Care Home: Hodge Hill Grange

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What the care home does well Pre admission assessments are undertaken so that the home and prospective person know that their individual needs can be met before they move in. People who use the service have access to a range of health and social care professionals and this ensures that any healthcare needs are met. People can see their visitors as they choose so that they can continue to have relationships that are important to them. The home creates a friendly and welcoming atmosphere where people can personalise their rooms to reflect preferences and tastes. Meetings are held so that people are involved in decisions about how the home is run. Small amounts of people`s personal money can be held safely by the home if people choose to use this facility. Maintenance records are well maintained and equipment is serviced regularly to ensure peoples safety. People told us: "I came with my husband for the day and had a meal before he moved in, it was nice" "The home looks after mom`s well being, health and personal hygiene needs" "The activities person is great, there is always something going on" "I get rice and peas it`s lovely" "The food is very good" "I would speak to the manager and it would certainly be sorted out" "People are generally friendly, kind and helpful" "Staff are marvelous" What has improved since the last inspection? Medication storage has improved so that it is stored accurately and safely. Staff were observed to treat people with respect and maintain their dignity. Activities and outings have been further developed so there are more things for people to do.Food intake charts were detailed so that staff can monitor how much food people have eaten. A Caribbean menu has been introduced so that people receive foods that meet their cultural needs and personal preferences. Some rooms have been redecorated and some rooms have had new carpets fitted. Carpets throughout the home have been deep cleaned and a number of new beds have been purchased. This will enhance the living environment for people at the home. Records demonstrated that new staff receive an induction so that they know information about the home. What the care home could do better: Information should be updated so that people have current details about the home. Air conditioning should be installed in the treatment room so that medicines are stored at the correct temperature. The home should continue with its redecoration programme. One person said "The decor could be better, many rooms are badly in need of redecoration". Night staff must ensure that they meet people`s individual needs in a timely way. One person said "when you press the buzzer night staff take a long time to come". Written references must be obtained prior to people starting work, to ensure that people are safe from harm. Key inspection report Care homes for older people Name: Address: Hodge Hill Grange 150 Coleshill Road Hodge Hill Birmingham West Midlands B36 8AD     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: Lisa Evitts     Date: 3 0 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 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) © 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 29 Information about the care home Name of care home: Address: Hodge Hill Grange 150 Coleshill Road Hodge Hill Birmingham West Midlands B36 8AD 01217301999 01217301888 hodgehillgrange@ashbournesl.co.uk www.schealthcare.co.uk Southern Cross Healthcare Services Ltd Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Petra Thompson Type of registration: Number of places registered: care home 54 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 54 The registered person may provide the following category of service only: Care Home with Nursing (Code N) 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 (OP) 54 Date of last inspection Brief description of the care home Hodge Hill Grange is a purpose built home providing nursing care for up to 54 older people. The Home is situated on the perimeter of Hodge Hill, within a pleasant suburb, north of Birmingham. Local amenities include shops and restaurants and there is a regular bus service for access to Birmingham City Centre. A drive enables access to the Care Homes for Older People Page 4 of 29 Over 65 54 0 1 7 0 4 2 0 0 9 Brief description of the care home front of the premises and there is sufficient off road parking for up to 10 vehicles to the rear of the building. Accommodation is provided on two floors accessible by passenger lift. Bedrooms are single occupancy with en suite facilities consisting of toilet and wash hand basin. The home has an adequate range of pressure relieving equipment and lifting aids to assist people with mobilisation and transfers. There are communal toilets and assisted bathing facilities to meet peoples individual needs. Each floor has a lounge and separate dining room with kitchenette and there is an additional small quieter lounge and dining room located on the ground floor. There is a secure pleasant garden located at the side and rear of the premises, which is used by people living at the home and their visitors. There is a notice board displaying forthcoming events and other information of interest to people living at the home and their visitors. Copies of our most recent inspection report are available for people to read if they choose to. Current fee rates are included in the service user guide and currently range from £392 to £750 per week dependent upon assessed needs and excluding the Registered Nursing Care Contribution. These fee rates are reviewed each April. Additional charges include hairdressing, toiletries, newspapers, opticians, chiropody, physiotherapy and escorts for pre planned appointments. 