Care Home: Ings House Nursing Home

Similar services:

• Abbey The
• Snydale Care Home
• Hawkhills
• Larchfield Manor
• Beeches The - North Yorkshire County Council
• Carentan House
• Ravensworth Lodge

What the care home does well People`s needs are assessed prior to them moving into the home and are able to visit the home to establish whether or not it is the right place for them. Staff were observed being friendly, polite with cheerful dialogue between themselves and people using the service. The standard of care and the service provided continues to be maintained to a good standard. Comments from people who use the service and relatives and friends include: "We feel as a family that Ings House is the right place for mum and have confidence in the home and the way that it is managed. We have no concerns whatever." "Very well cared for with dignity, great communication, and involve family wherever possible." "The Matron and all carers do their job fantastically. We have no problems at all; they not only look after the residents they also look after family members as well. This is a top class home." Comments from social and health care professionals (doctors, pharmacist, podiatrist, social workers etc.) include: "I have observed the care of residents first hand. Residents are treated with warmth and respect." "Ings House is a very friendly work environment and you are always made to feel welcome. All staff work above and beyond the NVQ (National Vocational Qualification) standards. It is evident that the clients are happy and well looked after at Ings House..." "All staff take time with the clients and nothing is too much for them, always accommodating their needs whilst maintaining their safety." "As a visiting professional, I have always found the staff to be informative and extremely caring and professional. They appear to have high standards of nursing care that are constantly maintained." What has improved since the last inspection? All staff have had safeguarding training and are aware of the procedure to follow to protect people from potential abuse. Seventy percent of care staff now have a level 2, National Vocational Qualification in Care (NVQ) and qualified staff have a better understanding of peoples needs. The sample of supervision records seen indicated that staff have formal supervisions approximately six times a year and this takes place to ensure staff are competent to do their job. To ensure that staff are up to date with fire procedures they now have regular fire lectures and drills. What the care home could do better: Care plans should include guidelines regarding individuals specific health care needs to enable the staff to meet those needs. This is to ensure that people receive the health care they need. To promote choice and ensure that the lifestyle of people living in the home matches their expectations, people must be consulted about and offered a programme of activities. A menu should be available offering a choice of food and there should not be too long a gap between meals. This is to ensure that people have a choice of food, are reminded what the choice was, and they are not hungry. All new staff must have movement and handling training to make sure that they are aware of current practice, and therefore reduce the risk of injury to themselves and people in their care. Good practice guidance is that all staff have two fire lectures a year to ensure that they are up to date with current fire procedures. Key inspection report Care homes for older people Name: Address: Ings House Nursing Home 350 Bradford Road Liversedge West Yorkshire WF15 6BY     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Karen Summers     Date: 1 5 1 2 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 32 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 32 Information about the care home Name of care home: Address: Ings House Nursing Home 350 Bradford Road Liversedge West Yorkshire WF15 6BY 01924411166 01924410131 ken.woolford@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr John Keen care home 32 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home Ings House care home was built in the early 1800s and was extensively renovated and refurbished in 1990, when it was converted for use as a nursing home. It is situated just off a main road from Heckmondwike to Cleckheaton and it is convenient for those travelling on public transport. Shops and local amenities are located fairly closely within 5 minutes walking distance. The home offers single and twin accommodation, some with en-suite facilities for up to 32 elderly people. The registered manager informed the Care Quality Commission on the 15/12/2009 that fees range from £376.62 to £561.14 per week. Additional charges include hairdressing, private chiropody, newspapers, clothing, and dry cleaning. Information about the home and the services provided are available from the home in Care Homes for Older People Page 4 of 32 Over 65 31 0 0 1 1 9 0 1 2 0 0 9 Brief description of the care home the statement of purpose and service users guide. Care Homes for Older People Page 5 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This report refers to an inspection, which included an unannounced visit by one inspector on the 15th December 2009, and the length of the inspection was 7 hours. The last inspection visit of this service was carried out on the 19th January 2009. As part of the inspection in order to provide information to help us form judgments about the quality of the service, the manager was asked to complete an annual quality assessment (AQAA) document. This he did, and the document provided the Care Quality Commission (CQC) with a lot of information about the way the home is run, and what they hope to achieve in the future. The purpose of this inspection was to look at how the needs of people living in the home are being met and we focused on the outcomes of the key standards. Care Homes for Older People Page 6 of 32 We did this inspection with an expert by experience who spoke to people who are using this