Care Home: Green Bank EMI Care Home

What the care home does well Pre-admission assessments are carried out prior to a resident moving into the home and other information from external professionals would also be gained to ensure that the home is able to meet the residents needs. Relatives and friends are welcome into the home at all times and are made welcome by the management and staff. Observation showed that staff interact with residents in a calm, friendly and professional manner. The complaints policy is up to date and displayed in the home. Staff levels at the time of this key inspection met the residents personal, health and social care needs. What has improved since the last inspection? The home now has a computerised care planning system and there was good evidence to show that residents and or their relatives/representatives are consulted and agree to the care plan. Care plans and risk assessments are more detailed and give staff clear guidance as to how residents assessed needs are to be met they are also reviewed on a regular basis and any changes are notified to the resident and or their relatives/representative. Alongside the care plans a `Listen to me` workbook is being developed for each resident, that highlights the residents preferences, choices, likes and dislikes. There has been some improvement to daily records but the Registered Manager recognises that further work needs to done to ensure that staff record in more detail about each individual resident rather than have generic daily reports. The inspector was shown evidence that the Registered Manager is working on a new format for daily reports. At the same time further improvements are being made both by the Registered Manager and the company providing the computerised system to ensure that all records are detailed and able to be triangulated. There is evidence that residents have access to a variety of external health care professionals, but feedback from these professionals needs to be more detailed. The receipt, storage, administration, recording and return of medication in the home has improved and is monitored on a weekly basis by the Deputy Manager to ensure that medication is managed alongside the homes medication policies and procedures. Two members of care staff have recently received activity training and there is good evidence in the home that residents now receive a variety of activities that they are able to relate to and that interest them. All meals supplied in the home offer choice and variety and cater for specialised diets. Six residents told the inspector that they enjoyed the food in the home, and there was only one negative report from a resident about food. The dining space in the home has improved with the conservatory offering residents a separate dining area and one of the communal lounges being used as a lounge/diner. The home has invested in the garden area of the home to ensure that residents are not at risk of trips or falls. This area is clean and secure providing residents with handrails and a pleasant out door space in which they can sit or wander at will. Infection control is well maintained in the home and residents are no longer placed at risk of cross infection. Staff recruitment practices have improved and the Registered Manager now ensures that all prospective staff are appropriately vetted before taking up employment in the home. Staff are now beginning to have knowledge of Dementia care and have taken part in a short Dementia care training course, with further longer and more detailed courses in Dementia to take place in the next few months. The qualification of staff in regard to NVQ qualifications is excellent with all care staff having obtained their NVQ level two or above qualification in Social Care. A quality assurance system has now been developed that seeks the views of residents and their relatives. Monitoring of systems used in the home now takes place on a regular basis. Further work still needs to be done to ensure the views of professionals visiting the home are sought, that the monitoring of systems used in the home coveres housekeeping, fire, health and safety. That an annual summary of the finds of questionnaires and monitoring forms is produced to show how the home has taken steps to improve and the plans for improvement in the next year. What the care home could do better: Further improvements need to be made in regard to staff assisting residents with feeding and observing residents dignity as well as regularly reviewing the needs of residents and eating aids to ensure that residents can maintain the independence when eating. Attention needs to be paid to communal toilets where the vinyl floor covering does not meet the bowl of the toilet and could lead to odours, also the vacant bedroom which has a slight odour needs attention prior to a new resident moving in. The Registered Manager must ensure that references are sought appropriately and `To whom it may concern` references are followed through in regard to authenticity. The Registered Manager while obtaining evidence of identity from new staff must also ensure that the staff personnel files have up to date photograph in place. Fire, health and safety checks must be carried out on each room in the home at regular intervals to ensure that residents are not placed at risk. Key inspection report Care homes for older people Name: Address: Green Bank EMI Care Home 11 Hastings Road Bexhill-on-sea East Sussex TN40 2HJ     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: June Davies     Date: 2 0 0 4 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: Green Bank EMI Care