Care Home: Hillbrook Grange

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What the care home does well There is a full assessment procedure from the initial enquiry to a stay in the assessment flat. This enables both the person who is thinking of moving into the home and the staff to make sure that Hillbrook Grange is the right place for them. A comprehensive care plan is completed from the assessment which provides the care team with vital information to help them meet health and personal care needs. Peoples privacy and dignity are respected and this was evident during our visit such as knocking on bedroom doors before entering and the way in which the care workers spoke with the people who lived there. A varied programme of activities was available for residents to choose from with regular outings taking place throughout the summer months and special events organised for occasions such as Easter and Christmas. On the day of our visit there was a craft class and one of the ladies showed us what she had made and she was very proud of it. We received two comments from the surveys which said that `the staff are very caring and provide plenty of activities for the residents, the food is excellent;` ` there are different kind of activities so everyone can find something interesting`. However one person thought that there could be more activities aimed specifically at the male residents. There was a complaints procedure in the service user guide, a copy displayed on one of the notice boards in the entrance hall. Peoples views were sought in a number of ways such as; a suggestion box on the table directly in front of the main entrance, questionnaires, committee members talking to the people who lived at the home on a regular basis. We received no complaints from any of the people who we spoke with during our visit or from the people who completed a survey form. The home and grounds are well maintained with a number of different areas for people to sit, both inside and outside of the home. The home was clean and free from any offensive odours. Residents were encouraged to personalise their bedrooms. One person commented that the home was spotlessly clean and hygienic throughout. New flat screen televisions had been purchased and a surround sound system provided in one of the lounges. There was a stable staff team with many of the staff having worked at the home for many years. Training was continuous with mandatory and National Vocational Qualifications being taken by the care workers. One of the care workers who completed a survey form said that `Hillbrook organised enough training for staff which gave a good knowledge about work in health care`. People said that the attitude of the staff was kind and caring. The organisation employed consultants to assist with health and safety, record keeping and employment legislation. The committee and the senior managers ensured that the home was run in the best interests of the people who lived there. IT systems had been improved so that information was more accessible to keep people up to date with the latest legislation, policies and procedures. What has improved since the last inspection? The care plans were now written using the computer which made them easier to read and easier to keep up-to-date with the most recent information. The committee have had major work done to the roof of the oldest part of the house and are to replace the flat roof over the kitchen and dining room with an apex roof. Bedrooms have had the fitted furniture and vanity units upgraded. Rooms as they become vacant are re-carpeted and re decorated. The committee have appointed a general manager who worked part-time alongside the executive and homes committee chairperson and the registered manager. Both the chairperson and the registered manager said that this was working well. A room had been dedicated to the keeping of medication and records which was locked at all times keeping people safe. The management responsible for the day-to-day management of the home continued to look for ways they could improve the service for the residents and staff team. What the care home could do better: We did discuss with the manager some minor improvements that could be made to record keeping procedures which she said would be implemented. There are no requirements or recommendations made in this report. Key inspection report Care homes for older people Name: Address: Hillbrook Grange Ack Lane East Bramhall Stockport Cheshire SK7 2BY     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Jacqueline Kelly     Date: 0 5 0 3 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Hillbrook Grange Ack Lane East Bramhall Stockport Cheshire SK7 2BY 0161-4397377 01614393880 JeannieF@hillbrookgrange.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Bramhall & Woodford Old People`s Welfare Committee Name of registered manager (if applicable) Mrs Jean Fowler Type of registration: Number of places registered: care home 36 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE The maximum number of service users who can be accommodated is: 36 Date of last inspection Brief description of the care home Hillbrook Grange is a care home providing personal care and accommodation for 36 older people. The home is administered by Bramhall and Woodford Old Peoples Welfare Committee and is a registered charity. Hillbrook Grange is located in the Bramhall district of Stockport and is close to local shops and other amenities, such as Care Homes for Older People Page 4 of 26 36 0 Over 65 0 36 Brief description of the care home cafes, restaurants, public houses, banks, chemists and post office. There are also churches of differing denominations, a library, a selection of health centres, dentists and opticians. Stockport town centre, motorway network and public transport are easily accessible. The original Victorian house has had a small annex and a larger twostorey extension added. Two passenger lifts have been installed (one for each side of the house). The grounds are extensive, combining lawns, a small wood and flowerbeds. There is a statement of purpose and service user guide. The inspection reports are also available on request. There is one fee of £365.00. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. The report was written on behalf of the Care Quality Commission therefore throughout the report the terms we and us were used. We last inspected this service on the 17 April 2007. On the 7 April 2008 and the 27 April 2009 we carried out an Annual Service Review. This is a review of good and excellent services that takes place between key inspections. At the time we conducted the review we found no evidence to suggest that our quality rating had changed or that we needed to bring the inspection forward. This was a key inspection and we spent a total of six hours at the home over two days. The staff at the home did not know we were going to visit on the first day. Care Homes for Older People Page 6 of 26 Before this key inspection we asked the manager of the home to complete an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they did well, what they needed to do better and to give us current information as to employment of staff and training provided over the past twelve months. The form had been completed honestly and it showed us the manager saw the service being provided the same way as we did. During the inspection we looked at the care files and care plans of two people who used the service. We made the decision not to look in depth at more files as they all followed the same format and were well organised and included all the information necessary for the care worker to meet the persons needs. We looked at a small number of the staff personnel files which included supervision and training records. Again these were well organised and contained all the necessary information to ensure that only suitable people were employed. We also looked at other documents such as accident records, complaints and compliments file and medication records. We talked to the people who were sitting in the lounges, library and their bedrooms. We saw the manager, deputy manager, chairperson of the Executive and Homes Committee, another committee member, two domestic assistants, care worker and the deputy manager. Questionnaires were sent out to ten people who were living at Hillbrook Grange and ten to the staff team. We had returned to us all the service user surveys and nine staff surveys. The information we received was positive from both the staff and the people who used the service. Three of the service user surveys had been completed with the help of relatives the remaining seven had been completed by themselves. Comments we received from the service user surveys to the question what does the home do well were; all aspects of care; general care towards all residents respect and dignity at all times; happy and friendly atmosphere all the staff very helpful at all times; Hillbrook Grange provides a pleasant atmosphere for the residents; care and attention as good as a 4 star hotel; the staff do a wonderful job of caring. One person did say to provide a seat with arms for residents when at the hairdressers. The staff said to the same question; keeping up to date with policies and procedures, regular supervision, keeping care plans up to date, residents well being; the home consistently give good care to residents, their individual needs are met, the residents have a good interesting diet, there are activities for them to join in daily, their physical and mental needs are met, their rooms are very clean and comfortable and the grounds provide space for residents to enjoy the outside space and walks; work well as a staff team, passing on relevant information, supporting service users and supporting needs, making our setting feel like a home; meets individuals needs enables people people to live in a relaxed, caring, safe environment; I think the atmosphere in Hillbrook Grange is really nice, staff have a good relationship with residents. There had been one complaint over the past twelve months which had been resolved to the satisfaction of the person who had complained. There had been no safeguarding adult protection referrals or investigations. Care Homes for Older People Page 7 of 26 What the care home does well: There is a full assessment procedure from the initial enquiry to a stay in the assessment flat. This enables both the person who is thinking of moving into the home and the staff to make sure that Hillbrook Grange is the right place for them. A comprehensive care plan is completed from the assessment which provides the care team with vital information to help them meet health and personal care needs. Peoples privacy and dignity are respected and this was evident during our visit such as knocking on bedroom doors before entering and the way in which the care workers spoke with the people who lived there. A varied programme of activities was available for residents to choose from with regular outings taking place throughout the summer months and special events organised for occasions such as Easter and Christmas. On the day of our visit there was a craft class and one of the ladies showed us what she had made and she was very proud of it. We received two comments from the surveys which said that the staff are very caring and provide plenty of activities for the residents, the food is excellent; there are different kind of activities so everyone can find something interesting. However one person thought that there could be more activities aimed specifically at the male residents. There was a complaints procedure in the service user guide, a copy displayed on one of the notice boards in the entrance hall. Peoples views were sought in a number of ways such as; a suggestion box on the table directly in front of the main entrance, questionnaires, committee members talking to the people who lived at the home on a regular basis. We received no complaints from any of the people who we spoke with during our visit or from the people who completed a survey form. The home and grounds are well maintained with a number of different areas for people to sit, both inside and outside of the home. The home was clean and free from any offensive odours. Residents were encouraged to personalise their bedrooms. One person commented that the home was spotlessly clean and hygienic throughout. New flat screen televisions had been purchased and a surround sound system provided in one of the lounges. There was a stable staff team with many of the staff having worked at the home for many years. Training was continuous with mandatory and National Vocational Qualifications being taken by the care workers. One of the care workers who completed a survey form said that Hillbrook organised enough training for staff which gave a good knowledge about work in health care. People said that the attitude of the staff was kind and caring. The organisation employed consultants to assist with health and safety, record keeping and