Care Home: Margaret House

What the care home does well Before being admitted to the home, people had their needs assessed. This was to establish if the service could provide the right care and support for them, before a placement is offered. Records showed admissions were planned for and arranged properly. Staff working in the home had the right training to care for people that included specialist training such as dementia and mental health care needs. Residents` who provided written comments indicated that they `always` receive the care and support they needed. Those interviewed during inspection made positive comments about the care and attention they receive at Margaret House. They considered they were treated well and staff were available when needed. Care planning for residents was excellent. Residents living in the home benefited from the support of a named worker referred to as a key worker. They chose their own carer to help them and personalise their care. This meant they benefited a continuation of support by people they knew and trusted. This is particularly beneficial for residents with dementia care needs. To ensure personal care and support was provided in a way, which maintained dignity and respected privacy and lifestyle, care plans were clear in identifying what was important to people. Residents also benefited from additional specialist support where needed such as healthcare, and their care needs was reviewed regularly. Risk management was very good and staff had enough information to know what to look for, to keep people safe. Care staff who provided written comments considered they were given enough information about residents to do their job well. They said, `Excellent care plans from managers`. And `We are taught to respect our residents choices and dignity`. Residents lifestyle was centred on them and they did not have to conform to any Institutional practice such as set times for getting up or going to bed. Some residents went on holiday, they had trips out, and those spoken to were generally pleased with what they did. Visiting arrangements were very good and residents said staff were considerate to their visitors needs and made them feel very welcome in the home. Meals provided met with residents tastes, needs and choice. Those residents spoken to during inspection said the food was `very good`. They said they could have what they wanted. Staff were observed as courteous and attentive when assisting those residents requiring support. Residents who were consulted, showed they knew who to talk to if they were not happy. People were confident to use the complaints procedure. Staff working at the home had been trained in adult protection and knew their responsibility in this area and confident they would `report bad practice` if ever the need arose. The home was well maintained, clean, tidy, and safe, and provided a homely and pleasant environment for residents, visitors, and staff.The numbers of staff employed, training provided, and safe recruitment practices, meant residents should be protected, and their needs effectively met. Residents were involved in staff recruitment. Communication, was good and there was evidence of the provider promoting equality of opportunity with training. Learning opportunities were very relevant to the homes purpose. All staff felt they were much appreciated for their work and were valued in the home. Staff interviewed had a good knowledge of understanding the needs of older people. Written comments for this inspection included, `I am very happy at my job. All our residents are happy and contented`. `We have a very good home for residents and I love working there`. `Margaret House cares for all residents and staff members. We all work together and thoroughly enjoy our work`. The home was well managed and run in the best interests of the people living and working there. The management skills and support given to staff demonstrated changes made for improvement in service delivery, the environment, and staffing was successful. Quality Assurance was carried out with residents, relatives, and professional people who gave their view on the service provided. Lancashire County Care Trust, NHS reported excellent outcomes. `The staff team also place great emphasis on developing a holistic approach to the health of the people using their service`. What has improved since the last inspection? There were no requirements made at the last key inspection to improve standards. However improvements have been made in the home. These included, provision of more staffing hours enabling resident to get out and about and enjoy community facilities. They had continued to provide staff training, and plans for 2009 training had been completed. Topics included were for example equality and diversity and computer skills for staff and residents. They had produced a newsletter for residents, relatives, and visitors. They had decorated the stairs, hallway, and bedrooms and had started work to provide en suite facilities for residents bedrooms. They had also converted the double bedroom into two single rooms. What the care home could do better: A permanent fixture should replace the freestanding radiator used in the bathroom. This will be safer for residents and staff. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Margaret House 221 Manchester Road Burnley Lancashire BB11 4HN     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: Marie Dickinson     Date: 0 8 0 1 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. the things that people have said are important to them: They reflect 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 29 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Margaret House 221 Manchester Road Burnley Lancashire BB11 4HN 01282423804 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Gordon Fell care home 11 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: The registered person may provide the following category/ies 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 (maximum number of places: 11) Mental disorder, excluding learning disability or dementia - Code MD (maximum number of places: 11) The maximum number of service users who can be accommodated is: 11 Date of last inspection Brief description of the care home Margaret House is registered with the Commission for Social Care Inspection to provide personal care and accommodation for 11 people, whose main care needs are mental health difficulties. Mr Fell the owner manages the home on a day-to-day basis. The home is located in a residential area of Burnley and is adjacent to Scott Park. There are pleasant accessible garden areas to the front and sides with a lawn area to the side and rear of the home. A bus stops outside the home, on route to the town centre. Accommodation offered is in single rooms, fitted with an emergency call system. Information about the service is available from the home for potential residents in a Care Homes for Older People Page 4 of 29 Over 65 0 0 11 11 Brief description of the care home Statement of purpose and Service User Guide. Weekly charges for personal care and accommodation range between £502:50 and £602:50. Residents are responsible for purchasing optional extras such as hairdressing, and private chiropody. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. A key unannounced inspection was conducted in respect of Margaret House on the 8th January 2009. The inspection involved getting information from an Annual Quality Assurance Assessment completed by the provider, staff records, care records and policies and procedures. It also involved talking to residents, staff on duty, and the provider. The premises were inspected as part of the process. Care Homes for Older People Page 6 of 29 The home was assessed against the National Minimum standards for Older People. An Annual Service Review had been completed in February 2008 and the findings were the home continued to provide good outcomes for residents living at the home. A random inspection to look at medication practice took place on 17th December 2008. This is referred to in this report. What the care home does well: Before being admitted to the home, people had their needs assessed. This was to establish if the service could provide the right care and support for them, before a placement is offered. Records showed admissions were planned for and arranged properly. Staff working in the home had the right training to care for people that included specialist training such as dementia and mental health care needs. Residents who provided written comments indicated that they always receive the care and support they needed. Those interviewed during inspection made positive comments about the care and attention they receive at Margaret House. They considered they were treated well and staff were available when needed. Care planning for residents was excellent. Residents living in the home benefited from the support of a named worker referred to as a key worker. They chose their own carer to help them and personalise their care. This meant they benefited a continuation of support by people they knew and trusted. This is particularly beneficial for residents with dementia care needs. To ensure personal care and support was provided in a way, which maintained dignity and respected privacy and lifestyle, care plans were clear in identifying what was important to people. Residents also benefited from additional specialist support where needed such as healthcare, and their care needs was reviewed regularly. Risk management was very good and staff had enough information to know what to look for, to keep people safe. Care staff who provided written comments considered they were given enough information about residents to do their job well. They said, Excellent care plans from managers. And We are taught to respect our residents choices and dignity. Residents lifestyle was centred on them and they did not have to conform to any Institutional practice such as set times for getting up or going to bed. Some residents went on holiday, they had trips out, and those spoken to were generally pleased with what they did. Visiting arrangements were very good and residents said staff were considerate to their visitors needs and made them feel very welcome in the home. Meals provided met with residents tastes, needs and choice. Those residents spoken to during inspection said the food was very good. They said they could have what they wanted. Staff were observed as courteous and attentive when assisting those residents requiring support. Residents who were consulted, showed they knew who to talk to if they were not happy. People were confident to use the complaints procedure. Staff working at the home had been trained in adult protection and knew their responsibility in this area and confident they would report bad practice if ever the need arose. The home was well maintained, clean, tidy, and safe, and provided a homely and pleasant environment for residents, visitors, and staff. Care Homes for Older People Page 8 of 29 The numbers of staff employed, training provided, and safe recruitment practices, meant residents should be protected, and their needs effectively met. Residents were involved in staff recruitment. Communication, was good and there was evidence of the provider promoting equality of opportunity with training. Learning opportunities were very relevant to the homes purpose. All staff felt they were much appreciated for their work and were valued in the home. Staff interviewed had a good knowledge of understanding the needs of older people. Written comments for this inspection included, I am very happy at my job. All our residents are happy and contented. We have a very good home for residents and I love working there. Margaret House cares for all residents and staff members. We all work together and thoroughly enjoy our work. The home was well managed and run in the best interests of the people living and working there. The management skills and support given to staff demonstrated changes made for improvement in service delivery, the environment, and staffing was successful. Quality Assurance was carried out with residents, relatives, and professional people who gave their view on the service provided. Lancashire County Care Trust, NHS reported excellent outcomes. The staff team also place great emphasis on developing a holistic approach to the health of the people using their service. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 29 Care Homes for Older People Page 10 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 11 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were consulted and had their needs assessed before they came to live at the home. This meant a decision could be made if the home was suitable to meet those needs. Evidence: Records showed that prior to any service being provided peoples needs had been assessed. This helped to make sure they would receive the right care and support they needed. This meant a record was made of what people wanted and what was important to them when receiving care. Information received at the Commission informed us that residents are introduced to the home over a period of time to complete assessments and make sure Margaret House could meet their needs. Records made in relation to the most recent admission showed how planned admissions were managed. An assessment had been completed by health and social Care Homes for Older People Page 12 of 29 Evidence: services and this information made available to the home. The provider had visited the resident and carried out a further assessment of needs that included for example health and personal care, mobility, and nutrition. This multidisciplinary approach to assessment supported the decision to offer a place at the home, and admission was agreed with all concerned. The range of needs of residents had been considered. Staffing levels were good. Staff training programme included specialist training to care for people with dementia and mental health needs. Care Homes for Older People Page 13 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans linked very well with residents assessed needs and requirements. This meant they received personal care according to their needs and wishes, and their privacy, dignity, and independence were promoted. Medication was managed safely. Evidence: Information received at the Commission indicated the home did well as they, Meet the needs of residents enabling them to take control of their lives. Staff respect residents rights, needs, choice, wishes and ambitions. They promoted high standards of health and personal care, and ensure that care needs are fully met by initial assessments, detailed care planning and regular reviews. Staff who provided written comments said they had Excellent care plans from managers. Three care plans were looked at in detail. These contained good information and linked very well to residents assessed needs. Needs identified such as personal care, mobility, communication, personal safety, medication, medical, and social were all listed. How identified needs were to be supported was clear and risk managed. Care Homes for Older People Page 14 of 29 Evidence: Residents chose their own key worker to help them and provide personalised care. This meant they benefited a continuation of care and support by people they knew and trusted. This is particularly beneficial for residents with dementia care needs. To ensure personal care and support was provided in a way, which maintained their dignity and respected their privacy and lifestyle, care plans were clear in identifying what was important to them, what they wanted and their wishes. For example, to live as independently as possible, to achieve optimum good health, to keep healthy and safe, and to always be offered choice, dignity and respect. Completed care records of care provided showed how this was achieved. For example, discreetly observe when bathing, whilst ensuring dignity and privacy. Ensure all toiletries, towels etc. are prepared and ready in the bathroom before he bathes. Written comments from staff We are taught to respect our residents choices and dignity. Residents had access to health care services both within the home and in the local community. They were registered with a GP and were supported by visits to the home by health care professionals. This included professionals such as the Community Psychiatric Nurse who gave support to residents with mental healthcare needs and gave care advice to staff. People attended hospital appointments. All healthcare support was recorded. Risk assessments were completed such as, diet and nutrition, and mental health. Risks to residents well being were excellent in how they were recorded and included potential consequences should the risk materialise, and what staff should do to prevent or minimise the risk. All risk assessments seen had been signed by staff as read and understood. Staff working at the home that provided written comments of their views said, the home did well because This service provides everything the service users need. And looks after service users, helps them feel comfortable. And it looks after its service users brilliantly. Residents spoken and those who provided written comments considered they received the right care and support at the home and received medical support they needed. Continence care was managed and necessary products used. A random inspection to look at medication practice took place in December 2008. A report of this was made. The Commission has been informed in writing of the action taken to improve the management of medication in response to a requirement and recommendations made. These issues were looked at again for this inspection and the outcome was satisfactory. The home operated a monitored dosage system for the administration of medication, which was dispensed into blister packs by the supplying pharmacist. An appropriate recording system was in place to record the