Care Home: Lord Hardy Court

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What the care home does well The home have developed comprehensive care plans to ensure people receive the care they need. They have good records to confirm people receive the medical care they need and district nurses told us that staff were very good at following instructions and undertaking assessments to ensure their nutritional needs were met. Surveys from people who use the service told us that they always receive the care and support they need and staff always listen and act on what they say. Surveys confirmed that they always receive the medical care they need. The home provides good opportunities for people to join in activities. People said they enjoy going out into the local community and the ballroom is great for films and we can see our visitors in the lovely cafe. Surveys confirmed that people can join in the activities they like. People said they enjoyed the meals provided and they always get a wide range of food and snacks. The accommodation provided to people is excellent. people said they loved their bedroom especially having their own bathroom. One person said "I found it very difficult to leave my other home, although it is very nice hear and the staff look after us very well". "I like the company, enjoy bingo and bowls and the home is always clean and tidy". The staff at the home have worked extremely hard to ensure the operate as a team. The manager told us the closure of homes and staff moving into a new home has been difficult, as it involved the merger of four homes and staff. The staff said the transition was difficult but they have now adapted, and all strive to providing a excellent home for people to spend their time. What has improved since the last inspection? This was the first inspection of the service following registration in February 2009. What the care home could do better: The service could improve the way they manage medication to ensure the system is as safe as possible. Where mistakes have taken place staff must be closely supervised to ensure they have the right skills and competencies. The home could improve the way they inform people about the activities offered to people. Menus should be clearly displayed in each of the dining areas to ensure people can make an informed choice about the choice of meals on offer. The complaints/concerns records should show how they deal with concerns that have been raised. The manager told us that concerns have been made during the settling in period, although none had been recorded. A review of the staffing ratios on nights should be undertaken to ensure they are sufficient in numbers and skills to ensure peoples needs are met. The gardens were overgrown and untidy, which means people were unable to access them easily. The manager said funding had been obtained to landscape the gardens which would improve the area. Relatives commented that the gardens spoiled the overall appearance of the home. Financial procedures could be improved to ensure people who have savings benefit from having their money transferred into an interest baring account. Key inspection report Care homes for older people Name: Address: Lord Hardy Court Lord Hardy Court Green Rise, Haugh Road Rawmarsh Rotherham South Yorkshire S62 7DH     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Valerie Hoyle     Date: 0 4 0 8 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: Lord Hardy Court Lord Hardy Court Green Rise, Haugh Road Rawmarsh Rotherham South Yorkshire S62 7DH 01709336188 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): www.rotherham.gov.uk Rotherham Metropolitan Borough Council Name of registered manager (if applicable) Mrs Lisa Maria Sykes Type of registration: Number of places registered: care home 60 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: The maximum number of users who can be accommodated is 60 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 Old age not falling within any other category - Code OP Dementia - Code DE Date of last inspection 0 0 0 Over 65 30 0 30 Care Homes for Older People Page 4 of 28 Brief description of the care home Lord Hardy Court is a new purpose built home situated in Rawmarsh, which is on the outskirts of Rotherham Town Centre. It has good road networks and has local shops within walking distance. It stands in extensive grounds and has a large car park to the front of the building. The care home is registered to provide accommodation for 60 older people. The accommodation is split into four distinctive units. Two of the 15 bed units accommodate people whose primary care needs is dementia. The other two 15 bed units accommodate people falling into the old age category. The home offers excellent accommodation, all rooms benefit from ensuite facilities with each unit having its own lounge and kitchenette. Two units share a large well equiped dining area, and there is a bathroom on each of the units. Each unit has bedrooms on both the ground and first floor and those rooms can be accessed via a passenger lift. There are a variety of communal areas including a large ballroom, activity and therapy rooms. The home provides a comprehensive information pack, which includes the Service Users Guide and Statement of Purpose. Information gained on 3rd August told us that weekly fees for the home are £485 and there are additional charges for hairdressing, newspapers and private chiropody. 