Care Home: Ifield Park

Similar services:

• The Shelley
• Springfield House
• Sutton Lodge Nursing Home
• St Helier`s Residential Hotel
• St Joseph`s
• Ridgemount
• Wingham Court
• Old Hastings House

What the care home does well The needs of prospective residents continue to be comprehensively assessed before they are admitted. This means prospective residents know that their needs will be met by the care home. Care plans have been drawn up for each resident using the information gathered by assessing residents needs. They include information for staff to follow to ensure residents assessed needs have been met. Care plans are also regularly reviewed and residents are consulted as part of this process. This means care plans include the wishes of residents and that up to date information is available to staff. A programme of activities has continued to be provided each week for residents to enjoy. They have ensured residents` recreational and social needs are met. The manager has continued to manage complaints in a positive manner. This means residents and relatives are confident that their concerns will be listened to and, where necessary, acted upon. Staff are available in sufficient numbers to meet the needs of residents. Staff continue to receive appropriate training which gives them the knowledge and skills to provide good quality care to residents. They have also been well supported by the managers and senior staff. The care home continues to be well managed and has been run with the best interests of residents in mind. What has improved since the last inspection? Staff have been trained in recognising different types of abuse and know how to report any incidents they may witness. This means vulnerable residents are protected. What the care home could do better: No requirements have been made on this occasion. Key inspection report Care homes for older people Name: Address: Ifield Park Rusper Road Ifield Crawley West Sussex RH11 0JE     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 Bannier     Date: 2 9 0 1 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 31 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 31 Information about the care home Name of care home: Address: Ifield Park Rusper Road Ifield Crawley West Sussex RH11 0JE 01293594200 01293594349 reception@iphs.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Ifield Park Housing Society Ltd. care home 73 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 73. The registered person may provide the following category/ies of service only: Care home with nursing - (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) to accommodate 9 people in the category DE Dementia Date of last inspection Brief description of the care home Ifield Park is registered as a care home with nursing and is able to accommodate up to seventy-two older people, over the age of sixty-five years. Residents are accommodated in three separate buildings. These are called Woodruff Benton, which provides nursing care, Penn Court and Ellwood Place, which provide personal care. All rooms have en-suite facilities and a variety of communal space is Care Homes for Older People Page 4 of 31 Over 65 0 73 9 0 Brief description of the care home provided in each unit. This includes lounges, dining areas and conservatories. There is a separate building in which is located the offices and training/meeting facilities. The home is located in a quiet residential area on the outskirts of Crawley. It is situated down a private drive, away from the road. There are extensive grounds, much of which is safely accessible to residents. Car parking is available. Fee levels are currently from £345 to £812 per week. The cost of chiropody, hairdressing and newspapers are extra. The registered provider is Ifield Park Housing Society Ltd who have appointed Miss Jennifer Whitfield as the responsible individual to act on their behalf. Miss Whitfield is also the registered manager and is responsible for the day to day running of the care home. Care Homes for Older People Page 5 of 31 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 star. This means the people who use this service experience excellent quality outcomes. The inspection has followed the Inspecting for Better Lives methodology and is called a key inspection as it assesses those standards determined by the Commission as key standards. This inspection will also determine the frequency of inspections hereafter. We asked the registered provider to return an Annual Quality Assessment Form known as an AQAA prior to the inspection. The information received from this document helps us to form an opinion about how well the service is being run and is a legal requirement. Information provided in this form will be referred to throughout this report. We also asked a selection of residents and staff and visiting health care professionals Care Homes for Older People Page 6 of 31 to complete and return survey forms entitled Have Your Say. They have been designed to provide stakeholders with an opportunity to give us their opinions about how well the think the care home is operating. They will also be referred to within this report. A visit to the care home was made on Friday 29th January 2010. As this was an unannounced inspection we gave the manager and provider no notification of our intention to visit. We spoke with several of the 55 residents currently accommodated at the care home and observed care practices. This helped us to form an opinion of what it is like to live in this care home. We also spoke to several staff who were on duty in order to gain a sense of how it is like to work at the care home. We also viewed some of the accommodation and examined some records. The visit started at 10am and was completed by approximately 6pm. The registered manager, Miss Jennifer Whifield was present during our visit and provided us with information about the service. We gave feedback of our findings to Miss Whitfield at the end of our visit. Care Homes for Older People Page 7 of 31 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. 