Care Home: Mount Denys

What the care home does well Prospective residents and the relatives/representatives are given detailed information about Mount Denys so they are able to make an informed choice in regard to moving into the home. Prior to a prospective resident moving in to Mount Denys the registered manager carries out a pre-admission assessment as well as obtaining other relevant information from the multi disciplinary teams. This is to ensure that the home is able to meet the assessed care needs of the resident. Care plans viewed were found to contain sufficient information so that staff are able to meet the residents individual needs. Health needs of the residents are well met, with good evidence of access to a variety of external health care professionals. The home has good working relationships with general practitioners, district nurses and St Annes Hospital. Residents are offered a variety of activities suitable to their needs. The home employs activity co-ordinators, who also ensure that residents who do not participate in organised activities have one to one socialisation time. Meals in the home are good offering residents a good choice of nutritional food as well has meeting their dietary requirements and specialised eating needs. The home as a good complaints and concerns policy and procedure which clearly explains the steps that need to be taken and the timescale in which a complaint or concern will be dealt with. There are clear policies and procedures for the safeguarding of vulnerable adults, and staff have received training on this topic, to ensure that are able to act quickly should they be concerned for the welfare of a resident. Mount Denys provides its residents with a warm, safe and secure environment, which is well maintained and free from offensive odours. Staff have received training in infection control procedures which helps to prevent cross infection and risk to residents. Staffing levels on the day of this key inspection were sufficient to meet the assessed needs of the residents. Staff in the home have the qualifications and training to ensure that residents receive a good quality of care. Health and safety in the home is a high priority to ensure that resident and staff are not placed at risk. Accidents and incidents are well recorded and monitored. Where concerns do arise they are reported immediately to external health care professionals. What has improved since the last inspection? The recruitment process in the home are stringent ensuring that any prospective employee is appropriately checked prior to being deployed to work in the home which helps to protect residents from abuse. Regular recorded health, safety and fire risk assessments are carried out this also includes a daily health and safety check of the home.A high percentage of staff have received mandatory training including Safeguarding of Vulnerable Adults and First Aid. All senior care officers have completed First Aid at Work training, some care officers have a Basic First Aid Certificate while other care officers have completed `Save a Life` training. What the care home could do better: All care plans viewed had generic risk assessments but it was noted that none of the care plans have individual risk assessments in place. All the residents have different needs and display different types of behaviour and health care needs which should generate individual risk assessments, so that staff have clear guidelines to reduce the element of risk to individual residents. While generally medication is well managed in the home, further improvements could be made in respect of liquid medication being dated on the bottle on the day of opening. While residents prescribed PRN (as required) medication have a PRN risk assessment for each medication. It was noted that were PRN (as required) painkillers have been prescribed by the General Practitioner, there are no guidelines for staff as to how each individual resident may show signs and symptoms of pain. For several residents the General Practitioners had written permissions letters for these residents to be given medication covertly. The letters state that the home must also consult the pharmacy in regard to covert administration of medicines, but there was no written evidence that this had been done. A requirement has been made in this report in relation to accessibility of call bells to residents, as during the inspection it was noted that many call bells were tied up out of reach for residents especially if they fell on the floor, some bedrooms did not have an accessible call bell cord. Key inspection report Care homes for older people Name: Address: Mount Denys 187 The Ridge Hastings East Sussex TN34 2AE     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: June Davies     Date: 0 2 1 1 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: Mount Denys 187 The Ridge Hastings East Sussex TN34 2AE 01424724940 01424724941 flobeddall@eastsussex.gov.uk www.eastsussex.gov.uk/socialcare East Sussex County Council Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Janice Phillips Type of registration: Number of places registered: care home 31 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users to be accommodated is 31 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category : Dementia (DE) Date of last inspection Brief description of the care home Mount Denys is a purpose built property on two floors, situated on the outskirts of Hastings and approximately two miles from the town centre. Managed by East Sussex County Council (ESCC) it is a specialist service for older people living with dementia in Hastings and Rother. Bexhill and Rother and Hastings and St Leonards Primary Care Trusts commission the service, with the care managed by ESCC. Service user accommodation comprises of thirty-one single bedrooms within three units in the home. There are two units of ten beds and one unit of eleven beds, which are used to provide service users with accommodation for either long term care, short stay, respite Care Homes for Older People Page 4 of 28 Over 65 0 31 Brief description of the care home care and periods of assessment. There is only one en-suite facility, but there are sufficient toilet and assisted bathing facilities on each of the units. Each unit has a dining and lounge area for service users to use. Additionally there is a large lounge area on the ground floor. Level access is facilitated in the home with the provision of a passenger lift. A pleasant garden is at the rear of the home. Information in regard to fees can be obtained by applying to the registered manager. The level of fees charged will depend on the outcome of a financial assessment. Additional charges are made for hairdressing, newspapers and toiletries. The Statement of Purpose, Service Users Guide and a copy of the last Inspection report are available to read in the reception area of the home. 