivered in the way the individual wishes. Evidence: The AQAA we received prior to the Key Inspection told us that All people have a detailed care plan which clearly shows personal, and healthcare needs and dietary requirements, and detail of how they will be delivered. A trained and knowledeable staff team are able to meet the changing needs of the people using the service. Staff respond appropriately and sensitively in all situations involving personal care, ensuring it is conducted in privacy, and that the service users respect and dignity is upheld at all times. The service encourage people to manage their own healthcare. If people live locally they can continue to use their own general practitioner, but if out of the area, the service have own general practitioner assigned to the unit who will visit when requested. The unit also arranges for healthcare professionals to visit if required. All management have received full first aid or emergency first aid training, and management organise in house training with health professionals. Internal Medication Policy that all management have read and signed, understand and follow. This policy Care Homes for Older People Page 13 of 29 Evidence: is bought up in supervision regularly. The service encourage people to manage their own medication, if we assess them as being capable. All management have completed Administration of Medication Course and have been issued with certificates. Risk assessments are in place where appropriate, all risk assessments are completed, monitored and reviewed on each stay. The majority of staff have had training on Dementia Care, to help increase awareness and understand challenging behaviour and stages of dementia. We looked at the care records of three people using the service. Records contained information regarding health care, personal care and risk assessments, that are reviewed on a regular basis, and each time the person stays at the unit. We saw health care records that identified people are able to use their own general practitioner if from the local area, or the units allocated general practitioner. We saw that all people are short-stay at the unit for respite or enablement, and bring medication in to the unit with them. Where possible self-medication continues following risk assessment, and all rooms have lockable facilities to house the required medication. We saw records that identified medications are administered by staff who have been trained in the administration of medication. We saw risk assessments in peoples care records that identified where support is required, and how it would be given. Risk assessments are reviewed at each stay the person has at the unit. We saw throughout this inspection the privacy and dignity of the people using the service being promoted. People were dealt with in a courteous manner. We received completed surveys from six people using the service that told us: Staff are always available and they get the care and support they need Always get the medical care they need We received six completed surveys from members of staff that told us: Staff are always given up to date information about the care needs of the people using the service Care Homes for Older People Page 14 of 29 Evidence: Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service make choices about their daily lifestyles, with visitors to the unit being made welcome. The food provided is of a high standard, with a varied nutritional diet being offered. Evidence: The AQAA we received prior to the Key Inspection told us that Staff ensure all people make choices about their lifestyles and are supported to develop their life skills. People are supported to gain confidence and regain skills in readiness for return home. People enjoy a stimulating lifestyle and can choose what they want to do on a daily basis. Staff look at the views of people and look at who is in the unit, and discuss preferences for daily activities. Any requests from people are incorporated into unit activity planning. People are encouraged to maintain social, emotional and independent living skills. People access transport, voluntary centre, day centre and local commumity venues as part of their continued lifestyle. People are encouraged and supported to be independent and are involved in all areas of daily living, including, shopping, planning meals,meal preparation and household tasks in readiness for their return home. Meals are very well balanced and nutritious and staff cater for varying cultural dietary needs. Service users play a massive part in menu planning, giving us their preferences all times. Mealtimes are flexible and relaxed and Care Homes for Older People Page 16 of 29 Evidence: staff are patient and helpful and give assisstance in a sensitive manner. We saw that there is an ever changing group of people at the unit,and spoke to all people at the time of this inspection. Some people were on rolling respite stays, others were staying at the unit for enablement, prior to returning home. We saw that activities take place pertinent to the group of people in the unit at any given time. The staff are working hard to develop a programme of daily regular activites that people have said they would like to do. We observed that one of the most discussed items was access to freeview television, the unit has now started to provide flat screen digital television in each bedroom via the comforts fund. People we talked to told us they appreciated this facility. We saw that there is an open visiting policy in place and visitors are welcome at anytime. Two community care workers were visiting one person at the unit and assisting them with their lunch, this provided continuity for this person. We saw that people on respite stays who had a day service place at Great Wyrley Day Centre, or Chase Day Services when at home, continue to go to day services to provide continuity for people. We saw the main meal of the day being served, this was nicely presented and portions were generous. People we talked to after lunch said the food was wonderful, plenty to eat with choices