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 8 of 31 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 9 of 31 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. Prospective residents continue to have a thorough assessments of their needs carried out, and are informed in writing that the home can meet their needs, before being accommodated. Evidence: From evidence found during our last visit we formed a judgement that prospective residents have a thorough assessments of their needs carried out, and are informed in writing that the home can meet their needs, before being accommodated. During this visit we examined the care records of five residents, some of whom had been admitted since our last inspection. They demonstrated that the needs of each resident had continued to be throughly assessed prior to admission. This included all health and personal care needs, a medical history and personal details. We spoke to three care staff who were on duty. They were able to explain clearly their Care Homes for Older People Page 10 of 31 Evidence: understanding of the needs of recently admitted residents. They informed us that they had been made aware of the needs of residents via care plans and daily meetings with trained nurses. Information provided in the AQAA confirmed that, Following enquiries to the home, senior managers arrange to view care plans, if applicable, with care professionals and then arrange a visit to assess whether the residents needs can be met in the home. prospective residents are invited for a trial stay or a day visit to familiarise themselves with the home and to assist them to make a choice. This pre admission inspection is open to the friends and family of the resident. We noted that , on the same day as our visit, two groups of relatives of prospective residents were being shown round Woodruffe Benton House. We could find no evidence that Ifield Park provides intermediate care. Care Homes for Older People Page 11 of 31 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. An individual care plan has been drawn up for each resident, which outlines the identified needs of the resident together clear directions for staff to follow to ensure they have been met. Residents social and health care needs continue to be met. Residents accommodated contine to be treated with courtesy and respect, ensuring their dignity is maintained. Residents safety and wellbeing continue to be protected by the homes practices and procedures for administering medication. Evidence: From evidence found during our last visit we formed a judgement that residents had a very comprehensive, up to date, plan of care drawn up from health assessments; residents health care needs were met; residents said their privacy and dignity was respected and staff were kind and polite; medication was safely stored and Care Homes for Older People Page 12 of 31 Evidence: administered with records kept. We sampled a selection of care records during this visit. We found that residents care records include care plans which have been drawn up from the information gathered at the pre admission assessment. Care plans include details of residents identified needs together with clear information for staff to follow so they know the action they are expected to take to ensure they have been met. Following discussion with the manager we identified small areas where care plans could be improved further to ensure information is clearer for staff. The manager informed us she was in the process of changing the format and presentation of care plans so that information is more accessible and easier to follow. There was also evidence that demonstrated care plans have been routinely reviewed. This means that information about residents care needs is kept up to date.Care records also include details of appointments with residents doctors or other health care professionals including details of any treatment prescribed and provided. Four surveys returned residents confirmed that they always receive the care and support they need. Two surveys confirmed this is usually the case whilst one survey stated this is only sometimes. Six surveys confirmed that the home always makes sure they get the medical care they need whilst one survey confirmed this is sometimes the case. Residents we spoke to confirmed that they are aware of the content of care plans and they are consulted before any amendments are made. They also informed us they were very satisfied with the care provided. Their needs were met by the actions of staff, and their wishes had been taken into account. One resident we spoke to told us, The care staff are superb. We spoke to care staff who were on duty. They were able to demonstrate they were familiar with the needs of identified residents and the actions they should take to ensure they have been met. A survey completed and returned by a visiting health care professional confirmed that peoples social and health care needs are usually properly monitored, reviewed and met by the care service. When asked to comment on what the service does well they informed us, The care home respects residents privacy and choices. They want to care for the residents as long as possible within the home. They are proactive and plan priorities of care with the resident and their relatives to prevent crisis. They are responsive to advice and will seek advice. Care Homes for Older People Page 13 of 31 Evidence: Information provided in the AQAA confirmed that, Risk assessments are in place for all residents. Care plans are in place and are evaluated monthly and when required. Continence and pressure management systems are in place. Palliative care under the gold standard are practiced in the nursing home. We observed care practices and found that staff are respectful when speaking to residents and ensure residents are treated with dignity when personal care is being provided. Staff were seen to address residents using the name and title they prefer. Staff were seen to knock on the doors to residents private accommodation and wait for a response before entering. We spoke to several residents during our visit. They informed us they felt well treated by the staff. Four surveys returned to us by residents confirmed that staff always listen to them and act on what they say. Two surveys confirmed this is usually the case whilst one survey confirmed staff sometimes listen and act on what they say. Information in the AQAA stated that, All staff receive ongoing training on the rights of residents including their right to privacy, dignity, choice and independence in their daily