Care Home: Hale Place Garden Lodge

What the care home does well The environment is well-maintained, clean and homely. The home is well furnished and offers plenty of choice for residents as to where they spend their time. The care and support that the home provides is excellent. Health needs are met and the residents are treated with respect and dignity. There is an excellent range of activities available to the residents, including regular community involvement in local clubs, pub lunches and religious activities and well as shopping trips to the nearby town. The home is well managed. Equality and diversity is promoted and there is an open an honest culture in the home that allows for continuous learning. The home has achieved the Investors in People Award. This is given to organisations that put the people who use their service at the forefront of everything they do, maintaining the highest standards in all aspects of their service. There is a stable and dedicated staff team with a variety of skills and experience. The staff work well together and treat the residents with kindness and respect. Staff training is excellent, there is a thorough induction programme for new staff and all staff hold recognised qualifications. What has improved since the last inspection? There have been a number of environmental improvements including purchase of new furniture, replacement windows and doors, a laundry refurbishment and a new food store. Staff training continues to improve and recently staff have received training in the Mental Capacity Act and the implications of Deprivation of Liberty. Staff retention is excellent. Only two staff members have left in the last twelve months. This was to undertake nurse training. What the care home could do better: The home is judged to provide an excellent service therefore no requirements were placed as a result of this inspection. Key inspection report Care homes for older people Name: Address: Hale Place Garden Lodge 77 Old Road East Peckham Tonbridge Kent TN12 5EN     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: Wendy Mills     Date: 1 8 1 2 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 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) 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 26 Information about the care home Name of care home: Address: Hale Place Garden Lodge 77 Old Road East Peckham Tonbridge Kent TN12 5EN 01622871081 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: info@haleplace.co.uk Hale Place Care Homes Limited care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users to be accommodated is 3 The registered person may provide the following category of service: 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 category : Dementia (DE) Date of last inspection Brief description of the care home Hale Place Garden Lodge is a residential home providing care and support for up to three older people with failing mental capacity. The home is a modern, detached house. The home has good communual space with a large lounge/diner and conservatory on the ground floor. The home has four bedrooms, three of the bedrooms are of good size and are used as single rooms for residents. The fourth is smaller and used as a sleep-over room for the staff member on night duty. There are toilet facilities on both levels of the home with a shower room on the first floor. The first floor is accessed by a domestic staircase with handrails but there is no lift so this home is only suitable for people who do not have significant mobility problems. Care Homes for Older People Page 4 of 26 Over 65 0 3 Brief description of the care home The home is located in the village of East Peckham, Kent, where there is a strong local community. The village has some shops, pubs, a garden centre with coffee shop, churches and a library. There are good road and public transport links to the village and the towns of Tonbridge, Tunbridge Wells and Maidstone are between eight and ten miles away. To the rear of the home there is a large enclosed garden with patio areas, pond and circular pathways. There is parking for two cars on the driveway and a further four cars on the driveway of the sister home next door. Hale Place Farmhouse provides accommodation for a further ten residents with higher dependencey needs. Although it is registered separately with the Commission, the two homes are run as one, sharing staff and facilities. The residents are able to use the communal areas in both homes. Meals for both homes are prepared in the kitchen of the Garden Lodge. The fees, given at the time of this visit, are £800 per week. Chiropody, hairdressing, personal toiletries and newspapers are all included in this price. Further information can be obtained by contacting the registered manager for the home. 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: 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 visit was unannounced and formed part of the annual inspection process of the Care Quality Commission under the Care Standards Act. This process takes into account information that we received prior to this visit and evidence that we gathered during the visit. The information we gathered prior to the visit includes the Annual Quality Assurance Assessment (AQAA) that the home is required to send us; any notifications of events that impact on the lives of the people who use this service; the results of surveys we have sent out; and any other information that we might have received, such as comments form visiting health and social care professionals. This evidence is then used to make a judgement about the quality rating for the service. During this visit we spoke to all the residents and