Care Home: Heath Lodge

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What the care home does well People`s care needs are properly assessed and they are given the opportunity to stay at the home before they move in permanently. This helps them make an informed decision about whether Heath Lodge is the right place for them to live. People are given enough information about the home before they move in. The senior staff from the home visits them and they are offered the opportunity to visit Heath Lodge for a look around and to ask questions about how the service is delivered. This enables them to make an informed decision as to whether the home is the right place for them to live. People living in the home said: "Staff very caring and helpful we have a friendly atmosphere with both staff and residents." "It is well run with caring staff who always do their best. The office staff go out of their way to help with any administration or finance problems". "There is a very pleasant atmosphere. The staff are first rate" "I consider myself extremely fortunate to be at Heath Lodge and cannot speak too highly of the care and ancillary staff who always treat me with kindness and respect". Comment made by visiting Health Care Professionals were: "The home is fine, have always thought it was good". "Really friendly home, residents are always doing something, very helpful staff, it`s one of the homes I like to come to". On the whole most people said the food at the home was good. A good choice of food and drinks are available. This ensures that people receive a varied and nutritious diet. One person said via the surveys, "Food is nice, helpful staff, trips out". Visitors are encouraged and made welcome. When staff come for a job at Heath Lodge all the right references and police checks are completed. This means that it is less likely that unsuitable staff are employed to work at the home. What has improved since the last inspection? A requirement was made at the last inspection for work regarding three magnetic door closures and a fire retardant hatch needing to be fitted to the main kitchen and doors. This work has now been completed. What the care home could do better: Care plans should be updated to reflect how staff at the home make sure that they meet the personal care needs of people. This should include information on how staff actually support people to have a bath. Up to date care plans help make sure that staff meet people`s needs at all times, including assisting them with personal care such as bathing. Some of the communal areas such as the corridors in the home should be re-decorated to improve the standard of the environment for people living at the home. Key inspection report Care homes for older people Name: Address: Heath Lodge 6 Pannal Ash Road Harrogate North Yorkshire HG2 9AB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Irene Ward     Date: 2 1 0 7 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Heath Lodge 6 Pannal Ash Road Harrogate North Yorkshire HG2 9AB 01423709409 01423709930 info@harrogateneighbours.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Harrogate Neighbours Housing Association Limited Name of registered manager (if applicable) Type of registration: Number of places registered: care home 28 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Heath Lodge provides residential personal and social care for older people. There are 28 registered places, which include 6 places for people who require dementia care. The service users with dementia are cared for in a separate unit called the Alison wing, which is specifically designed for this purpose. The home is a detached property set in its own grounds approximately one mile from Harrogate town centre, where there are good amenities and transport links. There are attractive well-maintained gardens with level access and seating areas and a car parking area at the front of the building. Heath Lodge has two floors, which are accessed by a vertical passenger lift and bedrooms are on both floors. There are 28 single bedrooms, 5 of which are enCare Homes for Older People Page 4 of 29 Over 65 6 22 0 0 Brief description of the care home suite. Weekly fees range from 429 pounds for a standard single room to 490 pounds for a room in Alison wing. This does not include hairdressing, chiropody services and individual items like newspapers and toiletries. 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: 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: The quality rating for this service is 2 star good. This means that people who use the service experience good quality outcomes. The Care Quality Commission inspects homes at a frequency determined by how the home has been risk assessed. The inspection process has now become a cycle of activity rather than a series of one-off events. Information is gathered from a variety of sources, one being a site visit. More information about the inspection process can be found on our website www.cqc.org.uk This is what we used to write this report: We looked at information we have received about the home since it was registered. We asked for information to be sent to us before the inspection, this is called an annual quality assurance assessment (AQAA). We sent surveys to people who live at the home and to staff and Health Care Care Homes for Older People Page 6 of 29 professionals. One inspector visited the home unannounced. This visit lasted five hours and included talking to the new manager and deputy manager and the staff about their work and checking some of the records, policies and procedures the home has to keep. The site visit took place on the 21st July 2009. Mrs Angela Spittlehouse, Deputy Manager and the new manager Mr Robert Murphy were available to assist throughout the visit and available for feedback at the end of the day. We spent time talking with people who live at the home. We looked at four peoples care records to check that they contained the information that staff needed to provide support to people according to their needs and wishes. We focused on the key standards and what the outcomes are for people who use the service. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: Care plans should be updated to reflect how staff at the home make sure that they meet the personal care needs of people. This should include information on how staff actually support people to have a bath. Up to date care plans help make sure that staff meet peoples needs at all times, including assisting them with personal care such as bathing. Some of the communal areas such as the corridors in the home should be re-decorated Care Homes for Older People Page 8 of 29 to improve the standard of the environment for people living at the home. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are properly assessed prior to admission, this makes sure that Heath Lodge is the right place for them to live. Evidence: The deputy manager confirmed that information is made available to anyone interested in moving into the home in the form of a service user guide, before they move in. This information is provided to people who are considering moving to the home, relatives or to care managers from local authorities. There have been several new admissions into the home since the last inspection visit. The deputy manager said that people are always given the opportunity to visit the home before they make a decision as to whether they wanted to live there. This was confirmed by one person who said that they had stayed in a guest room to see if they liked it. Four peoples files, one of which had recently moved into the home, were looked at in detail and confirmed good practice. Assessments were carried out before people Care Homes for Older People Page 11 of 29 Evidence: moved into the home and contained details of every aspect of peoples daily life and health needs. Examples of the information included were daily living, peoples background and life history and peoples long term needs. This was confirmed by a visiting relative who said that the home puts themselves out and that two staff visited her relative (who at the time lived in a different part of the country) to carry out an assessment to make sure the home could meet her needs. Separate files held copies of terms and conditions or contracts which had been agreed and signed by people living at the home or their representative. Contracts are available in different formats such as large print. People spoken to on the day said they liked living at Heath Lodge. People made positive comments on the day and in the surveys that were returned to us such as: Very friendly and caring home. Heath Lodge is excellent in every area of concern. The staff are admirable, the accommodation exceptionally clean, there are regular activities and the feedback to close family is very good. I consider myself extremely fortunate to be at Heath Lodge and cannot speak too highly of the care and ancillary staff who always treat me with kindness and respect. The home does not provide intermediate care. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal and health care is provided appropriately and sensitively according to individual needs. However further improvements should be made to care plans, so that they are clear for staff to follow when providing personal care, such as bathing. This makes sure that peoples personal care needs are always met. Evidence: Each person living at the home is registered with a General Practitioner. There are nine GP practices involved in looking after peoples health care needs at the home. People are able to have a female GP if they so wish. Other health care professionals are involved with peoples health care needs such as the optician, chiropodist and district nurses. Peoples health care needs were recorded in their individual care plans. Most areas were well detailed. However areas, such as supporting people with bathing, were not as well documented in how staff actually support people when assisting them to bathe. Care plans should have step-by-step instruction as to how people wished to be supported including when they are bathed. Care plans on the whole were well detailed and covered all areas of daily living. They also included details, such as risk assessments, nutritional assessments, mental capacity act Care Homes for Older People Page 13 of 29 Evidence: assessments, peoples likes and dislikes and peoples life history. Any changes to peoples health care needs are also recorded in daily records contained within their care plan. Staff were observed using disposable aprons and gloves. Anti-bacterial gel dispensers were discreetly fitted around the home. This maintains and promotes good levels of hygiene control. The home operates a key worker system. This means that individual care staff have responsibilities for a specific people, in making sure their overall care needs are consistently being met. Risk assessments were in place and help identify potential risks to people. This helps the staff to put into place arrangements which may minimise the risks. Waterlow assessments for people who have been identified as being at risk of developing a pressure sore, were also contained in peoples care plans. Nutritional risk assessments had also been completed and identified peoples likes and dislikes and helps make sure people are eating properly. People living at the home attend Harrogate District Hospital for all A & E (Accident and Emergency) and for most out patient appointments. A visiting GP was spoken to on the day of the inspection. They said