Care Home: Longmoor Lodge Care Home

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What the care home does well As stated in the providers self assessment people that are considering moving to the home are given information about the service and encouraged to visit prior to making a decision to move to Longmoor Lodge. Each person`s needs are carefully assessed before admission and a care plan is developed detailing how their needs will be met . The service offers a homely, well maintained and attractive environment with a range of activities and flexible routines. The home has developed positive links with local groups and services, which enables the people using the service to be part of the wider community. The home has a good skill mix of staff and a clear and forward thinking training matrix. People using the service, their representatives and the staff team are given opportunities to voice their opinion and make suggestions regarding the development of the service. The Manager and Deputy are supernumerary to the staffing levels and importance is given to the planning and development of the home through a positive ethos. What has improved since the last inspection? This is the first inspection of the service since the change in company name. What the care home could do better: The service and support provided to the people living at Longmoor Lodge is to a high standard. However environmental cues and information such as pictorial menus should be made available at the home as they may be beneficial and enhance the well being of the people living at the home with Dementia. Key inspection report Care homes for older people Name: Address: Longmoor Lodge Care Home 114 Longmoor Lane Sandiacre Notts NG105JP     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: Angela Kennedy     Date: 2 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 28 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 28 Information about the care home Name of care home: Address: Longmoor Lodge Care Home 114 Longmoor Lane Sandiacre Notts NG105JP 01159499991 01159499992 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): www.hillcare.net Hill Care Limited Name of registered manager (if applicable) Mrs Marion Spray Type of registration: Number of places registered: care home 46 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Dementia Code DE Old age, not falling within any other category - Code OP 2. The maximum number of service users who can be accommodated is : 46 Date of last inspection Brief description of the care home Longmoor Lodge is a purpose built care home in a residential area of Sandiacre. The home provides personal care and care for people with Dementia for up to forty-six persons aged 65 years and over. The facilities are on two floors. Access to the first floor is by stairs or passenger lift. All bedrooms are equipped with en-suite facilities. Communal areas are on the ground floor and include lounge and dining areas, a quiet Care Homes for Older People Page 4 of 28 Over 65 46 46 0 0 Brief description of the care home room and a kitchen. Loop systems have been installed in the lounges to assist the hard of hearing. A hairdressing salon is provided and the hairdresser visits regularly. On-site laundry services are provided. The home has well set out garden areas, which are accessible to the people using the service. The weekly fees at the time of this inspection visit were Lowest fee: £353.92 Highest fee: £455 Items not covered by the weekly fee included: Hairdressing Chiropody Dental and Optical treatment Toiletries Hospital Escort (for routine appointments) Contributions towards outside activities, such as day trips. Care Homes for Older People Page 5 of 28 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: This key inspection was unannounced and took place over one day. Key inspections take into account a wide range of information and commence before the site visit by examining previous reports and information such as any reported incidents. The site visit is used to see how the service is performing in practice and to meet with the people using the service. The focus of inspections is upon outcomes for the people using the service and their views on the service provided. This process considers the providers and registered managers capacity to meet regulatory requirements, minimum standards of practice, and focuses on aspects of service provision that need further development. An Annual Quality Assurance Assessment (AQAA) had been completed by the service. This is a self-assessment for providers, which is a legal requirement. This assessment gives the provider and registered manager an opportunity to let us know about their Care Homes for Older People Page 6 of 28 service and how well they think they are performing. The information provided in the AQAA is reflected within this report. At this inspection visit two people were case tracked. Case tracking is a method used to track the care of individuals from the assessments undertaken before they are admitted to a service through to the care and support they receive on a daily basis. This includes looking at care plans and other documents relating to that persons care, talking to staff regarding the care they provide and if possible talking to the individual. One person case tracked were able to express their views of the service and the support it provided. Other people living at the home that were not case tracked were also spoken with. Their views of the service and the care and support provided are included within this report. Two members of staff were spoken with at some length and their views and opinions of the care provided, the support and training given to them is included within this report. The comments provided within the six surveys received from the people living at the home and the two staff surveys received are also reflected throughout this report. The registered manager and senior mangers of the company were available on the day of this inspection and provided the relevant information requested. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have the information they need to make an informed choice about the service and they can be confident that the home can support then, as accurate assessments are undertaken before admission is agreed. Evidence: Both the Service User Guide and the Statement of Purpose were seen and both had been updated to reflect the change in the company name. The providers self assessment stated that all prospective residents are given an information pack to assist them to make an informed decision on whether they wish to proceed with their enquiry. One person spoken with said that due to being in hospital before moving to Longmoor Lodge they did not get an opportunity to visit the service personally before they moved in. They did confirm that their family representatives were able to do this on their behalf and stated that they received sufficient information about the home to Care Homes for Older People Page 10 of 28 Evidence: enable them to make a decision. The records held for the two people case tracked were looked at, relating to the assessments that had been undertaken prior to admission to determine their needs. Both people had needs assessments in place and evidence of annual reviews. These assessments covered all areas of health, social and personal care and included information on medical history and prescribed medication and family history/background. This ensured that the staff had all the relevant information about the individual to provide individualised care and support. Care plans were formulated from the information provided within the needs assessments. Care Homes for Older People Page 11 of 28 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. The health, personal and social care needs of individuals was met in their preferred way and people were supported to take their medicines in a safe way. Evidence: As stated in the providers self assessment comprehensive care plans devised using information gained from the pre admission assessment were in place, which included the action staff must take to ensure each persons assessed needs were met. The records of care and support for the two people case tracked was informative and addressed all areas of assessed need including any health conditions. The information within these plans of care had been reviewed each month or sooner if needs had changed. Care plans and risk assessments linked together and demonstrated that consistent support was provided. Information within both of the care files seen provided a clear understanding and instructions to the staff team of each individuals support needs, their level of independence and how they would like that support to be given. Care Homes for Older People Page 12 of 28 Evidence: People were involved and included in the way they were supported, this was seen in the records that were looked at that had been signed either by the individual or their family representative. Comments made both within the surveys returned and on the day of this visit also confirmed this. Senior members of staff were assigned as key workers for each person and were responsible for ensuring care plans were followed and kept up to date. Daily notes were kept for each person that ensured good communication between the staff team was maintained. Screening tools and assessments were in place for the two people case tracked and this ensured that these individuals were supported in a safe way. They assessed any areas of risk that had been identified, such as mobility, nutrition, weight, falls, skin condition and pressure ulcer risk and also included assessment that related to any specific health care conditions. Health care needs were clearly addressed and this was demonstrated in the records seen of the people case tracked. Everyone had access to health care such as G.P services, chiropodist, dentist and optician. People living at the home confirmed this both within the surveys returned and on the day of this visit. As stated in the providers self assessment people were encouraged to continue to attend appointments whenever possible within the community although domiciliary visits were arranged if needed. The surveys returned indicated that the people living at the home were happy with the care and support provided. On the people case tracked stated, Im very happy here, the staff are lovely, the care is very good. People were supported to take their medication safely. The medication records of the two people case tracked were looked at and no errors were noted. Records had been completed accurately. Medications were stored correctly and all records seen were clear and accurate. Staff administering medication had completed and passed an appropriate medication course. Staff were observed with some of the people living at the home and demonstrated a caring and friendly approach. People were observed to be supported in a respectful Care Homes for Older People Page 13 of 28 Evidence: and dignified way. Care Homes for Older People Page 14 of 28 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 are treated as individuals and the home is responsive to their preferences and beliefs. People are able to keep in touch with their family friends and representatives and meals are enjoyed. Evidence: As stated in the providers self assessment there was an activities co-ordinator employed at the home. The manager confirmed that this person worked thirty hours a week. Fifteen of these hours was spent providing