five of their relatives. We spoke to four staff members, two of them in private, and held in-depth discussion with the registered manager. We examined important documentation such as care plans, staff files and health and safety records. We made a tour of the home and used direct and Care Homes for Older People Page 6 of 26 indirect observation throughout the time in the home. The people who use this service refer to themselves as Residents. This term is also used by their relatives and the staff at the home. Therefore this is the term that is used to refer to the people who use this service throughout this report. The residents, their relatives, the staff and the registered manager are all thanked for the warm welcome they gave and their assistance throughout the inspection process. The quality rating for this service is 3 Stars. This means that the residents experience excellent outcomes in all aspects of their care in the home. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home gives prospective residents and their supporters very good information about the home so that they can make an informed decision about moving in. Thorough pre-admission assessments are made to ensure that only those people whose needs can be met and who are suited to the home are offered a place there. Evidence: The home has a statement of purpose and a service user guide. There is a website for the home and better use of the Internet is now being developed so that there is more information and a facility to receive comments and suggestions from relatives. Since the last inspection the information that the home gives residents, prospective residents and relatives has been reviewed and new brochures are due to be printed early in 2010 Care Homes for Older People Page 10 of 26 Evidence: Three care plans were examined. Care plans are important documents because they are one of the ways that the resident and their supporters can be assured that their care needs have been identified and the way these needs will be met has been recorded. They are also an important source of information for staff who must ensure that they give care in a consistent way in line with best care practice. Further, care plans can provide a basis for informing the decision making process in cases where there is failing mental capacity. The care plans are in good order and contain extensive information about each resident. We found good evidence that thorough pre-admission assessments are made prior to a place being offered in the home. The registered provider told us that he always goes to visit a prospective resident to carry out the assessment before offering a place in the home. Relatives confirmed that pre-admission visits had been made. The 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home positively promotes the health and wellbeing of the residents in a way that protects their privacy and dignity. Evidence: Three care plans were examined in detail. The care plans are very well laid out, well maintained and up-to-date. They contain comprehensive details about all care needs. This includes health and personal care needs, cultural and religious needs, hobbies and interests and likes and dislikes. The care plans also contain risk assessments There are good staffing levels with a staff to resident ratio of one to three during the daytime. The home operates a key worker system so that each resident has a named member of the care staff who takes the lead in ensuring their care is carefully planned and monitored. We spoke to five residents and four of their relatives and indirectly observed the interaction between staff and residents. One resident said, They look after us very well here. Relatives spoke very positively about the staff and the care they give. One Care Homes for Older People Page 12 of 26 Evidence: said, The staff have their heart and soul in the personal care they give. Our observations throughout the time spent in the home on the day of this visit supported this view. There is a very stable staff team with some senior staff having worked in the home for over fifteen years. Staff training is good and all the staff we spoke to understood the care needs of each resident very well indeed. Although the home has not had to use agency staff for a long time it would be helpful if there was a condensed version of each persons care plan so that staff new to the residents could quickly understand their immediate care needs. The home maintains very good working relationships with local General Practitioners (GPs) and other visiting health and social care professionals. There are three GP practices in the area and residents can choose which practice they wish to attend, dependent on the GPs accepting them onto their lists. We found good evidence that any necessary specialist healthcare appointments are made and that the residents supported to attend these when necessary. The interaction between staff and residents was seen to be friendly but respectful. Staff knocked on room doors, spoke appropriately to the residents and worked well with them. Nutrition is well managed. The residents are weighed regularly and nutritional assessments undertaken. Food intake and output is monitored when indicated. On the day of this visit all the residents were in good health and spirits. There are sound policies and procedures for the management and administration of medicines in the home. The home uses a local pharmacy that supplies most of the medicines needed in a monitored dose system (MDS). Those medicines not supplied in the MDS are usu sally those that have been started during the month or those not suitable for this system. The medicines room was inspected in company