Home 11 Hastings Road Bexhill-on-sea East Sussex TN40 2HJ 01424211704 01424218281 Pillowatrick@aol.com www.greenbankcarehome.com Mrs Judy Pillow Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr William Pillow Type of registration: Number of places registered: care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is: 20 The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) Dementia (DE). Date of last inspection Brief description of the care home Greenbank is located close to Bexhill-on-Sea old town and about one mile from the seafront. There is access to local shops, public transport, churches and other community services. Greenbank is a long established family owned home registered to accommodate up to 16 older people with a Dementia type illness. The property was originally a two storey Victorian house, which has since been extended to Care Homes for Older People Page 4 of 26 Over 65 0 20 20 0 1 5 0 6 2 0 0 9 Brief description of the care home accommodate residents on the ground floor of the building further improvements are in the process of be completed to offer further accommodation space. There are fifteen bedrooms, one of which may be used as a shared occupancy room but is currently used as single occupancy. All bedrooms have en-suite facilities and there are toilets and bathroom/shower rooms located throughout the premises. The home has communal areas with pleasant views. There is a large well maintained garden to the rear of the property with patio areas to one side of the home. Potential new residents can obtain information relating to the home via Care Managers, Placing Authorities by word of mouth and by contacting the home direct. Current fee charges can be obtained from the Registered Manager, extra charges are made for hairdressing, chiropody, newspapers and toiletries. 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: This unannounced key inspection took place over a period of seven hours on Tuesday 20th April 2010. During the inspection the inspector spoke with the Registered Provider, the Registered Manager, the Deputy Manager, three members of staff and six residents. Documentation relating to the key standards inspected were examined, a short audit was carried out of medication processes, communal areas, bedrooms, communal toilets and bathrooms and the gardens of the home were also seen. Residents spoken to were happy with the care they received, and all but one spoke highly of the meals provided. Care Homes for Older People Page 6 of 26 What the care home does well: What has improved since the last inspection? The home now has a computerised care planning system and there was good evidence to show that residents and or their relatives/representatives are consulted and agree to the care plan. Care plans and risk assessments are more detailed and give staff clear guidance as to how residents assessed needs are to be met they are also reviewed on a regular basis and any changes are notified to the resident and or their relatives/representative. Alongside the care plans a Listen to me workbook is being developed for each resident, that highlights the residents preferences, choices, likes and dislikes. There has been some improvement to daily records but the Registered Manager recognises that further work needs to done to ensure that staff record in more detail about each individual resident rather than have generic daily reports. The inspector was shown evidence that the Registered Manager is working on a new format for daily reports. At the same time further improvements are being made both by the Registered Manager and the company providing the computerised system to ensure that all records are detailed and able to be triangulated. There is evidence that residents have access to a variety of external health care professionals, but feedback from these professionals needs to be more detailed. The receipt, storage, administration, recording and return of medication in the home has improved and is monitored on a weekly basis by the Deputy Manager to ensure that medication is managed alongside the homes medication policies and procedures. Two members of care staff have recently received activity training and there is good evidence in the home that residents now receive a variety of activities that they are able to relate to and that interest them. All meals supplied in the home offer choice and variety and cater for specialised diets. Six residents told the inspector that they enjoyed the food in the home, and there was only one negative report from a resident about food. The dining space in the home has improved with the conservatory offering residents a separate dining area and one of the communal lounges being used as a lounge/diner. The home has invested in the garden area of the home to ensure that residents are not at risk of trips or falls. This area is clean and secure providing residents with handrails and a pleasant out door space in which they can sit or wander at will. Care Homes for Older People Page 7 of 26 Infection control is well maintained in the home and residents are no longer placed at risk of cross infection. Staff recruitment practices have improved and the Registered Manager now ensures that all prospective staff are appropriately vetted before taking up employment in the home. Staff are now beginning to have knowledge of Dementia care and have taken part in a short Dementia care training course, with further longer and more detailed courses in Dementia to take place in the next few months. The qualification of staff in regard to NVQ qualifications is excellent with all care staff having obtained their NVQ level two or above qualification in Social Care. A quality assurance system has now been developed that seeks the views of residents and their relatives. Monitoring of systems used in the home now takes place on a regular basis. Further work still needs to be done to ensure the views of professionals visiting the home are sought, that the monitoring of systems used in the home coveres housekeeping, fire, health and safety. That an annual summary of the finds of questionnaires and monitoring forms is produced to show how the home has taken steps to improve and the plans for improvement in the next year. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 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 9 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 statement of purpose has been updated to ensure prospective residents receive accurate information about the service that the home offers so they are able to make an informed choice about Green Banks EMI Care Home. Each prospective resident has a pre-admission assessment carried out to ensure that the home is able to meet that prospective residents care needs. Evidence: The homes statement of purpose has been reviewed and gives good information to interested parties. The pre-admission format has now changed and from one pre-admission assessment completed there is good evidence that as much information is obtained from prospective residents prior to them moving into the home, this includes details of health and daily living needs. Information from the pre-admission assessment is used Care Homes for Older People Page 10 of 26 Evidence: to ensure that the homes environment and staff skills and knowledge can meet the prospective residents needs. This information will also form the basis of the residents care plan. Green Bank EMI Care Home does not offer intermediate care. Care Homes for Older People Page 11 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. The care planning system in the home has improved and gives staff clear guidelines to follow in relation to each residents care needs. Some improvements need to be made in respect of daily reports to ensure they are individual for each resident and contain sufficient information. The receipt, storage, administration, recording and return of medication ensures that residents receive the correct medication prescribed for them. While generally staff respect the privacy and dignity of the residents, further improvements could be made in respect of assisting residents when eating, to ensure the dignity of residents is respected at all times. Evidence: Care planning for each resident has improved since the last key inspection in June 2009. The home has purchased a computerised system, that clearly details each residents personal, health and social care needs. There are clear directions for staff to follow as to how they can assist residents in their daily living needs. At the present Care Homes for Older People Page 12 of 26 Evidence: time this computerised system is still being developed by the home and the supplying company and staff are waiting for a blackberry system to be delivered which will assist them even further in meeting residents individual needs. Until such a time as this system is totally put into practice the Registered Manager was able to show the inspector how he was hoping to improve on daily reporting, staff meeting residents personal care needs and the recording of external health care visits by producing a new paper format for staff recording. General practitioner and other external health care visits are recorded onto the computerised system but could be more detailed. All care plans are signed by the individual resident and or their relative/representative. There is evidence that regular monthly reviews of care plans are carried out and residents and or relatives/representatives kept informed of any changes to the care plans. Risk assessments are detailed and individual for each resident in accordance with their differing needs, these too are reviewed on a regular basis. Alongside the computerised system of care planing a Listen to Me workbook is being developed with each resident this will give staff when the workbook is completed a total overview of the residents preferences, likes and dislikes in relation to all aspectis of their daily living routines. At the last key inspection in June 2009 a requirement was made for the improvement of care plans, at this inspection it was found that this requirement has been met. Medication in the home is well managed with up to date policies and procedures in place. The administration of medication being managed appropriately, and regular weekly monitoring of medication carried out by the Deputy Manager. These monitoring sheets were viewed by the inspector. The inspector found two gaps on the Monthly Administration Records, and the Deputy Manager said that she would have picked these up when monitoring the medication and will speak to the members of staff responsible for leaving these gaps. All medication received into the home was seen to have been checked in appropriately. Eye drops were dated on the box on the day of opening and the Deputy Manager confirmed that she will in future ensure that opening date is put on the bottles of eye drops and liquid medication. The return of unwanted or unused medication is detailed and shows that this medication is returned to the supplying pharmacy on a monthly basis. A sheet in the front of the Monthly Administration Record shows the list of staff trained to administer medication along with their signatures and initials. A requirement was made at the previous key inspection in June 2009 and found at this inspection that the requirement has been met. Staff were observed to be professional in their interaction with residents and ensure that residents privacy and dignity is upheld while personal care tasks are being carried out. The inspector has one concern in regard to staff standing while assisting residents Care Homes for Older People Page 13 of 26 Evidence: to eat. This was pointed out to both the Registered Provider and Deputy Manager. The Deputy Manager took immediate action by talking to these staff quietly and giving staff clear directions of the importance of sitting whilst giving residents assistance to eat. 