Care Home: Henwick Grange

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What the care home does well Henwick Grange Nursing Home provides a safe environment for people to live in. There is a relaxed and friendly atmosphere in the home, and staff were observed interacting with the residents. We were told by relatives and individuals that they had been provided with sufficient information about the home to assist them to make an informed choice prior to moving in. The manager encourages people to visit the home before making up their minds. All people are assessed before moving into the home to ensure that the home can meet their health and physical needs safely. People using the service told us that they have their health and personal care needs provided in a polite and courteous way, and their preferences about their care is respected. The staff told us that the home is committed to them receiving training, and that they have the skills and knowledge to meet the care needs of the people living there. The home has a thorough recruitment procedure in place so that only people suitable to work with vulnerable people are employed. People living at the home receive a well-balanced and varied diet that meets their nutritional and dietary needs The home is managed in the interests of the people who live there. The health and safety of the people who use the service are protected by the policies and procedures in the home. What has improved since the last inspection? Care plans and risk assessments have been further developed to assist the staff in ensuring peoples preferences are respected in how their care is delivered. Environmental improvements a treatment room has been developed to assist in the safe storage of medication in the home. The dining room and some bedrooms have been redecorated which enhance the appearance of these areas. What the care home could do better: This inspection made no requirements or recommendations and complemented the service on maintaining and improving the service provision to a good standard throughout all the key standards. Key inspection report Care homes for older people Name: Address: Henwick Grange 68 Hallow Road St Johns Worcester Worcestershire WR2 6BY     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: Christine Potter     Date: 2 6 1 1 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: Henwick Grange 68 Hallow Road St Johns Worcester Worcestershire WR2 6BY 01325351100 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Southern Cross OpCo Limited Name of registered manager (if applicable) Mrs Jeanette Bedford Type of registration: Number of places registered: care home 56 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users to be accommodated is 56. The registered person may provide the following category of service only: Care Home with Nursing (Code N) To service users of the following gender: Both Whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category (OP) 56 Physical Disability (PD) 56 Dementia (DE) 56 Date of last inspection Brief description of the care home Henwick Grange Nursing Home is a large Victorian building with purpose built extensions. The home stands in pleasant well maintained gardens, providing seating for residents and relatives to sit outside when the weather permits. The home is Care Homes for Older People Page 4 of 29 1 2 0 2 2 0 0 9 56 0 56 Over 65 0 56 0 Brief description of the care home conveniently situated within the boundary of the City of Worcester. There is ample parking at the home for visitors and a frequent bus service to and from the City. The home provides a vehicle for transportation of residents, which is suitable for people with a physical disability. The home changed ownership last year and is now owned by Southern Cross Op Co Limited. The home is registered to provide nursing care and accommodation for a maximum of 56 residents with dementia, a physical disability or frailty due to old age. There is good access into the home via a touch pad operated automatic door. Accommodation is provided over two floors with a passenger lift providing access to first floor rooms. Up-to-date information relating to the fees charged for the service is available on request from the home. 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 focus of inspections undertaken by the Care Quality Commission (CQC) is upon outcomes for the people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provisions that need further development. We visited the service during the day on the 26th November 2009 the last Key inspection was the 12th February 2009 . We spent time observing daily life, and we met with people and relatives who use the service. We spoke to staff and the manager who was present throughout the inspection. We looked at care files and records completed by the service which must be kept by the home to show that it is being run properly. Before we visited the service we looked at the information we had about the service Care Homes for Older People Page 6 of 29 since the last inspection. This included an annual service review, notifications of incidents sent to us by the service, surveys sent to us by people using the service and the Annual Quality Assessment. The Annual Quality Assessment is completed by the manager and should tell us how well the home think they are performing and should give us some information about the home, staff and people who live there, improvements and plans for improvement which we would take into consideration. 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: 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. Care Homes for Older People Page 8 of 29 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have enough information to assist them before moving in, so that they know what the home provides, and what they can expect when they move in to the home. Evidence: Henwick Grange offers a range of information about their service including their Service User Guide. This information is available to help people and their families decide whether they wish to live at Henwick Grange Nursing Home. One resident told us that they had received the information and been invited for a trial visit prior to them moving into the home. We saw copies of the Service Users Guide in the reception area of the home. The home can also provide the information in other formats including large print, and audio if this is required. Information about activities taking place, and photographs of activities undertaken were on display in the reception area of the home. We looked at the pre admission assessments for three people who had recently moved Care Homes for Older