Care Home: Kingfishers

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What the care home does well The home has good systems for assessing people`s needs before they are provided with a care service. This helps to assure people that the home will meet their needs. People receiving a care service feel staff treat them well and maintain their privacy. People who use the service are helped to exercise choice and control over their lives and there is an innovative and developing programme of social and recreational activities based on people`s individual needs and interests. The excellent design and layout of the home provides people with a homely, wellmaintained and comfortable environment, which promotes their independence. There is a comprehensive induction programme and staff are well trained, which helps to ensure that people`s needs are met. There are good systems to minimise identified risks to people and the home does not employ people unless they have been thoroughly checked, which helps to protect people. There are good systems for obtaining feedback from people using the service and for responding to any complaints, so that people are confident that any concerns they have will be listened to and acted upon. Comments we received from people who use the service include: "I must say how impressed I am with the choice of staff, from nursing sisters and carers to kitchen staff, cleaners and laundry. Everyone is always polite and friendly. Lovely". "I`m happy here". The staff "maintain a high level of friendly care". "Home from home. When I first arrived, my wife said I had a smile on my face that never stopped". They "Provide good meals". "Everything is really nice". What has improved since the last inspection? This is the first inspection of this service. What the care home could do better: The manager says there are plans to continue to develop links with the local communiity and involve the local community with events happening at Kingfishers. There are also plans to establish a team of dedicated social carers whose sole responsibility is the social care of people who use the service.There are plans to continue to develop the staff team through NVQ (National Vocational Qualifications) and further specialist training. Key inspection report Care homes for older people Name: Address: Kingfishers The Meadows Southern Lane New Milton Hampshire BH25 7JB     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: Laurie Stride     Date: 0 2 0 9 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 30 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 30 Information about the care home Name of care home: Address: Kingfishers The Meadows Southern Lane New Milton Hampshire BH25 7JB 01425626700 01425626770 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Colten Care Ltd Name of registered manager (if applicable) Mrs Rebecca Hannam Type of registration: Number of places registered: care home 60 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 60 The registered person may provide the following categories of service only: Care Home with nursing (N) to service users of the following gender: Either Whose primary needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) Dementia (DE) Date of last inspection Brief description of the care home Kingfishers is a purpose built care home with nursing that was registered in April 2009 and has a range of specialist equipment to meet peoples needs. The home is divided into units over three floors. The accommodation on the ground floor is for up to twelve people who have residential care needs. On the first floor there are thirty bedrooms for people who require nursing care. There are two units on the second floor: one for ten Care Homes for Older People Page 4 of 30 Over 65 0 60 60 0 Brief description of the care home people with dementia and nursing needs and the other for eight people with dementia and lower dependency. Kingfishers has been developed by Colten Care Ltd, Western Rd, Lymington, Hampshire. Colten care Ltd was established in 1980 and is a registered provider for other services in the Hampshire and Dorset areas. The home is situated near to local shops and to the seafront. Care Homes for Older People Page 5 of 30 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: We (the commission), carried out an unannounced visit to the home on 02/09/09. This visit was part of the first key inspection of this new service, which takes into account all the information we have received about the service since it was registered on 24/04/09. The information included the homes Annual Quality Assurance Assessment (AQAA), which the registered manager sent to us prior to this visit. The AQAA is a self assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. Before our visit, we had sent survey questionnaires to the manager to distribute to people who use the service, staff members and health and social care professionals. At the time of writing this report we had received completed questionnaires from seven of the people who use the service and four staff members. During this key inspection visit we met some of the people who use the service and spoke with four of them and two relatives. We spoke with the manager and a nurse Care Homes for Older People Page 6 of 30 and met some of the other staff. We also spoke with a relative over the telephone prior to our visit. We looked at samples of the records held by the home, including care plans and staff training records. Care Homes for Older People Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: The manager says there are plans to continue to develop links with the local communiity and involve the local community with events happening at Kingfishers. There are also plans to establish a team of dedicated social carers whose sole responsibility is the social care of people who use the service. Care Homes for Older People Page 8 of 30 There are plans to continue to develop the staff team through NVQ (National Vocational Qualifications) and further specialist training. 