Care Home: Holcroft Grange

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What the care home does well People who live at Holcroft Grange have confidence in the care home because it is managed by a qualified and experienced person who has developed her skills over time through training and personal development. There is a strong and consistent team of staff team who have been trained to a high standard so the people who live at the home are in safe hands. We could see that the manager provides good leadership so staff operate as an effective team because they know what to do and how it needs to be done to meet peoples needs and expectations. All the people we spoke with during the inspection praised the home, the manager and staff and commended them for their dedication to duty and attention to detail. People who are thinking of moving to Holcroft Grange are given good information to help them make decisions about the home. The information about the home, what it does and who it is for, is clearly written in plain and clear language so people are helped to understand the information and know what the home provides. This showed us that managers and staff understand the importance of providing people with the information they need to help them choose a home that is suitable for them. The information can be made available in a range of languages so people from the ethnic communities of Warrington and surrounding areas were able to read the information in their first language. This showed us that Holcroft Grange promotes the rights of people through the information it provides. Each person`s individual needs were known and their rights to privacy and confidentiality were respected so the support and care they got from staff was given in a way that met their needs and made them feel valued and respected. All the people who lived at the home had a care plan that had been written and developed with them so they received care and support in the way they wanted and preferred. The atmosphere in the home was relaxed and sociable. We could see that the staff delighted in providing a high quality service. They listened to people intently, were always polite and responded with understanding, kindness and care. People were offered a range of activities in the home and were supported and encouraged to explore and take advantage of opportunities for leisure, and socialising with other people in the local community. All the people we spoke with told us that they were happy there and their health and social care needs were met. For example one of the many positive comments made was: "The welfare of the residents is always the priority in Holcroft Grange. The manager and staff are excellent. We are well cared for. We are shown consideration, affection and respect in every way. Another person told us how they had been helped to cope with difficult personal problems and how the staff had helped them build their confidence. They said "I have never felt better I love being here its a great place." We could see that the managers and staff were very good at involving people in the day to day management of the home and getting their views on the quality of care, facilities and services provided. People told us that their views were always taken seriously and acted upon. This showed us that the home is run in the best interests of the people who live there. What has improved since the last inspection? At our last inspection we found that care plans for people living at the home did not always provide sufficient information about the person`s needs or the way the wanted things to be done. We could see that this had been addresses and significant improvements had been made. We found that care plans had more information about the person`s individual needs, wishes and personal preferences so they received care in the way they wanted and preferred. Holcroft Grange has effective systems for involving people in the day to day management of the home. People told us that they were asked for their views on a wide range of issues including, menus, activities and the selection of staff. We could see that peoples` views were acted upon and taken seriously so the home had been able to develop all aspects of care and service delivery. This meant that the people who lived at the home felt valued and respected and improvements will continue to be made as peoples needs and expectations change. What the care home could do better: We did not find any significant areas for improvement. The manager and staff work well with us and any minor issues were addressed immediately. Key inspection report Care homes for older people Name: Address: Holcroft Grange Jackson Avenue Culcheth Warrington Cheshire WA3 4EJ     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: David Jones     Date: 0 1 1 0 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 28 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 28 Information about the care home Name of care home: Address: Holcroft Grange Jackson Avenue Culcheth Warrington Cheshire WA3 4EJ 01925766488 01925766582 pauline.shaw@clsgroup.org.uk www.clsgroup.org.uk CLS Care Services Limited care home 40 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 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. The maximum number of service users who can be accommodated is: 40. Date of last inspection Brief description of the care home Holcroft Grange is a care home situated in the centre of the village of Culcheth. It is a single storey building. It offers accommodation, personal care and a wide range of facilities for up to forty older people. There are forty single bedrooms, four of which have en-suite facilities. There are three communal lounges and two dining rooms. A range of shops and other local facilities are within walking distance of the home and the village is supported by good public transport services. The home has good access for people in wheelchairs or with impaired mobility and there are pleasant garden areas for the people who live at the home to enjoy. Information about Holcroft Care Homes for Older People Page 4 of 28 Over 65 40 0 Brief description of the care home Grange including copies of the most recent inspection report is made available to each resident and can be acquired by contacting the home on the telephone number given above. Fees range from 490 to 520 pounds per week for accommodation, board and care, depending on the size of the room and whether additional facilities are provided such as en-suite toilet facilities. There are no additional charges other than hairdresser, toiletries, newspapers and other sundry items charged at cost. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 three stars. This means that people who live at Holcroft Grange experience excellent quality outcomes. This visit was unannounced. It took place over two days, taking 6 hours and 35 minutes in total, and was done by one inspector. This report will say we when referring to our activities and findings, as it is written on behalf of the Care Quality Commission. Our visit was just one part of the inspection. Before the visit took place we asked the manager to complete a questionnaire that we call an annual quality assurance assessment or AQAA for short. It gives us information about how the home is meeting the needs of the people who live there and includes plans for future development. We made survey questionnaires available for the people who live at the home, their Care Homes for Older People Page 6 of 28 relatives and staff. Replies we received have been taken into account in the report. We also looked at the information that we already had about the home and this, with the information from the AQAA, helped us to form our inspection plan. We checked the records of four people who lived at the home to see what care they receive. We spoke with several people who lived at the home and some of the staff who support and care for them and their views were taken into account. We looked at the communal areas of the home, including lounges, bathrooms and toilets to see how the home was decorated, maintained and furnished. We also looked at some policies and procedures to check that these were up to date and provided suitable guidance for staff. Care Homes for Older People Page 7 of 28 What the care home does well: People who live at Holcroft Grange have confidence in the care home because it is managed by a qualified and experienced person who has developed her skills over time through training and personal development. There is a strong and consistent team of staff team who have been trained to a high standard so the people who live at the home are in safe hands. We could see that the manager provides good leadership so staff operate as an effective team because they know what to do and how it needs to be done to meet peoples needs and expectations. All the people we spoke with during the inspection praised the home, the manager and staff and commended them for their dedication to duty and attention to detail. People who are thinking of moving to Holcroft Grange are given good information to help them make decisions about the home. The information about the home, what it does and who it is for, is clearly written in plain and clear language so people are helped to understand the information and know what the home provides. This showed us that managers and staff understand the importance of providing people with the information they need to help them choose a home that is suitable for them. The information can be made available in a range of languages so people from the ethnic communities of Warrington and surrounding areas were able to read the information in their first language. This showed us that Holcroft Grange promotes the rights of people through the information it provides. Each persons individual needs were known and their rights to privacy and confidentiality were respected so the support and care they got from staff was given in a way that met their needs and made them feel valued and respected. All the people who lived at the home had a care plan that had been written and developed with them so they received care and support in the way they wanted and preferred. The atmosphere in the home was relaxed and sociable. We could see that the staff delighted in providing a high quality service. They listened to people intently, were always polite and responded with understanding, kindness and care. People were offered a range of activities in the home and were supported and encouraged to explore and take advantage of opportunities for leisure, and socialising with other people in the local community. All the people we spoke with told us that they were happy there and their health and social care needs were met. For example one of the many positive comments made was: The welfare of the residents is always the priority in Holcroft Grange. The manager and staff are excellent. We are well cared for. We are shown consideration, affection and respect in every way. Another person told us how they had been helped to cope with difficult personal problems and how the staff had helped them build their confidence. They said I have never felt better I love being here its a great place. We could see that the managers and staff were very good at involving people in the day to day management of the home and getting their views on the quality of care, facilities and services provided. People told us that their views were always taken seriously and acted upon. This showed us that the home is run in the best interests of the people who live there. Care Homes for Older People Page 8 of 28 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 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are thinking of moving to Holcroft Grange are given clear information and are invited to visit so they can make a choice about the homes suitability for them. They have their needs assessed so they can be confident that their needs will be met when they move in. Evidence: The people who lived at Holcroft Grange and their relatives told us that the information they were given was very good because it was detailed clear and easy to read. They told us that they or someone close to them had been able to visit before they moved in so they could make an informed decision about the homes suitability for them. The information about what the home provides and who it is for Your Guide to Living at Holcroft Grange was available in a range of formats including large print and was written in plain and clear language so people were helped to understand what the home had to offer. Care Homes for Older People Page 11 of 28 Evidence: The guide could be made available in a range of languages so people from the ethnic communities of Warrington and surrounding areas were able to read the information in their first language. This showed us that Holcroft Grange promotes the rights of people through the information it provides. If people decide to stay at the home and become resident they were given a contract or statement of terms and conditions if they were funded by a local