People Page 11 of 29 Evidence: into Henwick Grange. We saw that detailed assessments had been completed and this included individual profiles, completion of the admission register, and medication details. People using the service and relatives confirmed that the manager had visited and assessed their relative prior to them being admitted to the home. We received 25 completed surveys from people using the service who confirmed that they had received enough information about the service. An example very clean caring and polite, I now feel at home and I am very happy with the care and attention given to my ------. One person confirmed that they had been assessed prior to admission, and visited for a trial session before making up their mind about the home. They told us that they were pleased with the choice of home and stated that there is not anything that is not done well. All staff we spoke to were able to demonstrate the individuals care needs. They also stated that they were provided with sufficient information about new people to enable them to meet their care needs. We saw signed copies of terms and conditions of admission to Henwick Grange. Which had been completed following the persons admission and a copy had been filed within the individuals care records. The AQAA received from the home clearly described how the home were meeting these standards. In the last 12 months improvements they have made to improve their service include, all documentation improved, the care plans are more person centered and training reiterated to old and new staff. The Service User Guide has been updated. 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. The health and personal care people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: The last key inspection rated these standards as adequate and noted the improvements made to the care plans and risk assessments for the residents. This assists staff in understanding the residents and how to deliver the care. This inspection found by examination of three residents care plans that there had been further improvements. We saw that the care plans had been developed from the pre admission assessments, and where possible the residents had been involved in the planing, development and review of their care plans. The care records showed the personal healthcare needs including specialist health, nursing and dietary requirements are clearly recorded in each persons record. The care records also provided information for the staff to assist them in delivering the Care Homes for Older People Page 13 of 29 Evidence: care for social, medication, communication, death and dying, skin care and dependency assessments. We spoke to various grades of staff who were able to provide clear information about the individuals and how they care for them. Staff were aware of people choices and confirmed that they respect peoples preferences for example what time they like to get up and return to bed. Individuals preference for male or female staff to deliver personal care is respected. Comments from people using the service included:I am very happy with the care and attention given to my ------ staff are always helpful and friendly very clean, caring and polite, I now feel at home. From reviewing the care plans we could see that people are well supported by their doctors, district nurses and other health care specialists as required. The manager confirmed that residents have a choice of doctor and health care professionals to support them with meeting individuals healthcare needs. A good range of specialist equipment is available to assist staff in meeting the health and personal care needs of the people living at Henwick Grange. A good range of pressure relieving equipment which is recorded in the health care needs assessment. Staff told us that the home had sufficient pressure relieving equipment to care for the residents prone to skin pressure damage. Staff also confirmed that they received training to use the equipment as part of their induction training prior to commencing. Since the last inspection the home has upgraded a room to provide a secure treatment room for the safe storage of medication. This was in the process of being completed at the time of the inspection. The home has good procedures in place for the management of medication. We looked at three peoples medication records and they had been completed by the nurse who administered the medication. The manager completes a monthly audit of the medication system and these records were looked at and support that the nurses are adhering to the homes medication policy. Nurses told us that they had received medication training in the last 12 months to assist them in keeping up to date with changes in medication. Peoples privacy was seen to be maintained by the staff, they were knocking on doors before entering and speaking to people courteously. Residents and relatives confirmed that staff respect residents privacy and dignity. Everyone appeared contented during the inspection and were seen enjoying the Care Homes for Older People Page 14 of 29 Evidence: activities, visits from family, watching television and reading newspapers. There was a friendly relaxed atmosphere throughout the home, and all staff were polite and courteous and enjoying laughter with people. The AQAA received from Henwick Grange told us how they are meeting these standards by employing both general and psychiatric nurses. This helps to meet the health and psychological needs for people who live at Henwick Grange. In the section what they could do better they have included, continue to monitor and review care practises, and care planning. The section improvements in the last 12 months includes, better personalised care plans, implementing a 48 hour care plan on admission on time. Introduction of the advanced care planning record. 