service. An expert by experience is a person who either has a shared experience of using services or understands how people in this service communicate. They visited the service with us to help us get a picture of what it is like to live in or use the service. This is important because the views and experiences of people who use services are central to helping us make a judgment about the quality of care. During the visit we spoke to people living in the home, visitors, staff and management. We looked at various records including peoples care plans and staff files. We looked around some of the building and we observed staff while they carried out their duties. To enable people who use the service to comment on the care it provides, we sent surveys to people living at the home, nine of which were returned, six were returned from relatives and three were returned from Social and Health care professionals involved with people living at the home. Comments from these surveys have been included in this report. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Older People Page 7 of 32 What the care home does well: What has improved since the last inspection? All staff have had safeguarding training and are aware of the procedure to follow to protect people from potential abuse. Seventy percent of care staff now have a level 2, National Vocational Qualification in Care (NVQ) and qualified staff have a better understanding of peoples needs. The sample of supervision records seen indicated that staff have formal supervisions approximately six times a year and this takes place to ensure staff are competent to do their job. Care Homes for Older People Page 8 of 32 To ensure that staff are up to date with fire procedures they now have regular fire lectures and drills. 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 32 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 32 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 are assessed prior to them moving into the home and are able to visit the home to establish whether or not it is the right place for them. Evidence: The care records of three people who use the service were looked at, all of which contained a Community Care Assessment carried out by the local authority who are funding the persons stay at the home. Each assessment contained detailed information about the persons health care needs before they moved into the home. Both of these assessments would have helped to make sure the home had the necessary equipment and the staff had the necessary skills to care for people. This was confirmed by the registered manager and the nurse manager at the time of the visit. The information in the annual quality assessment document confirmed that all Care Homes for Older People Page 11 of 32 Evidence: prospective people undergo a pre-admission assessment to ensure the home can meet any identified need and the placement will be appropriate. The information also states people are made aware of the advocacy services should they need guidance and assistance regarding their specific circumstances. Prospective people who use the service and their families are also encouraged to visit the home and spend some time there speaking to visitors and people who live there, to gain an insight of how they view the service. Without exception people living in the home and their families confirmed in the surveys that they receive enough information about the home before they moved in so they could decide if it was the right place for them. Care Homes for Older People Page 12 of 32 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. Peoples care plans outline the level of support and care each person requires in ensuring that their needs will be met. People are treated with respect. Evidence: Three peoples care plans were seen, and there was evidence to suggest that they continue to receive personal and health care support in a person centered way, and that their social, cultural, religious needs, and likes and dislikes were recorded. Relevant risk assessments were in place in all of the records examined, including falls, pressure care, nutrition and continence. However whilst staff were correctly monitoring blood sugar levels, there was no information about what would be the normal range for the person and what action should be taken if the level was too high or too low. Whilst the staff who were spoken with knew peoples individual needs, there are rare occasions when the home use agency staff and as such without this information there Care Homes for Older People Page 13 of 32 Evidence: is a risk that could lead to people not receiving the health care they need. The nurse manager agreed to up date the care records to reflect this information. There was information in the care records of involvement from peoples doctors, social workers, opticians and other health care professionals where needed. Care reviews had taken place, and the care plans had been updated monthly or as the needs of the person changed, and this was with the involvement of the person or their relative. Nine people who live at the home completed surveys and without exception everyone said that they receive the care and support they need, staff are available when they need them and staff listen and act on what they say. Six relatives returned surveys and all of them said that the care service meets the needs of their relative and that the service gives the support and care to their relative that was agreed. Comments include: Very well cared for with dignity, great communication, and involve family wherever possible. The Matron and all carers do their job fantastically. We have no problems at all; they not only look after the residents they also look after family members as well. This is a top class home. Comments from social and health care professionals (doctors, pharmacist, podiatrist, social workers etc.) include: I have observed the care of residents first hand. Residents are treated with warmth and respect. Ings House is a very friendly work environment and you are always made to feel