lives. This is followed up in regular supervision We looked at care records and medication records. We were satisfied that medication records had been well maintained and were up to date. We also noted that a secure facility had been provided to store all medication. We noted that some residents have been prescribed with medication on an as required basis. For example some residents have been prescribed medication as part of a regime of pain management. We found that residents care plans do not include directions to staff with regard to the circumstances and the dosage when pain relief should be administered. We also noted that, when medication has been administered, the dosage and the circumstances when this has taken place has not been routinely recorded. We spoke to the manager about our findings. She confirmed that she will make the necessary changes to procedures and take the necessary steps to ensure changes to practice are implemented. We noted that staff who handle medication had been provided with up to date and appropriate training. We were shown records of staff training which demonstrated all staff who administer medication are expected to undertake a review of their knowledge every six months. We noted that a training package is followed which includes procedures, a questionnaire and a practical assessment undertaken by a manager. Care Homes for Older People Page 14 of 31 Evidence: We observed the senior carer on duty administering medication over the mid day meal. The senior carer confirmed the training she had received and also told us about the six monthly training review. Medication was administered from a trolley which was locked when the member of staff was not present. Medication was taken to each resident, whether they were in the dining room or in their own room. The AQAA confirmed, Medication procedures are in place and medication training is reviewed on a 6 monthly basis. Care Homes for Older People Page 15 of 31 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Activities and social events continue to be provided for residents enjoyment on a regular basis. Residents continue to be supported and encouraged to maintain contact with family and friends. Residents continue to exercise choice and control in their daily lives. Residents continue to be provided with a nutritious and wholesome diet which meets individual needs. Evidence: During our last visit we formed a judgement that there were a large amount of social activities on offer which residents said they enjoyed. Visitors were welcomed into the home at any time. Residents could make choices and preferences which were respected. They were happy with the quality, quantity and choice of food offered. During this visit we noted that care records include details of each residents interests and hobbies. We were informed that an activities coordinator has been appointed who Care Homes for Older People Page 16 of 31 Evidence: has a team of three assistants who are responsible for organising activities for residents to enjoy. We were also informed that there is programme of activities which are arranged on a weekly basis. We were shown a copy of previous weeks activities programmes which covered the Christmas period. We noted that activities are held in each of the houses to ensure all residents wish to, are able to attend. They included bingo, hoopla, exercise sessions, quizzes and music sessions. There were also visiting groups from local schools and, colleges to sing Christmas Carols, and a Christmas party. The manager informed us the programme is given to each resident so they know what is on offer and where it is being held. We also noted a copy is also on display on a noticeboard in the front hallway of each house. During the morning of our visit we observed thirteen residents enjoying a bingo session in the dining room of Ellwood House. From observation, residents were clearly enjoying themselves and had sufficient assistance to enable them to take part. The atmosphere was very relaxed and homely. Residents we spoke to informed us that, whilst they enjoyed the activities that had been organised, they were able to choose if they wished to take part in them. We noted that communal areas such as lounges and dining rooms had been equipped with televisions and DVD players. We also saw bookshelves with large print books and a selection of board games for use by residents. Residents we spoke to informed us that, whilst they enjoyed the activities that had been organised, they were able to choose if they wished to take part in them. Three surveys returned by residents confirmed the home always arranges activities that they can take part in if they want. Three surveys confirmed this is usually the case. The AQAA confirmed, We offer a comprehensive activities schedule for residents to undertake. We offer community activities and invite community representatives into the home to meet and talk with residents. The activities team meet with residents on admission to draw up a tailor made activities and social events programme. This is reviewed during residents meetings. During this visit we noted that care records include details of residents families and next of kin, including telephone numbers, so that they may be contacted. Residents we spoke to confirmed that they are able to keep in touch with family and friends. One resident told us, My daughter visits me every day. We also noted that some residents were still in the process of getting as we visited each house during the morning. We were informed that residents are able to choose Care Homes for Older People Page 17 of 31 Evidence: when they wish to get up to suit their own needs. We observed routines of the day were relaxed and unhurried to ensure the pace was set by the needs and wishes of each resident We spoke to the chef during our visit who told us about the main meal of the day that was being prepared. This consisted of a choice of battered fish and chips, poached fish or omelettes followed by a choice of jam tart or chocolate fudge brownie with custard Alternatives such as jacket potatoes and salads were also available for those residents who required a lighter meal. The chef also informed us of the special diets that were currently being catered for. This included diets for residents who are diabetic and also those who required pureed or