Care Home: Grove Court (Woodbridge)

What the care home does well The home offers spacious, attractive accommodation in pleasant surroundings within easy reach of local facilities. Residents are provided with clear information about the home and given opportunities to participate in decisions about their own daily lives and matters relating to the home. They are fully consulted about their care, treated with respect and have their individual needs met. Activities that are offered are varied and wide-ranging and people are able to make a choice about taking part. The menus offer an exceptional choice of nutritious and appeatising meals and residents can chose whether to have their meals privately or with company in one of the dining rooms. The home has a well trained competent team of staff. It is well managed and run in the best interests of the residents. What has improved since the last inspection? We found the procedures for handling medication safe and the practice of mixing liquid medication had ceased. The care plans we looked at were detailed and specified residents personal wishes and preferences. The environment was well maintained and an ongoing maintenance programme was highly evident. The staff supervision programme in place had been extended to include anciliary staff. What the care home could do better: The home is achieving good and excellent outcomes in all areas and no requirements or recommendations have been made. Their AQAA demonstrates that they have robust monitoring and self assessment processes in place and they are continously seeking to improve. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Grove Court (Woodbridge) Beech Way Woodbridge Suffolk IP12 4BW     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Tina Burns     Date: 1 2 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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: Grove Court (Woodbridge) Beech Way Woodbridge Suffolk IP12 4BW 01394446500 01394446501 raphy.perez@efhl.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Elizabeth Finn Homes Ltd care home 61 Number of places (if applicable): Under 65 Over 65 61 old age, not falling within any other category Additional conditions: 0 Condition of Registration The Home has approval to care for one named service user (as per application for variation dated 19/8/05) under the age of 65 with palliative care needs. Date of last inspection Brief description of the care home Grove Court is owned by Elizabeth Finn Homes and is registered as a care home with nursing, accommodating a maximum of 61 older people. The home is located on the outskirts of Woodbridge town centre. To fit the slope of the land, the home is built on three floors, lower, middle and upper. The main entrance is located on the middle floor at the front of the building, with appropriate signage and parking nearby. Internally the building is modern and attractive in design, with communal and private accommodation at all levels. All bedrooms are single accommodation with en suite toilets, with some having en suite shower facilities. There are two dining rooms, a number of lounges including an activities lounge, library, physiotherapy and sensory Care Homes for Older People Page 4 of 29 Brief description of the care home rooms, hairdressing salon and shop. Externally there are attractive well-maintained gardens with views down to the River Deben. There is a central courtyard and patio area that can be accessed from a number of doors and has seating so residents can enjoy the planted containers. The fees for accommodation range between £740 and £940.00 weekly and do not include toiletries, hairdressing, newspapers and chiropody. 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 was an unannounced key inspection, which focused on the core standards relating to care homes for older people. The report has been written using accumulated evidence gathered prior to and during the inspection. The inspection process included a tour of the premises and examination of a wide range of documents and records including three residents care plans and three staff files. The inspector also spoke with four staff individually and five residents. Information has also been gathered from the homes Annual Quality Assurance assessment (AQAA) submitted to the Commission in April 2009, and survey forms completed by ten residents, seven care staff and three health care professionals. Care Homes for Older People Page 6 of 29 The registered manager, Mr Raphael Perez, was on duty at the time of our visit. He was helpful and co-operative, provided all the information we asked for and fully contributed to the inspection process. What the care home does well: What has improved since the last inspection? 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 set out 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 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 9 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents can expect to have the information they need to make an informed choice about living at the home. Evidence: The homes AQAA was detailed and told us how they ensure that prospective residents are provided with enough information to decide whether Grove Court is the right place for them. It told us that there is a thorough pre admission process that includes a visit by the homes manager who undertakes an assessment of the individuals needs. Residents and their relatives are also encouraged to visit the home prior to admission to look at the environment and discuss their personal requirements. Ten out of ten people that completed service user