welcome. All staff work above and beyond the NVQ (National Vocational Qualification) standards. It is evident that the clients are happy and well looked after at Ings House. All staff take time with the clients and nothing is too much for them, always Care Homes for Older People Page 14 of 32 Evidence: accommodating their needs whilst maintaining their safety. As a visiting professional, I have always found the staff to be informative and extremely caring and professional. They appear to have high standards of nursing care that are constantly maintained. Care Homes for Older People Page 15 of 32 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Not all people experience lifestyles in the home which match their expectations in relation to their social and recreational interests and needs. Evidence: On the day of the visit the majority of people were sat in the lounge areas, including the conservatory, and staff were seen to be circulating between all areas and attending to peoples needs in a kind and caring manner. A member of the care staff is responsible for activities, and she confirmed that she works Monday to Friday from 7.30am until 10.00am getting people up and ready for breakfast, and then between 10.00am and 12.00 mid day, she organises an activity session. The list of activities is displayed on a wipe board in the entrance to the home, but out of sight for people living there. The activities listed were: Monday- Bingo, Tuesday Nail care, Wednesday- Skittles, Thursday- dominoes/cards, Friday- nail care. The manager confirmed that these are the usual activities each week. No activities were listed for the weekend. Care Homes for Older People Page 16 of 32 Evidence: At 12.00pm the activities coordinator helps other carers to assist people with their lunches, and then she goes to the rooms of the people who cant get out and talk with them on a one to one until she finishes work at 2.00pm. Students also come from the local college on work experience and sometimes help in the activities. Usually these are for two week periods only, except for one person who has been attending Ings House for nearly 12 months. This was also confirmed by the manager and the staff at the home. At the time of the visit it was the homes Christmas party and an entertainer had come to sing. Peoples friends and relatives had been invited and were visiting. Staff were interacting with people by friendly banter and singing along with the songs. Everyone there, including peoples relatives, looked happy and enjoying the festivities. Comments from people living at the home and their relatives include: They are lovely friendly staff. I dont know whether they do activities. I think there was somebody who used to do activities. I can get my nails painted, Ive got red today. I like to sing to the Christmas carols. There was very little information or evidence in the care records relating to what activities people had been involved in, or the enjoyment of any activities. We discussed these issues with the registered manager and nurse manager and they agreed that people should be consulted about the activities that take place in the home, activities should be made available to meet the social needs of people and their enjoyment and participation in the activities should also be recorded. The registered manager said that he would organize a meeting with people to review the activities timetable and also review the amount of time available to spend on activities each day which would involve all people who are living in the home and who wish to participate. Staff said that peoples spiritual needs can be catered for if requested but no services take place other than a visiting priest who comes once a week to administer communion to a person living there. Two of the people who were spoken with confirmed that they could ask for a minister to visit if they wished. On the day of the visit there were two dining room tables in use and only seven people chose to sit at the table for their lunch time meal. Space was limited as chairs Care Homes for Older People Page 17 of 32 Evidence: took up part of the dining room. People sat with trays in front of them and when asked if they would like to sit at the table, everyone said that they preferred to stay where they were. In relation to food, staff said that people are informed during the morning of the meal that will be served at lunch time. The menu displaying the dish of the day was written on a white board in the hall and a choice of food was not displayed. The manager and a carer said that an alternative to the menu is available if the person does not wish to have the meal on offer and people can have what they want. Staff said that the chef knows peoples likes and dislikes and there was evidence of this written in the care plans. Breakfast, dinner and tea time were approximately at four hourly intervals with tea time at 3.45pm and then supper at 6.30pm. A carer said that at supper time people can have things to eat such as cereals, toast or a sandwich. People were also said to ask for food to eat during the night and one person had requested egg sandwiches which were made for them. Comments which were made to the expert by experience from relatives, people living in the home and staff include: The food is okay, sometimes I might not like what it is, but I dont mind I enjoyed my dinner, it was lovely I am welcome anytime to have a meal with my relative and I dont have to pay, its free. I dont mind my relative having their tea early as they like to go to bed at 6.00pm. We are allowed to have a meal here and we dont have to pay for it (carers) Prior to the meal aprons were used to protect peoples clothing from spillage. The use and type of aprons used was discussed with the manager. Whilst the aprons may be used to protect peoples clothing and their dignity when eating, the protectors can also have a reverse effect. The manager said that he would look at alternative clothes protectors and discuss the use of them with the people living at the home and their relatives. We were shown