Care Home: Hartford Hey

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What the care home does well The information about how the home works and who it is for (the service users guide and statement of purpose) are clear and well documented. People`s needs are checked before they move into the home to make sure that the staff have the information necessary to make a decision about whether the person`s needs can be met at the home. The home has an established staff team who were keen for high standards to be maintained. Residents` plans of care and individual case notes were well written and reflected each persons` needs so that staff would know how to meet those needs. Meals were varied and reflected peoples individual preferences. They offered choice and variety. The meals are home cooked and fresh vegetables were used. The people who live at Hartford Hey commented "The food is good" and "I like the meals here". There is a range of activities that people can join in with, and some people who live at Hartford Hey are supported by relatives and friends to take part in activities in the wider community. People who live at the home confirmed that there were activities available and they could join in with them if they wish. This helps to make sure they are able to take part in social interaction and stay active. A good standard of hygiene was seen throughout the home and the standard of decor was excellent. The furnishings were also good. There is a programme of maintenance and redecoration for the home to make sure that it is always well maintained and comfortable for the people living there. People`s bedrooms were individualised and thought had been given to making sure there is enough light and fresh air to ensure their comfort. People who live at Hartford Hey told us, "The carers have been very kind. The home is always fresh and clean", "They do just about everything well" and "They do everything well. I always like the meals". Staff commented, "There are usually enough staff to meet service users` needs. I always feel I have enough support", "We meet the needs of all the residents and it is a happy working atmosphere. The training is excellent" and "I regularly see my manager. My induction was very good". Other comments included "I am given training that is relevant to my role. I am always given up to date information about the service users", "I know what to do if someone has concerns about the home. There are always enough staff to meet the needs of the people living at Hartford Hey", "My induction mostly covered all the information I needed to do the job. My training since then has been relevant to my role", "We work well as a team and provide brilliant care for the residents. I am happy with everything" and "I always have enough support and knowledge to meet the needs of the residents". What has improved since the last inspection? To ensure that residents are cared for by staff that are trained and competent to do their jobs, mandatory and specialist training in line with residents` needs has been continued. Fifty percent of care staff have obtained National Vocational Qualification level 2 in Care and the manager has obtained National Vocational Qualification level 4 in Care and Management. These are nationally recognised qualifications that show staff are competent to provide good quality support, care and management. To ensure that staff are properly supervised in their role each staff member has continued to receive formal supervision sessions and annual appraisals. This gives them the opportunity to discuss their work with their manager and receive the guidance they need to provide good care for the people living at Hartford Hey. The choice of meals at each mealtime is now offered and these are varied and always recorded on the menu board and sheet. This shows that a varied, nutritious diet is available that people enjoy. To ensure that service users and their families have up to date information the service users` guide is reviewed annually and the current fees are included. Other formats for the service users` guide have been considered so that people have access to the information in a format that is suited to their particular needs. To ensure that service users are protected by the homes recruitment procedures identity checks are now carried out with regard to all staff members. This helps to make sure that the staff are suitable to work with the people who live at the home. A review sheet has been developed for monthly care plan reviews for all service users, to ensure their needs are being met and that staff have up to date and relevant information about the people they support. The activities diary is now kept up to date so that people can see what activities have taken place. The confusion about the complaints procedure for the home has been sorted out so that there is one clear procedure to tell people how to raise their concerns and how these will be dealt with. The manager now ensures that funds are available as necessary for people living at the home so that they can spend their money as they wish. Also the balances and records of money kept on behalf of people living at the home are checked regularly to make sure they are accurate and up to date. What the care home could do better: We made recommendations about recording the names of the people taking part in the various activities so staff could see who liked doing what, and that the names of staff attending staff meetings should be included in the notes of the meetings so it was clear who had taken part in them. We suggested that the satisfaction surveys that people had completed about the home should be analysed and this should be shared with the residents, their relatives and others as appropriate to show that their views were being taken into account in future developments at the home. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Hartford Hey Manorial Road South Parkgate South Wirral Cheshire CH64 6US     The quality rating for this care home is:   two star good 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: Maureen Brown     Date: 1 0 0 8 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 28 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 28 Information about the care home Name of care home: Address: Hartford Hey Manorial Road South Parkgate South Wirral Cheshire CH64 6US 01513364671 01513364671 hartfordhey@aol.com www.HartfordHey.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Hartford Hey Limited care home 28 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The home is registered for a maximum of 28 service users to include:- *Up to 28 service users in the category of OP (Old age not falling within any other category). Date of last inspection Brief description of the care home Hartford Hey is a residential care home providing personal care and accommodation for up to twenty-eight older people. It is a family run private business. The home is located in a residential area of Parkgate on the Wirral, near to the river Dee estuary. The home is within walking distance of shops, public houses and other community facilities. There are adequate car parking facilities available. Care Homes for Older People Page 4 of 28 Over 65 28 0 Brief description of the care home Hartford Hey consists of two large older style semi-detached houses converted into one. Service user accommodation is on three floors, with access to all floors by a passenger lift or the stairs. There are 22 single and 3 double bedrooms, twelve of which have en-suite facilities. The remaining bedrooms have wash hand basins fitted. The home has extensive patio and garden areas. Some of the bedrooms of the ground floor extension have direct access to the gardens via patio doors. The fees at Hartford Hey are 520.00 pounds per week. Optional extras include hairdressing, chiropody and newspapers. Care Homes for Older People Page 5 of 28 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: We carried out an unannounced visit to the home on 10 August 2009 and the visit lasted six and a half hours. It was done by one inspector. The report will say we when referring to what was done and found at the visit, as it is written on behalf of the Care Quality Commission. This visit was just one part of the inspection. Before the visit the home manager was asked to complete a questionnaire to provide up to date information about the home. We sent out questionnaires to people who live in the home and staff members to find out their views about Hartford Hey. Other information received about the home was also reviewed. During our visit we looked at various records and the premises. We looked at the care records of three people who live in the home, to see how their needs were being met. Care Homes for Older People Page 6 of 28 We also looked at three staff files to ensure that thorough recruitment processes had taken place and that people who live in the home were safeguarded from harm and supported safely. We spoke with some of the people who live at Hartford Hey, the manager, the director and members of staff who were on duty during this visit. They all gave their views about the home. What the care home does well: What has improved since the last inspection? To ensure that residents are cared for by staff that are trained and competent to do their jobs, mandatory and specialist training in line with residents needs has been continued. Fifty percent of care staff have obtained National Vocational Qualification level 2 in Care and the manager has obtained National Vocational Qualification level 4 Care Homes for Older People Page 8 of 28 in Care and Management. These are nationally recognised qualifications that show staff are competent to provide good quality support, care and management. To ensure that staff are properly supervised in their role each staff member has continued to receive formal supervision sessions and annual appraisals. This gives them the opportunity to discuss their work with their manager and receive the guidance they need to provide good care for the people living at Hartford Hey. The choice of meals at each mealtime is now offered and these are varied and always recorded on the menu board and sheet. This shows that a varied, nutritious diet is available that people enjoy. To ensure that service users and their families have up to date information the service users guide is reviewed annually and the current fees are included. Other formats for the service users guide have been considered so that people have access to the information in a format that is suited to their particular needs. To ensure that service users are protected by the homes recruitment procedures identity checks are now carried out with regard to all staff members. This helps to make sure that the staff are suitable to work with the people who live at the home. A review sheet has been developed for monthly care plan reviews for all service users, to ensure their needs are being met and that staff have up to date and relevant information about the people they support. The activities diary is now kept up to date so that people can see what activities have taken place. The confusion about the complaints procedure for the home has been sorted out so that there is one clear procedure to tell people how to raise their concerns and how these will be dealt with. The manager now ensures that funds are available as necessary for people living at the home so that they can spend their money as they wish. Also the balances and records of money kept on behalf of people living at the home are checked regularly to make sure they are accurate and up to date. 