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: 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 quality rating for this service is 2 stars. This means that the people who use this service experience good quality outcomes. This was the first inspection of the service which was registered with the Care Quality Commission in February 2009. The inspection took place over one and a half days starting at 09:00am finishing at 17:00pm on the first day and 09:00am to 13:00pm on the second day. We gained the views of staff, relatives, two district nurses and a number of people who use the service. Their views are included throughout this report. Eight surveys were received from people who use the service and eleven surveys were received from staff who work at the home. We have reviewed our practise when making requirements, to improve national Care Homes for Older People Page 6 of 28 consistency. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Occupancy at the home is high, although most of the current people that live at the home have transferred from homes within the local authority that had closed. Four peoples care plans were looked at, along with policies relating to medication, complaints, protection of vulnerable adults and the handling of peoples money. Five staff recruitment and training records were looked at to assess how people were protected. Procedures and risk assessments relating to health and safety were looked at and discussed with the manager. The manager is Lisa Sykes; she has worked as a manager in another home for a good period of time. She was appointed into her current position when the home opened in February 2009. She holds the required management and care qualifications and continues with her development by attending training as required by the organisation. An Annual Quality Assurance Assessment is a self-assessment and a dataset that is filled in once a year by all providers whatever their quality rating. It is one of the main ways that we will get information from providers about how they are meeting outcomes for people using the service. The AQAA also provides us with statistical information about the individual service and trends and patterns in social care. The AQAA was returned to us on time, which demonstrates responsiveness and cooperation 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: The service could improve the way they manage medication to ensure the system is as safe as possible. Where mistakes have taken place staff must be closely supervised to ensure they have the right skills and competencies. The home could improve the way they inform people about the activities offered to people. Menus should be clearly displayed in each of the dining areas to ensure people can make an informed choice about the choice of meals on offer. The complaints/concerns records should show how they deal with concerns that have been raised. The manager told us that concerns have been made during the settling in period, although none had been recorded. A review of the staffing ratios on nights should be undertaken to ensure they are sufficient in numbers and skills to ensure peoples needs are met. The gardens were overgrown and untidy, which means people were unable to access them easily. The manager said funding had been obtained to landscape the gardens which would improve the area. Relatives commented that the gardens spoiled the Care Homes for Older People Page 8 of 28 overall appearance of the home. Financial procedures could be improved to ensure people who have savings benefit from having their money transferred into an interest baring account. 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 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 10 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 who use the service were assessed before moving into the home to ensure their needs can be met. Evidence: The home has developed comprehensive information that was service specific and written in clear easy read format. It includes pictures to enhance the information. It was available for all new people using the service, and surveys received confirmed people found the information useful. Most (49) people currently living at the home were admitted from other care homes in the local authority. Their original accommodations were closed following the opening of Lord Hardy Court. The home has developed a comprehensive assessment document which was completed prior to admission. The manager told us that all people admitted to the home received a comprehensive assessment which was carried out by staff who had the skills and competencies to ensure peoples needs could be met. The service Care Homes for Older People Page 11 of 28 Evidence: was highly efficient in obtaining a summary of any assessments undertaken by social services, health professionals, and they also involve relatives to ensure they gather as much information as possible. Four completed assessments were looked at and they were comprehensive and focused on achieving positive outcomes for people who use the service. People said although they did not want to move from their previous home, the staff continued to care for them in the same way. Relatives said it was a difficult time prior to the move and their relative had taken a little while to adapt to the move, but were now settled. Surveys confirmed they receive the support and care they need. Care Homes for Older People Page 12 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their health and personal care needs met in a dignified manner. The management of medicines could be improved to make administration of medication safer. Evidence: One care plan from each of the four units were looked at. They were comprehensive and gave staff clear information about the needs of individuals. Staff spend time before the start of their shift reading the care notes to ensure they have up to date information. The team leaders told us that staff working on the two dementia care units have specific