by the manager the three menus which were used in rotation. The menus had been up dated and when looking at the old menus an alternative had Care Homes for Older People Page 18 of 32 Evidence: been recorded. The registered manager said that not recording the choice on the menu was an oversight on his behalf, and that he would ensure that a choice at meal time is added and that menus were made available to people. We also discussed that the meal times were close together. The registered manager agreed to have a meeting with the people living in the home to discuss the times they would like their meals and the menus. Care Homes for Older People Page 19 of 32 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be confident that their complaints will be listened to and taken seriously. People are protected from abuse. Evidence: People living in the home and their relatives said that they knew who to speak to if they were not happy and with the exception of two people everyone knew how to make a complaint. Comments received in surveys from people living in the home include: I am quite happy with everything appertaining to the home. No complaints. We are looked after well. The home has a complaints procedure and the manager confirmed that a copy of the procedure is made available to people living at the home and their relatives. The manager continues to have an open door policy for relatives and visitors to see him on a daily basis should they have any concerns and this was confirmed by relatives on the day. Care Homes for Older People Page 20 of 32 Evidence: In addition to this, the manager visits every person living in the home daily, and people living there confirmed this. No complaints have been received by the Commission since the last inspection. There was evidence in the training records to suggest that staff have had safeguarding (adult protection) training that provides information on how to protect people from abuse, and staff who were spoken with confirmed this. Care Homes for Older People Page 21 of 32 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 home offers people a homely and comfortable environment. Evidence: As part of the inspection a tour of the home took place, which included the communal areas, a number of bedrooms and the laundry. Ongoing refurbishment continues to take place, and includes the purchase of specialised mattresses and beds. The standard of cleanliness throughout the home was good, and systems are in place to control the spread of infection. Without exception, people said in the surveys that the home is always fresh and clean. Comments include: This is a top class home. The home is very very clean. People commented that their relatives clothes were always clean and tidy, and that people always look well presented. Care Homes for Older People Page 22 of 32 Evidence: Since the last inspection the dining room floor covering has been replaced, and the corridors and bathrooms have been painted and this was confirmed in the information received prior to inspection and on the day. A number of the lounge chairs were heavily stained and in need of cleaning or replacement. The AQAA confirmed that the home has a refurbishment and improvement business plan, and the manager also said that the chairs would be either professionally cleaned or, where appropriate replaced within the next three months. Within the last two months the boilers that control the heating have been replaced. The information received prior to inspection states that the boilers will enable the room temperatures to be controlled more effectively. However the manager said that over the last few days there had been problems with the room temperature and he had found that people had been turning the radiators off. On the day of the visit some unoccupied rooms were cold, whilst the occupied bedrooms were warm. We discussed with the registered manager that should a person wish to return to their room then they would have to wait for a period of time for the radiator to be put on and the room heated which was not acceptable. The registered manager agreed that the temperature of the rooms would be maintained at a constant temperature so that people could return to their rooms when they so wish. Also since the last inspection more specialised beds and mattresses have been purchased. The home now has a supply of mattresses to meet the needs and changing needs of people within the home. Care Homes for Older People Page 23 of 32 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. People benefit from being supported by caring and competent staff. Evidence: On the day of the visit there were thirty two people in residence. The duty rota was looked at, and there was evidence to suggest that there was a nurse on duty twenty four hours a day. There were also five care staff on duty between 8.30am to 2pm, four to five staff between 2pm and 8.30pm, and two staff on night duty. In addition to this the manager said that between 6.30am and 1pm a carer is employed to assist with the morning routines and assisting people to get up, and between 8.30am and 10am the activities person helps with the morning routines. The manager confirmed that he is extra to the above figures and works Monday to Friday. Support staff are also employed to meet the needs of the home and these include: kitchen staff, laundry staff, domestics, activities coordinator and maintenance person. The duty rota showed that there were enough staff to care for people properly and this was confirmed by the manager. When asked if the care staff have the right skill and experience to look after people Care Homes for Older People Page 24 of 32 Evidence: properly, health care professionals, (Dietician, Pharmacist and Social workers,) replied, Always or Usually Comments include, As a visiting professional, I have always found the staff to be informative and extremely caring and professional. They appear to have high standards of nursing care that are constantly maintained. Qualified staff contact me if they have any queries or with the patient updates