authority so they knew about their rights and responsibilities. We checked the care records of four people who lived at the home and we spoke with them and some of their relatives to see if they were satisfied with arrangements made for their care and support. All the people we spoke with praised the home and the staff for their dedication and attention to detail. In fact most people told us that the home had exceeded their expectations because staff were aware of their individual needs and personal preferences and always did their best to provide care with kindness respect and consideration. We could see that each person had a needs assessment done before they moved in so they were confident that their needs would be met. Each persons assessment included a risk assessment that focused on achieving positive outcomes including ensuring that staff had the skills and specialist training and guidance they required to meet the persons needs. The manager and care staff showed us that they had worked in partnership with each person and where appropriate their representatives including relatives and health and social care professionals so the persons needs were met in the way they wanted and preferred. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live at Holcroft Grange are actively involved in developing their own care plans so the health and personal care they receive is based on their individual needs and the principles of respect, privacy, dignity and promoting independence are put into practice. Evidence: Our observations and discussions with the staff and the people who lived at Holcroft Grange showed us that the staff team were fully committed in supporting people to lead dignified, purposeful and fulfilling lives as independently as possible. Each person had a care plan that had been developed and agreed with them or someone close to them so staff knew how to meet the persons needs in the way they wanted and preferred. All the people we spoke with praised the staff for their dedication and commitment to providing a high quality service. They told us how the care staff offer just the right amount of support so they can do what they want to do with the minimum guidance or and help. This helped people to practice and develop their skills so they stay as Care Homes for Older People Page 13 of 28 Evidence: independent as possible. For example: One person told us that they liked to make a cup of tea for themselves in their own room but had difficulty lifting a kettle which could be dangerous. The staff had worked with them to help them understand the risks and had helped them find a way around the problem so they could enjoy the pleasure of making a refreshing cup of tea for themselves and their visitors. Another person told us how the staff had helped them build confidence and skills to manage their own medication and go out of the home in to town alone or with and friend. In each case staff had developed a risk assessment with the person so they were aware of the possible dangers and knew what to do to make sure they were safe. This showed us that people were supported to make informed decisions about their lives and the care they received and had the right to take a calculated risk in the interests of living and fulfilled lifestyle. We observed staff and the people who lived at Holcroft Grange talking and socialising and we could see that they enjoyed good relationships. There was a lot of friendly and respectful banter laughter and fun. We could see that the staff delighted in pleasing people and nothing was too much trouble if it meant the persons health and social care needs were met. We could see that each persons right to privacy was respected and care was given in a way that maintained their dignity. We discussed care records with the people who lived at the home and we could see that they were familiar with them. This showed us that the home actively promotes peoples right to access information that the service holds about them. All staff we spoke with had a good knowledge of each persons health care needs. Care records showed that each persons health care needs were monitored. People were encouraged and supported to make their own appointments and where necessary staff made contact with the persons health and social care professionals so their health care needs were met. All staff we spoke with were aware of the differing needs of the people who lived at the home and communication among the staff team was good. The staff showed us that each persons case file was kept up to date and was reviewed when their needs or circumstances changed. This showed us that that staff had sufficient information to meet each persons needs in a consistent and appropriate way so their health and social care needs were met. The home had a policy on the management safekeeping safe storage and safe administration of medicines. Records showed that all staff involved in handling medicines had received training so they knew how to do it safely. A medication check Care Homes for Older People Page 14 of 28 Evidence: showed that staff were vigilant when checking medication so people were safe. Accurate records were kept so we could see that people received their medicines as their doctor prescribed them and their health care needs were met. Care Homes for Older People Page 15 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Holcroft Grange are able to make choices about their lifestyle, social activities and food so they have control over their lives. They are supported to be as independent as they can be and have opportunity to make the most of their abilities. There is a nutritious and varied diet on offer and people enjoy meals in a relaxed, sociable and pleasant environment. Evidence: Holcroft Grange had a warm, welcoming and sociable atmosphere throughout our visit. We could see that the tempo of the home changed with the moods and needs of the people who lived there. At times it was relaxed and quiet as people rested and at other times it was positively buzzing with activity, enjoyment and fun. All the people we spoke with told us that they were happy with the range of activities on offer including opportunities to go out into the local community to socialise and do ordinary things like shopping or having a coffee or going to church. Some people told us that the home had exceeded all their expectations and described it as excellent. They told us that the activities coordinator was very enthusiastic and always did her best to meet individual needs and requirements. For example one