with a senior staff member. It is safe and secure and temperatures of storage are checked regularly. All staff who administer medicines have been properly trained in the procedures. A sample of the current Medicines Administration Records (MARs) was examined. This was found to be in good order and up-to-date. There were no errors in the MARs in the sample we looked at and staff told us there have never been any errors in the administration of medicines. Care Homes for Older People Page 13 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a range of meaningful activities so that the residents can maintain their interests and independence. Evidence: There is a wide range of activities in the home. We looked at care plans, activities records and spoke to residents, relatives and staff about the activities the home offers. We also spent time throughout this visit, observing the interaction of staff and residents and the activities taking place. Likes and dislikes, cultural and religious needs and other preferences are all recorded in the care plans. Activities are then based on the known dislikes and preferences of the individual resident but the home also offers opportunities for new experiences. One of the care staff takes a lead on creative activities and another takes the lead for encouraging mobility and exercise. There are plenty of games, puzzles and similar activities. It was good to see that the home has several table games such as Scrabble and jigsaws and that these are in versions suitable for those who find handling small objects difficult. For example, the jigsaws that people were using had large, easily manipulated pieces but attractive and age-appropriate pictures. All staff were Care Homes for Older People Page 14 of 26 Evidence: observed to work on a one-to-one basis with each resident at different times during the visit, some spent time chatting to the residents whilst others encouraged the residents to take part in games and puzzles. It was particularly good to note the variety of activities related to day-to-day living that are supported. Some residents like to take part in the kind of activities that they used to carry out when living at home. The home supports them to continue these activities that include baking, dusting and gardening, when weather permits. The home has worked very hard to be part of the local community and to use local facilities. Some residents belong to clubs for older people and attend coffee mornings in the village. Other residents enjoy visits to a local garden centre. Records show that there are opportunities for residents to go out several times each week. The most recent outings were to a local garden centre to see the Christmas decorations, to have a pub lunch, Christmas shopping and two coffee mornings. Local ministers of different Christian denominations visit on a regular basis to hold services. Other members of their congregations also visit the home. Those residents who wish to attend church are supported to do so if they wish. At present all the residents in the home profess to be of a practicing or non-practicing, Christian domination. The registered manager said that the religious needs of people from other religions would be catered for should the need arise. Staff are commended for their diligence and determination in providing such an excellent range of meaningful activities. Since the last inspection one staff member has ensured that all residents have been issued with their bus pass to enable them to make shopping trips, accompanied by a staff member, to choose new clothing and presents for their families themselves. It is also good to note that the home supports such activities by providing the extra staffing needed. The home has two cats and two very friendly rabbits. The residents told us that they really enjoy the pets and that the rabbits really enjoy a cuddle. We asked the relatives who were visiting the home on the day of this visit if they thought the residents had enough to do and if they (the relatives) were made welcome to the home. They all said that they are made very welcome and praised the way that the staff interact with the residents. One said, They are friendly, yet professional. They have such patience and give each resident individual attention. Another said, I am always amazed at how they manage to get the residents to join in as much, they offer a lot of different things and gently help them to do things. I think Care Homes for Older People Page 15 of 26 Evidence: the staff are marvelous. I come here a lot and always find my mother well cared for, her wishes respected and that she takes part in activities - not bingo - that she enjoys and would have enjoyed when she was able think what she wanted to do. I am happy that shes happy and I am glad to have the opportunity to tell you how well I think they do here. The home has safe, secure, well-planted and well-maintained gardens with plenty of seating and things to enjoy. There is a rabbit run, fish pond, table tennis table and a basket ball hoop. Since the last inspection new, raised flower beds have been created so that those residents who enjoy gardening activities can become more involved. The home provides hairdressing, chiropody and newspapers. These costs are included in the weekly fees with no additional charges being made for these activities. This is to ensure that all residents are treated equally. The registered provider/manager told us that he was not prepared to see people who are unable to understand why they might be left out of an activity, be deprived of personal care such as hairdressing and nail care because the additional cost involved had not been sanctioned. A member of the care staff takes the lead on nutrition. She is responsible for ensuring that all the residents receive a nutritious diet and meals that they enjoy. She knows the residents well and understands their nutritional needs. Whilst there is not a formal menu choice each day as the home has small number of residents. The menu is based on the known likes and dislikes of each resident and contains plenty of locally purchased fruit and vegetables each day. If a resident does not like the meal on offer, then another that they would like, is prepared for them. The home provides a wide choice of drinks with meals, including red and white wine. In addition hot drinks, cake and biscuits are served at regular intervals throughout the day. All the residents said that they enjoy their meals and that they have plenty to eat and drink. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has sound policies and procedures for handling concerns, complaints and safeguarding. This protects the residents from harm. Evidence: There are robust policies and procedures in place for the management of concerns, complaints and safeguarding. Relatives we spoke to said that they are aware of these but had not had to make a formal complaint. One said, If anything is worrying me I know I can speak to any of the care staff and they will look into my concerns, but I really have not had to make any noise about anything, they do things so well here. There have been no formal complaints made for several years. The registered manager said that the home aims to deal with any concerns as they arise. Minor concerns are recorded and reviewed so that improvements can be made, if necessary, based on the information gathered. The Homes Annual Quality Assurance Assessment (AQAA) confirmed that the home seeks to ensure that the residents and their relatives are satisfied with the care and support the home gives. All staff have received updated safeguarding training in the last year. Those we spoke to were very clear about their responsibility to report any concerns about the safety of a resident. They said that there is an open culture in the home and that the registered manager encourages them to raise any concerns immediately. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment is well maintained, clean and safe. This means that the residents have a pleasant and homely place in which to live. Evidence: The home is a detached modern house that provides accommodation for up to three people with failing mental capacity who still maintain a good degree of independence and mobility. Upstairs there are three bedrooms for residents, a sleep-over room and a bathroom and toilet. Downstairs there is a well-equipped kitchen, a good-sized lounge-diner, a conservatory and a toilet with wash basin. There have been a number of improvements to the environment since the last inspection, these include:- the rebuilding of the conservatory; refurbishment of the laundry, new furniture and replacement of UPVC windows and doors. A tour of the home was made and the environment found to be welcoming, warm, clean and well-maintained. The homes Annual Quality Assurance Assessment (AQAA)confirmed that health and safety checks on the environment are carried out and that the required certificates are in place. Care Homes for Older People Page 18 of 26 Evidence: The home has sound infection control measures in place. The laundry has been updated since the last inspection and new equipment purchased, all staff have attended infection control training in the last year and gloves, aprons, paper towels and liquid soap are all readily available to staff. Residents were confident in moving around the home and said that they are happy living there. Relatives said that they are pleased with the individual rooms and that they had been able to make them homely by bringing in items from home. The AQAA told us that the home provides all the necessary specialist equipment, including hoists, bathing aids, special cutlery, beakers and grab rails. The home has a large, attractive and well-maintained garden. Relatives told us that the residents very much enjoy this in the summer. Since the last inspection new paving has been put down and raised flower beds provided. A path links Hale Place Farmhouse with its sister home, Hale Place Garden Lodge. Residents are able to move freely between the two homes and can choose where to take their meals and spend their time. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels, staff training and recruitment practices are all good. This means that the residents are cared for by a well qualified and carefully vetted staff. Evidence: The home has good staffing levels and a stable staff team. Most of the staff have worked in the home for over three years. Only one member of staff has left in the last twelve months and this was to go on to higher education. Staff rosters confirm that there are sufficient staff to meet the needs of the residents. There is flexibility in staffing levels and more staff are scheduled if needed. For example, if residents are going on an outing or to a coffee morning, then additional staff are scheduled. Domestic staff are employed in sufficient numbers to ensure that high cleanliness standards are maintained. We examined three staff files in detail. There is good evidence that staff receive excellent training opportunities. The home uses the Skills for Care Induction books for all new staff unless they go straight onto a National Vocational Qualification (NVQ) programme or already hold relevant qualifications. If this is the case then the registered manager maps out an agreed training plan and provided the induction training himself. The staff