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 Care Homes for Older People Page 9 of 28 7535. Care Homes for Older People Page 10 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 11 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive good information about the home for them to make an informed decision about moving in and their needs are checked before they move in so they know that these can be met at Hartford Hey. Evidence: We saw a copy of the information that tells people how the home works, the service users guide, and this had been updated in April 2009. It is produced in standard print and plain English and can also be provided in large print. There is enough information about the home contained in the guide for people to decide if they want to live at Hartford Hey. The information included details of the where the home is, general information about it, its facilities and services and information about the staff and the manager. Photographs of the home were also included and comments from people who live in the home. Their views included, The cook does a marvellous job, there is always variety on the menu and staff are very kind, I feel the home is just right, The food is nice and the bed is comfortable, you cant wish for more and I have Care Homes for Older People Page 12 of 28 Evidence: been here quite a while and I am happy with the home. The updated guide also included information about the current fees for living in the home. The information about who the home is for, called the statement of purpose, contains all the details required including information about the owner of the home, its aims and quality policy. This document had been reviewed in April 2009 to make sure that it is accurate and up to date. A document was available for staff to use with people before they move into the home to check on what their needs are. This covers personal information, details of the next of kin and GP, medication and medical history and all health and personal care needs. This is used with information gathered from social services to make sure that people who move in can be well supported by the staff team. The manager confirmed that intermediate care was not provided at Hartford Hey. Care Homes for Older People Page 13 of 28 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 health, personal care and social needs of people living in the home are met effectively by the staff team in a way that enables them to maintain their privacy and dignity. Evidence: We looked at the care plans of three people who live at Hartford Hey, to check the care they receive. They were well written and each file contained details that had been obtained when the person moved in, relevant personal information, care plans and reviews. There were also details about visits from healthcare professionals to check on peoples healthcare needs, risk assessments and daily records. The daily records were completed over the day and showed each persons well-being and activities undertaken during that day. Details of any visitors they had received were also recorded so that staff and others could see that people were well and active. All the files had reviews of the care plans that had been done to make sure that these were up to date and still effective. Some of the people in the home were not able to confirm that they had been involved in planning or reviewing their own care; however Care Homes for Older People Page 14 of 28 Evidence: they were able to confirm that staff helped them when they needed it such as with personal care tasks. A form was included in the care plan that was signed by the person receiving care or their relative to show they were involved in the care planning process. Risk assessments were included in the care plans. These were up to date and had been carried out for activities such as bathing, activities of daily living which included moving and handling and falls, and possible risks to people around the home such as uncovered radiators. The risk assessments were completed to make sure that that people were safe in their daily activities and that any help they might need was identified. The medication for people living in the home is stored in a locked medication trolley. A monitored dosage system is used which is supplied by the local chemist. Medication administration record sheets were completed when medication is given to people by staff to confirm they have received their medicines as prescribed by their doctors. Staff had completed medication awareness training to help make sure that those who give out medication know how to do it safely so that errors do not happen. Visits from health care professionals were recorded and it was seen that GPs, district nurses, opticians, dentists, continence nurse and the chiropodist visited the home regularly to make sure people remain well. Care Homes for Older People Page 15 of 28 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. Social activities and meals are well managed so people living at Hartford Hey receive a varied diet they enjoy and they have daily variation and interest in their activities. Evidence: There is a book used to record activities that have been undertaken at the home. This showed that since January 2009, activities available have included bingo, quizzes, films, music, beauty treatments, ball games, exercises, darts, cooking, bowls, skittles and sing-a-longs. There is a computer play station for the people living at the home to use and entertainers visit throughout the year. Activities that people take part in outside of the home in the community are usually undertaken with support from family and friends. People have access to a range of activities within the home and people living there who we spoke with were satisfied with them. We suggested that the names of the people who have taken part in each activity should be recorded so staff can see easily who likes doing what and the activity programme can be scheduled accordingly. Other activities available include reading newspapers, visiting mobile library and church services. People who live at Hartford Hey can see their visitors in one of the two lounges, the conservatory or their own bedrooms. There are no restrictions on visiting and during Care Homes for Older People Page 16 of 28 Evidence: our visit to the home we saw that staff warmly welcomed visitors into the home and