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 30 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 30 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. No person moves into the home without having his/her needs assessed and been assured that these will be met. Evidence: The AQAA informed us that the homes Statement of Purpose and additional written information is given to people who are interested in using the service. People are invited to come to the home for a lunch, to join activity sessions or to come and stay for a week respite to see if the home will suit their needs and lifestyle in the long term. A person who uses the residential care service and their visitor told us about their experience of the admission process. They met with the Head of Care and were able to visit the home several times and were always made to feel welcome by the staff, who learned names quickly. They told us they were impressed with the homes brochure, which gave clear information about the service, and that financial matters were well Care Homes for Older People Page 11 of 30 Evidence: handled and explained to them. We spoke with another person who told us they had initially come to the home for a two week trial period and had subsequently extended their stay. The AQAA stated that a comprehensive pre-admission assessment is carried out to ensure that the service is fully able to meet all the persons needs and any necessary additional equipment is obtained. During our visit we saw the care records of five of the people who use the service, which included detailed assessments of their individual needs, carried out by the Head of Care. A pre-admission assessment is followed by further assessment after the person comes to stay and there is then a formal six monthly review. The care plans that are developed from the assessment information are reviewed on a monthly basis. The home does not provide intermediate care, therefore this standard is not applicable. Care Homes for Older People Page 12 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their individual needs and the principles of respect, dignity and privacy are put into practice. The homes policies and procedures for handling medication protect people who use the service. Evidence: During our visit we saw the care records of five of the people who use the service, including people receiving residential, nursing and/or dementia care and support. Care plans contained information about, for example, nutrition, mouth care, skin and wound care, mental health and social needs. There are also risk assessments and guidance for staff, such as the use of bed rails, mobility and falls. We saw guidance on managing behaviour in relation to two people who live in the home. This incuded charts for monitoring and recording any identified patterns of behaviour. The nurse showing us the care plans demonstrated a thorough knowledge of the individuals needs and preferences. There are three staff handovers a day to ensure that changes in anyones condition, mood or care needs are updated frequently. We saw there are also staff communication books to ensure observations are written down and passed between the staff. Care Homes for Older People Page 13 of 30 Evidence: Four members of staff took part in our survey. Asked if they are given up to date information about the needs of the people they support or care for, three said always and one said usually. Two staff members indicated that they always feel they have enough support, experience and knowledge to meet the different needs of people who live at the home. The other two said that they usually do. Detailed daily records are kept, which enabled us to see that the care plans were being adhered to in full and what the outcomes were for people receiving the care and support. For example, one person had been admitted to the home in an anxious state of mind and on a special diet of pureed food. Care plans had been put in place for communication, mobility and maintaining a safe environment, amongst others. The daily records showed that following admission and a review of their medication, this person had been walking and chatting with staff and was now on a normal diet. The notes also indicated that the persons relatives had visited and were pleased with their progress. We saw that a daily life plan had been completed by the relatives, showing what the persons interests and preferences are. Food and fluid monitoring charts were being completed by staff. We briefly met the individual receiving the care, who was active and sociable and showed us their accommodation. We also heard from the wife of a resident who has dementia that since coming to the home he was more sociable. A diary is kept of regular visits to the home by a chiropodist and an optician and staff write in the names of individuals who require these services. The manager told us there are good links with the local GP surgeries and a local hospice. There were records of monthly reviews of the care provided to individuals. The manager told us that the home operates a resident of the day system throughout each month, when staff focus on all aspects of the individuals personal, social and health care needs, including their accommodation, so that a full analysis is done for each review. The records also indicated that the individuals and/or their family and friends are encouraged to participate in the planning and review of their care. A person who uses the residential care service and their visitor told us that they had access to and knowledge of the care plan and that everybody is very caring. Another person we spoke to told us she was happy with the care she received and the way staff treated her. People we spoke with confirmed that staff respect their privacy. We saw that staff gave personal care to people in the privacy of their own rooms and all rooms have en suite shower rooms. The manager asked a person who uses the service if she would Care Homes for Older People Page 14 of 30 Evidence: mind us seeing her care notes. The person indicated that she did not want us to and this wish was respected. One of the people we spoke with told us that staff had discussed with them their final wishes and that this had been handled sensitively. The home is equipped with well organised clinical rooms on each floor where medication is stored in purpose built cabinets and trolleys. We looked at a sample of the medication administration records for two individuals and these had been completed and signed in line with the procedure, including any changes in a persons medication. The records contained up to date photographs of each person for identification purposes. There are procedures