Care Home: Laureston House Residential Home

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What the care home does well It is evident through us talking to members of staff that the emotional health of the residents is of a high priority to the home and that staff are pro-active in maintaining and supporting residents with their emotional needs in order to maintain their quality of life in accordance to their plan of care. Staff demonstrate their commitment to achieving best outcomes for residents. Residents who spoke to us confirmed in their own words that they receive a good quality of care from staff who are courteous, respectful, communicate well. The service actively encourages and provides imaginative and varied opportunities for residents to develop and maintain social, emotional, communication and independent living skills. The staff have a strong ethos and focuses on involving residents in all areas of their life, and actively promotes the rights of individuals to make informed choices, providing links to specialist support when needed. Comments received from completed comment cards showed:"I think of Laureston House as my home and all the staff are my friends" "Very caring professional staff always tendering to my mothers needs" "Staff are very caring and thoughtful" "Staff are very thoughtful" What has improved since the last inspection? The management of the home see improvement as something that should always be worked on. The home had identified issues for improvement and has seen this as an area to be kept under review. The AQAA shows that the home had identified areas to be improved and evidence showed what had been done to achieve this. What the care home could do better: The inspection identified several areas that were in need of being addressed. The management of the home has recognised the shortfalls and has indicated a willingness to work with the Commission to ensure that any shortfalls are addressed. Shortfalls were noted with regard to training updates in key areas with regard to adult protection training. Evidence seen following discussion with the manager shows that this is an improving situation. No requirement has been made therefore at this time. Quality assurance was discussed with the manager. Whilst the views and opinions of the residents is sought no formal record of provider visits could be found. Whilst visits occur they are on a more informal basis. We requested that such visits are made more formal and a record kept and complete what is known as a Regulation 26 visit (Statutory documented visits by the provider to monitor standards within the home). This requires the provider to assess the quality of care within the home and ensure that it is meeting with the required Care home Regulations 2001. Such visits need to focus on outcomes for residents with regard to quality of care, staffing, adult protection, audits of policies and procedures and that they are followed, staff training, Activities, Health and Safety etc. along with speaking to staff and residents. Evidence of Social Care Planning need to be evidenced within the care planning process. Key inspection report Care homes for older people Name: Address: Laureston House Residential Home Laureston Place Dover Kent CT16 1QU     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: Robert Pettiford     Date: 1 5 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Laureston House Residential Home Laureston Place Dover Kent CT16 1QU 01304204283 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: laurestonhouse@aol.com Mr Leslie Charles Roberts,Mrs Gillian Mary Roberts care home 21 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 21 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender; Either whose primary care needs on admission to the home are within the following category : Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Laureston House provides care and support for up to 21 frail elderly people. The home is located in a secluded area on top of a hill in a side road overlooking the town of Dover. Public transport services are approximately five minutes walking distance. The building is on 3 levels with both staircase and passenger lift connecting the floors. The home comprises of a large lounge and a dining room on the ground floor and a smaller lounge in the basement. There is a rear terraced garden with a suitable patio area adjacent to the dining room accessible for wheelchair users. The current fees for the service at the time of the visit are according to assessment. There Care Homes for Older People Page 4 of 29 Over 65 21 0 Brief description of the care home are additional charges for chiropidy, hairdressing, newspapers and toiletries. Information on the homes services and the CSCI reports for prospective residents/relatives will be referred to in the statement of purpose and service user guide. This information is also included with quality assurance questionnaires which are forwarded to residents, relatives and other stakeholders. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: We agreed and explained the inspection process with the registered manager present. The focus of the inspection was to assess the home in accordance with the Care Home Regulations 2001 and the National Minimum Standards for Older Persons. In some instances the judgement of compliance was based solely on verbal responses given by those spoken with. We used a varied method of gathering evidence to complete this inspection, pre inspection information such as the previous report and discussion and correspondence with the registered provider/manager was used in the planning process. This was to support us to explore any issues of concern and verify practise and service provision. The home had completed an annual quality assurance assessment questionnaire (AQAA). This provided us with information relating to What the agency considers it does well, What we could do better, What has improved within the last 12 months and Care Homes for Older People Page 6 of 29 plans for improvement. The judgements have been made using the Key Lines of Regulatory Assessment (KLORA), which are guidelines that enable the Commission to be able to make an informed decision about outcome areas. Further information can be found on the Commissions website with regards to information on KLORAs and AQAAs. Documentation and records were read. Time was spent reading a sample of written policies and procedures, reviewing care plans and records kept within the home. Other areas viewed included risk assessments, pre-admission assessments, rotas, and training records. In addition an environmental tour took place. We identified several residents for case tracking (a review of the level of care and support needed, and if it is being provided in a way that treats them with respect and dignity). Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: The inspection identified several areas that were in need of being addressed. The management of the home has recognised the shortfalls and has indicated a willingness to work with the Commission to ensure that any shortfalls are addressed. Shortfalls were noted with regard to training updates in key areas with regard to adult protection training. Evidence seen following discussion with the manager shows that this is an improving situation. No requirement has been made therefore at this time. Quality assurance was discussed with the manager. Whilst the views and opinions of the residents is sought no formal record of provider visits could be found. Whilst visits occur they are on a more informal basis. We requested that such visits are made more formal and a record kept and complete what is known as a Regulation 26 visit (Statutory documented visits by the provider to monitor standards within the home). This requires the provider to assess the quality of care within the home and ensure that it is meeting with the required Care home Regulations 2001. Such visits need to focus on outcomes for residents with regard to quality of care, staffing, adult Care Homes for Older People Page 8 of 29 protection, audits of policies and procedures and that they are followed, staff training, Activities, Health and Safety etc. along with speaking to staff and residents. Evidence of Social Care Planning need to be evidenced within the care planning process. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can feel 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. However improvements are needed to the information provided. Intermediate care is not provided. Evidence: Residents can be confident that 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 where possible and have got full, clear information about the home. However improvements need to be made to ensure that it contains all of the information as required of the regulations and is available in different formats in accordance to the needs of the residents. Care Homes for Older People Page 11 of 29 Evidence: The manager in a subsequent e-mail confirmed information has now been amended to and will contain more reference to addressing different cultural beliefs (not just church) which will entail more details. There is now a copy of the complaints procedure in the statement of purpose, an easy read version, in large and bolder font will also be available. They stated the home will adapt at all times, to make the statement of purpose viable to meet all residents needs. The AQAA and other information showed the home ensures that whenever possible the prospective residents visit the home and discusses with them and their families what their needs are. They address any concerns that they may have and ensure that the new residents room is correctly equipped prior to their arrival. All residents are given a welcome pack (Service User Guide) containing the complaints policy when they arrive, and the management team have an open door policy so that they are available to listen to any problems should they arise. Records held showed that residents have an assessment, which identifies their individual needs prior to or on admission to the home. The information is provided by the residents, their families and health / social care professionals. The assessment focuses on achieving positive outcomes for people and this includes ensuring that the facilities, staffing and specialist services provided by the home meet needs of the individual. Staff are appropriately trained on evidence seen and have the skills required to meet the needs of the assessed prospective resident. The AQAA states all residents are encouraged to follow their own religious beliefs. All staff are instructed during their induction and NVQ programmes to respect all the residents whatever their religious belief, race,gender identity, disability and sexual orientation. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from having individual plans that identify there physical and medical needs and provide the support they need and are written in great detail. However more information could be provided with regard to social care planning. Residents can feel very confident that they are fully supported with their healthcare needs. Residents are treated with respect and dignity and their rights to make decisions about their lives and they have the opportunity to be consulted on, participate in, all aspects of life within the home as they wish or their capacity allows. Residents can feel confident that the homes policy and procedures with regard to the administration and dispensing of medication is sound. Evidence: The staff at the home are committed to supporting all residents including those to make informed decisions, understand the range of options, which are available to Care Homes for Older People Page 13 of 29 Evidence: them and have the right to take responsible risks. Evidence of this was gathered through taking to the residents, staff, and the manager. We discussed with the manager the care records relating to several residents. In the care plans viewed there were guidelines in respect to support needed. The home undertakes regular reviews. Formal reviews involving significant professionals where possible are also undertaken. Whilst the residents experiences of the care received is excellent the homes care plans do not wholly use a socially lead model. From the care plans viewed they were of a medical / clinical approach. The plan of care needs to better evidence social and personal goals including hopes, and aspirations where possible, to better evidence social care planning . We viewed a sample of care records and specific health care records relating to several residents. Records viewed confirmed residents had access to a range of health care input as and when required and as part of regular health checks. This included access to their chosen G.P (where possible), Dentist(where possible), Optician and Chiropodist in addition to identified specialist health care input. The Home facilitates residents keeping hospital appointments and seeing their own GP. It is evident through talking to members of staff at the home that the wellbeing of the residents is of a high priority and that staff are pro-active in maintaining and supporting residents with their needs in order to maintain their quality of life. This was confirmed in discussions with many of the residents who lived at the home a relative and feedback received from comment cards returned. Risk assessments were reviewed within the home and discussed with the manager. Assessments seen detailed how to support residents to minimise risks for personal safety and had been updated and reviewed. We visited the home at 8:15AM. During the inspection we noted that residents up were seen making choices about their lives and were seen to be part of the decision process as their capacity allowed. A relaxed atmosphere was noted with the residents taking to staff and eating their breakfast. The AQAA states the home recognises that for some older people confusion, forgetfulness and dementia are part of the ageing process. There are referrals to the mental health team, daily district nurse accessibility, medical professionals input, individualised care plans, staff on each shift trained to dispense medication, medication audits. Care Homes for Older People Page 14 of 29 Evidence: Daily records were not wholly comprentaneous however in that they had gaps and full names of staff were not seen. It was recommended that the home follow the Nursing and Midwifery Council guidance: Guidelines for records and record keeping. We viewed the storage arrangements and some records including Medication Administration Record (MAR) sheets, and the protocols for the administration of Medication within the home. The manager confirmed that all staff that dispense medication have received the appropriate training. Medication was inspected and found to be administered correctly on evidence seen. The home consults with a pharmacist and implements any suggestions with regard to the management of medication within the home. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents social and recreational interest and needs are provided for with a range of activities organised and are supported to maintain contact with family and friends, which ensures they continue to receive stimulation and emotional support. Residents nutritional needs are met by a home that Sees food as something to be enjoyed and required to maintain good health. Evidence: The AQAA and other evidence shows residents are encouraged to participate in all activities, and go out with their families whenever they wish to. The home provides a range of activities to suit as many people as possible, and it is their choice whether they attend or not, the carers inform residents of the activities of the day, and they are promoted widely. Residents are encouraged to take park in a variety of activities as their interest and capacity allows. The home has sought the views of residents and considered their varied interests and abilities when arranging activities. The activities and plans are resident focused, regularly reviewed. However social care planning could be better evidenced. This has been highlighted elsewhere within this report. Care Homes for Older People Page 16 of 29 Evidence: Residents are actively encouraged to keep in contact with family and friends living in the community. Visitors are welcome at any time and facilities are available for them to have a drink. Residents can choose to entertain visitors in their own rooms, lounge or patio garden areas. The AQAA states that mealtimes are very important to residents and they are encouraged to socialise and sit with friends. There are some residents who like to eat in their own rooms and this is accommodated.The catering is provided by a experienced cook. There are regular meetings with the residents, staff to discuss meals. We viewed residents eating their midday meal. From observation, records viewed and comments made by residents it was evident that residents had been offered a choice of menus that met their dietary needs and individual preferences. The food provided for the residents was found to be varied and nutritious and of a good quality. The chef meets the residents regularly to ensure she has feedback about the meals provided. During the inspection food storage areas were viewed along with quantity and quality of food. A good variety of food was found including meat, vegetables tins and fresh fruit. The kitchen and storage areas were seen to be well organised and clean.The cook stated the Kitchen meets with the requirements of the Environmental Health Officer of the local council. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can feel confident that their concerns or complaints are supported by robust policies and a pro active management team. Residents are protected by staff who are supported by adult protection policies and procedures. Evidence: The home had a written complaints procedure, which was seen in the foyer. Residents spoken with felt free to voice their concerns. The home has received no formal complaints since the last inspection. Following discussions the manager confirmed that the home ensures complaints are taken seriously and dealt with in an appropriate manner. The home at time of inspection did not have a current policy for the Protection of Residents and staff Whistle blowing procedure. These should include procedures for the reporting of suspicion or evidence of abuse with a format for the recording of any allegations and action to be taken. Full training has been provided however for the majority of staff. The registered manager subsequent to the inspection has sought information which has been put in place in the home. Staffs have the information for reporting and recording. Management now has a referral system and will keep up to date with ongoing changes. The manager stated certificated training will start for staffs that have not completed their NVQ training and a continuation plan for all staff Care Homes for Older People Page 18 of 29 Evidence: to have refresher training will be continually ongoing and reviewed. The manager confirmed Criminal Record Bureau Checks (CRB) have been obtained for all staff. The Manager is aware of her obligations with regard to ensuring the safety of Residents and protecting them from abuse. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from living in a home that provides for a homely environment which provides safe access to comfortable indoor and outdoor communal areas. The standards of internal and external decoration were found to be of a good quality overall with some areas needing a degree of refurbishment. Residents health is protected by the homes infection control procedures. Evidence: The management and staff encourage residents to see the home as their own home. Personal items were found in many of the residents rooms to make them feel more at home. It provides a overall well maintained, safe, comfortable home. However concerns were noted with regard to corrosion on one of the bath chairs, additionally some parts of the home would benefit from a degree of re-furbishment. Subsequent to the inspection the home has made an undertaking that immediate work is being carried out on bath chair to eradicate erosion. The rest of the home is undertaking a re- decoration programme. Carpets and chairs are being cleaned immediately in the social areas, bedrooms will follow. This will be carried out on a regular basis. Purchasing of new furniture will be discussed at the next financial meeting which is on 17/5/2010. Garden area will be cleared of debris and continual schedule of maintenance will be put in place. Patio area will be cleaned ready for the Care Homes for Older People Page 20 of 29 Evidence: summer, gazebo erected, soft furnishings brought out of storage, and bedding plants and sunflowers will be planted with some of the residents. As well as a good selection of general aids such as hoists the home also ensures that equipment is individualised for each residents and all staff members are trained in the safe use of aids and equipment. All residents are assessed for their need to have equipment or aids before they move into the home and these are provided to them on admission. There is a selection of communal areas, according to the numbers of residents, this means that residents have a choice of place to sit quietly, meet with family and friends or be actively engaged with other residents. The home was found to be is well lit, clean and tidy and smell fresh at the time of inspection. The management has a proactive infection control policy. Staff wear protective clothing (gloves and aprons) when providing personal care or handling soiled linen. Laundry facilities are comprehensive and meet the needs of residents and current guidance. Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can feel confident that their care, social and emotional needs are promoted by the employment of overall trained care staff in sufficient numbers to meet their needs. Residents are protected by the recruitment procedures within the home. Evidence: The ratios of care staff to residents are determined according to the assessed needs of residents. Following discussions with the manager, a review of the rota and observations made during the inspection. The Commission is of the opinion that sufficient care staff were on duty to support residents with their needs. Residents spoken with were happy and content with the level of support provided. Relatives who had completed comment cards confirmed this in that they felt that their relatives were adequately supported with their needs. The home employs a number of ancillary staff who work as