offered them refreshments. The meals are written up on a board outside the kitchen door each day. There is a choice of main meal and dessert each day. We looked at the menus and saw that the meals provided are mainly a traditional type that people living at the home would enjoy. The meals were home cooked and freshly prepared by the cook. The cook told us that she knew peoples preferences well and that some people had smaller appetites so they were offered a smaller portion. Most people liked the main choice of meal but an alternative was always available. At the time of our visit, apart from one person on a reducing diet no other specific dietary needs were required. The cook confirmed that she had cooked for people with diabetes, those needing soft diets and people with an intolerance for gluten in the past. Records were kept of the meals served, the temperatures of the hot meals as well as the temperatures of the fridges and freezers to ensure all food is kept at the appropriate temperature. Care Homes for Older People Page 17 of 28 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 homes procedures for complaints and safeguarding are effective so that the concerns of people who live at Hartford Hey are listened to and they are protected from abuse or harm. Evidence: We looked at staff files during our visit and these showed that staff had completed training about safeguarding adults. The manager confirmed this and showed that she was aware of the policy, procedure and guidance on safeguarding. There were also policies available in the home on restraint, safeguarding, signs of abuse, preventing abuse of a person in our care, suspicion of abuse, bullying, harassment and whistle blowing. The training and the policies helped to make sure that staff would know what to do to protect people living at Hartford Hey from abuse. No referrals had been made by the home over the last year under the local safeguarding procedures. The complaints procedure we saw was satisfactory and contained details of how to contact us. We have not received any complaints about Hartford Hey since our last inspection there. The home had not received any complaints over the last year. People who live at Hartford Hey said they would contact the staff or manager if they had any concerns or problems. During this visit we saw the compliments file and this contained a range of cards and letters showing appreciation for the support given to people who live at Hartford Hey, Care Homes for Older People Page 18 of 28 Evidence: family and friends. Some of the comments included The staff are very caring and The friendliness of staff and attention to detail is excellent. Care Homes for Older People Page 19 of 28 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. Hartford Hey is well maintained and furnished to an excellent standard so the people who live there do so in safe, comfortable surroundings. Evidence: During our visit we toured the building and we saw all the shared (communal) areas as well as a number of bedrooms. There are twenty-two single and three double bedrooms. Twelve bedrooms are en-suite. The standard of decor is excellent and the furnishings are good. The home was clean and free from unpleasant odours. People who live at Hartford Hey had made their bedrooms more homely using ornaments, pictures, photographs and some furniture they had brought with them when they moved in. People who lived at the home told us, The home is always clean and I like my room very much. A rolling programme of maintenance and redecoration takes place at Hartford Hey and over the last year nine bedrooms, the kitchen and lounge have been redecorated, and carpets had been renewed in the lounge and four bedrooms. There is maintenance support for the home to make sure it is looked after inside and out. A relative told us, the lounge is too hot; general cleanliness is poor. Standards have Care Homes for Older People Page 20 of 28 Evidence: dropped. The issue about the temperature in the lounge had already been brought to the managers attention and steps had been taken to resolve it. During this visit we found that the cleanliness was good and that the overall standards of the home had improved since our last visit. Care Homes for Older People Page 21 of 28 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. People living at Hartford Hey are supported by well trained, effective staff who have gone through a thorough recruitment process, so that peoples needs are met and they are safe from possible harm or poor practice. Evidence: The staff rotas showed the number of staff on duty over the week. There were three staff on in the morning and evening and they were supported by the cleaner, cook, laundry and maintenance people. People who live at Hartford Hey confirmed there were enough staff around to help them and during this visit we saw that staff were attentive to peoples needs. A relative had commented to us, I am concerned regarding staffing levels of 2 or 3 in an evening; staff having breaks together and no one around during this time for people who live at the home... However staff are very caring. Have raised issues but got no satisfactory response. During this visit we discussed these issues with the manager who said that she had not had a complaint from any relative about this. She confirmed that in the evenings the staff did have the breaks at the same time for ten minutes but that they sat near to the communal areas and if the call system, telephone or door bell rang then the staff took it in turns to answer this. We checked three staff files and they all had the necessary pre-employment checks in Care Homes for Older People Page 22 of 28 Evidence: place including identity checks, Criminal Record Bureau checks, references and completed application forms. These checks are carried out to make sure that staff are suitable to work with the people who live at Hartford Hey. The training staff had received included an induction course, moving and handling, safeguarding