for ordering and receiving medication and records of monthly drug audits. Care Homes for Older People Page 15 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are helped to exercise choice and control over their lives. There is an innovative and developing programme of social and recreational activities to meet individuals expectations. People who live in the home receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Evidence: In the AQAA the manager told us that the service place a strong emphasis on social interaction, physical and mental stimulation and involvement in the life of the home. The home offers people a minimum of five activities a day and try to tailor activities to suit peoples individual needs and preferences. A person who uses the residential care service and their visitor told us about their experience of the home. The home asks people and their relatives to provide as much detail as possible about the personal histories of people who use the service. This is then used to identify suitable activities and ways of keeping the person mentally stimulated. They confirmed that the activities offered tie in with the detailed history. They said the activities organiser comes in each morning and asks them if they are coming into the lounge when activities are taking place. Each person is provided with a written programme of activities and events. A garden fete was arranged for the Care Homes for Older People Page 16 of 30 Evidence: weekend and the person said they were going to run one of the stalls, which was part of a fundraising event for a charity nominated by people who live in the home. They said they had been out in the homes mini bus and they owned a scooter, which the home stored for them when not in use. The persons visitor said they are invited to relatives meetings that are held in the home and is also made welcome at the sherry and chatter social events that are held three times a week for people who use the service. They said they stay for an occasional meal at the home and that the food is cooked and presented very well and meals include fresh fruit and vegetables. The person who lives in the home told us that staff monitor their appetitie and check they are ok. The persons visitor said there had been a wonderful Indian barbeque night held at the home and staff had thought of everything. The home has a guest room where relatives who have to travel long distances to visit can stay. We saw a daily life plan that had been completed by the relatives of one person, showing that the person likes musical activities, naming the actors and having their hair done. Activities to suit the persons preferences were included in the programme. Another persons care plan gave details of their individual daily routine, such as the times that they like to get up and when they go to bed. This person told us that the staff encourage people to join in the activites but that she likes to read and staff respect her choice. She said she can move around the home as she likes and has cups of tea and meals with her husband. She told us that the food is nice and always hot. During the day we observed people enjoying musical entertainment and a ball game activity. Another person we spoke to told us they were happy with the activities on offer and had enough things to do in the home. We spoke with the activities organiser and saw detailed weekly and monthly activity programmes. These included open discussions, card painting, memory games, themed fun activities, musical entertainers, sherry social events, films and cinema shows in the activities room. The organiser and people who use the service had been making jam and chutney to sell at the forthcoming fete. The activities organiser works full time including alternate weekends and keeps a record of who attends activities. This helps to identify those people who are not able to or prefer not to participate in group activity and these people are then referred by the co-ordinator for social care visits. These are provided by health care assistants, who also maintain a diary of such activities. The AQAA informed us that there were plans to recruit a second activity organiser to specifically work with people who have dementia as soon as occupancy reached in excess of thirty residents. At the time of our visit the manager informed us that a second activity organiser had been recruited to start work in October. At present the social carers provide varied activities to supplement the activities provided by the full Care Homes for Older People Page 17 of 30 Evidence: time activity organiser. The AQAA also states there are plans to establish a strong team of dedicated social carers whos sole responsibility is the social care of residents throughout the home. At lunchtime we observed the meal taking place in the dining areas on each of the three floors. We saw that staff members were available in each area and some were providing one to one support where this was required. Two of the people who are resident on an upper floor had chosen to come downstairs and have their lunch in the residential dining room. The food menu was attractively displayed and showed a wide choice of meals. The lunch menu for the day gave a choice of baked virginia ham, lambs kidney turbigo, battered haddock or (vegetarian) mushroom stroganoff. For dessert there was a choice of rhubarb crumble, assorted ice-cream, stewed fruit, a sweet trolley, tea and coffee. For supper there was home made mushroom soup with a soft roll, macaroni cheese, assorted sandwiches and fruit juice on offer. The AQAA stated that a later supper time had been arranged for one person who found 6.00pm too early to eat the evening meal. The Chef meets with the Head of Care once a week and a record is made of any changes in peoples dietary needs. Care Homes for Older People Page 18 of 30 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 feel confident to express any concerns and have access to an effective complaints procedure. People are protected from abuse through the homes procedures and staff training. Evidence: The AQAA informed us that the home has a comprehensive complaints policy and procedure, which is fully explained in the Statement of Purpose and information booklet given to people who use the service. We looked at the homes complaints log, which showed that any concerns that had been