skills to meet their specific care. The care plans include well written daily records and regular reviews ensure staff can assess how the plan is working. Comprehensive risk assessments ensure people can maintain their independence, while remaining safe. Surveys returned confirmed that people always receive the care and the support they need and staff are mainly available when needed. Health and medical records confirm people receive the support they need to maintain their health. The home had good records to demonstrate they use assessment tools to Care Homes for Older People Page 13 of 28 Evidence: help maintain healthy skin and meet peoples nutritional needs. Surveys received confirmed that people always receive the medical support they need. A visiting district nurse said staff were very good at notifying nursing services for advice and support. A advanced nurse practitioner also confirmed that staff were very good at utilising emergency support to prevent visits to accident and emergency. The nurse is able to prescribe some medications, give injections and attend to wounds following falls, which means people receive attention quicker and people can be treated without having the trauma of going to hospital. The home has introduced a person centered approach administering medication to people who use the service. All bedrooms have a secure unit to store medication and staff administer medicines from the persons room. Records are stored with the medication and a second record is kept to ensure medication is administered safely. The medication is stored in boxes, which makes auditing difficult. A monitored dosage system would provide an easily audited system and would be safer for staff to administer from. All staff have received training to administer medication and team leaders undertake regular audits to ensure people receive medication as prescribed. They evaluate staff competencies and provide additional support where required. One record looked at showed a member of staff was receiving additional supervision following a mistake although their was no evidence to confirm the staff member was now competent. Throughout the visit staff were seen interacting with people in a kind manner, they spent time talking to people and were observed knocking on peoples bedroom doors before entering. People were referred to by their first name and this was agreed in the care plans looked at. Surveys confirmed people were treated with respect and people said staff always maintain my privacy when attending to their needs. They said they had made choices about the time they get up and go to bed and also how many times they want staff to check them during the night. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social activities are organised which are appropriate to the needs of people who use the service. Mealtimes were well managed and people can maintain contact with family and friends, and have opportunities to maintain links with the local community. Evidence: There is a large ballroom used for parties and it has a large cinema screen for movie nights. There is a hairdressing salon and a therapy room for massage which is also used for chiropody. There is a dedicated team of activity coordinators who work with both small and large groups of people. They keep detailed log of the activities that take place and they also provide a non profit making shop which people can buy a range of goods. Although the home has only been operational for six months they have developed good links with the local community including the Church which provides a service in the ballroom. The coordinators have arranged trips to Hornsea, garden centres and the theatre. On the day of the inspection people were enjoying having their hair set while others enjoyed ball games in the lounge. On the second day of the inspection people were Care Homes for Older People Page 15 of 28 Evidence: out on a trip to the local garden centre. People said they really enjoyed the activities in particular bingo and music to movement. They have held events to involve family and friends and raise funds by holding coffee mornings and a summer fayre. They have held a family day where relatives were able to join their relative for Sunday lunch. The coordinators said they had further plans to have entertainment evenings and they are planning outings using the local authority transport once a month. Surveys returned confirmed that people enjoy the activities provided an most said the staff do their best to make us happy. The home could improve the way they advertise events and activity schedules by providing better notice boards around the home which is accessible to people who use the service. Visitors to the home had mixed views on activities and how staff meet the needs of people. Three relatives said their parent had found it difficult to settle after the move from their previous home, which was small and homely. They said the accommodation was very good and staff always made them feel welcome. Two other relatives said they would like more opportunities for people to join in activities and outings. Relatives visiting the home have the opportunity to entertain their family in the small cafe area in the entrance of the home. They are able to make their own drinks, and they are able to have lunch with their family. The home has a room available for relatives to stay over and the manager said the room had been used and the family was very pleased. Mealtimes were well organised and people were given the opportunity to have their meal in their room if they wished. There is two main dining areas where two units join together to dine. The dining areas were bright and the tables were pleasantly layed with