liquidised meals. We were given copies of recent menus to look through. They demonstrated that a varied, wholesome and nutritious diet has been provided. We observed the main meal of the day being served in Elwood House. We noted that tables in the dining room had been attractively presented with linen tablecloths and napkins, fresh flowers condiments, a choice of cold drinks and individual place settings. The main kitchen is located in Elwood House. Meals prepared here are transported to the other houses by heated trolleys. Residents we spoke to during the meal confirmed the meal was tasty and nicely cooked. We also spoke to other residents who confirmed they were satisfied with the food provided. Comments made in surveys returned by residents were mixed. Two surveys confirmed they always like the meals at the home whilst one survey confirmed this is usually the case. Three surveys said they only sometimes like them meals provided. One resident commented, I would like more chocolate and more fruit. In response to being asked what could the home do better, another resident commented, More choice of food - more fish! The AQAA confirmed, Nutritional choices are catered for and documented in care plans. Residents with vegan diets and soft diets have meetings with the catering manager to ensure they continue to receive ample and varied choice. Care Homes for Older People Page 18 of 31 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. The provider has continued to ensure complaints made by residents and their relatives will be listened to, taken seriously and, where necessary, acted upon. All staff have continued to receive appropriate training to ensure residents are protected from abuse. Evidence: During our last visit to Ifield Park we formed a judgement that residents were confident their complaints and concerns would be taken seriously and acted upon. Not all incidents of potential abuse had been correctly reported by care staff. The manager, who was unaware of this, took immediate action to rectify the issue. Discussion with the responsible individual and registered manager during a previous visit confirmed that this had been addressed. On this occasion we noted that a copy of the homes complaint procedure was on display in each of the houses. Residents we spoke to during our visit confirmed they knew who to speak to if they wished to make a complaint. They also confirmed they were confident their concerns would be listened to and taken seriously. One resident commented, If I needed to make a complaint I would go to the head of the home. Five surveys returned by residents confirmed there is someone they could speak to informally if they were not happy. Four surveys confirmed they knew how to make a formal complaint. Care Homes for Older People Page 19 of 31 Evidence: We examined the record of complaints that have been received. They demonstrated that the manager ensures complaints are fully investigated and that the complainant is provided information about the outcome and any action which has been taken to rectify any shortfalls identified. Information in the AQAA confirmed that, We provide suggestion boxes which are sited throughout the buildings for suggestions and comments. Monthly resident and quarterly staff meetings give all the opportunity to be updated with and contribute to new processes and plans A complaints log book is sited in each home as is a catering comment book. An advocacy service is offered to all residents through Care Aware and we have a clear concise charter of rights. Information regarding complaints processes are provided to residents on admission and covered in residents monthly meetings. The AQAA also confirmed one complaint has been received over the past 12 months. it also confirmed is has been resolved to the satisfaction of the person making the complaint within agreed timescales. During this visit we spoke to some staff who were on duty. They confirmed they have received training with regard to identifying different types of abuse. Following discussion the staff were able to demonstrate they knew the different categories of abuse that they might encounter. They were also able to explain who they should notify if they witnessed an incident where a resident had been abused. We also examined records of staff training which confirmed they had received training in this area. Residents we spoke to confirmed they were satisfied with the quality of care provided. They also confirmed they felt they were in safe hands. The AQAA confirmed, There are whistle blowing procedures, grievance and disciplinary procedures in place. The recruitment procedures are regularly reviewed to remain up to date with current legislation and stringent checks are made on new staff to ensure their suitability to work with our residents. The home has strict and enforceable guidelines and training on abuse recognition, reporting and prevention. Care Homes for Older People Page 20 of 31 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. The environment has been well maintained and is safe and comfortable for residents accommodated. The home has been kept to a high standard is cleanliness and hygiene. Evidence: During our last visit we found evidence which confirmed that residents live in a safe, well maintained environment. We looked at the private accommodation of several residents along with the communal areas, including the dining rooms and the lounges of each house. These areas were clean, decorated and furnished in a comfortable manner that met the needs of the residents accommodated. Residents have been encouraged to bring personal effects and small items of furniture in order to make bedrooms as individual as possible. The manager informed us of plans for improvements and refurbishment to the environment. This included decoration and recarpetting of some of the communal areas. Residents we spoke to told us they were satisfied with their accommodation. One resident told us, I am happy with my room. The cleaners are great. They will do anything for you. I have just had a change round in my room which has made it better for me. All six surveys returned by residents confirmed the home is always fresh and Care Homes for Older People Page 21 of 31 Evidence: clean. We also visited the kitchen area, the laundry, and several bathrooms. We noted that these