activities and the other fifteen reviewing the activities provided and updating each perons records regarding the activities that they had participated in. Within the care plans seen information was provided regarding the persons preferred actvities, their social history, this included their family relationships, their career and any specific skills, hobbies or interests they had or still had, their communication methods and any specific communication aids or staff support required. This enabled the staff to have a better understanding of each person, which in turn allowed them to ensure that their social needs could be met to enhance their well being. From this information an activities assesment was undertaken, this addressed not only Care Homes for Older People Page 15 of 28 Evidence: the persons interests and preferred activities but also looked at their preferences regarding social settings, such as if they prefered or were better suited to small group activities, if they liked visiting the local community and any aids, equipment or support they needed to participate in activites. Within the home two notice boards were seen that showed the activities and events that were planned. One board was situated in the main entrance to the home and one near the dining area. A weekly activities schedule was in place on these boards which included activites such as memory games, table top games, beauty care, excercised based activities and hand eye coordination activities. Other information on the notice board included the dates of visits fom external entertainers such as musical entertainment and animal therapy. Trips out to the local pub also took place for bingo, lunch and a sing a long and the price list of the hairdressing services provided by the hair stylist who visited the home each Tuesday. The providers self assessment confirmed that they had a regular delivery from the local library of bound books and cassette tapes for the use of the people living at the home. The surveys returned by the people living at the home confirmed that there was activites available. One person case tracked said that they enjoyed going to the pub but would like more activities both within the home and out in the community. As stated in the providers self assessment the local churches provided opportunities for worship from various faiths and denominations. Each month a group called Churches Together visited the home for hymn singing. The manager confirmed that the service had strong links with a number of community organisations. The providers self assessment stated that visits from friends/relatives were always welcome and that they were encouraged to join in events at the home and were able to come and go as they please. Information was also available on the notice boards regarding the meetings that were held for the people living at the home. This information included any actions that had been taken and the latests audit of the annual surveys undertaken. The providers self assessment also confirmed that newsletters were produced and stated that the people living at the home were encouraged to be involved in this. The manager confirmed that local advocacy services were used by the service when Care Homes for Older People Page 16 of 28 Evidence: needed and were advertised to ensure relatives and the people living at the home were aware of the services provided. Three cooks were employed at the home. Two were on duty each lunch time and one for the evening meal. Menus were on display on the notice board. This included the meals for each day and an alternative list of meals that were always available if the main meal was not preferred. The alternative dishes included a variety of salads, jacket potatoes, omlettes, and desserts such as yoghurts, ice creams and fresh fruit. The comments within the surveys indicated that the meals were enjoyed. One person case tracked said that they thought the meals were of a good quality but felt there could be more variety. Specialist diets were catered for such as gluten free and diabetic diets and a variety of finger foods and soft diets were available for people that required them. There were no pictorial menus available at the home. This was discussed with the senior manager on the day of this visit and it was agreed that these may be beneficial to some of the people using the service, who were no longer able to read. Care Homes for Older People Page 17 of 28 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. Concerns are looked into and actions are taken to put things right and the practices in place safeguard people from abuse and neglect. Evidence: The service has updated their policies and procedures to reflect the change in the company name. This included the complaints procedure. As stated in the providers self assessment a clear complaints procedure was displayed on the notice board as well as in the information pack. This ensured that the people using the service and their representatives had clear information about how to make a complaint. As stated earlier in this report meetings were regularly held for the people living at the home. The registered manager confirmed that at some of these meetings relatives / representatives were also invited. This provided further opportunities for the people using the service and their representatives to raise any concerns or put forward any suggestion they had. A managers surgery was also held every Wednesday from 4pm until 6pm for people to raise any concerns or discuss any issues they had. The registered manager stated that this service was infrequently used. She felt this was due to the fact that she had an open door policy and therefore people using the service and their representatives were able to discuss any issues they