condiments flowers and serviettes. There was a good balanced menu and people had a choice of main courses and dessert. Surveys confirmed that people always enjoy their meal and people said the food was very good with plenty of choice. The menu was not displayed and people were unsure what was on the menu for the main meal. The cook said they were still making amendments to the menus and when they were completed they were going to be displayed in each of the dining areas. The home has been awarded a 5 Star Food Hygeine award for standards in the kitchen. Care Homes for Older People Page 16 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. People who use the service can access the complaints procedure and were aware of who to contact if they had a concern. Safeguarding procedures ensure people were safe and protected. Evidence: The home has a complaints procedure that was accessible to people who use the service and visitors to the home. The procedure was also referred to in the Service Users Guide, which identified the stages to follow, it includes the timescales to respond to complaints. The AQAA confirmed that no complaints had been received since the home opened, although the manager told us that concerns have been made during the settling in period, although none had been formally recorded. Surveys received confirmed people knew who to speak to if they were not happy and they knew how to make a complaint. There was a comprehensive Safeguarding adults procedure and staff follow the procedures to those standards. The registered manager operates to those standards and would know the agencies to notify if there was any suspicions of abuse. The AQAA confirmed one allegation had been reported to the safeguarding adults team, although this had not reached any conclusion and was still being investigated. Staff have attended training to identify signs of abuse and they know who to contact and was aware of the whistle blowing procedures. All eleven surveys received from staff confirmed they know what to do if they had a concerns about care practise, and they Care Homes for Older People Page 17 of 28 Evidence: confirmed the training they recieved was relevant and up to date. Care Homes for Older People Page 18 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment is fit for purpose with excellent facilities for people to spend their time. Evidence: The home purpose built and was opened six months ago. It has excellent facilities both communal and individual space has been developed to a high specification. All bedrooms are ensuite and they are spacious and each has their own outside balcony. There are four units each with there own lounge area. Two units share dining facilities. There are excellent communal activity areas including fully fitted hairdressing and therapy rooms. There is a designated room for people to pray, although this has not been commissioned. A large ballroom also doubles up as a cinema, where films and outside entertainment takes place. The layout of the home has been designed specifically to enable people with dementia to move freely around each of the units. They have specialised equipment on each of the units to ensure people can be moved safely. People who use the service and their visitors can meet and have refreshments in the cafe at the front of the building. The home was clean and fresh and surveys confirmed that the home was always kept Care Homes for Older People Page 19 of 28 Evidence: to a high standard. Domestic staff are currently spilt between staff employed by the home and contracted staff. they are commended for maintaining a clean environment. The home provides sanitising gel to help control the spread of infection and the home has good sluicing facilities on each unit. There are vast gardens and a safe area for people who reside on the dementia units. There is also a paved walkway around the home and the manager said they were hoping to develop an area for people to grow vegetables and flowers. The gardens were totally overgrown and need to be landscaped to enable people to access and enjoy the grounds. The manager said they had been informed that the grounds would be developed in the near future. Relatives said the home provided excellent facilities, although they were disappointed with the surrounding gardens which let the home down. Care Homes for Older People Page 20 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 are cared for by enough staff who are well trained and safely recruited, this means that individual needs are routinely met. Evidence: A large staff group has been established from local authority homes that have closed. The manager and her senior team has worked hard to merge the workforce and overcome different ways of working into a team that functions well together. Staff were deployed to work specifically on each of the units and staff have specific skills to work with people on the two dementia units. Staffing was sufficient to meet the needs of people although numbers working on nights could be better as more staff are deployed on the two dementia units leaving the other two units with only basic numbers. They could also improve the way staff work on nights as there is no one designated as senior on duty. This means there is no one specifically designated to make important decisions about safety and emergency situations. Staff on nights have not received training to administer medication and by having a designated senior they could also have that added responsibility so that people could receive medication if required. The home arranged for all staff to attend a two week induction programme prior to the opening of the home which mean there was a consistent approach to the expectations of