surveys confirmed that they were provided with enough information about the home before they moved in. Further more the information displayed in the reception area of the home included a copy of the Care Homes for Older People Page 10 of 29 Evidence: homes brochure and their Statement of purpose. The document contained all the information required and included a copy of their last inspection report, residents comments and the homes complaints procedure. It was also available in large print. People we spoke with and records we examined told us that new residents have a six week trial stay followed by a review to agree whether or not the home is appropriately meeting the needs of the individual. The files we looked at also included signed contracts that specified the terms and conditions of occupancy. The AQAA tells us that the homes pre admission assessments have been developed in the last twelve months to be more resident focused and also to clearly identify any risks which must be addressed immediately following admission. The records we examined included assessments that had been undertaken before and after each persons admission. The assessments were detailed and covered a wide range of needs, for example; diet and nutrition, communication, mobility, personal care, continence, cognition, social interests and family involvement. Care Homes for Older People Page 11 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. People who use this service can expect to be treated with respect and have their individual needs met. Evidence: The AQAA tells us that there are comprehensive individual care plans in place that are based on the Roper, Logan and Tierney 12 Activities of daily living. The actions recorded in the care plans are set in consultation with the residents and their families or representatives. They are reviewed on a monthly basis, or before if needs change. The records we looked at and the people we spoke with confirmed that the information provided in the AQAA reflected the practice that took place. The twelve areas covered in the care support plans were; Maintaining a safe environment, Communication, Breathing, Eating and Drinking, Elimination, Personal cleansing and dressing, Controlling body temperature, Mobility, Work and Play, Privacy and Dignity, Sleeping and Night care and Dying. The three care plans that we looked Care Homes for Older People Page 12 of 29 Evidence: at were highly individual and reflected peoples individual needs, likes and preferences. People we spoke with confirmed that they were satisfied with the care and support they received at the home. Comments included; Im happy. I think most people are extremely happy, You have as much (support and assistance) as you need and I felt lucky to get in here. The home had undertaken an annual review of residents views. Over thirty people had completed satisfaction surveys and the results showed a high level of satisfaction with their care and support. Out of the ten surveys returned to us by people that use the service eight said that they always receive the care and support they need and two said usually. Nine said that they always receive the medical support they need and one said usually. Three surveys that were completed by health professionals said that individual health care needs are always met. Feedback included; I am pleased to say I am well looked after, I could not wish to be treated anymore kindly than I am. Everyone and everything is good and I am very happy here and find the staff very helpful and very kind. The files contained risk assessments for moving and handling, nutritional needs, skin integrity and falls. There was evidence that the assessments are regularly reviewed and care plans are updated to reflect any changes. The AQAA tells us that the home consults specialist practitioners such as dietitians, speech and language therapists, district nurses and a tissue viability nurse as necessary. They also employ two physiotherapists to support the residents with their mobility needs and advise and teach staff about mobility requirements. One resident we spoke with told us how helpful they had found their physiotherapy. Records of contact with residents GPs or other health professionals are maintained together with the outcome of appointments. Comments we received from health professionals when we asked what the service does well included; Person centred care, Privacy, Excellent facilities available and Residents needs are assessed and appropriate, timely action is taken. Records we looked at, information provided in the AQAA and discussion with the manager and staff during our visit confirmed that the home has appropriate policies and procedures in place for the safe handling of medication. The home uses a monitored dosage system (MDS), so blister packs are filled by a local pharmacy and delivered to the home on a monthly basis. Medication Administration Records (MAR sheets) examined had been correctly completed and since our last inspection the Care Homes for Older People Page 13 of 29 Evidence: practice of dispensing two liquid medicines to one person in the same pot, which was potentially unsafe, had stopped. Care Homes for Older People Page 14 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 who use this service can expect to follow a lifestyle of their choice and be offered a wholesome, appealing and balanced diet. Evidence: People we spoke with and observations made during our visit confirmed that residents friends and families are made welcome and encouraged to visit. One visitor was seen having lunch with their relative in the dining room and