Care Home: Longmead House

What the care home does well Residents live in a clean, homely environment with their bedrooms personalised to reflect them individually and their lifestyles. A relative commented "my dads room is always very neat and tidy and smells fresh". Considerable positive feedback was received regarding the importance of the homely friendly atmosphere of the home. A sample of comments made by residents and relatives regarding their experiences at the home included "Longmead stood out from the other homes I looked at I was given lots of information from the manager and shown around. I also met several members of staff" " I am very well looked after it is as near to your own home as is possible I am more than satisfied" "provides a personal care service that is exceptional" "the care is excellent and often extends beyond what would be normally expected" "longmead is very caring and nice home to be in" and "we are extremely happy with Longmead and the care and affection give to our mother ". There is a good care planning system in place which provides staff with the information they need to be able to meet residents needs in a consistent and individual way. Staff demonstrated a good understanding of the assessed needs of residents and were observed following the guidance in care plans. The health and medication needs of residents are well met with evidence of regular input from a range of health care professionals. Health care professionals and residents confirmed that prompt medical intervention is usually sought by the home. A relative said "Longmead recognises very early any medical change in my dad and have swiftly arranged hospital care". Personal support is offered in ways, which promotes and protect resident`s privacy and dignity with residents commenting "they always show me such kindness and respect my privacy when they help me to bath" "you have got your privacy if you want it, you can just go to your room or you can join in the lounge with everyone else". Residents are treated as individuals who are helped to exercise choice and control over their lives with flexible routines being an integral part of daily practice at the home. A resident commented "I can choose when to go to bed and I can please myself for the rest of the day and free to do what I can". A health care professional feedback "respect for individual choices and promotes encourages them to do as much as they can for themselves patient empowerment is their priority " Links with families and friends are highly valued and supported by the home. A relative commented "I can visit whenever I want always offered refreshments very friendly staff and we are kept informed of anything we need to know". Resident`s lives are enriched by the home providing various opportunities for occupation and leisure. The meals are good offering both choice and variety. Residents commented "very varied menu and the food is well presented and enjoyable" and "the home is flexible as to when she has her main meal of the day".Resident`s benefit from an experienced and established manager who ensures a clear ethos and values of the home that enables staff to provide good quality consistent care to residents. A resident commented "manager about everyday very good she does not just own the place she cares about the place and making sure we are all well looked after". Staff make a positive contribution in residents lives as residents benefit from a trained and enthusiastic staff team that know them and who are employed in sufficient numbers as is necessary to meet their needs. Comments made about staff included "staff very kind know what to do and they understand what support I need one or two change rounds of late small staff changes but most have been here a long time" "they give you a chance to try and be independent they encourage you and then support you if you cant" and "the staff are very knowledgeably about each resident. They could not be more welcoming there is not any staff who does not greet you with a smile. It does not matter what time of day you come they care all the same". What has improved since the last inspection? There were no areas of shortfall noted at the previous inspection. The home continues to undergo a gradual refurbishment and upgrade to ensure good standard of decor throughout. This has seen the recent redecoration of the dinning room, an upper floor corridor and some bedrooms. A relative said "it may not be the most luxurious of homes but it is the most caring". What the care home could do better: There are no shortfalls noted at this inspection that have resulted in requirements being made. The manager has identified the areas in need of further refurbishment which are due to be undertaken in proceeding months. This includes the refurbishment of the kitchen, further bedrooms, lounge and remaining corridors. One example was noted whereby the manager was not able to evidence at inspection the employment eligibility of a staff member as they had not obtained a copy of the necessary documentation when they originally examined them. The manager did subsequently confirm that they had immediately obtained the necessary copies and updated their files. A staff member did not follow the homes accident procedure which has resulted in the incident being referred under safeguarding adults procedures by the Commission. The manager did undertake robust and swift disciplinary action regarding this incident. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Longmead House Longmead House 1 Buxton Lane Caterham Surrey CR3 5HG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jane Jewell     Date: 0 8 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 31 Information about the care home Name of care home: Address: Longmead House 1 Buxton Lane Longmead House Caterham Surrey CR3 5HG 01883340686 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : catherina_mcaleese@yahoo.co.uk Mrs Bridget Catherina McAleese care home 23 Number of places (if applicable): Under 65 Over 65 0 23 dementia old age, not falling within any other category Additional conditions: 23 0 The maximum number of service users to be accommodated is 23 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: Dementia (DE) Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Longmead House is registered to provide residential care for up to twenty three older people. The premises are a large converted Victorian House situation on the outskirts of Caterham and near to road and bus links. The home is managed and owned by the registered individual who also lives adjacent to the home. The home is presented across four floors with residents accommodation situated on Care Homes for Older People Page 4 of 31 Brief description of the care home the ground, first and second floors with a passenger list providing level access to floors above ground level. The majority of bedrooms provide for single accommodation with some facility to offer up to four rooms as double occupancy. Two bedrooms provide ensuite facilities. Communal space consists of a dining room, lounge and conservatory. There is a rear secure garden which provides level access. Care Homes for Older People Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: The information contained in this report has been comprised from an unannounced inspection undertaken over six and half hours and information gathered about the home before and after the inspection. An Annual Quality Assurance Assessment (AQAA) form had been completed prior to the inspection and the information contained in this document has been used to inform the inspection process. The inspection was facilitated by Mrs C McAlease (the registered provider /manager). The inspection consisted of a tour of the premises, examination of the homes documentation and in discussion with four residents, seven staff and four relatives. The inspector had lunch with residents and observed a small group of residents for signs of well-being/ ill-being (terminology used for observing behaviour for people who do no Care Homes for Older People Page 6 of 31 use verbal communication) in order to make Judgments about their experiences and wellbeing. Feedback surveys were sent to the home for distribution in order to obtain the views on the quality of the services and facilities being provided. Eleven were returned in total, four from residents six from relatives and one from health care professional. Their feedback is included in this report. There were sixteen residents living at the home at the time of the inspection. What the care home does well: Residents live in a clean, homely environment with their bedrooms personalised to reflect them individually and their lifestyles. A relative commented my dads room is always very neat and tidy and smells fresh. Considerable positive feedback was received regarding the importance of the homely friendly atmosphere of the home. A sample of comments made by residents and relatives regarding their experiences at the home included Longmead stood out from the other homes I looked at I was given lots of information from the manager and shown around. I also met several members of staff I am very well looked after it is as near to your own home as is possible I am more than satisfied provides a personal care service that is exceptional the care is excellent and often extends beyond what would be normally expected longmead is very caring and nice home to be in and we are extremely happy with Longmead and the care and affection give to our mother . There is a good care planning system in place which provides staff with the information they need to be able to meet residents needs in a consistent and individual way. Staff demonstrated a good understanding of the assessed needs of residents and were observed following the guidance in care plans. The health and medication needs of residents are well met with evidence of regular input from a range of health care professionals. Health care professionals and residents confirmed that prompt medical intervention is usually sought by the home. A relative said Longmead recognises very early any medical change in my dad and have swiftly arranged hospital care. Personal support is offered in ways, which promotes and protect residents privacy and dignity with residents commenting they always show me such kindness and respect my privacy when they help me to bath you have got your privacy if you want it, you can just go to your room or you can join in the lounge with everyone else. Residents are treated as individuals who are helped to exercise choice and control over their lives with flexible routines being an integral part of daily practice at the home. A resident commented I can choose when to go to bed and I can please myself for the rest of the day and free to do what I can. A health care professional feedback respect for individual choices and promotes encourages them to do as much as they can for themselves patient empowerment is their priority Links with families and friends are highly valued and supported by the home. A relative commented I can visit whenever I want always offered refreshments very friendly staff and we are kept informed of anything we need to know. Residents lives are enriched by the home providing various opportunities for occupation and leisure. The meals are good offering both choice and variety. Residents commented very varied menu and the food is well presented and enjoyable and the home is flexible as to when she has her main meal of the day. Care Homes for Older People Page 8 of 31 Residents benefit