areas have been maintained to a high standard of cleanliness. We spoke to number of the housekeeping staff who informed us of their duties and the training they had received to ensure they had the knowledge and skills to ensure the environment is maintained to a high standard of hygiene and cleanliness. Information within the AQAA confirmed, A dedicated team of housekeepers ensure the homes are clean and adhere to infection control procedures. The housekeepers work with the residents to keep individual rooms to a high standard of cleanliness. The laundry team ensures that residents clothing is washed and ironed and returned within a four day timescale and often return laundered clothes on the same day. The homes infection control procedures and clinical waste management is monitored and reviewed to ensure compliance with the high standards we provide. Care Homes for Older People Page 22 of 31 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. Staffing levels are sufficient to meet the current needs of residents. The homes recruitment procedures and practices supports and protects residents accommodated at the care home. Staff have been provided with training and supervision to ensure they are skilled and competent to do the work expected of them, Evidence: During our last visit we formed a judgement that staff numbers and skill mix was suitable to meet the needs of the residents accommodated. Staff received appropriate training and a high proportion of them had completed or were enrolled on the NVQ training. Staff were recruited in a manner which protected the vulnerable adults in their care. During this visit we examined a selection of staff rotas. They showed that on Woodroffe Benton House there is a trained nurse on duty 24 hours a day. The trained nurse is supported by at least four care assistants whilst some mornings there are five care assistants. Each night care is provided to residents by a trained nurse and a care assistant who are awake and on duty. In Penn Court during the morning shift care is provided to residents by a team of five care assistants whilst during the afternoon and Care Homes for Older People Page 23 of 31 Evidence: evening shift there is a team of four. Each team has a designated senior who is responsible for leading the shift. At night care is provided to residents by two care assistants who are awake and on duty. In Ellwood Place residents care needs are provided for by a team of three care assistants during the morning shift and a team of two care assistants during the afternoon and evening shifts. Again there is a designated senior for each team. At night residents receive care from a care assistant who is awake and on duty. The is also a care assistant who is asleep on the premises and on call in case of emergency. In addition to the care staff there are housekeeping staffing, including chefs and domestic staff who are responsible for the providing meals to residents and for keeping the premises clean. Four surveys returned to us by residents confirmed there are always staff available when you need them, whilst two surveys confirmed this is usually the case. Residents we spoke to during our visit confirmed they are satisfied with the care provided. One resident told us, The care staff are superb. We could do with an extra person in the dining room. When I have eaten my meal I have to wait for help to get to my room. We spoke to the manager about this who agreed to ensure sufficient staff are made available to residents after the have finished their meal. From evidence seen in care records, discussions with residents and direct observations of care provided we concluded there were sufficient staff on duty to meet the current needs of residents. Information provided by the AQAA confirmed, We employ staff to meet the needs of residents and not to fill a vacancy. We do not have demarcation in jobs, staff work as a team and all assist one another should the need arise. We looked through the recruitment records of two staff who have been appointed since our last visit. These records demonstrated that the registered providers have obtained appropriate checks for staff, including criminal records checks, written references and proof of each persons identity. All five surveys returned by staff confirmed that their employer carried out checks, such as CRB and references, before they started work. The AQAA also confirmed, We use our comprehensive recruitment policy and procedure to employ staff to the standard we require. We ensure that references and checks are obtained prior to commencement of duty. During this visit we looked at a selection of staff training records. They demonstrated Care Homes for Older People Page 24 of 31 Evidence: that newly appointed staff undertake structured induction training. This includes providing an understanding of the principles of good care practices and covers the promoting of residents rights, independence, choice and dignity. Training records also provided evidence that confirmed staff have been provided with mandatory training including fire safety, health and safety, manual handling and food hygiene. We spoke a group of staff who were on duty. Following discussion, they told us about their role in the care home, the training they have undertaken, their understanding of the needs of identified residents and the action they are expected to take to ensure residents needs have been met. Three surveys returned by staff confirmed that induction provided covered everything they needed to know to do the job when they started very well. Two surveys confirmed this was mostly the case. Four surveys confirmed they they have been provided with training that is relevant to their role, helped them understand and meet the individual needs of people, kept them up to date with new ways of working and gave them enough knowledge about health care and medication. One survey was returned without this section being completed. The AQAA confirmed, All staff have equal opportunities to undertake training and maintain a good skill mix within the staff team. Mandatory training is in place for adult protection, fire safety, food hygiene, health and safety, and moving and handling. The AQAA also confirmed that, of the 20 permanent care workers employed, nine have obtained the National Vocational Qualification (NVQ) in Care