receipt, administration, and disposal of medication. A clear audit of medication received was kept. The record of medication administration was signed and storage of medication was secure. Staff responsible for administration had been trained. Care Homes for Older People Page 15 of 29 Care Homes for Older People Page 16 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The level of staffing and choice of activities made available enabled the residents have their social, cultural, religious and recreational interests and needs met. Visiting arrangements were very good which meant residents could stay in contact with their relatives and friends. Catering arrangements were to the residents satisfaction. Evidence: Staff were observed throughout the visit. Staff interactions with residents showed they were caring and supportive. Records showed residents preferences in respect of social activities had been recorded as part of their assessment, and care plans had sufficient information as to how personal preferences would be managed, and who would be responsible to support residents and ensure these needs were regularly met. Residents care plans included a daily living plan with preferred routines recorded to support residents personalise their day. Observations showed residents appeared to have freedom of choice over their lives within their capability. For example several residents said they got up when they wanted and went to bed when it suited them, or went to their room to read or watch television. They also said they were satisfied with the activities in the home. There were some indoor leisure activities in place such as Care Homes for Older People Page 17 of 29 Evidence: card and board games, dominoes and a pool table. Most residents however enjoyed the personal approach, and records maintained showed residents were given opportunities to live an ordinary meaningful life in the wider community with the support from staff. Staffing levels were good. To support people to have freedom of choice over their lives within their capability, residents had a weekly planner they could follow. This helped them remember for example what day they visited their friends or relative, had a bath, or went out socially. Some residents went on holiday, they had trips out and those spoken to were generally pleased with what they did. Residents were able to receive visitors at any time and were able to entertain their guests in the privacy of their room. There were no visitors during inspection but residents said they were always made welcome by the staff. Residents were also supported to continue with their chosen religion. Residents bedrooms were personalised. They were able to bring in personal belongings and arrange their rooms how they wished. Meals provided were homemade and choices were offered. Residents could choose where to eat their meals. Most sat at the dining tables. The residents thought the food was good. If residents did not like what was offered an alternative was provided. Varied comments about the food were made such as its good and no complaints, and very good. Meals were unhurried and staff supported those residents who needed encouragement and help to eat. A record of actual meals served had been kept up to date since the last inspection. Provisions were plentiful and residents were involved in food shopping. Information received at the Commission for this inspection stated, All staff were trained in malnutrition care and assistance with eating. Care Homes for Older People Page 18 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints procedure was clear which helped residents have confidence to raise any concern they may have. There were policies and procedures, and appropriate training for staff in adult protection issues. This meant residents safety and welfare was promoted. Evidence: Residents who provided written responses and those spoken to during inspection, said they had no complaints against the staff. Staff were described as being very good. Residents had chosen their key worker to support them. They had opportunities to raise any issue they may have in monthly one to one chats when complaints and protection issues were discussed with them. Information received at the Commission for this inspection informed us they had zero tolerance to bad practice in the home. All staff had been trained in Adult protection, and policies and procedures were available for staff reference to ensure a proper response to any suspicion or allegation of abuse. Staff spoken to during inspection and those who provided written comments, had a good understanding of the procedures to be followed, and their responsibility to report any suspicion of abuse or neglect. They had received training, and records showed they had signed a disclaimer for not accepting gifts, or being involved in residents financial affairs when they start work. Care Homes for Older People Page 19 of 29 Care Homes for Older People Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provided a homely, pleasant, hygienic and safe environment for residents, visitors, and staff. Evidence: Margaret House is a large adapted Victorian style property adjacent to Scot Park in Burnley. Since the last inspection further work had been done to upgrade the home. The lounge had been decorated and new furniture provided. It was homely and comfortable. The staircase had been painted and work had started to add en suite facilities to the bedrooms. The double bedroom had been divided making all the rooms in the home single occupancy. All windows had been replaced. Residents said they liked the home. It was near to the park, shops, and town centre. They thought it was very nice, comfortable, and they were pleased with the improvements made. Nearly all of the bedrooms in the home were nicely decorated and furnished. Those seen were personalised, clean, and comfortable. Residents were very pleased with their rooms. When people are admitted to the home, they can bring with them items of furniture