from an experienced and established manager who ensures a clear ethos and values of the home that enables staff to provide good quality consistent care to residents. A resident commented manager about everyday very good she does not just own the place she cares about the place and making sure we are all well looked after. Staff make a positive contribution in residents lives as residents benefit from a trained and enthusiastic staff team that know them and who are employed in sufficient numbers as is necessary to meet their needs. Comments made about staff included staff very kind know what to do and they understand what support I need one or two change rounds of late small staff changes but most have been here a long time they give you a chance to try and be independent they encourage you and then support you if you cant and the staff are very knowledgeably about each resident. They could not be more welcoming there is not any staff who does not greet you with a smile. It does not matter what time of day you come they care all the same. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 9 of 31 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 10 of 31 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 11 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides both prospective and existing residents, with a range of information about what services are provided and what to expect when living at the home. The way in which prospective residents are assessed ensures that the home admits only those residents whos needs can be met by living at the home. The home is able to identify and meet the needs of the residents. Evidence: There is a range of well documented information about the home and the services it provides, this includes a statement of purpose and service user guide which are available at the home and given to prospective residents, representatives and other Care Homes for Older People Page 12 of 31 Evidence: interested parties. Relatives spoke of receiving information about the home and how useful this was. The vast majority of residents and relatives consulted with spoke of choosing the home through the recommendation of others who knew the home. Residents are provided with a written contract of terms and conditions of residency with the home. This can be used with residents and their families to make explicit the placement arrangements and clarify mutual expectations around rights and responsibilities. The assessment documentation was examined for recent admissions and this showed that the home ensures that prospective residents are accommodated only following an assessment of their needs by the manager. Advice is sought during the assessment process from health care professionals and others who know and understand the needs of the prospective resident. The needs assessment then forms the basis of their initial care plan. This helps ensure that staff are aware of the recorded needs of new residents prior to them moving into the home. A residents spoke of the manager assessing them whilst they were in hospital and they were able to ask the manager many questions about the home. A resident feedback Longmead stood out from the other homes I looked at I was given lots of information from the manager and shown around. I also met several members of staff. There is a range of needs being accommodated at the home this includes older people with dementia and physical needs and some residents living an independent lifestyle. The majority of residents are assessed as having low to medium assessed needs. Through observation, looking at records and speaking to residents, staff and relatives, there was clear evidence that the home is meeting the needs of residents. All persons consulted regarding the home spoke positively about their experiences with the home. A sample of their comments includes I am very well looked after it is as near to your own home as is possible I am more than satisfied provides a personal care service that is exceptional the care is excellent and often extends beyond what would be normally expected longmead is very caring and nice home to be in and we are extremely happy with Longmead and the care and affection give to our mother. A staff member said best thing is we have time to give good quality care we all work as a team it is like a family atmosphere. Residents and relatives consulted with all spoke of being provided with the opportunity to visit the home in advance to assess the quality, facilities and suitability of the home. Consistent feedback received that when residents or their families visited they were made very welcome and any queries were answered knowledgeable, with a residents saying we did look around the home before we made the final decision the manager answered all of our questions, we knew straight away that this was the home. Care Homes for Older People Page 13 of 31 Evidence: Care Homes for Older People Page 14 of 31 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a good care planning system in place which provides staff with the information they need to be able to meet residents needs in a consistent and individual way. The health needs of residents are well met with evidence of regular input from a range of health care professionals. Medication practices are well managed promoting good health. Personal support is offered in ways, which promotes and protect residents privacy and dignity. Evidence: Four individual plans of care were examined and these showed that a range of information is gathered about each resident which provided staff with the guidance on the needs and preferences of each resident. The majority of staff have worked at the home for a number of years and demonstrated a good understanding of the assessed needs of residents and how to meet