Care Home: Marbury House

Similar services:

• Chirnside House
• Keer Sands Residential Home
• Ruskin Lodge
• Bushell House
• Langrigg House
• Parkside
• Dystlegh Grange
• Thornton Lodge

What the care home does well The manager carried out an assessment and provided people with information before they were offered a place at the home. People were also asked if they wished to visit the home for a few hours and have a meal. The information from the assessments was written into the care plans to make sure that the care workers would know what the personal and social care needs of the person were and how they should meet these needs. The care plans contained information about the needs of the people who lived at the home including a short history which helped the care workers to see the persons likes, dislikes, hobbies and interests rather than just their health care needs. The intermediate care scheme provided a service to help people who were not ready to go home from hospital to receive further support for a short period of time. The main aim of the service was to provide general support from the care workers together with physiotherapy and occupational therapy so that they would return home in better health and more able to manage. There were records of GP and district nurse visits and other services such as opticians and podiatrist. On the day of our visit we saw the community pharmacist and the podiatrist both of whom said that they had no concerns about the home and that they were always welcomed by the staff team. The people we spoke with who lived at Marbury and the relatives we saw whilst they were visiting were happy with the care provided and had no complaints. One relative said that they always felt comfortable when they left their relative after visiting and did not worry that they were not being looked after. The person had visited many homes before making any decisions but had no regrets on the choice made. When asked people said that their privacy and dignity were respected by the staff team. Activities took place each afternoon and ranged from music to movement, bingo and carpet bowls. People also went out shopping and out to pubs and restaurants. A trip to Chester Zoo was being arranged. Visitors were encouraged and people we saw on the day of our visit said that they came to the home every day to see their relative. The home had a large dining room and another seating area on the first floor although people can eat in their own rooms if this is what they want to do. The tables in the dining rooms looked good with matching table cloths and serviettes, a small vase of flowers and a menu card on each table. There was a mixed response about the food some people saying that it was very good whilst others saying it was `alright`. One person said that she had eaten a piece of steak the day before which was like she would have cooked at home. The home was well maintained with any repairs necessary logged for the handyman to carry out. The home was clean and tidy and free from offensive odours. Residents were encouraged to personalise their bedrooms. There was a reasonably sized garden with patio area and garden furniture for residents to use during the better weather.The home had a stable staff team of care workers and a low staff turnover, many had worked at the home for a number of years. Induction training for new staff took place both in the home and at head office where staff spent four days looking at dementia care, safe guarding adults and general care practices. Staff were encouraged to take National Vocational Qualifications (NVQ) in care. The manager told us that forty percent of the staff group had received the qualification. All the senior staff who gave out medication had received safe handling of medication training. The manager had introduced some new ideas such as a dessert trolley after both the lunch and tea time meals. There were usually at least four different dessert for the residents to choose from. A breakfast trolley had also been introduced in the dining room on the first floor which contained different types of cereals and drinks. The front entrance had been refurbished in brighter colours than previous which made the area appear much lighter. The manager was also aware of where further improvements could be made. The staff who were spoken with said that the manager always sorted out any problems quickly. Residents and relatives views were sought through meetings and questionnaires. Completed questionnaires were looked at by head office and incorporated in the annual report. Any complaints or areas of concern were acted on wherever possible. We were also showed a file which contained cards and letter from relatives and people who had used the service complementing the staff team. One relative had brought in forty cream cakes one each for all the staff. The company was a registered charity and representatives from the committee visit the home on a regular basis. The company also employed a person to visit all of the homes once a month and write a report on how the home was functioning. A copy of these reports were available to us as required under the care homes regulations. The home followed safe working practices. They had in place policies and procedures for staff to follow which were reviewed regularly to make sure they met with current legislation and requirements. Equipment was serviced and checked at appropriate intervals. All staff received training in moving and handling, infection control, first aid and adult protection. What has improved since the last inspection? The care files and staff files were better organised making it easier to find information. The entrance hall and corridor leading to the dining room on the ground floor had been refurbished in brighter colours which made it look cleaner and lighter. The complaints and compliments record had been separated which again meant information was easier to find. What the care home could do better: The service user guide and statement of purpose required amending as to the changes in our inspection frequency and our change of address and telephone number. The application form required amending to ask for more information about an applicants employment history. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Marbury House Marbury Road Heaton Chapel Stockport Cheshire SK4 5NU     The quality rating for this care home is:   three star excellent 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: Jacqueline Kelly     Date: 2 7 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 28 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 28 Information about the care home Name of care home: Address: Marbury House Marbury Road Heaton Chapel Stockport Cheshire SK4 5NU 0161-4322825 01619479687 marburyhouse@boroughcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Borough Care Limited care home 40 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: 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 The maximum number of service users who can be accommodated is: 40 Date of last inspection Brief description of the care home Marbury House is owned by Borough Care Limited; a not for profit organisation who also manage a number of homes in the Stockport area. The home is registered for up to 40 people. The home was purpose built approximately forty-five years ago and is situated on a small housing estate in the Heaton Chapel area of Stockport. An Care Homes for Older People Page 4 of 28 Over 65 0 40 40 0 Brief description of the care home extension has been added so that all bedrooms are single occupancy with some having an en-suite toilet with wash hand basin. To the rear of the house there is a reasonably sized garden with shrubs and patio. Marbury House is situated opposite a bus stop, which is a direct route into Stockport town centre. There is also a train station approximately a thirty-minute walk with a direct line through from Buxton to Manchester. The motorway network is within easy reach. The fees range from £365.00 to £442.00. The home has a statement of purpose and information pack, which includes the service user guide. A notice was pinned to the front door stating that a copy of the latest inspection report was available.The organisation has achieved the Investors in People Award and is a registered charity. 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: The quality rating for this service is three star. This means that the people who use this service experience excellent quality outcomes. The report was written on behalf of the Care Quality Commission therefore throughout the report the terms we and us are used. We last inspected this service on the 12 June 2007. This inspection took place on the 20th and 27th June 2009. The manager was not told beforehand of the first date that the inspection took place. Before the inspection we asked the manager of Marbury House to complete a form called an Annual Quality Assurance Assessment (AQAA). This forms asks the manager to tell us what they did well and what they could do better. We felt that time had been Care Homes for Older People Page 6 of 28 given to filling in the form and that it had been completed honestly and that it showed us the manager saw the service being provided the same way that we did. During the visit to the home we looked at the care files of the residents, staff records, complaints and compliments books, service user guide and statement of purpose and medication records. We talked to the manager Mrs Jackie Crewe and other members of the staff team including the deputy manager, administration assistant, housekeeper, laundress and a care worker. We also talked with the residents and their families. Other people we had contact with were the pharmacist, podiatrist and the social worker from Age Concern. We sent to the manager ten staff and fifteen individually named survey forms for the people who lived at Marbury and with them survey forms for relatives; all had attached pre-paid addressed envelopes for their return. At the time of writing this report six staff questionnaires had been returned, thirteen service user and five relative. All the service user surveys had been completed with support; the majority by the care workers. The surveys from the staff were very positive saying that they had an induction when they first started, training in core skills such as moving and handling, first aid, health and safety were mandatory. They also said that they had the right support, experience and knowledge to meet the different needs of the people who used the service. Comments received were; we offer an excellent service caring dedicated staff very good choice of meals from some very nice menus. We try to do everything well; provide an excellent service for both residents and staff; all staff have regular supervision sessions. The surveys we received from residents and relatives were for the most part happy with the service. The majority said that always or usually staff were available when they needed them, that staff listened and acted on what they said, that they received the care and support they needed, and that the home was fresh and clean. We received some direct comments as follows; food - good choices. Standard of the home being clean. Staff are caring; they help me to get up....get out and about...help me to phone my son; kept clean and nice; provides a nice friendly and caring place, I am very happy to say that if I am ever unwell I am looked after in a caring way and are pleased with how quick the doctor is informed. There were a few negative comments mainly about activities; more things organised for us to look forward to, getting out and about e.g. for lunch and to shops; have little more entertainment and singers for example; have more staff to spend with residents for company, personal assistance and outings. We had received one complaint and one safeguarding referral. The safeguarding investigation had resulted in the member of staff being dismissed and referred to the Protection of Vulnerable Adults (POVA) manager for possible inclusion on the register. The complaint had been completed during the writing of this report. The complainant had received a reply from the company and acknowledged that the Borough Care were going to address the areas of concern that had been raised. The staff at Marbury had recorded four complaints in their complaints record two of which are indicated in the above paragraph. The remaining two were resolved to the satisfaction of the relatives and the people who use the service. What the care home does well: The manager carried out an assessment and provided people with information before they were offered a place at the home. People were also asked if they wished to visit the home for a few hours and have a meal. The information from the assessments was written into the care plans to make sure that the care workers would know what the personal and social care needs of the person were and how they should meet these needs. The care plans contained information about the needs of the people who lived at the home including a short history which helped the care workers to see the persons likes, dislikes, hobbies and interests rather than just their health care needs. The intermediate care scheme provided a service to help people who were not