available. Lunch consisted of chicken salad, braised steak, fresh vegetables, pineapple upside down cake, ice cream, custard, youghurt and jelly. We saw that the unit now has its own kitchen and cook, this has much improved the flexibility of choice available to people using the service at this unit. Individual menus are displayed on each table and available in large print. We received six completed surveys from people using the service that told us: There are usually activities that they take part in and enjoy Always like the food provided at the unit Care Homes for Older People Page 17 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 who use the service are able to make complaints and are safeguarded by the services procedures. Evidence: The AQAA we received prior to the Key Inspection told us that Staff welcome complaints and suggestions about the service and use them positively and learn from them. The unit has received no complaints in the last 6 years. All Staff are aware of taking peoples views seriously and they know to listen and respond to issues by reporting onto contact sheets, minor grumbles book and to officer. Complaints procedure is displayed throughout the unit and in the Easy Access Informatjon Files situated in all peoples bedrooms for them to access at their leisure. Complaints procedure is discussed regularly at peoples meetings ensuring people know how and who to complain to. All policies and procedures relating to safeguarding and vulnerable adults are available to staff, and are discussed in supervision and staff meetings. Staff are trained in violence and aggression, safeguarding vulnerable adults and complaints and understand how to respond to any incidents. Staff complete, monitor and review risk assessments for people and staff ensure people and carers sign them. We saw the unit has in place a complaints book. No complaints have been received since 2003. There have been no complaints made to the Commission. Care Homes for Older People Page 18 of 29 Evidence: We saw a suggestion box in the reception area for comments, compliments or suggestions, this is used by people using the service and their relatives or carers. We talked to people in the unit who told us they knew how to make a complaint, most said they would tell staff if they were unhappy about something. We discussed peoples finances with the Head of Unit who told us, people on respite and enablement manage their own finances. We talked to staff who told us they are familiar with the complaints procedure. This is discussed during the meetings of people who use the service, and staff supervision. We saw staff training records that identified staff have received training in Safeguarding and the Protection of Vulnerable Adults. Depravation of Liberties training has also been carried out. We saw on staff files that Criminal Records Bureau and Protection of Vulnerable Adults checks are carried out, two written references are taken up prior to employment. We received completed surveys from six people using the service that told us: People knew how to make a complaint Care Homes for Older People Page 19 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 physical design and layout of Great Wyrley Support Unit enables people to live in a safe, clean, well-maintained and comfortable environment. Evidence: The AQAA we received prior to the Key Inspection told us that The physical environment of the unit is well maintained and has an ongoing redecoration and maintenance programme in place. People are encouraged to see the unit as their own whilst they stay here and are encouraged to bring in personal items to help their stay be more enjoyable. The unit has good access to community facilities and services with a bus stop positioned at the end of the driveway. The unit has a wide range of specialist equipment and adaptations. A single storey building with easy access for wheelchairs. The unit is laid out with four bungalows all interlinked by corridors. There are 4 communal lounge diners and 16 bedrooms all with en suite facilities. There is a small kitchen for people to access to enable them to promote kitchen skills and meal preparation. Kitchen audits are completed annually and visits from Environmental Health officers have given a 5 star rating. Service users are given keys to their bedrooms, unless a risk assessment indicates otherwise. The unit has a proactive infection control policy, all staff are aware via supervision and in house training. The unit works extremely closely with external specialists to ensure infection is kept to a minimum. Care Homes for Older People Page 20 of 29 Evidence: We saw the physical design and layout of the unit meets the needs of the people using the service. All areas are spacious and comfortable, maintained to a high standard, and provide easy access for wheelchairs. We saw that people using the service were relaxed in their surroundings and moving freely around both inside and outside the unit. Externally there are very attractive grounds with grassed areas and pathways. We saw good infection control practices are in place with kitchen audits completed annually. Environmental Health have identified the unit as 5 star. Staff have received infection control training, policies and procedures are in place. Care Homes for Older People Page 21 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A well trained and consistent staff team support the people using the service. Evidence: The AQAA we received prior to the Key Inspection told us that The unit has a robust recruitement procedure in place. Staff are checked at interview for Eligibility to Work in the UK and staff are Protection Of Vulnerable Adults and Criminal Records Bureau checked before commencing work. Staffing levels support the needs of people, and staff are keyworkers to individuals. The unit have a diverse staff team with a balance of skills, knowledge and experience. Staff training is high priority, management prioritise and facilitate in house training. All staff have personal files with photograph and Criminal Records Bureau number. Induction and probationary periods are robust, detailed and specific. Rotas are flexible, cover 3 shift patterns and staffing levels reflect the needs of the people. Training matrix for staff is in place, to see at a glance what training is needed and what has been completed. Staff meetings take place regularly, for consultation, and questions. Agendas are made, minutes taken and signed off by staff who are unable to attend. Staff supervision takes place every 6/8 weeks to help develop staff. Personal Performance Reviews are done 6 monthly as a way of staff appraisal. The unit has 90 of staff qualified to National Vocational Qualifications levels 2 and 3. We saw on arrival at the unit the following staff were on duty as identified on the staff Care Homes for Older People Page 22 of 29 Evidence: rota. Head of Home 8-4, Care shift leader 7.45 2.45, Four Care Assistants 2 working 8-3 and 2 working 8-2. 