them in a consistent way. Staff were observed Care Homes for Older People Page 15 of 31 Evidence: undertaking the mobility programme for a resident which was consistent with the guidance provided in their care plan. Changes in residents needs and preferences had been promptly identified through the manager regularly reviewing care plans. The home maintains a daily record for each resident on events and occurrences. The standard of recording was noted to be good with a clear account of actions and events that had occurred which were written in respectful and sensitive language. Records of medical intervention showed that the home works closely with a range of health care professionals including GPs, district and specialist nurses, chiropodists, opticians and dentists to ensure residents receive a range of health care intervention. Residents consulted said that when they have asked to see a Doctor then this has been sought promptly. A relative feedback Longmead recognises very early any medical change in my dad and have swiftly arranged hospital care. Health care professionals consulted felt that there was always good communication between the staff and themselves whenever they visited with staff being knowledgeable about residents health care needs, make referrals promptly with staff also aware of their limitations as a residential care home. A relative spoke of the improvements to their relatives overall medical conditions since being at the home in a very short space of time which they felt was due to the care and medical input they have received. An audit of the medication practices showed that the system for the administration of medication was good with clear and comprehensive arrangements in place to ensure residents medication needs are able to be safely met. Residents consulted with said they always show me such kindness and respect my privacy when they help me to bath you have got your privacy if you want it, you can just go to your room or you can join in the lounge with everyone else and I have been made welcome and treated with respect and appreciated being given privacy. Staff consulted with showed a good understanding of good practices in preserving residents rights to privacy and dignity. Staff were able to give examples of how they promote these rights in their every day care practices. This was supported by the inspectors own observations of residents personal appearance, interactions between staff and residents and the experiences of a visiting health care professionals. The manager spoke of the support they had received in the past from health care professionals during the care of residents who were dying. Staff also spoke sensitively about the care and support provided to residents and their families when residents Care Homes for Older People Page 16 of 31 Evidence: have become terminally ill. Care Homes for Older People Page 17 of 31 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are treated as individuals who are helped to exercise choice and control over their lives with flexible routines being an integral part of daily practice at the home. Links with families and friends are highly valued and supported by the home. Residents lives are enriched by the home providing various opportunities for occupation and leisure. The meals are good offering both choice and variety. Evidence: Staff spoke of it being part of their duties to provide suitable occupation and stimulation for residents. Residents spoke of participating in games, exercises, reading, art, sing -alongs and visits from external entertainers . There is the opportunity to meet a visiting clergymen. The manager spoke of also providing summer garden drinks. One resident spoke of visiting local churches and theatres with friends and family. There is a homes cat which many residents clearly enjoyed caring for. Without exception all residents and relatives commented positively on how welcome Care Homes for Older People Page 18 of 31 Evidence: they or their visitors were made to feel when visiting. A relative commented I can visit whenever I want always offered refreshments very friendly staff and we are kept informed of anything we need to know . A resident spoke of having their own phone and how important this was to keep in touch with their family and friends. Observation of the daily routines and discussion with residents confirmed that staff accommodate residents personal wishes with regard to meal times, going to bed, rising and bathing. During the inspection residents were observed to move around the home choosing which room to be in and what level of company they wanted to enjoy. A residents said I can choose when to go to bed and I can please myself for the rest of the day and free to do what I can. A health care professional feedback respect for individual choices and promotes encourages them to do as much as they can for themselves patient empowerment is their priority. The inspector had lunch with residents with the meal served at inspection being presented well with individual preferences respected. Discrete sensitive support was provided by staff to those residents who needed some support to eat their meals. Much positive feedback was received with regard to the meals provided with particular reference to the quality of soups and choice provided. A sample of comments about food included very varied menu and the food is well presented and enjoyable the home is flexible as to when she has her main meal of the day. The manager reported that the kitchen was about to be immediately refurbished with arrangements in place to close down the kitchen for a few days while the work was being undertaken. Care Homes for Older People Page 19 of 31 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is an effective complaints system