staff. The induction package was looked at and it was comprehensive and service Care Homes for Older People Page 21 of 28 Evidence: specific. The manager has responsibility to submit a training plan to ensure statutory training is up to date and meet the needs of the service. Training is mainly provided internally, although the manager said service specific training could be accessed from outside training organisations. They have high levels of staff that have achieved National Vocational Qualifications in care and the manager said they continue to invest in NVQ and they hope to have all staff NVQ Level 2 qualified, with some team leaders accessing higher levels in both NVQ and management qualifications. There were robust recruitment and selection procedures that ensures people who use the service were safe and protected. Most of the staff employed have transferred from homes within the local authority, although they all went through the recruitment process. A number of staff recruitment files were looked at, they included the required employment checks including application form, proof of identity, two references and a Criminal Record Bureau check Care Homes for Older People Page 22 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed, and they have good procedures to ensure the health, safety and welfare of people using the service is maintained. Evidence: The registered manager has a wealth of experience and knowledge and was able to demonstrate her ability to manage the home. She had achieved the required management and care qualifications and continues to attend training as required by the organisation. She has spent time developing relationships with families to overcome difficulties brought about by the closure of a number of homes to transfer people into the new home. She leads a strong team of team leaders who have responsibility for the day to day operation on the four units. Staff and group meetings take place frequently to ensure staff have the opportunity to give their views on how the service can progress. Relatives and resident meetings were frequently held to assist with the settling in process. Quality assurance systems were in place and the manager said they had used surveys to gain the views of people Care Homes for Older People Page 23 of 28 Evidence: who use the service. The manager said although surveys had been sent to people they were not at the stage of providing details of outcomes for people. Representatives of the organisation visit the home regularly to undertake a quality audit (regulation 26), from the visit a report is available which was available for inspection. People who use the service were able to manage their own finances, although most prefer the home to assist with dealing with their personal monies due to their limited capacity. Records were looked at and they were an accurate reflection of the accounts held on peoples behalf. The procedures to manage peoples money states a limit that should be held, before money is transfered to other bank accounts. Some of the records looked at showed a number of people had more than the limit. This was discussed with the administrator who should make alternative provision for peoples savings, to ensure they act in the best interest of the people. Accident reports were analysed by the manager to ensure risk assessments developed where required. The home has their own qualified staff to deliver moving and handling training which means staff can react quickly to the changing needs of people who use the service. Maintenance and service records were looked at and were up to date and current to the services provided. The manager has the required Health and Safety policies and procedures and displays the relevant notices. Fire safety procedures were in place and service records were looked at and were current, ensuring the safety of people who use the service. The manager was able to provide evidence that staff had received intensive fire safety training as part of their induction, and they have continued to undertake the required drills to ensure staff have the skills and competencies to keep people safe. Care Homes for Older People Page 24 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 25 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 9 Where records show a mistake with the administering medication has occurred, the staff member should be supervised until deemed competent and a this should be recorded. Consideration should be given to have medication delivered in a monitored dosage system, which will provide an easily audited system and make the way staff administer the medicines to people safer. The home could improve the way they advertise events and activity schedules by providing better notice boards around the home which is accessible to people who use the service. Daily menus should be prominently displayed so that people can make informed choices about the meals they eat. The complaints records should reflect the concerns raised and resolved within the procedures timescales The gardens require landscaping to make them accessible to people who use the service. 2 9 3 12 4 15 5 6 16 19 Care Homes for Older People Page 26 of 28 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 7 27 A review of the staffing ratios on nights should be undertaken to ensure they are sufficient in numbers and skills to ensure peoples needs are met. Financial procedures should be followed to ensure peoples money is transfered into bank accounts. To ensure staff act in the best interests of people who use the service. 8 35 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. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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