we were advised that guests were always welcome at reasonable times and not expected to avoid meals. The residents records we looked at included good information about their previous life styles, interests and hobbies. They also included information about their friends and families, how much contact they enjoyed and what support, if necessary, was required to enable them to maintain contact. The home is a member of Advocacy Aware and information about them and other potentially helpful organisations is on display in the foyer. This was positive to see as it actively encouraged people to seek independant and specialist advice about matters important to them. Care Homes for Older People Page 15 of 29 Evidence: The home has funds for two part time social events co-ordinators. One of the posts was vacant so the existing co-ordinator was working almost full time hours in the meantime. The co-ordinator is responsible for organising a programme of activities in consultation with residents. People we spoke to said that there was a good range of activities. One of them told us that they had found the group showing of President Obamas inauguration particularly memorable. The programme on display for the month of June 2009 included the following activities and events; art classes, yesterdays music, physiotherapy, exercise class, pat dog, shopping trips, musical appreciation, bingo, film showings, walks, flower arranging, french conversation, board games, carpet bowls, holy communion, reminiscence, poetry readings, a guest speaker, nail painting, skittles, wimbledon and strawberry tea, music and movement, what the papers say and scrabble. The home also has a lounge area that is designated as an activities room with a good range of resources such as books, videos, board games and talking books. There is also a library with a wide choice of books and a computer with email facilities, a hairdressing salon and a trolley shop. Residents are also invited to enjoy morning coffee as a social event in the lounges and come to the bar for complimentary drinks on a Sunday before lunch. At the time of our visit celebrations were also being planned for the 10th Anniversary of Grove Court. The AQAA tells us that great care is taken to ensure that all residents who are unable to leave their rooms are visited each day so that they are given the opportunity to talk or engage in activity such as listening to some readings or music. The home has a team of chefs and kitchen assistants that provide all the meals on the premises. Food is sourced locally and is free range where possible. There had been a food hygiene inspection undertaken by the local council in October 2008 and they had found that Good standards in place. Fresh fruit was available to residents throughout the day. Information displayed on notice boards included a sign saying The bowls of fruit in the dining rooms are for residents to help themselves whenever they wish. If you need assistance to cut or peel any fruit please ask a member of staff who will be pleased to help you. Information provided in the AQAA and on the day of our visit told us that the chef manager is responsible for completing the draft menus in consultation with the residents forum. The menu is then sent off to the companys head office where it is scrutinised by a qualified dietician before it is approved. The four week summer menu Care Homes for Older People Page 16 of 29 Evidence: that we looked at was exceptionally good. It included a wide range of breakfast options, three course lunches that included a meat option, vegetarian option and fish option for the main course, suppers that included a choice of soups, a hot meal, sandwiches or salads every day and a range of other alternatives. Residents are able to take their meals in one of the two dining rooms, or in the privacy of their own room. Since our last visit the process for serving meals to rooms had been reviewed so that the food was served one by one from a hot trolley and maintained at a suitable temperature. One person we spoke with told us that they were given personal assistance at meal times as they were very frail and needed to be fed. They said that the assistance they were given was good and they were able to eat at a suitable pace to them. On the day of our visit we joined three residents in one of the dining rooms at lunch time. They were enjoying salmon fishcakes, macaroni and blue cheese, fresh vegetables and dauphinoise potatoes. For dessert the main option was Eton Mess. There was a pleasant atmosphere, the tables were nicely laid with napkins and condiments and people were able to serve themselves with vegetables and potatoes at their tables. The food looked highly appetising and comments we received included Very good, excellent really and First class. 