ready to go home from hospital to receive further support for a short period of time. The main aim of the service was to provide general support from the care workers together with physiotherapy and occupational therapy so that they would return home in better health and more able to manage. There were records of GP and district nurse visits and other services such as opticians and podiatrist. On the day of our visit we saw the community pharmacist and the podiatrist both of whom said that they had no concerns about the home and that they were always welcomed by the staff team. The people we spoke with who lived at Marbury and the relatives we saw whilst they were visiting were happy with the care provided and had no complaints. One relative said that they always felt comfortable when they left their relative after visiting and did not worry that they were not being looked after. The person had visited many homes before making any decisions but had no regrets on the choice made. When asked people said that their privacy and dignity were respected by the staff team. Activities took place each afternoon and ranged from music to movement, bingo and carpet bowls. People also went out shopping and out to pubs and restaurants. A trip to Chester Zoo was being arranged. Visitors were encouraged and people we saw on the day of our visit said that they came to the home every day to see their relative. The home had a large dining room and another seating area on the first floor although people can eat in their own rooms if this is what they want to do. The tables in the dining rooms looked good with matching table cloths and serviettes, a small vase of flowers and a menu card on each table. There was a mixed response about the food some people saying that it was very good whilst others saying it was alright. One person said that she had eaten a piece of steak the day before which was like she would have cooked at home. The home was well maintained with any repairs necessary logged for the handyman to carry out. The home was clean and tidy and free from offensive odours. Residents were encouraged to personalise their bedrooms. There was a reasonably sized garden with patio area and garden furniture for residents to use during the better weather. Care Homes for Older People Page 8 of 28 The home had a stable staff team of care workers and a low staff turnover, many had worked at the home for a number of years. Induction training for new staff took place both in the home and at head office where staff spent four days looking at dementia care, safe guarding adults and general care practices. Staff were encouraged to take National Vocational Qualifications (NVQ) in care. The manager told us that forty percent of the staff group had received the qualification. All the senior staff who gave out medication had received safe handling of medication training. The manager had introduced some new ideas such as a dessert trolley after both the lunch and tea time meals. There were usually at least four different dessert for the residents to choose from. A breakfast trolley had also been introduced in the dining room on the first floor which contained different types of cereals and drinks. The front entrance had been refurbished in brighter colours than previous which made the area appear much lighter. The manager was also aware of where further improvements could be made. The staff who were spoken with said that the manager always sorted out any problems quickly. Residents and relatives views were sought through meetings and questionnaires. Completed questionnaires were looked at by head office and incorporated in the annual report. Any complaints or areas of concern were acted on wherever possible. We were also showed a file which contained cards and letter from relatives and people who had used the service complementing the staff team. One relative had brought in forty cream cakes one each for all the staff. The company was a registered charity and representatives from the committee visit the home on a regular basis. The company also employed a person to visit all of the homes once a month and write a report on how the home was functioning. A copy of these reports were available to us as required under the care homes regulations. The home followed safe working practices. They had in place policies and procedures for staff to follow which were reviewed regularly to make sure they met with current legislation and requirements. Equipment was serviced and checked at appropriate intervals. All staff received training in moving and handling, infection control, first aid and adult protection. What has improved since the last inspection? What they could do better: The service user guide and statement of purpose required amending as to the changes in our inspection frequency and our change of address and telephone number. Care Homes for Older People Page 9 of 28 The application form required amending to ask for more information about an applicants employment history. 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. 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 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 11 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 their needs assessed and are given information about Marbury House before they move into the home to ensure that their care needs can be met and help them make choices. Evidence: The manager said that all the people who were thinking of living at the home received a Service User Guide and a Welcome Pack. A copy of the Welcome Pack was in all the bedrooms. The service user guide was looked at during the inspection and discussed with the manager. It was necessary to make some amendments such as frequency of the inspections by us and making sure that our most up to date address and telephone number were included. The service user guide was now available in large print and the company were looking to put the guide on tape for those people who may be registered blind or partially sighted. There was also a separate booklet for those people who were admitted under the Care Homes for Older People Page 12 of 28 Evidence: Intermediate Care Scheme. This scheme allowed people who were not ready to go home from hospital to go into Marbury House for a few weeks whilst they spent time improving their strength and wellbeing. The physiotherapist and occupational therapist visited the people each week to help them with any problems they had such as walking or daily living activities. The home had six beds available for this service. Everyone had an assessment by the manager or another member of the senior team before they were offered a place at the