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: This unannounced key inspection was carried out on Monday 2nd November 2009 over a period of 7 hours. During the inspection the inspector spoke with the registered manager, several members of staff and four residents. Observations took place of a lunch time meal, administration of medication, staff interaction with residents and the environment. A short audit of medicines was carried out and documentation relating the key standards inspected were also viewed. Ten resident surveys were sent out, with six being completed by residents relatives. The six surveys stated that the home cares well for its residents that staff are attentive and friendly and that residents are always well presented. Care Homes for Older People Page 6 of 28 What the care home does well: What has improved since the last inspection? The recruitment process in the home are stringent ensuring that any prospective employee is appropriately checked prior to being deployed to work in the home which helps to protect residents from abuse. Regular recorded health, safety and fire risk assessments are carried out this also includes a daily health and safety check of the home. Care Homes for Older People Page 7 of 28 A high percentage of staff have received mandatory training including Safeguarding of Vulnerable Adults and First Aid. All senior care officers have completed First Aid at Work training, some care officers have a Basic First Aid Certificate while other care officers have completed Save a Life training. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Pre-admission assessments and plans of care help to ensure that residents care needs are met when moving into the home. Evidence: Two pre-admission assessments were looked at for residents who have a permanent place in Mount Denys and one pre-admission assessment for a resident who has a short stay in the respite wing of the home. Pre-admission assessments and care manager plans of care contained comprehensive information as to the basic care needs of the residents. On one residents file there was also detailed and useful information supplied by the consultant psychiatrist. This information helps the registered manager to ensure that the home is able to meet the assessed needs and level of dementia of the residents. Mount Denys does not offer intermediate care. Care Homes for Older People Page 10 of 28 Evidence: From six surveys completed by relatives five said they were given sufficient information about the home prior to the resident moving in to the home. Care Homes for Older People Page 11 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes care planning system is good with evidence that monthly reviews take place and that residents receive the care they require in accordance with assessed needs. Health care in the home is well managed with residents have access to external health care professionals as and when required. Staff treat resident with respect and ensure the residents rights to privacy and dignity are upheld. Medication in the home is generally well managed, but some improvements are needed to ensure residents are not placed at risk. Evidence: Three care plans viewed by inspector two were for permanent residents and one for a respite resident. All care plans were seen to be informative, two care plans for permanent residents had been reviewed regularly, and there was evidence of care Care Homes for Older People Page 12 of 28 Evidence: plan updates for the respite resident. While all care plans contained generic risk assessments, there was no evidence that risk assessments had been completed for individual risks. This was discussed with the registered manager, who explained that staff do know what to do, but that it was not recorded. Risk assessments should be available for individual risks to ensure that staff have clear, consistent steps to follow to help reduce the risk to the resident. There was evidence in all care plans that residents have access to external health care specialists as and when necessary. General practitioners and district nurses visit residents as and when required. There are regular chiropody, optician visits to the home and a visiting dentist is called upon when required. Residents can visit opticians and dentists of their choice if they wish to. Residents have full access to psychiatry services at St Annes Hospital. The inspector observed that staff treat residents with respect and talk to them in a friendly and professional manner. Staff spend time with residents on one to one basis, just sitting talking and chatting. When personal hygiene tasks are being carried out staff respect the residents rights to privacy and dignity by ensuring that bedroom, toilet and bathroom doors are closed. The inspector observed the administration of lunch time medicines. This was carried out appropriately with each residents medication being signed off after the member of staff had observed the resident taking their medication. It was noted that liquid medication is not always dated on the bottle on the day of opening. The monthly administration record file was divided off for each resident, and there was evidence of permissions from General practitioners when medicines were not available in liquid form and where tablets needed to be given covertly. However in letter of permission the General Practitioner does say that the home should also contact the pharmacy to inform them of covert administration of medication, and there was no evidence that this had been done or written evidence from the pharmacy that the effect of the medicine/s would not be damaged by covert administration. Where residents are prescribed PRN (as required medication) there was a separate risk assessment for each medication and each resident, the inspector did note that where a PRN (as required) painkiller is prescribed while there is a risk assessment, there were no clear guidelines for staff to follow as to how they should identify signs and symptoms of pain in the residents. Many of the residents due to their levels of dementia would not be able to express verbally when they are in pain, therefore it is more likely that they would display signs and symptoms and these should be recorded on the PRN (as required) risk assessment. From six surveys completed by relatives five said that their resident receives the care and suppport they need and that they receive the medical care they need. Some Care Homes for Older People Page 13 of 28 Evidence: comments were - my mother is looked after extremely well, my father is well cared for, my father is treated with respect and care. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are offered a variety of activities and are able to choose the activities they wish to participate in. Meals in the home are good and cater for a variety of needs and special diets, menus could be produced in different formats to enable residents to make a more informed choice. Evidence: As far as possible and with differing levels of dementia, residents are able to make choices in regard to their daily living routines. Notes regarding choices and preferences are noted on residents care plans. The home employs two activities co-ordinators, one who works in Oak and Willow units and one working in Laurel the respite care unit. Activities co-ordinators are available seven days a week. There is evidence both in activity sheets and posters on notice boards around the home that residents are offered a variety of activities suitable to their needs. Some of the activities on offer are Music and movement, puzzles, craft work, Karaoke, reading and discussing newspaper articles, reminiscence groups. In the activities folder there are many guides, suggesting ideas for activities Care Homes for Older People Page 15 of 28 Evidence: for residents suffering with dementia type illnesses. The activities co-ordinators also spend one to one time with residents who do not participate in group activities. One member of staff is a qualified hairdresser and she does the hairdressing for the residents. Residents are also able to visit an external hairdresser if they wish to get their hair cut. Staff also ensure on a daily basis that residents hair is presentable. The registered manager said that she is always looking for new ideas for activities that would Be appropriate for the residents. There are about five outings a year organised for the residents. There was evidence via photographs of residents enjoying a day out at the blackberry farm, and some residents have recently visited Bewl Water. A Reverend from the Church of England, visits the residents on a regular basis. One resident receives regular monthly visits from a member of the church she used to attend. The registered manager confirmed that if a resident wished to follow their religious beliefs then arrangements would be made for them to do so. The home has an open visiting policy and families and friends are welcome to visit at any time. Some relatives take their residents out into the community. Staff also take some residents out to the towns shopping centre. Where possible residents are encouraged to maintain autonomy in the lives, but in many instances this is difficult due to the level of dementia. None of the residents manage their own finances and have either nominated a member of the family or a representative to do this for them. The inspector observed that in the few resident bedrooms visited that residents are encouraged to bring small personal items into the home with them, to reflect their interests and personalities. Residents are offered a choice of meals at each of the three mealtimes in the home. Residents are able to choose what breakfast cereal they would like,at lunch time there is always a choice of cooked meal. Staff said that at teatime residents have a choice of finger foods which they really enjoy. It was noted that menus are only produced in typed format, there are no menus in large font or picture menus which would allow residents to make a more informed choice. The inspector observed a lunchtime meal in Oak Unit, one resident required a liquidised diet, and this was served in an attractive manner. Staff spend time with residents encouraging them to sit and eat, and where a resident needs total assistance with feeding this is done discreetly with one member of staff sitting with the resident throughout the meal. Mealtimes are unhurried, and staff help to provide a relaxed and congenial atmosphere. Specialised diets are catered for as and when requested. Care Homes for Older People Page 16 of 28 Evidence: From six surveys completed by residents relatives five said that home arranges activities that residents can take part in, five said that residents always like the meals in the home. Comments on two surveys said - take residents out sometimes, if possible a bit more one to one support to encourage my mother to be active and also to relieve the boredom. 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. Any concerns and complaints are listened to and acted upon in line with the homes concerns and complaints policy and procedures. Staff have a good knowledge of Safeguarding Vulnerable Adults which helps to prevent residents being abused. Evidence: Mount Denys has East Sussex County Councils complaints policy and procedure, which is displayed in the home and details of how residents, their relatives or representatives can make a complaint or raise any concerns to the home. Concerns or complaints are logged and reported to higher management. Records of investigations and outcomes are logged on residents own file. There have been two complaints made since the last key inspection, these have been investigated appropriately and outcomes recorded with responses made to the complainant. From six surveys completed by relatives four said that they would know how to complain and one said they would not know how to complain. Five surveys said that there was someone they could talk to if they were unhappy. The home has a detailed policy and procedure for safeguarding vulnerable adults. There have been three safeguarding vulnerable adult referrals since the last key inspection, all have been appropriately investigated and closed. All staff have received safeguarding vulnerable adults training and are knowledgeable in recognising any Care Homes for Older People Page 18 of 28 Evidence: form of abuse and the actions they should take. All prospective new members of staff are appropriately vetted prior to taking up employment in the home to help protect residents from abuse. 