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 this service have their complaints taken seriously and acted upon. Further more, they can expect to be protected from abuse. Evidence: Ten out of ten residents that completed surveys told us that they would know how to make a complaint. They also said that staff listen to them and act on what they say. The complaints procedure was included in the Statement of Purpose and a copy was in the entrance hall of the home. It was clearly detailed and included relevant contact details and information about the different stages of the complaints process. It was positive to see that if a complaint was not satisfactorily resolved there was the opportunity for an independent, external adjudicator. The AQAA tells us that the complaints procedure is available in regular font, large print and on CD. This was confirmed during our visit. Since the last inspection we received one complaint about the home from an anonymous caller. We asked the manager to deal with the complaint directly. The complaint was found to be unsubstantiated following a thorough investigation. Full details of the investigation and the subsequent outcome was sent to us by the manager at the time. Care Homes for Older People Page 18 of 29 Evidence: During our visit we looked at the homes complaints records for 2009 and found that there had been five complaints recorded. The records were clear and included the details of the complaint and any subsequent investigation or action. We could see that all of the complaints, irrespective of how minor they were, had been taken seriously and acted upon. Comments we received during our visit included; I dont ever think ive had to go in the office with a grumble. A request? yes, once or twice, and thats sorted really quickly and They do their best to make people happy. Information provided in the AQAA, training records examined and staff spoken with evidenced that staff are provided with training on dealing with complaints and safeguarding adults. The training provided also covers whistle blowing, awareness of the Mental Capacity Act and Deprivation of Liberty Safeguards. The home continues to work within the local authority multi agency safeguarding protocols. They keep us informed of events that occur that they are required to notify us about. They have shown us that they are quick to report and respond to serious incidents and they keep us up to date and informed. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service can expect to live in clean, comfortable and pleasant surroundings. Evidence: This purpose built home was opened in 1999. It offers individual rooms to sixty-one residents. The rooms all have some en suite facilities with those in the residential section having a shower as well as toilet and basin. The layout over three floors is airy and spacious. All the rooms look over the large gardens or the well-maintained central courtyard. The decor and furnishings are bright and fresh with furniture appropriate for the client group. Access between the three floors is by stairs or passenger lifts. The home provides a good choice of communal areas throughout the home so people can chose where they want to spend their time when they are not in the privacy of their room. One person we spoke with told us There are lots of places to sit and talk. The AQAA tells us that the home has a supportive estates department with a robust maintenance programme, it details an extensive list of improvements that were made in the past twelve months. It also says that they have a full time maintenance officer and a full time gardener. On the day of inspection we found the premises and grounds were maintained to a high standard. Equally, all areas seen were fresh and clean with Care Homes for Older People Page 20 of 29 Evidence: no unpleasant odours. Feedback from staff and observations on the day of our visit confirmed that the home is well resourced with plenty of moving and handling equipment, such as hoists, and bathrooms and WCs have handrails suitably placed. During our visit we met the senior housekeeper who told us that the laundry service had improved since our last visit. We were told that personal clothes are laundered and returned to their owners within twenty four hours. Residents also have their towels changed on a daily basis. The home has appropriate laundry facilities in place although we were advised that the intention is to improve and upgrade the laundry area in the coming year. Care staff we spoke with had undertaken training on infection control and were provided with disposable gloves and aprons and hand wash. 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. People who use this service can expect to be safeguarded by robust recruitment procedures. Furthermore, they can expect to receive a high standard of care from a competent and dedicated team of staff. Evidence: The home is divided into three care bases one for residential residents and the other two for people requiring nursing care. Staffing at the home consists of the registered manager, a team of senior staff, nurses, carers and ancillary staff who are responsible for the housekeeping, laundry, kitchen, gardens, maintenance and administration. On the day of our visit our observations were that there was a high staff presence and nursing and care staff were available at all times to attend to peoples needs. Seven out of ten residents that completed surveys told us that staff were always available when they needed them and three said that they were usually available. Eight said that they always received the care and support they need and two said usually. Staff spoken with and feedback in staff surveys confirmed that they felt that there were enough people on each shift to meet the needs of residents and the quality of care they provided was good. Comments included; Ninety-nine percent of the time we have our staffing levels right, Quality of care is excellent. My team is very, very Care Homes for Older People Page 22 of 29 Evidence: good. We work very hard, we have to, to keep standards high and Ive never had any pressure to perform differently because of fluctuating staffing levels. Three staff recruitment records were examined and included evidence of personal identification checks, evidence of Criminal Record Bureau CRB checks (CRBs), copies of application forms, written references and declarations of health. One of the records that