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 are given choice in regard to daily living routines and activities they wish to participate in. Menus give residents choice at each mealtime but further attention could be paid to ensure residents dignity is maintained. Evidence: Through development of Listen to me work books residents are able to have more choice in relation to their daily living routines. There is evidence in the home through resident activity sheet that a variety of activities are on offer that are appropriate to the needs of the residents. The home has recently received an invite from another home in the area to participate in joint activities. Residents have access to local community as and when they wish to. One residents has several trips a day out into the community weather permitting. The priest from the the local church visits the home on a regular basis so that residents can participate in a short service and communion. A requirement made at the previous key inspection in June 2009 has now been met. There are no restrictions on visiting in the home and residents are able to choose Care Homes for Older People Page 15 of 26 Evidence: where they entertain their visitors. The majority of residents have chosen their relatives/representative to deal with their finances on their behalf. Walking around the home with the registered manager the inspector noted that residents are encouraged to bring small personal items into the home with them so they may personalise their bedrooms. Menus are devised by the residents, cook and management of the home. Residents are offered choice at each mealtime. The home is able to cater for specialised diets as and when required, at present the home is catering for diabetic and vegetarian diets. The inspector noted that one resident was having difficulty getting food from his plate this was discussed with the Deputy Manager who later discussed with the cook the need for a plate collar to be used in future. The inspector also noted that three residents needed assistance with feeding but that staff were standing to help these residents, rather than sitting with the residents to preserve their dignity and maintain an unrushed atmosphere. The Registered Provider and Deputy Manager said that they would ensure in future that staff did sit to give assistance with feeding. A requirement made at the previous inspection in June 2009 has now been met. 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. The complaints policy and procedure is up to date and displayed in the home, all complaints will be listened to a fully investigated. Procedures in the home ensure that residents are protected from abuse. Evidence: There have been no complaints made to the home since the last key inspection in June 2009. The complaints policy and procedure is prominently displayed in the home and a complaints file is kept in the office. One resident said that they would know how to complain if they needed to. Policies and procedures are in place in relation to Safeguarding Vulnerable Adults. There have been no Safeguarding Vulnerable Adults referrals to East Sussex County Council since the last key inspection in June 2009. All care staff have received Safeguarding Vulnerable Adults training but it was noted from training matrix in the case of four members of staff this training took place between 3 and 4 years ago and needs to be updated. New staff are only permitted to work in the home following appropriate vetting. Care Homes for Older People Page 17 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. Recent investment in this home ensures that residents live in a well maintained and homely environment. Attention has been paid to infection control issues so that residents are not put at risk from cross infection. Evidence: Green Bank EMI Care Home provides residents with a well maintained, warm, well furnished home in which to live. Communal corridors throughout the home have been decorated. There are two communal lounges, one with a dining table and and communal dining room, all are well furnished and maintained. Bedrooms show attention to detail in choice of decoration, furniture and soft furnishings. The home has invested in its outside space ensuring that it is now safe for residents to used. The inspector found there were no tripping hazards, handrails have been provided around all areas of the garden including the side patio areas. This outdoor space is now secure and safe for residents to use as and when they wish to. On the day of this inspection the inspector found the home to be clean and hygienic, one vacant bedroom had a slight odour and the deputy manager said that she would get this looked into. Eleven out of fifteen care staff have undertaken infection control Care Homes for Older People Page 18 of 26 Evidence: training. All staff are provided with protective clothing, blue for dealing with food and white for carrying out personal hygiene tasks. All toilets and bathrooms were clean, the inspector did notice that in some toilets vinyl flooring had not been fitted close to the toilet bowl and this could cause odour problems. 