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 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 Henwick Grange are supported to take part in activities, maintain their interests and their religious beliefs. People are able to keep in touch with family, friends and representatives. They have nutritious and attractive meals and snacks, at a time and place to suit them. Evidence: The last key inspection rated these standards as good. At the moment two staff are employed to arrange activities for the people living at Henwick Grange over the seven days. We spent time with one of the activity co ordinators talking about their job, current activities and future activity plans. On display around the home were photographs and some of the peoples art and craft work. Some of the activities arranged include gardening club, pat a dog, exercise class with musical instruments. They are currently making up sensory boards for the people with dementia which have a textured touch for them. They are encouraging relatives to assist them in making up memory boxes for the residents to include old photographs, and memorabilia items for them. They have a monthly concert which the majority of residents participate in. In the mornings they tend to do more one to one activities and group activities in the afternoons. Staff and residents were excited about Care Homes for Older People Page 16 of 29 Evidence: the pantomime being performed by some of the staff. The home has a computer in the lounge that residents can use if they wish to. Residents told us that they when they move into the home, they are asked questions about what time they prefer to get up, go to bed, whether they prefer male or female carers. The home then respects their wishes, and if they decide to stay up late this is respected by the carers. From the surveys received from prior to the inspection and comments from visitors on the day of the inspection, all were complimentary about the home. All said that the staff were friendly and made them feel welcome when they visited. Relatives were seen coming and going during the day and made welcome by the staff. One resident told us I would not wish to live anywhere else. For visitors there is a staff board in the reception area for relatives to see who is on duty, and a copy of the homes newsletter so people can see what is going on. The home provides varied well balanced meals for the residents and caters for cultural and dietary needs. The manager told us that the residents have a lot of input into the food choices, and the menu provides a varied choice and rotates four weekly. If people request an alternative this is accommodated for example one person prefers curry and spicy food. Meal times are breakfast 08:00am, lunch 12:00pm, 16:30 to 17:00pm tea, in between the home provides hot drinks and snacks, we observed the tea trolley offering people a choice of fresh fruit or cake with their hot drinks. The last inspection recommended that the home review the serving of meals on the first floor to maintain a hot temperature. This has been addressed and all meals are served from heated trolleys. The recent environmental health officers visit awarded the kitchen a four star rating which is good. Comments received from people living at the home about the food includedthe food is wonderful Staff also told us that the quality of food was good, but would appreciate an extra staff member to assist at lunch times given the high dependency of residents and those that required assistance with their meal. The gardens are well maintained providing a pleasant outlook from the home. The gardens won a Worcester in Bloom certificate this year. Plans are in hand to provide additional seating for people to sit outside when the weather permits. The AQAA received from the home showed how they are meeting these standards. Included in the section for what they could do better, to expand on the social care plans. Recorded in the section improvements in the last 12 months, increased Care Homes for Older People Page 17 of 29 Evidence: visiting entertainment and external visits. They have arranged and provided training for staff on person centred care and implemented dignity in care champions. They have implemented a dementia team. They have reviewed and updated the menu with the people living in the home. plans for improvement in the next 12 months include better links with the community, and further develop the social care plans. 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 are able to express their concerns, and have access to a robust, effective complaints procedure. They are protected from abuse, and have their rights protected Evidence: The last key inspection rated these standards as good, and gave no requirements or recommendations. This inspection found that the home remain good for these standards. People using the service and relatives told us they were aware of the complaints procedure, including how to complain to the Care Quality Commission by way of information provided by the home, e.g. the Service Users Guide and notices displayed in the homes reception area. Records demonstrated complaints are investigated by the manager and or area manager and responded to within given timescales. Review of the current accident book showed no occurrences, or trends, in the nature and type of reported accidents. The homes thorough approach to the prevention and management of incidents, such as falls, was evident through crosschecking with the individual documentation. These showed people recorded as having had falls, had all been risk assessed with regard to their mobility and potential for falling. The home operates an open door policy to allow residents and visitors to voice their Care Homes for Older People Page 19 of 29 Evidence: concerns at any time. Residents and relatives confirmed to us they would have no hesitation in raising concerns they might have. Relatives and residents are supported to share their views and give feedback on the service through their regular meetings. Policies and Procedures on whistle blowing and advocacy information is available on display for all everyone, and all staff receive abuse training during their induction. We had discussions with four staff, all of whom were able to describe the action they should take if they were in receipt of a complaint, or observed abuse of a resident. Training records confirmed they had all received relevant adult protection training. The AQAA received from Henwick Grange told us how they are meeting these standards, and provided information about how they evidence this. Under the section for improvements in the last 12 months they have included improved training for the staff including all grades of staff have commenced external training NVQ in food, care and management. All registered nurses have completed the safe handling medication course. 