as required. As a visiting service to Ings House, I have observed the care of residents firsthand. Residents are treated with warmth and respect. We are given all relevant information concerning residents and assistance to give the best possible podiatry care to residents. Care practice observed during this visit, and the relationship between staff and people being cared for was positive. Three peoples recruitment records were inspected and with the exception of one person who had recently started work at the home, the records contained the required information and employment checks. These checks are necessary to help protect people from potentially unsuitable staff. One person had recently started work at the home as a carer and we were shown copies of this persons recruitment checks. The documentation requested two references however only one written reference was seen in the records. The registered manager said that he had received a verbal reference from this persons last employee, and at the time of the visit the carer delivered the second reference. The registered manager said that he had not allowed this person to work unsupervised, and he had obtained the necessary police checks; however he would in future ensure that he obtains two written references prior to allowing staff to work at the home. There was also evidence in the staff records and staff confirmed that they had induction training when they came to work at the home, which provides them with the knowledge and skill to look after people in their care. The manager and nurse manager have had training relating to dementia care, and arranging further training for the staff to attend. This will ensure that staff have the skills and knowledge to care for people with dementia. Seventy per cent of care staff now have a level 2, National Vocational Qualification in Care Homes for Older People Page 25 of 32 Evidence: Care (NVQ) and qualified staff have a better understanding of peoples needs. Care Homes for Older People Page 26 of 32 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is generally run in peoples best interests. Evidence: The registered manager has a number of years experience of working at the home and has completed the Registered Managers Award, and an NVQ level 4 in Management and Social Care Organisations. Staff and people living at the home continue to speak positively about the approach of the manager and how he is available should they need to speak with him. As part of the inspection in order to provide information to help us form judgments about the quality of the service, the manager was asked to complete an annual quality assessment (AQAA) document. This he did, and the document provided the Care Quality Commission (CQC) with a lot of information about the way the home is run, and what they hope to achieve in the future. Care Homes for Older People Page 27 of 32 Evidence: The information supplied by the home in the AQAA states that they continue to be accredited with the Investors in People award. The managers said that an annual quality monitoring survey is sent out to people who live at the home and their relatives. The results of the survey are made public and an action plan is developed to address any issues identified. The results of the survey from 2009 were seen and were positive. Comments include: We find the home is very well run and your staff are excellent, so patient. Everything is done well in both care and welfare. The home does not hold personal monies on behalf of people. Should they require any money then it is supplied by the home and re charged to the persons monthly bill. Records were seen of staff supervisions which take place approximately six times a year. Staff are supervised to ensure they are competent to do their job. Routine health and safety and maintenance are carried out and appropriate records were seen of those looked at. Records were also seen of fire alarm and emergency lighting tests. Fire drills and a fire lecture had also been carried out and staff confirmed that they had received training. However, the records showed that staff had received one fire lecture in the year. Following consultation with the fire safety officer, she confirmed that it is good practice to have two fire lectures a year. It is also good practice to have regular fire drills. According to the training records, with the exception of one member of staff who has recently started work at the home, all staff have had movement and handling training to ensure that they know how to move people safely. Training had been identified for the new recruit to be carried out in March when the annual movement and handling training is scheduled. In the interim the registered manager said that the person would be shown by staff and supervised when carrying out any movement and handling. Following discussion with the manger, the training for the new recruit has been arranged for January 2010. Care Homes for Older People Page 28 of 32 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 32 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 12 16 People must be consulted about and offered a programme of activities. This is to enable them to take part in activities of their choice. 15/02/2010 2 15 16 A choice at meal time must be offered and there must not be too long a gap between meals. This is so that people have a choice and are not hungry. 31/12/2009 3 38 13 All new staff must have movement and handling training. This is to to make sure that they are aware of current practice, and therefore reduce the risk of injury to themselves and people in their care. 26/01/2010 Care Homes for Older People Page 30 of 32 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 Care plans should include guidelines regarding individuals specific health care needs to enable the staff to meet those needs. This is to ensure that people receive the health care they need. Care Homes for Older People Page 31 of 32 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 32 of 32 - 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!