brought to the attention of the management had been looked into and resolved quickly. The logbook gave a record of the issue raised, action taken and the outcome. A person who uses the residential care service and their visitor told us they cant find anything wrong with the service and wanted us to know how good it is here. They said that the manager asks if everything is ok, attends residents meetings and checks that they are satisfied with the care service. If there were any issues they wanted to raise they said they would feel confident that these would be taken seriously and resolved. Another person who lives in the home told us that if she had any concerns she would speak with the manager. She said she had raised an issues once and the Head of Care had dealt with it immediately and that the home encourages feedback. Another person we spoke to also told us they had no concerns and would speak to the manager if they had any. People who use the service who took part in our survey Care Homes for Older People Page 19 of 30 Evidence: indicated they know who to speak to if they are not happy and all said they know how to make a complaint. All four staff who completed our questionnaire said that they know what to do if someone has concerns about the home. The manager demonstrated a thorough knowledge of the procedures to safeguard people who live in the home and had completed recognised training in order to train staff in abuse awareness. The AQAA stated that staff are trained and updated on an annual basis on protection and adult abuse awareness. This training integrates equality and diversity, dignity and respect issues as well to ensure all areas of psychological wellbeing are considered. We saw that the induction programme for staff included these areas of training. The manager told us she had also attended specific training in Mental Capacity Act and Deprivation of Liberties to ensure that people who use the service are protected. A person who lives in the home told us they feel safe there. Care Homes for Older People Page 20 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The excellent design and layout of the home enables people who use the service to live in a homely, well-maintained and comfortable environment, which encourages independence. Evidence: Kingfishers is a new, purpose designed and built care home with a very high standard of specification and furnishings. There is a specially designed dementia care suite which has many carefully thought out aspects to help people suffering from memory loss to be orientated and familiar with their surroundings. For example, there are spotlights outside the bedroom doors that make it easier for people to recognise their rooms and the en-suite facilities have sensor lights and doors that open both ways. We saw a number of the bedrooms throughout the home and these were spacious and had been decorated and furnished to a high standard with a variety of room colours and co-ordinating furnishings. En-suite facilities are provided in all rooms, with sufficient room to manoeuvre hoists or shower chairs. The corridors are wide and airy and decorated with pictures and plants. All areas within the home are very well lit, fully accessible by wheelchair and tailored to nursing care requirements. The home has ample built in storage space. The home has a full time Maintenance Man to ensure that all building requirements Care Homes for Older People Page 21 of 30 Evidence: are dealt with immediately. The Maintenance Man is also on hand Monday to Friday to help people personalise their rooms, for example by putting up pictures and fitting shelves. A person who uses the residential care service and their visitor said managers and staff told told them to make it their home and they were able to bring in personal items before moving in. They told us that their requests for pictures to be put up in the room were responded to immediately. This person has a ground floor room with access to a patio, garden furniture and a bird feeding station. They also told us that the laundry is fabulous, its back in a day. The home has a team of housekeeping staff who have had training in infection control.The laundry room has in and out doors, three commercial washing machines with sluice and disinfection facilities, three commercial dryers and an ironing machine, a sink and hand wash basin with towels and soap dispensers. There is a delivery area for used linen and clean linen trolleys. Seven people who use the service and took part in our survey all said the home is always fresh and clean. A persons relative said its a lovely place. Two of the four staff who completed our survey told us that the home is very warm to work in. The manager told us that she will be looking into providing portable air conditioning for the next summer. There is plenty of communal space for people to use outside their rooms, participate in activities or entertain visitors. On the ground floor there is a large lounge and a large dining room. There is a hairdressing room, a Wellness suite and an activities room with a computer station and internet access. On the first floor there is a quiet room and a small lounge overlooking a living roof of sedum rock plants. The two units on the second floor are each equipped with lounge/diner and kitchen areas and furnishings of a high standard. The large landscaped gardens have several covered seating areas and easy access for people who use the service. There is a seperate secure sensory garden, which is designed specifically to stimulate the mental and physical wellbeing of people with dementia. There is a circular walkway and key pad controlled gates. We saw plants and tomatoes that people who use the service had planted. There are five bathrooms equipped with specialist baths and lockable doors. All the bathrooms have been decorated with calming colours and pictures and ornaments to create a homely atmosphere. There are two toilets on each floor and these are located near the lounges, can be locked and are fitted with soap and towel dispensers. Care Homes for Older People Page 22 of 30 Evidence: Low surface temperature radiators are installed throughout the home. Hot water outlets are fitted with thermostatic valves and there is a system in place for checking the temperatures and maintenance of valves. The windows in all rooms have restricted