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 our inspections is upon outcomes for 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. The visit to the home was undertaken by two inspectors over one day. We, the commission were assisted throughout the day by the Registered Manager. The home did not know that we were visiting that day when there were 53 people living there. Two people were in hospital. Information was gathered from speaking to four people who live at the home and from watching the care they received. Two staff, two relatives and a visitor were also spoken to. Three people were case tracked. Case tracking involves discovering individual experiences of living at the home by meeting or observing them, discussing their care Care Homes for Older People Page 6 of 29 with staff, looking at medication and care files and reviewing areas of the home relevant to these people, in order to focus on outcomes. Case tracking helps us to understand the experiences of people who use the service. Staff files and health and safety records were reviewed. Prior to our visit we sent out random surveys to 10 people who live at the home. Four people who live at the home returned the surveys. Comments were positive about the home and are included in this report. We were sent an Annual Quality Assurance Assessment (AQAA) by the home. This tells us about what the home think they are doing well and where they need to improve. It also gives us some numerical information about the staff and people who live at the home. Before our visit we reviewed any notifications received about the home, these are reports about things that have happened in the home that they must tell us about. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? Medication storage has improved so that it is stored accurately and safely. Staff were observed to treat people with respect and maintain their dignity. Activities and outings have been further developed so there are more things for people to do. Care Homes for Older People Page 8 of 29 Food intake charts were detailed so that staff can monitor how much food people have eaten. A Caribbean menu has been introduced so that people receive foods that meet their cultural needs and personal preferences. Some rooms have been redecorated and some rooms have had new carpets fitted. Carpets throughout the home have been deep cleaned and a number of new beds have been purchased. This will enhance the living environment for people at the home. Records demonstrated that new staff receive an induction so that they know information about the home. 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 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. Arrangements are in place to ensure that people have the information they need and can be confident that their needs will be met if they decide to live at the home. Evidence: The home has a service users guide and statement of purpose. These are available in the reception area and in each persons bedroom. The documents can be made available in larger print and audio cassette so that people with visual impairments can access the information. These documents needed some minor changes to ensure that the guides gave correct information following some management changes within the organisation. This will ensure that people have current information about the home. The certificate of registration was clearly displayed and reflected the service offered by the home. The previous inspection report was displayed so that people can read this if they choose to. Care Homes for Older People Page 11 of 29 Evidence: Before anyone comes to live at the home, comprehensive pre admission assessments are undertaken so that the person and the home know that their individual needs can be met before they move in. The home also offers people the opportunity to visit the home and sample what it would be like to live there. One relative said I came with my husband for the day and had a meal before he moved in, it was nice. We spoke to people who had recently moved into the home and they told us: I like it here Somebody told me what the home was like but I didnt visit, I came straight here, So far so good 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 personal care and health needs of the people living there are met so ensuring their well being. Evidence: Each person had a written care plan. This is an individualised plan about what the person is able to do independently and states what support is required from staff in order for the person to meet their needs. We looked at three peoples care files. Care plans provided staff with information about how they should assist people to meet their needs in a way that they prefer. Plans gave information about peoples likes and dislikes. Staff spoken to knew about peoples needs and it was pleasing that staff followed the information in the care plans. For example one persons plan talked about a particular style of clothing and we saw that the person was wearing this on the day of our visit. Comprehensive risk assessments were in place for falls, nutrition, medication Care Homes for Older People Page 13 of 29 Evidence: administration and sore skin. In addition, people had individual risk assessments for example, for pain. This ensures that peoples needs are individually assessed. People who were identified as needing nutritional monitoring had food and fluid charts which identified how much they were eating and drinking. This means that staff would be able to monitor for changes and seek further advice if required. One person sometimes displayed some difficult to manage behaviour but there was no care plan written so that staff knew how to manage this. This was completed on the day