with evidence that residents and relatives feel that their views would be listened to. Staff have the guidance and training necessary to show them what to do if abuse is suspected. Evidence: There is an accessible complaints procedure for residents, their representatives, and staff to follow should they be unhappy with any aspect of the service. All residents, staff and relatives consulted with said that they felt able to share any concerns they had with the manager. A resident confirmed manager can approach with any problems or queries you have, you can tell her anything. The manager reported that there have been no formal complaints made since the previous inspection. The home has written policies covering safeguarding adults and whistle blowing. These make clear the vulnerability of people in residential care, and the duty of staff to report any concerns they may have to a responsible authority for investigation. Staff consulted with said that they had undertaken the necessary training in safeguarding adults and prevention of abuse and showed a good understanding of their roles and responsibilities under safeguarding adults guidelines. Care Homes for Older People Page 20 of 31 Evidence: A safeguarding referral was made by the Commission to social services for investigation following the inspection as a result of an incident at the home where the homes accident procedure was not followed by a staff member. The outcome of which at the time of publishing this report had not yet been concluded. Care Homes for Older People Page 21 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a clean homely environment. Residents bedrooms are personalised to reflect them individually and their lifestyles. There is ongoing refurbishment and upgrade plans to ensure the home remains decorated and furnished to good standard throughout. Evidence: The home is a converted detached Victorian house with some original features maintained. The manager has identified that parts of the home are in need of redecoration and upgrade and has been gradually undertaking a programme of redecoration over the last 18 months. This has seen the redecoration of several bedrooms, dinning room and corridors. Works are planned for the lounge, further corridors, bedrooms and kitchen in the next few months. A relative commented it may not be the luxurious of homes but it is the most caring. Much effort is made to create a homely feel with residents bedrooms individualised with residents confirming they are encouraged to personalised their bedrooms. Although some bedrooms are below the recommended size residents consulted felt that their bedrooms provided adequate space and provided everything they needed. One resident has their own caged bird in their bedroom which staff help to look after. Care Homes for Older People Page 22 of 31 Evidence: Communal space consist of a dinning room lounge and conservatory which leads out onto a small well kept rear garden. There are ramps leading to the garden making it easily accessible. Residents spoke of using the garden independently and how much they liked sitting in the garden when the weather was nice. There is sufficient number of toilets and bathrooms located around the home, including a shower and assisted bathing facilities. Fitted throughout the home are call points, which enable assistance to be summoned when pressed. A resident commented when I ring the bell they come pretty smartish day or night. All areas inspected were observed to be cleaned to a high standard, comments made about the standard of hygiene included the place is kept so clean and my dads room is always very neat and tidy and smells fresh. The home employs sufficient staff to ensure that standards of hygiene and cleanliness can be maintained. Systems were in place for the control of infection and staff said that they have been trained in this area and were observed to be working in ways that minimised the risk of infection. Care Homes for Older People Page 23 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff make a positive contribution in residents lives as residents benefit from a well trained and enthusiastic staff team that know them and who are employed in sufficient numbers as is necessary to meet their needs. Although in the majority of cases there is evidence that all of the necessary employment checks are undertaken to ensure robust and safe recruitment practices one example was noted whereby significant employment documentation, although seen by the manager had not been copied. This was necessary in order for the manager to evidence their employment eligibility, the manager has since confirmed that all of the necessary documentation had now been copied. Evidence: Staff, relatives and residents felt that there was always sufficient numbers of staff on duty for staff to undertake their roles in a timely manner and for residents to receive the support they needed, when they wanted it. There is a core group of staff who have worked at the home for a number of years and who showed an in depth knowledge of the individual needs and preferences of residents. Staff on duty were observed to have a good rapport with residents and visitors which promoted a relaxed atmosphere in the home. Consistent feedback was received from residents and relatives that the small size of the home meant that residents received individual attention and that there Care Homes for Older People Page 24 of 31 Evidence: were close attachments between staff and residents. A sample of comments about staff included staff professional well training well informed caring with good communication Staff very kind know what to do and they understand what support I need one or two change rounds of late small staff changes but most have been here a long time They give you a