home. Part of the assessment also allowed people to visit the home before accepting the offer so they were able to see if they thought they would like to live there. The first six weeks were on a trial basis after which a review took place. The purpose of the review was to ensure that the resident was happy with the care being received and that the home could meet their needs. The assessment was written up which also included information about the persons likes, dislikes, social and health care needs Care Homes for Older People Page 13 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 who live at Marbury House have their needs met and their care is provided in a manner that protects their privacy and dignity. Evidence: All the residents had a care plan which had been written up from the information obtained during the assessment. Information was also added to it as people spent time in the home and the care workers became more familiar with their needs and special requirements. All the care plans followed the same format and were written on a computer before being printed off and put in the persons file. The care plans showed what the needs of the people were and how and why the care workers were to meet these needs. Other information contained in the care file were records of GP visits, District Nurse, Opticians and any special needs, treatments or visits to consultants. A social history form was written up by the staff with the help of the people who were living at Marbury House and their relatives or friends. This helped to give a balanced view of the person rather than just their physical needs. Care Homes for Older People Page 14 of 28 Evidence: We spoke with a number of people during our visit to the home including the people who lived there and their relatives. Every one was happy with the care they or their relative received. We also saw the Community Pharmacist who said that he had no major concerns about the home. The home was in the process of introducing a new medication package system and training was being given to the senior team by Boots Chemist. The senior staff who administered the medication had received training in the safe handling of medicines. We also spoke with the podiatrist and a social worker from Age Concern both of whom had no concerns about the care provided at the home. The care workers were observed to be treating the residents well. Everyone had a single room and said that their privacy and dignity were respected. The brochure contained statements about the rights of residents to expect their privacy, dignity, independence and choice to be respected. Care Homes for Older People Page 15 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 were provided with activities and a variety of home cooked food. People were offered choices and had the opportunity to tell the managers of the home what they wanted. Evidence: Residents were encouraged to take part in the activities that took place each afternoon. On the day of the inspection in one of the lounges a small number were taking part in a music to movement session. Others were watching TV either in the lounge or in their bedroom. People were reading or talking with visitors. Activities that took place included bingo, carpet bowls and entertainers visited every two months. Residents meetings were held every eight weeks where people were able to put their views and opinions forward. Minutes of the last but one meeting were looked at. Seven residents attended the meeting. Meals were discussed and all agreed that they were much better. They liked the dessert trolley that had been introduced after lunch and tea which had about four choices. They were also asked for ideas for a new activity programme. Staff were to arrange an outing to Chester zoo. The manager said that contacts with the local community could improve and was hoping to do this for example with Coffee Mornings and by having Summer and Christmas Fayres. Care Homes for Older People Page 16 of 28 Evidence: A number of relatives were seen during the visit and all said that they were made welcome. There was also a visitors kitchen where people could make drinks if they wanted to. The priest from the local church visited to offer communion to those who wished to receive it. People were able to bring with them items to personalise their rooms. The people themselves or their relatives handled financial affairs. The menus were changed with the seasons and people were asked what they would like to eat and their choices and ideas were incorporated into the menu. There was a mixed response about the food some saying it was good others saying it was alright but not like home. When asked what they were having for lunch people said they didnt know. However there were menus on each of the tables. The dining tables were set out with table cloths and matching serviettes with a small vase of flowers on each of the tables. The table cloths and serviettes were clean and the dining room looked inviting. The manager said that a breakfast trolley had now been introduced which had different cereals and drinks which had stopped the staff having to go back and forth to the kitchen each time a person came to the dining room for breakfast. This was better for the people as it meant they were served quicker. 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. People using the service were proctected by the complaints and safeguarding procedures. Evidence: The complaints procedure was contained in the service user guide which was given to all the people who used the service. No one we saw during the visit to the home had any complaints about the care they received. During the visit we looked at the complaints file which had four recorded incidents over the past twelve months two of which we had also received. The complaints had been investigated and the complainants were mostly satisfied with the response they received. There had been one safeguarding referral which the manager and the company had fully investigated and followed the correct procedures. This resulted in a member of staff being dismissed and referred to the Protection of Vulnerable Adults (POVA) manager. All staff had a Criminal Record Bureau check, two written references were obtained and medical clearance was necessary before starting work. This was to make sure that only suitable staff was employed. Care Homes for Older People Page 18 of 28 Evidence: The company followed the Stockport Safeguarding Policy and all staff received training in safeguarding adults and whistle blowing. 