or Health and Social care at Level 2 or above. Staff we spoke to told us they receive supervision every two months and attend staff meetings regularly. They also confirmed they felt well supported by the management. The manager showed us recent records of supervision sessions together with a record of sessions planned to take place in the future. The AQAA confirmed, We induct staff over a week and go through all aspects of the induction workbook. We ensure staff shadow competent and professional team members to learn the correct manner in which to provide care to our residents. We follow the induction training with regular supervisions and annual appraisals to ensure the focus and standards are maintained. We ensure all training the staff member requires is met and training they would like to undertake is offered. We offer all staff the opportunity to progress through the NVQ structure to ensure the highest possible calibre of staff available. The AQAA also confirmed that, of the 40 permanent care workers employed, eight have obtained the National Vocational Qualification (NVQ) in Care or Health and Social care at Level 2 or above. 16 staff have completed the induction training described and recommended by TOPSS England/Skills for Care. Care Homes for Older People Page 25 of 31 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 manager is appropriately experienced and qualified to fulfill the responsibilities of the post. The care home continues to be run in the best interests of residents. Staff continue to receive support and supervision on a regular basis. Systems are in place to ensure the health and safety of residents and staff continues to be maintained. Evidence: During our last visit to the care home we formed a judgement that residents and staff benefit from the home being run by an experienced manager. The quality of the service and practices is subject to audit and improvement strategies are in place. The health and safety of the residents was protected. Care Homes for Older People Page 26 of 31 Evidence: Miss Jennifer Whitfield, who is also the responsible individual, has registered with us as the manager since our last visit. She has demonstrated she has the necessary skills, knowledge and experience to manage a care home for elderly people whose needs include nursing care, such as Ifield Park. A management team has been put in place which consists of the registered manager, the nursing care manager, who is a registered nurse and is responsible for overseeing the nursing care provision, and the care manager, who is responsible for overseeing the residential care provision. We met and spoke to all three managers during our visit. Our discussions indicated that the nursing care manager and the care manager have the necessary skills and knowledge to carry out their duties. We were shown copies of minutes of recent residents meetings. They demonstrated they take place regularly and residents relatives are able to attend if they wish. Meetings included discussions about activities and planned outings. There is also an opportunity for residents to raise issues regarding the day to day running of the home. We were shown minutes of staff meetings. They also demonstrated they are held regularly and that the manager uses them as a means of communicating with the staff of the care home. We were also shown records which demonstrated that all staff have attended individual supervision sessions on a regular basis. This ensures they receive the support the require and there is a means of identifying training needs for each member of staff. Information provided in the AQAA confirmed that, We have organised and efficient systems for managing paperwork. We monitor the systems and processes in place and strive to find better ways of managing the service. The senior managers work together as a team and respect each others different approaches. The registered provider has set up a quality assurance system to be used in this care home. The manager is expected to carry out monthly audits on various areas about the the day to day management of the care home. We were shown audit reports carried out on accidents and incidents which have occurred over the past month. We were informed, when the manager assess accidents and incidents, she is expected to look for trends and reasons why they have occurred. This information is then used to review policies and practices to determine if improvements are needed. Representatives of the registered provider also visit the home on a monthly basis to monitor and evaluate how well the home is being managed. We examined copies of the reports of such visits. They confirmed that they had been undertaken regularly and had been used to monitor the service provided. Care Homes for Older People Page 27 of 31 Evidence: We did not examine records of monies kept by the care home on behalf of residents during this visit. The manager informed us the home has system, which has been audited, to account for the money and valuables kept on behalf of residents. During this visit we noted that the premises had been well maintained. There was no evidence that the property or equipment seen put at risk the safety and wellbeing of residents or staff. The AQAA confirmed, Administration is comprehensive and relevant. Reports are clear and delivered in a timely manner. In house reports accompany statutory requirements to ensure full details on any occurrence can be documented. Quality monitoring of systems is undertaken regularly to ensure all practice remains current and relevant. The external part of Regulation 26 visits is undertaken by a member of the management committee. Information supplied in the AQAA also confirmed the registered provider has taken appropriate steps to ensure the premises and equipment within the care home is safe for use. For example, gas and electrical appliances have been checked and maintained regularly. We found evidence that a programme of training provided to all staff includes health and safety issues, fire prevention, manual handling and first aid. Care Homes for Older People Page 28 of 31 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 29 of 31 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 30 of 31 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 31 of 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!