chance to try and be independent they encourage you and then support you if you cant the staff are very knowledgably about each resident. and they could not be more welcoming there is not any staff who does not greet you with a smile. It does not matter what time of day you come they care all the same. The home has been proactive in ensuring that all of the staff have completed a National Vocational Qualification in care. Staff consulted with confirmed that they have undertaken the mandatory training needed to work safely with residents. This included medication, manual handling, first aid and fire safety. Training records showed that some areas of specialised training is also undertaken or about to be undertaken in areas such as dementia care and infection control. The manager confirmed that newly appointed staff undertake Skills for Care Common Induction Standards to help ensure they were prepared for the caring role. The personal files of four staff were inspected and these showed that in all but one case all of the necessary documentation had been obtained to evidence that all employment checks had been undertaken. This is necessary in order to access that only staff who are suitable to work with vulnerable people are employed. In the case where documentation was missing, the manager stated that they had seen the original documentation of a staff members employment eligibility but had not obtained a copy. They confirmed subsequently to the inspection that they had now obtained the necessary documentation and confirmed the staff members employment status and had updated their files accordingly, therefore no requirement is made regarding this issue. Care Homes for Older People Page 25 of 31 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience 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 an experienced and established provider manager who ensures a clear ethos and values of the home that enables staff to provide good quality consistent care to residents. A range of regular health and safety checks helps to promote the health and safety of residents and staff. Evidence: The manager is also the registered provider and has considerable experience in managing and owing a care home for older people. They demonstrated a clear understanding of their legal responsibilities and of the day to day running of a care home for older people. They live adjacent to the home and reported that they are on call throughout the night and outside of office hours. They originally trained as a nurse and have completed the recommended management qualifications. They reported that Care Homes for Older People Page 26 of 31 Evidence: they also attend the same training as staff in order to update their knowledge on changes in legislation and good practices. Without exception all persons consulted spoke positively about the manager with particular reference to their approachability a sample of comments included very happy with the services they provide especially the manager is wonderful very professional and an excellent boss to the staff manager about everyday very good she does not just own the place she cares about the place and making sure we are all well looked after very good very caring very nice affectionate always willing to listen and so are staff. There are several mechanisms in place for the home to obtain feedback on the quality of the services provided and whether it is achieving its aims and objectives. This includes annual feedback surveys sent to residents and stakeholders involved in residents care. As a result of this feedback, changes to menus, the environment and practices have been undertaken in order to further enhance services at the home. Residents are encouraged to retain control of their own finances for as long as they are able to do so and if unable then this responsibility is taken on by a relative or another responsible persons external to the home. Care staff spoke of receiving regular formal supervision and direct supervision when working with the manager and felt well supported by them to undertake their role. A staff member commented we are supported by the manager at all times she is very hands on she keeps us up to date. The manager reported that they also undertake night spot checks to ensure that night staff receive some direct supervisor. Written guidance is available on issues related to health and safety. Records submitted by the home stated that all of the necessary servicing and testing of health and safety equipment has been undertaken including regular internal health safety checks. Systems are in place to support fire safety, which include regular fire alarms and emergency lighting checks, staff training and maintenance of fire equipment and fire drills were reported to have been undertaken. the manager reported that a fire risk assessment had been completed by a fire safety expert, which recorded any significant findings and the actions taken to ensure adequate fire safety precautions in the home. The manager reported that recommendations made as a result of Surreys fire safety services have been all addressed. An example was highlighted whereby the homes accident policy had not been followed by a staff member. This resulted in the incident subsequently being reported under safeguarding adults procedure, which is in the process of being instigated. The manager demonstrated robust and prompt disciplinary practices regarding the staff who failed to follow the home procedures. Care Homes for Older People Page 27 of 31 Care Homes for Older People Page 28 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 29 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 30 of 31 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 31 of 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!