and personal effects that can be reasonably accommodated in their bedroom. Most residents used the separate dining room at meal times. The entrance hall Care Homes for Older People Page 21 of 29 Evidence: provided a nice sitting area with homely furniture, and was popular with the residents. Residents who had difficulty managing the stairs could use the stair lift. There were no restricted areas and residents had access to outdoor garden areas to the side and rear of the home. Also provided was a pool room for residents who enjoyed the game. The home was warm, however the method of heating the bathroom should be reviewed to replace the freestanding radiator currently used. The overall standard of hygiene and cleanliness in the home was very good. Care Homes for Older People Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The numbers of staff employed, training provided, and safe recruitment practices, meant residents should be protected, and their needs effectively met. Evidence: Rotas completed showed the compliment of staff was sufficient to cover all essential duties in providing care, and maintaining essential standards in the home such as hygiene and catering, and senior staff were on duty at all times. Written comments from staff stated, There are always enough staff on duty to meet individual needs. And We have good staffing levels on rota and a senior on every shift. Margaret House is always fully staffed and no one wants to leave. Staff files showed recruitment checks to be complete and satisfactory. References and Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) register check had been applied for, prior to employment. Staff were given a contract of employment and job description. Residents were involved in staff selection. All the staff in the home had attended training following their induction. Records were kept of carers individual training profile showing the homes commitment to providing both specialist and mandatory training such as dementia care and moving and handling. Information received at the Commission show training was planned and Care Homes for Older People Page 23 of 29 Evidence: arranged for all staff during the year. Staff confirmed they were properly supported with training. The percentage of staff having completed a national vocational qualification in care level 2 and above was near 100 per cent. Staff felt the home was run in the interest of the residents, and were committed to give residents a high standard of care. Written comments included, we all work together and thoroughly enjoy our work. I am very happy at my job. All our residents are happy and contented. We have a very good home for residents and I love working there. Margaret House cares for all residents and staff members. We all work together and thoroughly enjoy our work. Care Homes for Older People Page 24 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience 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 run in the best interests of the people living there. Evidence: Mr Fell the registered provider manages the home. He holds relevant qualifications in management and care. He is supported in his role by a home manager and senior staff who have delegated responsibilities such as staff supervision. Quality assurance had also been carried out in the home on a regular basis and residents were given the opportunity to have their say. Residents have monthly one to one chats about the service they receive and a record kept of their comments. This information supported resident care and is viewed as an opportunity for staff to look at how well they are meeting residents needs. Other methods of quality assurance included Investors In People Award, and Lancashire County care Trust NHS reported excellent outcomes in areas such as environment, care, staffing and training, management and protection. Comments included, The staff team also place great Care Homes for Older People Page 25 of 29 Evidence: emphasis on developing a holistic approach to the health of the people using their service. A newsletter had been produced and distributed to residents, relatives, and friends. Records showed staff supervision was given, providing staff with an opportunity to individually express themselves, their concerns, and their plans for the future or to receive feedback on their performance. Written comments from staff indicated they were given Regular support. And this is important to get support and discuss your job role so that you know you are doing your job properly. Always, due to training and help from my manager. Staff considered communication in the home was very good and supported their work. Comments included, Yes in meetings, every day working, diary, supervisions, appraisals and mouth to mouth. Records showed staff had appraisals. Staff meetings were held at regular intervals during which staff received information on polices and procedures and had an opportunity to voice their opinion and share information. Observations made during the inspection showed staff worked as a team, and were well thought of by the residents. The financial interests of residents considered. The home does not manage residents finances. People unable to manage their own affairs were supported by legal representation. All the records required for the efficient running of the home were available to look at. They were stored securely, readily available for this inspection, and organised. Information received at the Commission showed regular health and safety auditing had been carried out. Fire risk assessment for the building had been completed. The home had access to professional business, legal, and financial advice and had all the necessary insurance cover in place to enable it to fulfill any loss or legal liabilities. Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 19 The free standing radiator in the ground floor bathroom should be replaced with a permanent fixture. Care Homes for Older People Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!