employment legislation. The committee and the senior managers ensured that the home was run in the best interests of the people who lived there. IT systems had been improved so that information was more accessible to keep people up to date with the latest legislation, policies and procedures. Care Homes for Older People Page 8 of 26 What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People thinking of moving into the home received sufficient information to help them make a decision and staff received enough information to understand the persons needs. Evidence: The initial enquiry made by a person thinking of using the service was recorded to allow a brief assessment to be made to see if the home could meet their needs. Brochures were sent out to the person on request and the last inspection report was also available. People were invited to visit the home either by appointment or if preferred they could just call in at a time convenient to themselves. The manager offered to visit people in their home if they wished and/or they could arrange to spend a day or half day at Hillbrook Grange and have a meal so the person could see what the home was like. Care Homes for Older People Page 11 of 26 Evidence: Once the above process had been gone through arrangements were made for the person to stay in the assessment flat, usually for two weeks at the end of which they returned home to consider their future (the time could be extended if necessary). Should they and the home decide that Hillbrook Grange was for them, they were admitted with a view to permanent residency. A care file was set up which contained all the necessary forms such as needs assessment, risk assessments, care plans, doctors report and other general information. This enabled the care workers to meet the needs of the people who were to stay at the home. Standard 6 was not applicable, as the home did not have any intermediate care beds. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Hillbrook Grange have their needs met and their care is provided in a manner that protects their privacy and dignity. Evidence: The care plans were now produced on computer which made them easier to read and easier to keep up-to-date with the most recent information. They contained details of the persons health and social care needs which included assistance required, how the assistance was to be given by the care workers and a date when the care plan should be reviewed. Other information included risk assessments, details of doctors and district nurse visits when applicable, nutritional risk triggers and falls risk assessments. All those that completed this section of the survey form said that they always had the medical care they needed. The people we spoke with during the visit or completed a survey form said that they were happy with the care provided. The majority also said that the staff listened to them and that staff were available when they needed them. Care Homes for Older People Page 13 of 26 Evidence: Peoples privacy and dignity was respected by the staff team and this was evident with people knocking on doors before entering and was confirmed by the people we spoke with during our visit. Medication records were looked at and found to be in good order. A room that was locked at all times had now been designated for the keeping of medication and medication records. This was the responsibility of the deputy manager and was well kept, clean and well organised. All the care workers who administered medication had received training. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The social care needs of people are met effectively by the staff team in a way that enables people to maintain their privacy and dignity. Evidence: On the morning of our visit people were in different parts of the home which included the two lounges, bedrooms, and library. The television was on in one of the lounges and in the library the radio was playing. Also in the library a care worker was giving a number of residents a manicure. The person who attends the home to conduct the crafts class was due in the afternoon. Other activities, which took place on a regular basis were drives out and theatre trips. The activities programme which included coloured pictures was displayed by the entrance to the dining room. A coffee morning was to be held on the 17 March 2010 and there were posters around the home informing people of this event. People can visit the local churches or can attend the ones that are conducted in the home. There was one comment which said that more suitable activities for the male residents could be accessed and provided. Visitors were welcomed at the home and as everyone had their own room they were able to see people in private if they so wished. A family Christmas party had been organised where everyone had been invited. The chairperson of the executive Care Homes for Older People Page 15 of 26 Evidence: committee said that it had been well attended. The home did not handle anyones finances; family, friends or solicitors helped those who needed it. People could bring in some small personal items however due to the sizes of the rooms and the fitted furniture in the majority of the rooms these are limited to a small chair, chest of draws and ornaments. The majority of people we spoke with during our visit and who completed a survey form were always or usually happy with the food. It was a set menu and a chalk board in the dining room displayed what was on the menu that day. If someone did not want what was available they would discuss this with the cook who would provide an alternative. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Policies and procedures are in place which help to make sure that people using this service are protected from harm of injury. Evidence: The complaints procedure was part of the service user guide which was given to all the residents. A copy of the complaints procedure was also displayed on one of the notice boards in the entrance hall. There was a suggestions box on the sideboard directly in front of the main door where people signed in. Both the chairperson of the executive committee and the manager said that people did put suggestions in the box from time to time and that they were always acted on. Mrs Renn, the chairperson of both the executive and homes committees, visited the home for at least four hours every day and was available to talk with residents and relatives on an informal or formal basis as they wished. Each resident was allocated a care worker known as a key worker with whom the resident could also talk too on a personal and private level. None of the residents we had contact with had any complaints. There had been one complaint which had been dealt with to the persons satisfaction. Care Homes for Older People Page 17 of 26 Evidence: No safeguarding adult referrals had been made. All staff had to complete a Criminal Record Bureau check and received training on safeguarding adults as part of their induction and ongoing training. Two of the committee members, the general manager, the registered manager and senior staff had received training in the Mental Capacity Act. The manager and senior care worker had completed training in the Deprivation of Liberty Safeguards (DOLS). It was hoped that this training would be extended to the staff team when it was available from professional trainers. Care Homes for Older People Page 18 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience 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 suitably adapted, clean, comfortable and very pleasant surroundings. Evidence: We looked round the home which was comfortably furnished, very well maintained and decorated, clean, and free from any unpleasant odours. A lot of work to the roof on the oldest part of the house had been completed and it was intended in the coming months to replace the flat roof over the kitchen and dining room with an apex roof. There were two passenger lifts, one for each side of the home. The grounds were extensive and were used by the residents and their relatives, weather permitting. A gardening company kept the gardens maintained. The bedrooms we saw had been personalised and reflected the people that occupied them. The bedrooms in the extension all have fitted furniture with vanity units which have been upgraded. When a room becomes vacant new carpet is laid and the room decorated. None of the rooms have an en suite facility but there were a sufficient number of bathrooms and toilets available. There are a number of different areas on the ground floor where residents can sit to chat, read or watch television. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living at Hillbrook Grange are supported by well trained, effective staff who have gone through a thorough recruitment process, so peoples needs are met and they are safe from possible harm or poor practice. Evidence: There was enough staff to meet the needs of the people who lived at Hillbrook Grange including managers, care workers, domestic assistants and cooks. Eight of the nine staff who completed a survey form said that there was always enough staff to meet the needs of the people who lived at the home; the remaining person said usually. The staff group was stable with the majority having worked at the home for a number of years. Many of the care workers had achieved a National Vocational Qualification (NVQ) level 2 or 3. Other training and qualifications included NVQ assessor training that allowed the person to assess the work of less experienced staff to help them gain an NVQ. All staff have to go through a thorough recruitment process which included completing an application form, interview, medical questionnaire, Criminal Record Bureau check and induction. Whilst there were copies of certificates, passports and other documentation in the staff files these need to be signed and dated confirming that the Care Homes for Older People Page 20 of 26 Evidence: originals had been seen. It was recommended to the manager that this be done with all future applicants and she agreed to do this. We also discussed with the manager that she should consider implementing a work book for induction that staff completed which would provide evidence that they had understood policies and procedures and good practice. The manager said that she would make inquiries with Skills for Care and implement this. Other training that had taken place and was ongoing was moving and handling, first aid, health and safety, infection control and food hygiene. There had been no training on malnutrition and assistance with feeding but this was an area that the manager was looking into and was to provide. The deputy manager was currently working towards an NVQ level 4 in care management. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Hillbrook Grange is well managed and is run in the best interests of the people who live there. Evidence: A new manager had been appointed since the previous inspection of April 2007. She has all the necessary experience and qualifications to manage the home. Her qualifications included a foundation Degree in Health and Social Care and the Registered Managers Award. The manager was assisted in her role by a deputy manager and care supervisor who were all responsible for the day to day health and social care needs of the people who lived at the home. A committee who had many years of experience run the home. The chairperson of the executive and homes committee worked at the home daily offering support to the manager. A recent appointment of a general manager had been made who worked part time alongside both the chairperson and the registered manager. The responsible individual visited the home regularly and completed a monthly report as they were Care Homes for Older People Page 22 of 26 Evidence: required to do under the current legislation. The chairman produced an annual report for the Committee. Two new members had been co-opted onto the committee. Questionnaires were regularly circulated to the people, relatives and other professionals such as doctors so that their views could be obtained to improve the service provided. All the committee members speak with the people who live at the home after committee meetings to keep themselves informed of the peoples feelings and to give them the chance to voice any concerns they may have. Should the manager keep small amounts of money for day to day expenses for individuals a record is kept. The home was not involved in anyones finances. The manager and the committee make sure that everyone who lives, works and visits the home are kept safe and free from harm by implementing safe working practices. A record of accidents was kept and where necessary acted on. It was clarified with the manager that we should be informed of every visit a persons makes to the accident and emergency even if no treatment was given and they returned home within a few hours. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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