adults, fire awareness, food hygiene and first aid. Other courses included optical awareness, infection control, medication awareness, continence awareness and Is it Me?, a course on support of older people with mental health problems. We saw copies of certificates from training courses in staff files and this showed that staff had completed they training they need to provide good care for people living at the home. Staff meetings are usually held each month. However, the most recent meeting before out visit was in June 2009. The manager told us that a meeting was being planned for the near future. These meetings help make sure that the managers and staff know what is happening in the home, about any changes that are needed and that things continue to be run in the best interests of the people who live in the home. It was recommended that details of people who attended the meetings be included in the minutes of each meeting, as a record of who had attended. Good progress has been made with National Vocational Qualification (NVQ) level 2 in care. Eleven out of eighteen staff have obtained this award. Five staff are working towards NVQ level 3 in care and six staff are undertaking NVQ level 2 in care currently. This means that a good percentage of staff have a nationally recognised qualification in care to help them provide good quality support for the people who live at Hartford Hey. Care Homes for Older People Page 23 of 28 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. Hartford Hey is well managed with systems, policies and procedures in place to ensure the health and safety of staff and people living there are promoted and protected and that the home is run in the best interests of the people who live there. Evidence: The manager is a qualified nurse with many years experience in providing care for people. She has worked in care of the elderly for fourteen years. She has NVQ level 2 in care and NVQ level 4 in management. She knows the service well and can make sure that it is run well for the people who live there. There is a quality assurance process for the home which includes residents meetings which are held each month with records kept. These were seen at the time of our visit. The most recent meeting before our visit was held on 7 July 2009 and about half of the residents attended. The most recent satisfaction surveys were completed in August 2008 and were due to Care Homes for Older People Page 24 of 28 Evidence: be completed again during the Autumn 2009. They are given to people who live at Hartford Hey, their relatives, friends and other visiting professionals. It was recommended that an analysis of the responses be completed following the next surveys and this information shared with the people who live at Hartford Hey, any other interested parties and the commission. This would help to show that the views of the people living at the home were taken into account in planning future developments there. The manager confirmed that she looks after money for about half the people who live at Hartford Hey. Records are kept of all transactions made and these are signed by the staff member. We looked at records of several residents finances and found these to be correct. Each person has their own record sheet of expenses and the money is kept securely in the home so it is safe. The manager now ensures that funds are available as necessary for people living at the home so that they can spend their money as they wish. Also the balances and records of money kept on behalf of people living at the home are checked regularly to make sure they are accurate and up to date. Day to day supervision of staff was good and formal supervision is undertaken on a regular basis with records kept. Annual appraisals are undertaken with records kept. This ensures that staff have a chance to discuss their work with managers, so they can continue to provide good quality care for the people who live at Hartford Hey. Safe working practices were in place in the home. There was up to date safety checks on the homes electrical system and there was evidence to show that the gas safety has been checked on a regular basis. There were policies in the home about safe working practices and these included ones on risk taking, food hygiene, nutrition, health and safety, fire awareness and moving and handling. The home also had policies on smoking and non-smoking, which identify that within the home smoking is not permitted but a smoking area is available in the rear garden. We also saw the fire safety equipment tests log book and up to date checks had been made on the fire safety system and staff had received regular fire awareness training. This showed that the fire safety systems were working properly and that staff would know what to do to keep people safe if a fire broke out. During this visit we saw a range of policies and procedures and these were up to date and had been reviewed between February and May 2009. The home has a policy on gifts and signing legal documents. It states that staff are not permitted to directly accept gifts from residents or to sign as a witness any legal document. Care Homes for Older People Page 25 of 28 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 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 12 The names of the people who are joining in the activities should be noted in the log so that it can easily be seen who likes to do which activity. The names of the staff that attended the meetings should be included in the minutes of each meeting so that it is clear which staff attended the meeting. An analysis of the satisfaction surveys about the home completed by residents, relatives and others should be produced and shared with the people who live at Hartford Hey, their families, friends, the staff team, and other interested parties including the commission. 2 27 3 33 Care Homes for Older People Page 27 of 28 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. 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