of our visit. One persons plan was not clear that a wound had healed. Staff told us that the dressing in place was for protection only. There was no guidance about how staff were to monitor this to ensure that the skin did not become sore beneath the dressing. This was brought to the attention of the manager and this was addressed at the time. Short term care plans were written to provide staff with guidance when someone had an infection. People told us: The home looks after moms well being, health and personal hygiene needs The nurses will call the GP if need be if they are concerned about any residents We are very happy We looked at the medication management in the home and found that this was managed well and ensures that people receive their medication as prescribed. All of the audits undertaken were correct and records were accurate. Staff did not always record variable dosages for example, if one or two tablets were given. This should be recorded so that there is a clear audit trail and so that staff can monitor the effect of the medication. Copies of prescriptions were kept so that staff could check they had received the correct medication for people. Medication was signed in for upon receipt and records were clear if a person had refused their medication. Controlled drugs were stored appropriately and records were accurate. At the last visit to the home we were told that a quote had been obtained for air conditioning to be installed in the ground floor medication room as the room became hot during summer months. This had still not been completed and we were able to see evidence that the manager had requested this on three occasions. The temperature of the room was satisfactory on the day of our visit however it is recommended that the organisation consider the installation of air conditioning before the summer months to ensure that medication is stored at the correct temperature. Care Homes for Older People Page 14 of 29 Evidence: People were well supported by staff to choose clothing appropriate for the time of year, which reflected individual cultural, gender and personal preferences. Staff were seen to treat people with respect and used blankets to cover people with when they were being hoisted in order to promote their dignity. 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 have a choice of meals and activities to participate in so that they experience a meaningful lifestyle. Evidence: Since our last visit to the home a new full time activity coordinator has been in post. People were very complimentary about this person and the activities offered. They told us: Im very pleased with the current activities organiser The activities person is great, there is always something going on I play dominoes and bingo in the lounge Sometimes I watch TV, sometimes I get involved in the games The St Patricks day celebration was excellent Care Homes for Older People Page 16 of 29 Evidence: The home has a varied activity programme including quizzes, arts and crafts, film shows and games. There are exercise and music afternoons and new clubs have been introduced such as dominoes. The home has a volunteer minibus driver and people have been registered with the ring and ride service so that they can go out on trips outside of the home. External entertainers such as vocalists and ukalely players visit the home. The hairdresser visits so that people can have their hair styled in a way they prefer. Church services are held so that people can continue to follow their chosen religion. There are notice boards on each floor and in reception which display information about events held and forthcoming events. A monthly newsletter is also written so that people know what is happening in the home. There is an open visiting policy so that people can see their visitors as they choose. This means they can maintain relationships that are important to them. There is a four week rotating menu. There is a choice of a cooked breakfast if people want this. There are choices of two meals at dinnertime and for the evening meal. Alternatives and snacks are available throughout the day and the menus clearly state what choices people can have. The home is able to cater for special diets for cultural or medical needs and for personal choices. Since our last visit to the home a Carribean menu has been introduced three times a week to meet peoples cultural needs. People told us: The meals are good and there is plenty to choose from The food is nice I like the curried goat and rice I get rice and peas its lovely The food is very good We observed the lunchtime meal and saw that staff assisted people in a way that promoted their dignity. Some people wore protective clothing whilst eating their meals. Tables were nicely presented and set with condiments. People were offered choices. There was a nice calm atmosphere and in one dining room, people were having a sing along with staff while they waited for their meals to come from the main Care Homes for Older People Page 17 of 29 Evidence: kitchen. 