related to a member of the nursing team also included evidence that their personal identification number (PIN) had been checked with the Nursing and Midwifery Council. There was also good evidence that face to face interviews are carried out as part of the staff selection process. Feedback from surveys, discussion with staff and training records examined confirmed that new staff are provided with a thorough induction programme that complies with the Skills for Care Induction Standards. One person we spoke with had been recently recruited and they told us that they had applied to work at the Grove because of the high reputation it has locally. They were very happy with the homes induction and training process and said that they had been supported by an excellent mentorand a helpful team. Staff training records were well maintained and provided documentary evidence that the following training is provided; Health and Safety in the workplace, The Mental Capacity Act and Deprivation of Liberty Safeguards, Nutrition, Hospitality and Complaints Management, Venepuncture, Dementia and Confusion, Food Awareness, Fire Safety and Fire Marshall training, Parkinsons, Tissue Viability, Recognising and Responding to Abuse and Neglect, Medication, First Aid, Managing Continence and Moving and Handling. Comments we received from staff included; This is the best place Ive ever been for training, Second to none here, I couldnt fault it and Training at Grove Court is excellent as it covers far more than health and safety, moving and handling, safeguarding adults and fire safety. At the time of our visit the home employed fifty-five care staff excluding trained nurses. Thirty-six of them had achieved an NVQ in care at level 2 or 3 and ten further staff had commenced their NVQ 2 training or planned to start it this year. Care Homes for Older People Page 23 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 can expect the home to be well managed and run in their best interests. Evidence: The registered manager, Mr Raphael Perez, is a trained nurse, registered with the Nursing and Midwifery Council (NMC). He has a teaching and assessing nurses qualification, a BA (Honours) in healthcare studies, Diploma in Management Studies and Registered Managers Award. Mr Perez has also completed training with the local authority to enable him to provide in-house safeguarding adults training and keeps his core training, in areas such as moving and handling and health and safety up to date. He also told us that he likes to work occasional shifts to keep his practice current and up to date. The AQAA tells us that the manager has a sound knowledge of the homes strategic and financial planning and how it is supported by the organisations financial and operating systems. This clearly enables him to take good advantage of the knowledge Care Homes for Older People Page 24 of 29 Evidence: and resources within the company and manage the home effectively. Records available to us and feedback from staff and residents confirmed that the home has a range of systems in place to enable people to give their views and participate in making decisions about the home. There was good evidence that staff meetings, management meetings and residents committee meetings take place. We could also see that customer satisfaction surveys are undertaken every six months; the information they provide is analysed and published and action points arising from them are addressed. The homes AQAA that was submitted to us in April 2009 was detailed and fully complete. It demonstrated that the manager has a good understanding of National Minimum Standards and included information about how they are able to evidence what they do well. It also demonstrated that the home has thorough quality assurance systems in place so that they are clear about what they do well and where they can improve. The home does not handle large sums of residents personal monies or manage anyones personal accounts. However, they do have a facility for holding residents cash if required. In these circumstances the money is held in a secure safe, all deposits and withdrawals are recorded and two signatures are required. Care staff spoken with said they had regular supervision sessions with senior staff in which concerns and issues were openly discussed and training needs identified. The registered manager confirmed that the supervision programme had been extended to include ancillary staff. The home has a health and safety committee that meet on a quarterly basis. We looked at the minutes for the meeting that they had in May 2009 and could see that they were used effectively to maintain health and safety in the workplace. Areas on the agenda included staff training, audits, infection control, hygiene and housekeeping, estates management, accidents and incidents, falls reports & investigations and risk assessments. Staff training included health and safety, food hygiene, moving and handling and fire safety. The AQAA tells us that appliances are fully serviced and maintained to a high standard. It also tells us that a more robust system has been put in place to report repairs. This was in response to a requirement made at the last inspection. The AQAA also tells us that the home has reviewed and updated their health and safety policy and fire risk assessment in the past twelve months. Care Homes for Older People Page 25 of 29 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 or Textphone: or 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) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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