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. People live in a suitably adapted, clean and comfortable home which is well maintained. Evidence: The home was clean, tidy and maintained to a good standard. A small number of bedrooms were seen during our walk round the home and they were also clean and tidy with some people having brought personal items such as pictures and ornaments. The garden to the rear of the property was a reasonable size and was well kept with plants and a patio area. The garden area had been improved since the previous inspection with new benches and a water feature. The manager said that she hoped the green house would be up and running by the summer and that residents would be involved with the planting etc. The foyer and ground floor corridor leading to the dining room had been refurbished and looked much brighter and cleaner than at the previous visit in 2007. The manager said that the main stairwell was to be redecorated and bedrooms would be done as needed. She also said that a room upstairs was to be allocated for the residents to take part in Look good Feel good sessions. Care Homes for Older People Page 20 of 28 Evidence: Areas in need of redecoration were recorded and acted upon. The manager told us that there was a handyman log book and that repairs were carried out quickly. The home complied with the fire safety regulations and environmental health standards. The manager had used the Essential Steps process to assess the management of infection control. Twenty five staff had received training in infection control. There was a well equipped laundry with the washing machines having sluicing and high temperature facilities. 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. The people living at Marbury House are supported by a trained staff team who have gone through a recruitment process so that peoples needs are met and they are safe from possible harm or poor practice. Evidence: The manager and the staff we had contact with felt that there were sufficient staff employed to meet the residents health and personal care needs. None of the residents or relatives we spoke with made any comments as to the number of staff available. There were a group of staff employed to make sure that residents enjoyed a clean environment and received a well balanced diet. The staff had received training in core skills, such as adult protection, medication administration, moving and handling and health and safety. Many had completed a National Vocational Qualification NVQ Level 2 and or Level 3. The manager told us that induction training had been extended to 4.5 days to include dementia awareness. The file of the last person to be employed was looked at which contained the application form and other documents such as references and training record. It is recommended that the application form be amended with regard to employment history to remove ten years and replace with from leaving school or full time Care Homes for Older People Page 22 of 28 Evidence: education. This is to make sure that only suitable people are employed. 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. Marbury House is well managed so that it is run in the best interest of the people who live there. Evidence: The registered manager was qualified, experienced and competent to manage Marbury House. The manager made sure that the staff carried out the companys policies and procedures. The staff we spoke with said that the manager always sorted out any problems or concerns they had. The manager said that the office door was always open for people to discuss any issues or concerns they may have. She was working closely with a resident and their relative to resolve issues around safe smoking practice. She also spent time on the floor particularly at meal times in order to makes sure that people were being served their meal appropriately. Peoples views and opinions were sought in various ways such as, resident meetings Care Homes for Older People Page 24 of 28 Evidence: and questionnaires for both staff and relatives to complete. The people who were admitted under the intermediate care scheme were given a questionnaire and a stamped addressed envelope when they left the home. New people were also given a questionnaire at the end of their six week trial period at the time of their review. Again they were given a stamped addressed envelope to send the completed form to head office. Quality assurance audits and reports were completed by staff from the companys head office. We saw during our visit the last annual quality report for 2007 and 2008. It now stated the number of questionnaires given out and the number returned, this made the outcomes of the surveys more meaningful to the people who may read it. A copy was available on request. A person was employed by the company to visit each home monthly and produce a report. The purpose of these visits and reports was to monitor the home and the care provided to make sure that the people who used the service were receiving the service they deserved. Copies of these reports were kept on the premises for us to see during our visits. The company had the Investors in People Award. Residents were encouraged to manage their own money and finances. Lockable facilities were available to all residents in their bedrooms. Some money was kept for some of the people by the staff team and records were kept of transactions. An audit took place annually by finance services from head office. Staff meetings and staff supervision (when the member of staff had the opportunity to discuss in private any problems and training needs) took place every three months. The staff meetings and supervision sessions were recorded. The manager had restructured the office and had re-organised all files with the result that information was easier to find. The manager and the company made sure that safe working practices were followed by the staff team. They also provided policies and procedures and staff handbook to inform people of what was required of them. These were updated regularly to keep pace with legislation and best practice. 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 1 As discussed with the manager the service user guide needs some amendments to bring it up to date with the current practices of the Care Quality Commission and address and telephone numbers. The company should amend the application form to remove the ten year history and replace with the statement from leaving school or full time education. This is to make sure that only suitable people are employed for the protection of the people who use the service. 2 29 Care Homes for Older People Page 27 of 28 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. 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