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. At the time of this key inspection staff were employed on all shifts in sufficient numbers so as to meet the needs of the residents. All care staff employed in the home have a qualification in Social Care, further attention needs to be paid to mandatory training and Dementia Care training to ensure that care staff have the skills and knowledge to meet the specialist needs of the residents and to ensure residents are safe at all times. Recruitment practices in the home are good and this helps to ensure that residents are not placed at risk of abuse. Evidence: At the time of the inspection there were sufficient staff on duty on each shift to meet the assessed, personal, health and social care needs of the residents. All care staff in the home have obtained their NVQ level 2 or above in Social Care. The inspector viewed three staff personnel files and found that generally recruitment practices in the home are good with appropriate checks being carried out prior to the new member of staff being deployed to work in the home. Evidence showed that in the case of one member of staff a To whom it may concern reference had been Care Homes for Older People Page 20 of 26 Evidence: accepted without being checked out, this was discussed with the Registered Manager who will insure in the future that these references are further checked to ensure their authenticity. The inspector also found that while the staff files contained proof of identification none of the files contained a recent photograph of the member of staff, again the Registered Manager stated that he would ensure recent photographs are placed in staff files. All new staff receive initial induction and Skills for Care induction is carried out by an external training agency. Staff personnel files and the management training matrix show that the majority of staff have completed mandatory training, but it was noted that some of this training had taken place more than two years ago and needs to be updated. All staff should complete this mandatory training within the first six months of their employment. While the majority of staff have completed a six hour course on Dementia Care further more detailed training has been booked for staff so they are able to show a more in depth knowledge of Dementia 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 Registered Manager has the skills and knowledge to manage the home effectively and in the best interests of the residents. A good quality assurance system has been developed, with a few additions the home will be able to ensure that residents receive a good quality of care throughout. The home has good policies and procedures in place for Health and Safety in the home ensuring that regular checks are carried out on equipment and appliances so that residents live and staff work in a safe environment. Evidence: William Pillow the Registered Manager of Green Bank EMI Care Home has the skills and qualification to manage the home, he has achieved his NVQ level four in Social Care and Registered Managers Award, he has since the last key inspection obtained Level 3 in Food Safety for Supervisors. During the inspection it was noted that William Pillow has good working relationships with the Deputy Manager, members of staff and Care Homes for Older People Page 22 of 26 Evidence: the residents. His interaction with residents in the home is good and he looks at ways in which he can improve the personal, health and social care needs of each individual resident. Since the last Key Inspection in June 2009 a quality assurance system has been developed in the home that seeks the views of the residents their relatives/representatives on the quality of care that the home provides. Monitoring of systems used in the home is carried out on a regular basis, with some work still to do on developing a monitoring system for housekeeping, fire, health and safety of each room in the home. Views of visiting professionals should also be obtained. The information gained from residents and relatives questionnaires and monitoring of systems used in the home still needs to be developed into an annual summary that sets out what the home has achieved in the past year and issues that need attention in the coming year. The home does not manage any of the residents personal allowances, but does make purchases on the residents behalf from petty cash as well as paying for residents hairdressing and chiropody services. Receipts are kept of all purchases made on the residents behalf. At the end of each month residents relatives/representatives are billed for purchases or services received. The inspector evidenced that all appliances and equipment used in the home have an up to date maintenance certificate. Regular checks are made on fire call points, emergency lighting and temperatures of hot water outlets in the home. All staff are required to completed when necessary an accident/incident report and this is then transferred onto the computerised care planning system for each individual resident. Where there is history of a number of falls, accidents or incidents taking place over a short space of time this would be referred to the residents General Practitioner. 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. 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 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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