The home is fine, I have always thought it was good. A visiting health care professional who was visiting the home was also spoken to on the day of the inspection. They said Really friendly home, residents are always doing something, very helpful staff, its one of the homes I like to come to. During the morning the staff were observed as being pleasant, courteous and helpful and there was a sense that staff really cared about the people they look after. Staff spoke and interacted with people and had a cheerful banter with them. When speaking to people who live at the home they made positive comments about the staff and the care they receive. Eight surveys were returned from people living at the home. All were satisfied with the service they receive from the home. All surveys said that people receive the care and support they need and that staff always listened to them and were available when needed. Six surveys were returned from relatives who made comments such as: They take care of my mothers health and wellbeing. As far as I am concerned Heath Lodge does everything well for my mother. I am extremely happy that she is there and confident that they do everything to care for her. The standard of hygiene and cleanliness is very high as is the quality of food provided. They look after my mother to the best of their ability. I have an excellent relationship with the staff and can talk to them about anything. When relatives were asked What the home could do better? they said: Liaison with Care Homes for Older People Page 14 of 29 Evidence: relatives over matters such as clothing requirements, medical appointments, optical, chiropody, etc. Could make better use of technology to communicate with relatives and maintain cash floats etc. Provide better personal care in terms of hygiene i.e. washing/shaving/cleaning teeth etc.(my father has Alzheimers and does not always know what to do with a razor, tooth brush. So simply putting one into his hand or telling him to do it is not enough. Also trips out. This matter was discussed with the deputy manager who explained that this had occurred when the home had used agency staff and in future they would make sure that this would not happen again. When relatives were asked, Is there anything else you would like to tell us? they said: We would be at a loss without Heath Lodge - little in life meets my mothers expectations so it is a great credit to Heath Lodge that she settled from day one. Three surveys had been received from health care professionals who when asked What do you feel the care service does well? answered: Good communication between staff members and outside agencies (such as ourselves) The patients we visit are happy and well cared for and needs are addressed. Asks for help from specialist services. When asked what the home could do better one health care professional commented: Increase training for all staff who work with people with mental health problems, reducing the risk of agitation and reducing the risk of incidents. Clearer and more accurate documentation. When asked Is there anything else you would like to tell us? one health care professional said: There is not a great deal that I can contribute to this survey. I only visit when a resident or relatives request my services. However if staff notice that a residents feet require treatment I am contacted. The staff always appear to have the residents best interest at heart and they do their best. The home operates a monitored dosage system for medication. There is a policy in place for the safe storage and administration of medication for all staff working in the home to follow. The Medication Administration Records (MARs) show that everyone receives their medication as prescribed. Records were up to date and well maintained. Medication seen in the home was securely stored in a locked drugs cabinet. Controlled drugs were stored appropriately and records were maintained as required. All staff that administer medication in the home have been provided with medication training. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home have the opportunity to participate in various activities and are supported by staff to carry these out. Evidence: People who live at Heath Lodge have the opportunity to participate in various activities, such as flower arranging, knitting and discussing current affairs, singing afternoons, exercise class, bingo,individual quiz and jigsaws, summer fair, musical afternoons, big band sound, holy communion, pat-a-dog, film afternoons, trips out, gardening, jewellery making, carer led activity, nails care, individual walk and talk, summer collage and picture making. During the morning of our visit there were people sat doing a crossword in the conservatory. In the afternoon a group of several residents were jewellery making in the dinning room. People spoken to on the day said they enjoyed living at the home. They were all enjoying making jewellery and had sold quite a bit of it at the summer fair. A list of activities both for the main home and the dementia care unit are on display on the notice board in the home. Staff are committed to people being stimulated, motivated and they are encouraged to participate and try new activities on a regular basis. Relatives spoken to confirmed they were able to visit at anytime and were always Care Homes for Older People Page 16 of 29 Evidence: made to feel welcome and are always offered a drink. The deputy manager is fully aware of issues regarding peoples mental capacity and the need to put into place the necessary protocols, for the home to deal with such matters on behalf of people who require day to day decisions being made on their behalf. Mealtimes were discussed with the chef manager on the day of the visit. Menus seen were on a four week