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. Arrangements are in place to listen and act upon peoples views and to safeguard people from harm. Evidence: The complaints procedure is displayed in the home and is included in the service user guide in each persons room. This document can be made available in larger print and audio cassette so that people with visual impairments can access the information, so that they know what to do if they want to make a complaint. We had not received any complaints about this service since our last visit to the home. The AQAA told us that the home had received nine complaints. These were relating to people being disturbed by other people, care needs, missing items, staff conduct and clothing problems. Six of these had resulted in the home making safeguarding referrals to ensure that people were safeguarded from harm. Three had been accepted as safeguarding and further investigations were completed. All of the safeguarding referrals have now been closed. The complaints records were detailed with the nature of the complaint, how it was investigated and the outcome. This should mean that people can be confident that their concerns are listened to and acted upon. There is also a comments book in the reception area where people can write in any low level concerns. The manager reviews this book and writes in what action has been taken. Care Homes for Older People Page 19 of 29 Evidence: In the surveys returned to us four people said there was always someone they could talk to if they had any concerns. On the day of our visit one person said I would speak to the manager and it would certainly be sorted out. The home has copies of various Multi Agency Guidelines and has devised a flow chart which is available at the nurses stations for staff to follow. This means that staff have guidance about what to do in the event of an allegation being made. We spoke to two staff who were able to give good verbal accounts of the actions they would take in the event of an allegation being made to keep people safe. The home has a rolling programme of staff training for safeguarding to ensure that staff receive regular updates. Action on elder abuse telephone numbers are displayed in the home so that anyone can make a referral if they have any concerns. 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 are provided with a clean and comfortable environment in which to live that meets their individual needs. Evidence: The home has two floors and there are three homely communal lounges and dining rooms where people can spend their time. Some people prefer to stay in their rooms and this choice is respected by staff. There is a separate hair salon so that people can visit the hairdresser. Since our last visit the smoking room has been decommissioned and a suitable shelter has been sought so that people can smoke outside if they choose to. The garden has a patio area and has a ramp with handrails so that people can access all areas of the garden. The AQAA told us that the home plans to develop the garden areas further by planting more shrubs, developing a sensory garden in the raised flowerbed and purchasing some garden benches. This will make the garden more pleasurable for the people living at the home. Corridors are wide and spacious and enable people to move around the home using any aids they may require. The home has hoists to help people move their position and each floor has two bathrooms and a shower so that people can have a choice. Care Homes for Older People Page 21 of 29 Evidence: All of the bedrooms are single with ensuite facilities. We looked at the bedrooms of the people we case tracked and these were found to be personalised and reflected individual tastes, gender and preferences. People are encouraged to bring in their own possessions in order to have familiar items around them to make their rooms as homely as possible. One person told us that they could not see their TV and the manager discussed changing the layout of the room or the possibility of the TV being mounted on the wall. This will ensure that peoples needs are met. People told us: The decor could be better, many rooms are badly in need of redecoration The bedrooms could do with a paint up These comments were discussed with the manager on the day of the visit. The manager was aware that some rooms were in need of redecoration and has a rolling maintenance programme in place to address this. Since our last visit some of the bedrooms have been redecorated and six rooms have had new carpets. Some divan style beds have been replaced with profile beds. (These are electric beds which can assist people to alter their position by means of a hand held control). The home was clean and fresh on the day of our visit. In the surveys returned to us, three people said that the home was always clean and fresh and one person said usually. There was a pleasant and relaxed atmosphere at the home. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff may not always support people to meet their nighttime needs in a way they prefer. The recruitment procedure may not fully protect people from harm. Evidence: The home has two registered nurses and nine care staff on duty throughout the morning, two registered nurses and eight care staff throughout the afternoon/evening and two registered nurses and four care staff during the night. These staffing levels met the needs of the people living at the home on the day of our visit. In addition to nursing and care staff the home has domestic, catering, maintenance and administrative staff to help meet all the needs of the people living at the home. There are currently no care staff vacancies at the home. The AQAA told us that 69 of staff have completed a National Vocational Qualification (NVQ) in care. This should ensure that the majority of staff have the knowledge and skills to care for people individually and collectively. People told us: Excellent attitude of many of the staff People are generally friendly, kind and helpful Care Homes for Older People Page 23 of 29 Evidence: Staff are marvelous Staff are ok, they help me One person told us When you press the buzzer the night staff take a long time to come. A relative told us that they had raised a concern that night staff had not applied cream to their relative as requested and had not helped them into a comfortable position before leaving them. This may mean that people are not always assisted to have their needs met at night in a way that they