had as they arose. Care Homes for Older People Page 18 of 28 Evidence: The registered manager confirmed that since the service has changed their company name they have not received any complaints. We have received no complaints regarding the service. Both the surveys returned and comments made at this visit indicated that the people using the service or their representatives knew how to make a complaint and were confident that any concerns they had would be addressed. The registered manager confirmed that a Safeguarding Adults Policy was in place. This included the companys own policy and the Local Authority Policy, who are the lead investigators in any safeguarding referrals. The registered manager has demonstrated to us that she has a good understanding of the Safeguarding adults policy, as she has made two Safeguarding referrals since the change in company name. One of these referrals did not relate to the service but did relate to the care of a person living at the home that had used health care services. The second referral related to an allegation made by a member of staff at the home and this was fully investigated under the safeguarding procedure to ensure the safety of the people using the service was maintained. The training statistics record showed ninety three percent of the staff team had received up to date Safeguarding adults training. The training matrix demonstrated that some staff had undertaken this training in August and September of this year. The registered manager stated that these figures had not yet been added to the training statistics record. This indicates that the staff team are aware of the correct procedures to be followed in the event of any concerns or allegations of abuse. Staff spoken with demonstrated a good understanding of the procedures that were to be followed to ensure people at the home were kept safe. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides sufficient space and facilities and is kept to a good standard to ensure peoples safety and well-being is maintained. Evidence: A partial tour of the home was undertaken to look at communal areas and some of the bedrooms. All of the bedrooms had an en suite toilet and wash hand basin. Bedroom doors had attractive brass name plates. However these may not be helpful to some of the people living at the home who have dementia, in identifying their bedroom. Some bedroom doors did have the persons photograph on their bedroom door, this may be more beneficial than a name plate for some people. The corridors were all coloured magnolia and again this may not be helpful to some of the people living at the home who have dementia, as this makes all areas identical. The registered manager stated that she planned to remove the pictures that were hanging high up on the corridor walls. She stated that she did not feel these were beneficial to the people living at the home and felt that more sensory type pictures would benefit them. There was a sufficient number of bathrooms with moving and handling equipment Care Homes for Older People Page 20 of 28 Evidence: such as hoists to accommodate the people using the service. However it was clear that some of these bathrooms were not regularly used, as they appeared to be used for storage. The registered manager confirmed that certain bathrooms were preferred such as the large bathroom with the parker bath and shower area. Toilet and bathroom doors did not have pictorial signs to help people identify them. Discussions took place with the registered manager regarding this. The registered manager said that the home was short on storage space. However discussions with the senior managers of the company indicated that there was an area that could be used for storage next to the laundry room. The communal areas provided sufficient space and seating for the people living at the home. There was two lounges with televisions and one lounge with a music system. The manager said this enabled individuals to make a choice of where they preferred to sit. On discussions with some of the people using the service it was clear that they had their preferred communal area, where they chose to sit. The garden area had been landscaped to make it easily accessible to the people using the service.The patio area had a ramp that led to the lawn. Raised planters had been placed on the lawn and the registered manager discussed plans to use these planters to provide a sensory area for the people using the service. There were two dining areas and a residents kitchen that was available for use by the people using the service that were able to use this area safely and for use by visitors to make drinks and light refreshments. As stated in the providers self assessment many parts of the home have been redecorated which has greatly improved the quality of the environment. This included replacing the old kitchen with a new one to accommodate the changing tastes and requests of the people using the service. The laundry area was sited away firm the main building and housed 2 large washing machines and 2 large tumble driers. The registered manager stated that the laundry was staffed every day including weekends. Comments within surveys and on the day of this visited indicated that people living at the home were happy with the laundry service provided and that good standards of hygiene were maintained throughout the home. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have safe and appropriate support as there are enough competent staff on duty at all times. Appropriate staff checks ensure individuals safety is maintained. Evidence: The rotas demonstrated that one senior member of staff and four to five care staff were rostered on shift in the mornings and afternoons. At night three waking night staff were on duty to meet the needs of the people using the service. Comments within surveys both from staff and people living at the home and from discussions on the day of this visit, indicated that there was sufficient staff on duty to meet individuals needs. As stated in the providers self assessment all care staff have either achieved or were in the process of obtaining a National Vocational Qualification in care at level 2 or above and Senior staff were qualified to NVQ level 3. This demonstrates that the staff team have the required qualifications to ensure individuals needs are met. The recruitment practices at Longmoor Lodge were looked at. As stated in the providers self assessment a robust recruitment procedure was in place. Two staff recruitment files were looked at and all of the information required by law was in place. This demonstrates that the home has taken all the required precautions to Care Homes for Older People Page 22 of 28 Evidence: ascertain that the staff employed are safe to work with the people using the service. The training records were seen. As stated in the providers self assessment staff were given full induction and this was seen in staffs personal files that were looked at. The service had a training matrix and a training statistics record. These records demonstrated that staff training was kept up to date and refresher courses were provided as required. As stated in the providers self assessment along with mandatory training the records showed that staff were offered additional training to ensure that individuals specific needs were met. Staff surveys and staff spoken with during this visit confirmed that the training provided was regular and useful in developing their skills and knowledge. This enabled them to provide a good standard of care to the people living at the home. One member of staff said about the manager, she has given me great opportunities to better myself at work Records of regular staff meetings were seen. As stated in the providers self assessment this ensured that communication between the staff and management was maintained. Care Homes for Older People Page 23 of 28 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. People have confidence in the service provided because the home is led and managed appropriately, with their health and safety maintained and finances safeguarded. Evidence: As stated in the providers self assessment the registered manager has achieved a management qualification and a National Vocational Qualification at level 4. Staff that were spoken with reflected the information that was provided in the providers self assessment, which stated that there is effective communication within the home. That there is regular staff and management meetings and that all staff have regular access to the manager during their normal working hours, to discuss any matters or concerns. As stated earlier in this report there was an effective quality assurance process in place, which ensured that the people using the service and their representatives were Care Homes for Older People Page 24 of 28 Evidence: consulted and involved in its development. As stated in the providers self assessment this included regular meetings for the people using the service and their representatives. Individuals involvement in their care reviews. A newsletter, which provided up to date news and information and the annual quality assurance survey audit and actions taken as a result of this. The registered manager has also held regular formal and informal chats with the people using the service and their families/visitors. Customer surveys also gave the people using the service and their families/friends an opportunity to voice their opinions and a weekly managers surgery which gave the people using the service and relatives an opportunity to voice concerns or just visit for a chat. The system for handling individuals personal monies was examined for the two people case tracked and there was suitable accounting procedures in place that ensured individuals financial welfare is safeguarded. New policies and procedures have been written since the change in company name and some of these were looked at on the day of this visit. This ensured that the staff team were working to up to date information and practices and this in turn ensured the welfare of the people using the service was promoted. The environment is safe for people because the appropriate health and safety checks and training are carried out. As stated earlier in this report the records demonstrated that staff training was kept up to date and refresher courses were provided as required. This included training in health and safety, moving and handling, fire awareness and fire safety, first aid, infection control and food hygiene. The records demonstrated that fire safety tests were conducted as required and the information in the providers self assessment confirmed that the service and maintenance of equipment and appliances was maintained to ensure that they were in good working order. This ensured the safety of the people using the service, the staff team and visitors to the home was maintained. Care Homes for Older People Page 25 of 28 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 26 of 28 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 1 15 Pictorial menus should be made available at the home as they may be beneficial to some of the people using the service,who were no longer able to read. The environment should be reviewed. This should be based on new guidance that is available for people who provide a service for people with dementia. 2 19 Care Homes for Older People Page 27 of 28 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. 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