confirmed that they are given a great deal of training and that they are paid for training time. One said, Theres always training going on. Care Homes for Older People Page 20 of 26 Evidence: Two members of the care staff were spoken to in private and others were spoken to during the tour of the home. Staff told us that they really love working at the home and say everyone feels part of a large family. They said that they believe they work well as a team and work to their strengths. For example, one senior staff member is really creative and takes the lead on activities whilst another is meticulous and takes the lead on the management and administration of medicines in the home. From conversation, it is clear that the staff know the residents well and understand their individual needs. Direct and indirect observations were made throughout the day. The staff were seen to interact really well with each resident and they had created a calm and warm atmosphere in the home. Relatives said that the staff are always helpful and take any of their concerns and worries seriously. One said, Whenever I come here the staff are always working with the residents and are always kind and courteous. We found good evidence that, as well as thorough induction and statutory training, there is a good level of specialist training being undertaken. Staff have had training in dementia care and all have recently undertaken training in the Mental Capacity Act and the safeguards surrounding Deprivation of Liberty. There is a diverse staff team that has a balance of the skills, knowledge and experience needed to meet the residents needs. All staff hold the NVQ at level two and twenty-five percent have achieved level three. In addition, two people hold the Registered Manager Award and NVQ at level four. All new staff are given a Code of Conduct booklet at induction and all long established staff were given a copy as part of their refresher training. There are rigorous recruitment procedures that have the needs of people who use the service at its core. The procedures show a good understanding of diversity through the use of equal opportunity monitoring forms, person specifications and set questions at interview so that equality is shown to all applicant. All staff recruited are aware of the specific nature of the home and the care it offers for people with failing mental capacity. All the required documentation, including written references, Criminal Records Bureau (CRB) checks and interview notes are all in good order in the files were examined 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and run in the best interests of the people who use this service. Evidence: The registered manager owns the company that is the registered provider for the home. The homes Annual Quality Assurance Assessment (AQAA) told us that he is usually in the home seven days each week. Staff confirmed that he is readily available to them and that he take a very hands on approach to running the home. The registered manager also runs an accredited training company that provides much, but not all, of the staff training for the home. He is well qualified and experienced for his role in the home. He is a qualified business and care manager and holds the National Vocational Qualification (NVQ) in management and care at level four. He maintains his continuing professional development by attending training with staff, undertaking further courses and reading. In addition, he is qualified as an NVQ assessor for learners undertaking the NVQ at levels two, three and four. He has run Care Homes for Older People Page 22 of 26 Evidence: the home successfully for over twenty-one years. Conversation with the registered manager showed that he has extensive knowledge of best care practice and relevant legislation. Staff said that he promotes equality and diversity and an open and honest culture in the home. They said that they have plenty of opportunities to discuss any concerns with him, both at formal meetings and on a one-to-one basis. The AQAA told us that the home is committed to, Continuous improvement, customer satisfaction and quality assurance. We found good evidence that the home seeks the views of the people who use this service and their supporters both on a formal and informal basis. Relatives confirmed that they ask are asked for their views about the home. The home has achieved the Investors in People award. In order to qualify for this award an organisation must be able to demonstrate sound organisational management and quality assurances systems, that it puts the person who uses the service at the centre of everything it does and that it values the staff team. The home does not handle any large sums of money on behalf of the residents, who all have failing mental capacity. All residents have someone, usually a family member, who has power of attorney and some have deputies appointed by the Court. The home does not hold small sums of pocket money on behalf of residents, instead, money is provided from the homes petty cash, receipts are kept and an invoice sent to the person who has power of attorney. There are robust policies and procedures for the management of health and safety in the home. Environmental risk assessments are in place. There is safe storage of hazardous substances and environmental risk assessments are in place. Accidents are recorded and reported when necessary. Records are maintained properly and there was good evidence to show that regular health and safety checks are carried out. No health and safety hazards were noted during a tour of the home. 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). 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