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. Residents of Henwick Grange enjoy a comfortable and homely environment. The home is spacious and is kept clean and well maintained. Evidence: The last key inspection rated these standards as good, and the improvements from the previous AQAA have been implemented. Since the last key inspection Henwick Grange have reviewed the use of some of the bedrooms, so are now able to accommodate 47 people, the manager told us that their are plans to reduce the occupancy levels to 45. The treatment room for storing medication is almost complete, the dining room has been redecorated and is awaiting new curtains, and several bedrooms have been redecorated. Henwick Grange Nursing Home is a large Victorian building with purpose built extensions. There are pleasant well maintained gardens, providing seating for residents and relatives to sit outside when the weather permits. There is good access into the building via a touch pad operated automatic door. Accommodation is provided over two floors with a passenger lift to assist people with mobility problems to access all areas of the home. We looked at parts of the home that included some residents bedrooms. The home is Care Homes for Older People Page 21 of 29 Evidence: well maintained, attractively furnished and has a pleasant atmosphere. There were no odours noticeable during the inspection visit. Dedicated staff are employed to keep the environment clean and welcoming. The laundry room is located in a separate building in the grounds. All cleaning materials are locked in the laundry room. Staff were seen using personal protective equipment suitable for the work they were doing. The manager said that all staff complete infection control training and records confirm this. Routine repairs are carried out in house and maintenance records are kept. The AQAA received from Henwick Grange told us how the home continues to meet these standards. Included in the section what the home could do better included complete the planned refurbishment for the home, and increase the seating in the gardens for the residents to use. 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. Training is provided to help the staff provide the care and support people living at Henwick Grange need. All checks are completed to make sure that suitable staff are employed to keep the residents safe. Evidence: The last key inspection rated these standards as good, and this inspection found they have maintained these standards. The manager told us about how staff allocation in the home. The two floors are staffed separately the ground floor for 26 people with one nurse and five carers on days. The first floor for 21 people has one nurse plus four carers on days. The manager is supernumerary to the duty rota. Staff told us that they had enough staff on the variable shifts to enable them to meet the health care needs of the residents. One member of staff recommended that it would benefit the people living in the home if an additional person were able to assist at meal times. Staff confirmed that it is a pleasant atmosphere to work in and the manager and all staff are supportive. They acknowledged that they are provided with sufficient information about residents and have regular hand overs where any changes in the residents are reported. Comments about the staff from people using the service included: they employ very caring staff, they are all friendly not only to the residents Care Homes for Older People Page 23 of 29 Evidence: but also the visitors. They are respectful and always close the door when attending to residents. I am very happy with the care and attention provided at the home staff are always helpful and friendly. A review of three staff files relating to the most recently employed staff demonstrated recruitment practices to be satisfactory, with all elements required by the Care Homes Regulations being completed, and evidence retained on file. This included confirmation of address and identity. All applicants complete an appropriate application form and Henwick Grange ensure references are obtained prior to offering a position. Appropriate criminal records and other checks such as checking nurses are registered with the Nursing and Midwifery Council (NMC), are done. Staff confirmed that the checks had been completed prior to them commencing and they had received induction training and shown how to use equipment. We looked at the training records for the staff and the service have prioritised in this area. Mandatory training such as health and safety, fire safety, food hygiene, moving and handling, infection control, nutrition, communication and other specialist training to assist staff in meeting the needs of the residents. The AQAA received from Henwick Grange clearly told us how they are meeting these standards. The AQAA informs us that 13 staff have completed NVQ level two or above in care. 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 living at Henwick Grange can be confident that the management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a competent manager. Evidence: The last key inspection rated these standards as good, and this inspection found that these standards have been maintained. Since the last inspection the manager (Jeanette Bedford) has formerly registered with the Care Quality Commission. Jeanette has completed the NVQ level 4 in management and the registered managers award. Jeanette is enthusiastic about the home in ensuring that standards and good care are maintained. She is currently completing a diploma in dementia care. All people using the service and staff complimented Jeanette and told us she was supportive and always available to talk to. We are so lucky to have the right person as manager here. Care Homes for Older People Page 25 of 29 Evidence: The manager completes monthly audits in medication, wound care, infection control and accidents to assist in monitoring the homes performance and also ensure staff are following correct procedures. Feedback is encouraged from the people using the service, relatives and professionals using the service. The comments from the doctors and social workers covering the home have been complimentary. The home does not take responsibility for residents monies. Invoices are sent to the nominated person for payment. Small amounts of money for newspapers and hairdressing can be held by the home and records of this are audited frequently. The home employs a maintenance operative who has a well organised system for ensuring that the safety checks are completed, the fire records requested were available and up to date. All staff attend regular meetings, and have supervision six times a year, followed by an annual appraisal. Staff spoken with confirmed this and how useful they found the supervision sessions. The AQAA received from the home told us clearly how the home are meeting these standards. Information included that they hold monthly health and safety meetings and deal with issues as they arise. The manager has completed the registered managers award and is an NVQ assessor. Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 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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