opening. Care Homes for Older People Page 23 of 30 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. Staff in the home are well trained, skilled and in sufficient numbers to support the people who use the service. Evidence: Throughout the day we observed staff supporting people in a polite and friendly manner on each of the three floors of the home and people who live in the home and their relatives made positive comments about the attitude of staff members. Four of the seven people who use the service, or their relatives, who completed our survey, said they thought that more staff were needed. A person and their visitor we spoke with during our visit said that staff are always responsive to calls. One staff member who took part in the survey said that there are always enough staff to meet the individual needs of all the people who use the service. Two staff said there usually are, while another said there sometimes are. The manager showed us the staffing figures which showed that these would go up as occupancy increased. The home started admitting people in May and more referrals were coming in. We saw that staff interviews were taking place on the day of our visit. The manager told us in the AQAA that there are clearly defined recruitment policies and a rigorous interview procedure. We looked at the personnel records for two staff members and these contained proof that POVA (Protection of Vulnerable Adults) and CRB (Criminal Records Bureau) checks had taken place prior to their recruitment. The Care Homes for Older People Page 24 of 30 Evidence: records also included two written references for each staff member, probation review and supervision notes. We saw that there is a comprehensive induction training programme, which the current staff team undertook in April before people were admitted to the home. The induction programme includes mandatory subjects such as infection control, fire safety, manual handling and the use of mobility equipment, as well as specialist subjects including dementia care, palliative care, the Mental Capacity Act and abuse awareness. The manager kept records showing that out of twenty-six health care assistants, eleven already had obtained NVQ (National Vocational Qualification) at level 2 or 3 in health and social care, and seven others were working towards the qualifications at level 2 or 3. Another staff member had an NVQ level 4. Three staff who completed our questionnaire said that their induction covered everything they needed to know to do the job before they started very well, and another said it mostly did. All four told us that they are being given training that is relevant to their role, helps them understand and meet the individual needs of people and keeps them up to date with new ways of working. A nurse we spoke with during our visit said that the training is intensive and brilliant. She told us how the first two weeks working at the home had focused on team building before people were admitted to the service. Care Homes for Older People Page 25 of 30 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 management of the home is based on openness and respect and seeks the views of people who use the service. The health, safety and welfare of the people who live in the home and the staff are promoted and protected. Evidence: The AQAA informed us that the manager was employed by the organisation three months prior to the opening of the home, which allowed for a comprehensive induction and for her to play a key role in the recruitment of staff and the development of relationships with local professionals and referrers. The manager is registered and has relevant qualifications for the role, including a diploma in Healthcare Management. The Statement of Purpose shows that the manager is supported in running the home by a Head of Care responsible for clinical matters, a deputy manager, a head of housekeeping, a maintenance manager, two chefs and a receptionist. There is also a hotel services manager who oversees all Colten Care homes. The AQAA informed us that the manager has a weekly informal meeting with people Care Homes for Older People Page 26 of 30 Evidence: who use the service and she and the Head of Care maintain daily interaction with residents, visitors and staff. We observed that the interactions between the manager and people who use the service were very open and positive. People we spoke with during our visit told us that the manager asks how they are doing and for feedback about the service they receive. Formal review meetings are held every six months for each person who lives in the home. The manager showed us the results of the homes first annual resident satisfaction survey from 30/06/09, in which thirteen out of twenty-six residents living in the home at the time took part. The results indicated good overall levels of satisfaction with the service, with some particualr areas such as the friendliness of staff and their respectfulness towards residents rated very highly. Meals, decor and comfort, and the management of the home were also highly rated and there were no areas rated poor or unacceptable. We met the operations manager, who conducts the monthly regulation 26 visits and three monthly reviews of the home. We saw records are kept of these and a range of checks and audits for all aspects of the service. The home looks after small amounts of residents money, which are administered solely by the manager and the receptionist. Monies are reconciled on a weekly basis and fully documented. During our visit we looked at the records and cash balance for one person who uses the service, which were up to date and correct and each transaction and weekly check had been signed for. The home has systems in place to ensure the safety and welfare of people who use the service, visitors and staff. Records of weekly fire alarm tests and other checks were on file and there is a health and safety committee that meets every three months. The personnel records showed that staff have the required training in health and safety matters and risk assessments are carried out. Care Homes for Older People Page 27 of 30 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 28 of 30 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 29 of 30 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). 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