cleaners, laundry, gardener, maintenance staff. Thus allowing care staff the time to meet the needs of residents. The staff training records indicated undertaken training. Individual and group staff training needs had been identified. From documentary evidence seen the standard of staff training was good overall with the majority of staff completing basic courses. Care Homes for Older People Page 22 of 29 Evidence: However shortfall were noted with regard to adult protection. Some staff have received training in Dementia care. It was recommended that all staff receive such training to meet the changing needs of residents. Evidence confirmed that the home meets with the required standards with regard to achieving an NVQ National Vocational Qualification Level 2 or above care qualification. The manager was able to confirm that the home has a development programme for all new staff, which meets Sector Skills Councils workforce training targets and ensures staff fulfil the aims of the home and meet the changing needs of residents, and that all members of staff receive induction training to specification. The home showed that it undertakes a recruitment practice including submission of an application form detailing all previous work history, requests proof of identity and copies of qualification certificates, seeks two written references, and confirms work status. The homes recruitment files observed were seen to include all the information as required under schedule 2 of the Care Home Regulations 2001. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and or their relatives can be confident that their views and opinions effect how the home is run and that the home is managed to a high standard and that quality assurance systems are in place to monitor service provision. Residents can feel confident that their health and safety is protected Evidence: The registered manager has the required qualification and experience, is highly competent to run the home and meets its stated aims and objectives. Evidence of this was obtained through the inspection process, completed comment cards, talking to staff and residents. The manager has sound knowledge of care and puts the residents needs first. The manager is approachable in her style and communicates a clear sense of direction. Staff spoken with upheld this judgement and felt like a team and well supported. The manager is able to demonstrate through formal qualification, and experience and ability that she is highly competent in a range of areas. These can include service-specific good practice areas, good people skills, strong leadership of Care Homes for Older People Page 24 of 29 Evidence: staff and responds to the needs of residents. The report evidences that whilst acknowledging that this home is currently rated as excellent shortfalls were noted in some key areas. The outcomes for people who use the service are good and the management of the service recognise that there are areas for improvement and have expressed a willingness to work with the Commission to address these as a priority. The Commission wishes to be proportionate in these matters and is confident that such shortfalls will be addressed in a timely manner such a undertaking has already been given and that any subsequent inspection will evidence full compliance. If such compliance is not evidenced further action may be considered. No requirements have been made at this time Quality assurance was discussed and the views and opinions of many of the residents relatives sought. They confirmed a great deal of satisfaction in living within the home and felt confident that their views and opinions were valued by the staff and management. The manager confirmed that the home does undertake quality assurance by means of asking residents, relatives to complete questionnaires in addition to healthcare professionals. This enables the home to ensure it is meeting the goals that are set out in the Statement of Purpose. The registered provider of the home does visit the home regularly, but does not however complete what is known as a Regulation 26 visit (Statutory documented visits by the provider to monitor standards within the home). This requires the provider to assess the quality of care within the home and ensure that it is meeting with the required National Minimum Standards. The manager is aware of this shortfall and confirmed that it will be addressed. The AQAA further showed that families and friends are welcome at anytime, and there are relatives meetings where they can be updated on what is happening. Quality Assurance questionnaires are circulated annually and the results analysed. The annual quality assurance assessment (AQAA) contains excellent information that is fully supported by appropriate evidence. The service demonstrates a high level of self awareness and recognises the areas that it still needs to improve. It has clearly detailed the innovative ways in which it plans to do this. The service fully recognises the importance of the AQAA and has used the content to inform its own quality assurance. The data section of the AQAA is accurately and fully completed and provides supporting evidence to the self-assessment section. The Commission viewed records relating to Health and Safety Procedures, maintenance and servicing, and risk assessments. The Commission viewed the Fire Log book, which was up-to-date. The Commission was able to evidence that checks Care Homes for Older People Page 25 of 29 Evidence: and servicing of fire safety equipment and emergency lighting had been undertaken at the required Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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