person told us that they had wanted the computer to be connected to the internet. Her request was Care Homes for Older People Page 16 of 28 Evidence: granted and she was thrilled that she was able to keep in touch with her family and friends by email and surf the net. Others had shown interest in the personal computer and several people were learning how to use it. Some people said that they did not wish to take part in all activities but most people said their was something for everyone. For example one person told us Bingo is not everyones cup of tea but they enjoyed the quiz and discussion group on a Tuesday. People told us that staff respect their wishes and choices and hobbies and personal interests were always supported and encouraged. For example one person told us that they had shown an interest in oil painting and staff had helped them to get the canvases and paints they needed. We could see that staff actively support people to be independent and involved in all areas of daily living in the home. People told us that they had been supported and encouraged to develop their skills and confidence so they could do as much for themselves as they were able to do. This included managing their own medication, going out alone or doing ordinary domestic tasks around the home like looking after their bedroom or making a cup of tea for themselves and their visitors. Residents meetings were held regularly and people told us that staff listened and acted on what they said. For example some people had requested more fish in their diet. Records showed that the cooks had responded to this request by offering fish or sea food between three and four times in a week. All the people we spoke with where happy with the standard of catering in the home. The cook kept a list of each persons likes, dislikes and personal preferences and we could see that these were catered for. Some people said that the vegetables were often overcooked and others said they liked them that way. The manager told us that the cooks would be able to offer vegetables cooked to each persons personal taste and requirements and would arrange for personal preferences to be recorded. This showed us that the home is committed to providing an individual and personalised service so peoples needs are met in the way they want and prefer. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Holcroft Grange has a clear complaints procedure and thorough adult safeguarding procedures so the people who live at the home are able to express their concerns, are listened to and are safeguarded from abuse or neglect. Evidence: The people who live at Holcroft Grange told us that they have confidence in the manager and staff team and know that any concerns they may have will be listened to and acted upon. All the people who responded to our survey told us that they know how to make a complaint and many made very positive comments about the standard of care provided. For example one person commented: The home provides a pleasant, comfortable and cheerful atmosphere and keeps us in touch with normal everyday living. The staff are considerate, cheerful and encouraging. Whilst being very efficient, they are always ready to listen and support us if we are anxious or confused. Another person said: Holcroft Grange is an excellent place to live and fulfills our needs. It is a very happy place to live in. I would have no hesitation in recommending it to other people interested. The complaints procedure is provided in large print and plain language so people can read it easily. The home had received two complaints in the last 12 months. Complaints records showed that both of these complaints had been investigated and responded to appropriately. Care Homes for Older People Page 18 of 28 Evidence: The home had good procedures for responding to suspicion or evidence of abuse or neglect including a whistle blowing policy so staff know they can report poor practice if needed. Training records show that staff had received training and guidance on adult safeguarding procedures so they know what to do in the event of any suspicion of abuse. Five adult safeguarding referrals had been made to the local authority since we did our last inspection . In each case managers and staff had worked in partnership with the local authority so vulnerable people were safeguarded. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Holcroft Grange is spacious, well equipped, well maintained and pleasantly decorated so it provides clean and comfortable accommodation that meets peoples needs and expectations. Evidence: Holcroft Grange is located in the centre of Culcheth village with easy access to the local shops and general amenities. We found that the home provides comfortable, well maintained and well equipped accommodation with good quality furnishings and fittings. There is an attractive garden and inner courtyard that provides a safe area for people who live at the home and their visitors to sit and enjoy. The people who live at Holcroft Grange told us that they were happy with the accommodation and comfortable in their surroundings. They told us that the home is always or usually clean and fresh and some described the home as excellent. They particularly like the way they were able and were encouraged to personalise their bedrooms, which were furnished and decorated to suit their individual tastes and personal preferences. There is a choice of shared/communal areas including lounges and dining rooms so the people have opportunities to meet with their relatives and friends in private, if they so choose. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff at Holcroft Grange were trained, skilled and employed in sufficient numbers to meet the health and social care needs of the people who lived at the home. Recruitment procedures were thorough so the people who lived at the home were safeguarded. Evidence: We could see from or own observations that the staff working in the home were skilled and experienced in caring for older people. They carried out their work in good humour with sensitivity for each persons needs and communication abilities. Staff rotas and our observations showed us that there were enough staff on duty to meet the needs of the people who lived at the home. The manager told us that staffing rotas take into account the changing needs of people who live at the home and more staff were employed at times of higher demand. The people who live at the home told us that staff were available when they needed them. We could see that the staff delighted in providing a high quality service. They listened to people intently, were always polite and responded with empathy, kindness and attentive care. All the people we spoke with during the inspection praised the staff for their skill, kindness and attention to detail. For example one of the many positive comments made was: The welfare of the residents is always the priority in Holcroft Care Homes for Older People Page 21 of 28 Evidence: Grange. The manager and staff are excellent. We are well cared for. We are shown consideration, affection and respect in every way. Another person told us how they had been helped to cope with difficult personal problems and how the staff had helped them build their confidence. They said I have never felt better I love being here its a great place. We talked to the manager and three senior care staff about training opportunities and we looked at staff training records. We could see that there was a comprehensive staff training programme with opportunities for training in a range of relevant topics. All new staff complete the Skills for Care induction programme. This includes the common induction training standards so all new staff have the skills they need to carry out their jobs effectively and competently. Fifteen of the homes 23 care workers had achieved a national vocational qualification (NVQ) in care at level 2 and others were working toward the qualification. NVQs are nationally recognised qualifications for staff in the care profession. This showed that the home had exceeded the target for a minimum of 50 percent of staff to achieve a nationally recognised qualification in care. This shows us that people are safe and have appropriate support because the staff providing their care are qualified and competent. We checked the records of a new care worker who had been recruited since our last inspection. We could see that the homes recruitment procedures were thorough to make sure new staff are suitable to work with people who live at the home. People told us that they take part in the recruitment process so they have a say in who provides their care and support. This showed us that the home is managed in the best interests of the people who live there. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live at Holcroft Grange have confidence in the home because it is well managed. People are involved in the running of the home and their views about the quality of care, facilities and services provided are taken seriously and acted upon so they know the home is run in their best interests. Evidence: The manager is competent and experienced in the care of older people. We found that she is an effective leader who is person centred in her approach and has developed her skills over time achieving a City and Guilds in Community Care, a post graduate Diploma in Management Studies, NVQ level 4 in care and the Registered Managers Award. This showed us that the manager is suitably qualified and competent to run the home. There is a strong and consistent team of staff team who have been trained to a high Care Homes for Older People Page 23 of 28 Evidence: standard so the people who live at the home are in safe hands. Staff told us that the manager communicates a clear sense of leadership and direction so they operate as an effective team with the benefit of shared aims and objectives. All the people we spoke with during the inspection praised the home, the manager and staff and commended them for their dedication to duty and attention to detail. All made positive comments about the facilities and care provided and some described the home as excellent telling us that it had exceeded all their expectations. There was clear evidence that the managers and staff were promoting best practice principles of care including person centred planning and continuous improvement through involving the people who use the service in quality assurance and the day to day management of the home. People told us that they were consulted on a wide range of subjects at residents meetings and some had been involved in the selection of staff so they had a say in who provides their care and support. We could see that the home had effective quality assurance and quality monitoring processes in place. These were based on seeking the views of the people who lived at the home, their relatives, and representatives including health and social care professionals involved in their care. The quality assurance system includes care plan audits, medication audits, customer feedback forms, effective complaints procedures and annual satisfaction surveys by questionnaire. The results of this work were published so people know what action is taken to address quality issues and improve the standard of care and facilities and service provided. We made checks to see if peoples comments on quality issues had been put into practice. Records showed that peoples views were taken seriously and were acted upon so the home continued to develop and improve facilities services and care practices. CLS Group seeks to ensure the health and safety of all employees and people who live at or enter their premises. Risk assessment and risk management is central to the conduct of the home. The manager ensures that risk assessments are carried out for all safe working practice topics and significant findings are recorded and reviewed. Information provided showed us that fire precautions were in place and routine maintenance checks of gas and electrical systems, hoist, electrical appliances, fire alarms, extinguishers and emergency lighting systems were undertaken and were up to date. Records showed that the home had good systems for assisting people with their money so their financial interests were safeguarded. All the staff spoken with during the inspection told us that they were well supported and they appreciated the guidance and leadership provided by the manager and senior Care Homes for Older People Page 24 of 28 Evidence: staff team. Staff meetings were held on a regular basis and all staff benefited from regular structured supervision. All staff were familiar with the concepts of equality and diversity and told us how they recognised and met peoples needs through person centred planning. This showed us that the home is managed in the best interests of the people who live there. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 27 of 28 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. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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