rotation. Menus were varied and nutritionally balanced. The lunch seen on the day of the site visit looked appetising and people were observed enjoying their lunch. The chef manager said that the home caters for special diets such as diabetics. Staff were available, helped people in a dignified manner and the atmosphere was calm and relaxed without people being rushed. People have choices and are offered a cooked meal or sandwiches and a desert at teatime. The main cooked meal is at lunchtime. People on the whole spoke highly about the food provided by the home and made comments such as: Food, nice helpful staff, trips out. I consider myself extremely fortunate to be at Heath Lodge and cannot speak too highly of the care and ancillary staff who always treat me with kindness and respect. Take care of my mothers health and wellbeing. Heath Lodge is excellent in every area of concern. The staff are admirable, the accommodation exceptionally clean, there are regular activities and the feedback to close family is very good. Food sometimes good. Staff are very good,especially senior staff The home is lovely, food can vary, some days are better than others. Staff are fantastic and her key worker is good. Spends time with her and talks to her. The housekeeper is excellent. Mum loves her food,and the home is always spotless. When people were asked what could the home do better? They said: More variety with meals. More interesting food. More day trips. Nothing the staff are excellent. The EMI unit would with considerable advantage be enlarged to allow more space for residents to move about. But this is the only downside of such a small unit(6 residents). The up side is the homely atmosphere and the fact that staff know the individual residents so well. When people were asked Is there anything else you would like to tell us? people said: Nowhere to keep electric wheelchair other than in the room. Comments received from relatives were also positive and they made comments such as: As far as I am concerned Heath Lodge does everything well for my mother. I am extremely happy that she is there and confident that they do everything to care for Care Homes for Older People Page 17 of 29 Evidence: her. The standard of hygiene and cleanliness is very high as is the quality of food provided. Provides an extremely caring compassionate environment in which residents feel at home. Good variety of activities/trips for residents. High quality of food. I looked around fifteen homes in the Harrogate area - Heath Lodge was the best EMI unit in most respects despite its small size. I was very pleased to find my relative a place where I believe they are as happy as they could be. Care Homes for Older People Page 18 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have access to an effective complaints procedure and are protected from harm. Evidence: A comprehensive complaints procedure is followed and is made available to people and any other interested parties. The complaints procedure was on display in the main foyer of the home. The home had received one formal complaint since the last key inspection. This had been appropriately dealt with by the home and records had been maintained. No complaints have been received by the Care Quality Commission. People when asked were clear as to whom they would speak to if they had any concerns or worries. All said they would speak to the homes manager, deputy manager or staff at the home. There is a policy and procedure with regard to safeguarding adults and the procedure to take if there is a suspicion of abuse. Staff demonstrated a good awareness of this. Staff receive training in adult protection and safeguarding issues during induction training and further training when required. The deputy manager said that safeguarding training is completed annually by staff. There have been no recent allegations regarding safeguarding made to the home or to the Care Quality Commission. Care Homes for Older People Page 19 of 29 Evidence: Appropriate recruitment procedures are followed, with references and Criminal Records Bureau (CRB) checks made to reduce the risk of unsuitable people working in the home. Peoples finances were found to be appropriately managed, with receipts being obtained for all purchases made. Care Homes for Older People Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean, comfortable and safe home that is decorated and furnished to a good standard. Further improvements could be made by re-decorating some of the communal areas, such as main corridors. Evidence: The home provides spacious accommodation for people, that is based on two floors. This includes a lounge, conservatory and dining room on the ground floor. There are sufficient bathrooms and toilets on both floors. There are five bedrooms with en-suite facilities. Peoples rooms on the first floor are accessed by the use of a vertical passenger lift or stairs. Two peoples bedrooms were seen and both had been personalised with all their own possessions. People said they had brought some of their own furniture when they moved in. Flowers and pictures were on display throughout the home. The home has a separate wing named Alison Wing, which is specifically for people with dementia. This accommodates up to six people. There is a lounge, dinning room and bathroom and six bedrooms. There is a safe and secure fenced garden which is accessed from the dining room. The home was spotlessly clean in all of the communal areas, the kitchen was also clean and everywhere was free from odours. There were alcohol gel dispensers Care Homes for Older People Page 21 of 29 Evidence: discreetly fitted in certain areas of the home. This maintains and promotes good levels of hygiene control. The home was decorated to a good standard through out. Although