1 Care shift leader 3.15 to 10 15, 4 care staff 2x 3-10 1x 3x9 1 x 4 10 2 Night staff 1 is night suprintendent 1 is care staff, work from 10pm to 8 pm. Cook 8 to 2 x 7 days. New Housekeeping staff 1x 3x7 1x 9x1. We saw the staff records of the last three people employed at the home. records told us staff have received appropriate pre-employment checks prior to commencing employment at the unit. We saw staff training records in staff files, and on the training matrix, that identified 90 of the staff team are trained to National Vocational Qualification levels 2 and 3. We saw all new staff receive induction to the unit, and work alongside experienced staff as part of induction. This is recorded in staff files. We talked to the Head of Unit who told us that the management team deal with preadmission assessments to provide consistency. We saw positive, relaxed and cheerful banter being exchanged between people using the service and staff. Staff commitment to care is clearly high and this was confirmed in discussions with people using the service. We talked to members of staff who told us they received regular training opportunities, and that training is scheduled into the rota. We talked to the cook who told us that provisions are ample, fresh produce is used, baking is home made. Cook on duty over 7 days. We received completed surveys from six members of staff that told us: Staff received appropriate pre-employment checks prior to commencing employment. Staff received induction training and ongoing training relevant to their role at the unit. Well supported by management, usually enough staff on duty. Additional comments made by staff: The community Support unit adapts well to to the changing needs of the people using the service. We have been able to access many training courses which have helped us gain a better insight into the health Care Homes for Older People Page 23 of 29 Evidence: conditions of the people. 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. People using the service are safeguarded by competent management systems. Evidence: The AQAA we received prior to the Key Inspection told us that The Head of Home holds Registered Managers Award, NEBSM,D32 D33, first aid at work, and 13 years management experience. Head of Home is competent to run the unit and meet the units aims and objectives. People using the service are safeguarded by accounting and financial procedures in place, and by body charts being completed on admission. The unit demonstrates effective financial planning by keeping within allocated budgets. The management practice, skills and knowledge is based on continuous development gained through training. The manager has good leadership skills and is reponsive to the needs of the people. The unit has an open door policy. Quality Assurrance systems are in place, monitored and reviewed on a regular basis. The unit has its own Business Plan to work towards. Record keeping is to a high standard. All records are kept locked for confidentiality and security. All staff are aware of The Data Protection Act. Care Homes for Older People Page 25 of 29 Evidence: Safe working practices are in place. Health and safety of people, staff and visitors are promoted and protected. Accident forms are kept for staff and people using the service, and are monitored. All Health & Safety policy and procedures are in place and staff have good knowledge of them. All management have completed risk assessment training. All risk assessments for environment, people using the service and staff are in place, monitored and reviewed regularly. All management have been trained in fire safety, health and safety and moving & handling. We saw that the Head of Unit is experienced and qualified to National Vocational Qualification level 4, and has the Registered Managers Award. The Head of Unit has twenty years experience working with older people, 13 years in management. We saw that good leadership was in place, and staff knew what was expected of them. Relationship between management, staff, and people using the service generates a happy and relaxed atmosphere. We saw good quality monitoring systems in place, the management team monitors the well being of people using the service and the practices in the unit. We saw records that told us there are regular meetings for people using the service, minutes seen were also in large print allowing opportunity for feedback about the service. Additional quality assurance is monitored by regular audits and questionnaires to people. The result were seen and positive and included such statement as, would recommend this unit to anyone, it could not be bettered, enjoy going out in the garden. We saw that robust systems are in place for the management of peoples monies. People staying at the unit at the time of this inspection were dealing with their own money. We observed safe working practices to be in place, staff records show that health and safety training has been completed, along with mandatory training. The Head of Unit continues to update her training to ensure awareness of current guidelines. Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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