prefer. The manager should review the needs of people at night along with staffing levels to ensure that peoples needs are met. The manager was aware of both of these concerns and had plans to address this. In a survey returned to us one person said that they would like to see staff in the lounges at all times as accidents can happen when people try to stand on their own. We discussed this with the manager and she told us that this had been discussed in a recent staff meeting and that it was being monitored. We saw the minutes from the meeting and they included a discussion about supervision of the lounges. We reviewed three staff files. One person had been at the home for almost a year. There was a Protection of Vulnerable Adults (POVA) first in place but no confirmation that a full Criminal Records Bureau (CRB) had been received. One person had not had written references obtained prior to them starting work at the home. We were told that verbal references had been sought but there was no written evidence to support this. These lapses may not fully protect people from harm. There was evidence that staff receive an induction into the home so that they have all the information they need to know. Staff receive training in areas such as fire safety, food hygiene, moving and handling, health and safety, infection control, abuse, challenging behaviour, first aid and dementia. These are all relevant to the needs of the people living at the home. 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. The home is run in the best interests of the people who live there. Evidence: The Registered Manager has numerous years experience of working with older people and within management roles. The manager is a Registered Nurse and has a post graduate diploma in management studies and a masters degree in business administration. The manager continues to update her knowledge by attending study days and courses so that she has up to date knowledge to lead the staff team. Staff spoken to told us that the manager was approachable and supportive. The manager was observed to interact well with the people living at the home and their relatives. She was able to tell us about peoples needs and people living at the home clearly knew who she was. A weekly surgery is held so that people can arrange to meet with the manager and discuss any concerns. People are encouraged to contact the manager by telephone or Care Homes for Older People Page 25 of 29 Evidence: leave her a note if they have any concerns. Regular staff, residents and relatives meetings are held. Minutes of the residents meetings are displayed in reception in large print so that people can see what has been discussed. These meetings give people an opportunity to socialise and discuss any ideas or concerns they may have. It was pleasing to see that when concerns had been raised the minutes included an action plan about how the home was to address the concerns. Resident and visitor satisfaction surveys had been sent out in February 2010 and a report of these had been compiled. The report was in large print and used graphs so the information was clear for people to understand. The report included an action plan and was to be displayed. Senior managers visit the home and write a report about the quality of the home each month. The last report available was for January 2010. The manager confirmed that a visit had taken place but she did not have a copy of the report. These should be available for us to see when we visit the home. Prior to the inspection the manager had completed the AQAA. This was detailed and gave us information about how the home thought they were performing, what they do well and how they could improve. The manager had identified areas where improvements could be made and had plans how to achieve this. The information in the AQAA was consistent with our findings on the day of our visit. We looked at how the home looks after small amounts of peoples money. There was a clear audit trail and detailed records were held for all transactions made. People are provided with individual statements each month or upon request. A sample of records in relation to health and safety and maintenance checks were looked at and we found that checks had been undertaken to ensure that the equipment was safe and in full working order. Staff attend fire drills and training to ensure that they know how to keep people safe in the event of a fire. During the day we saw that a housekeeper had left her trolley unattended with cleaning products on top. People who live at the home were in the area. This was brought to the attention of the nurse who spoke to the person to ensure that products were not left unattended. This will minimise the risks to people living at the home. 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 1 29 19 Two written references must 11/05/2010 be obtained prior to employment commencing. To ensure that people are safe from harm. 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 2 3 1 9 9 The service users guide should be updated so that people have current information about the home. Variable dosages should be recorded so that staff can monitor the effects of the medication. Air conditioning should be installed into the treatment room to ensure that medicines are stored at the correct temperature. The manager should review staffing levels and the needs of people living at the home at nighttime. To ensure that they meet the needs of people living at the home at all times. Reports about the quality of the service should be available for us to see when we visit the home. 4 27 5 33 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). 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. 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