some of the communal areas, such as the main corridors the decor was looking tired. The home had already acknowledged this in the information they provided to us before the inspection and have said that they intend to address this. At the last key inspection some work regarding three magnetic door closures and a fire retardant hatch that needed to be fitted to the main kitchen and doors leading from this area was outstanding. A requirement was made to have this addressed and the work has now been completed. People living at the home said that the home is always fresh and clean. People said: Heath Lodge is excellent in every area of concern. The staff are admirable, the accommodation exceptionally clean, there are regular activities and the feedback to close family is very good. The housekeeper is excellent. Mum loves her food,and the home is always spotless. To the outside of the main house there is a large garden to the front which is enclosed and safe for people to sit in. There is a large car park. Regular maintenance checks are carried out. The home employs a maintenance man and a Gardener. Care Homes for Older People Page 22 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to support people who use the service. Evidence: Staffing levels were sufficient for meeting the needs of people living at Heath Lodge. The duty rota showed that there are usually four members of care staff on duty both in a morning and afternoon. This does not include the managers hours. The home also employs a number of ancillary staff such as domestic staff, kitchen staff, A maintenance person, housekeeper and administrative staff. We looked at three staff records to make sure the home were employing suitable people for the job. We found all the necessary pre-employment checks had been carried out prior to the new workers starting in post. All records showed completed application forms, two written references, CRB (Criminal Record Bureau) checks had been obtained. Staff records showed that they received regular supervision and appraisals from their managers. There is an induction programme in place that ensures new staff members are given the right information to be able to do their jobs well. The National Vocation Qualification Level 2 (NVQ) training has been completed by five Care Homes for Older People Page 23 of 29 Evidence: staff at the home. NVQ Level 3 has been completed by five staff. Four staff are currently completing their NVQ Level 3.The new manager holds the Registered Managers Award NVQ level 4 in Care. Staff confirmed in the surveys they returned to us, that they received regular supervision. Records of supervision were seen at the site visit to the home. Staff commented positively about the support they receive from the management team. When asked what does the service do well? staff made comments such as: The staff at Heath Lodge are very passionate about their work. They also work very hard. All the residents are very happy. They all socialise very well with each other. Heath Lodge is a very happy care home. Heath Lodge cares very well for the residents. It is a very clean environment and the staff are very caring and well trained. It is a pleasure to work in this home. When asked what could the service do better? staff said: Communication could be better between all departments within the home. Improve holidays for staff on very low pay especially the care assistants who work very hard. Nothing as everything is of very high quality. People living at the home spoke positively about the staff. Records confirmed that regular staff meetings take place. Care Homes for Older People Page 24 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a well managed home, in which their needs and wishes are put first. Evidence: The deputy manager has worked at the home for sometime. The new manager had only been in post for six weeks. The ethos of the home is open and positive. People who use the service, relatives, health and social care professionals and staff all commented highly about the home. Regular residents and staff meetings are held and minutes are taken. Peoples finances were checked at this site visit. There was evidence that their financial interests are safeguarded by the systems the home has in place. Information provided from the Annual Quality Assurance Assessment (AQAA) and the examination of selected health and safety documents show that regular checks to electrical equipment, such as the passenger lift and fire safety equipment are regularly Care Homes for Older People Page 25 of 29 Evidence: undertaken. The deputy manager told us that the annual checks for health and safety are in place. Records of hot water temperatures are kept, to make sure that safe temperature levels of hot water are maintained. All accidents are recorded as required and an accident book is maintained in line with the requirements of Data Protection. The home carried out a Quality Audit in May 2008 and questionnaires were given to people living at the home and their relatives. They have produced a report which details the findings from the audit. Comments made from people who live at the home were all positive. 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 1 7 Care plans should be updated to reflect how staff at the home make sure that they meet the personal care needs of people.This includes how staff actually support people to have a bath. This makes sure that staff meet peoples needs at all times including assisting them with personal care such as bathing. Some of the communal areas in the home, such as corridors, need to be re-decorated. This will improve the standard of the environment for people living at the home. 2 19 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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