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. Mount Denys provides it residents with a warm, comfortable and well maintained home in which to live, some attention needs to be paid to call bell system so that residents can summon assistance. Infection control procedures in the home are good helping to ensure that residents are not placed at risk of cross infection. Evidence: The home is divided into three units, two on the ground floor namely Oak and Willow provide accommodation for permanent residents, while the Laurel Unit on the first floor is used mainly for residents receiving respite care. On the day of this key inspection the home found to be well maintained and hygienically clean. Oak and Willow units have their own small communal lounge with a very large lounge that separates to the two units. Residents tend to use the very large lounge where there is ample space for them to wander and to access a secure and safe large patio area. Laurel unit has two communal lounge areas, one also has an integral dining area. There are a range of aids throughout the home to assist residents with their mobility, especially in communal bathrooms and toilets. It was noted from visiting three residents bedrooms and communal bathrooms and toilets, that call bell cords were out of reach for residents who might fall and require assistance. This was discussed with the registered manager who did not feel that residents would remember what the call Care Homes for Older People Page 20 of 28 Evidence: bell cord was for. A requirement is being made that residents have free access to call bells throughout the home, which they may use should they need to. Each unit in the home has its own laundry room fitted with industrial washing machine with sluicing facility and industrial tumble driers. The laundrys, communal toilets and bathrooms all have provision of liquid soap and paper hand towels. Clinical waste is appropriately managed on each unit in the home. All staff have received infection control training and are aware of what they must do to prevent the risk of cross infection. On the day of this key inspection there were no offensive odours in any of the communal areas, of the three bedrooms viewed, only one had a slight offensive odour. 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. At the present time staff are employed in sufficient numbers to meet the assessed needs of the residents. Staff have the skills and qualifications to meet the diverse needs of the residents. Recruitment procedures are stringent to help ensure residents are not placed at risk of abuse. Evidence: From rotas viewed on the day of this key inspection at the present time there are sufficient staff employed to meet assessed needs of the residents. From six surveys completed by relatives, four said that there are always staff available when needed, one said that there are usually staff available when needed, one survey was not completed. The NVQ matrix viewed showed that 63 of staff have completed their NVQ level 2 or above. The registered manager stated that if the home employs a new member of staff who has not achieved this qualification they will be required to undertake a NVQ qualification. Three staff files were viewed and showed thorough and in depth recruitment practises Care Homes for Older People Page 22 of 28 Evidence: for all staff employed in the home. All staff have the relevant checks to help ensure that residents are not placed at risk of abuse. The registered manager confirmed that the result of these checks must be received prior to employing the new member of staff to work in the home. All files contained a recent photo and proof of identity. All staff have undertaken an in depth induction including health, safety and welfare. The registered manager confirmed that any new member of staff will be required to complete a Skills for Care induction in their first weeks of employment. The training matrix showed that a high percentage of staff have completed their mandatory training to cover most health and safety issues. Any member of staff who has not completed this training will be expected to attend the next available training session. Many of the staff have completed or are in the process of completing a distance learning course for Understanding Dementia. 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 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, with the registered manager receiving good support from her senior staff. The quality assurance system in the home is good, this helps to ensure that residents receive a good quality of care. Health and safety is given priority to ensure the residents living and staff working in the home are not placed at risk. Evidence: Janice Phillips is the registered manager of Mount Denys, she has work at the home since 1991 and care officer and senior care officer and was registered by CSCI in 2007. Janice has obtained her NVQ level 4 and Leadership and Management qualification. She has kept up to date with all her mandatory training, and is a Moving and Handling Risk Assessor. Janice has obtained her 4 day Work place First Aid certificate and is a SVA level 1 Assessor. Care Homes for Older People Page 24 of 28 Evidence: There is a good quality assurance system in place which seeks the views of relatives and representatives and some external stakeholders. Systems used in the home are regularly monitored and recorded. Regular health, safety and fire risk assessments take place. All staff and management meetings are recorded. Results of questionnaires, monitoring and health, safety and fire risk assessments are included in an annual Quality Assurance Report which is displayed in the home. The inspector noted that supervision records in staff files showed that not all staff are receiving regular two monthly supervisions. This was discussed with the manager, who agreed that supervisions do need to be carried out on a regular basis. All residents personal allowances are paid into a Safe Custody Account, that is managed by East Sussex County Council. Any expenditure made on a residents behalf is paid from petty cash account in the home, receipts are retained and forward to East Sussex County Council. Each resident has an account sheet kept in the home. The inspector evidence that fire points, emergency lighting and hot water temperature delivery is checked and recorded on a weekly basis in the home. All equipment used in the home has an up to date maintenance certificate. Each unit has it own accident and incident book. All accidents and incidents are monitored monthly and any concerns are reported to the residents General Practitioner. 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 1 22 23 2. The registered person shall having regard to the number and needs of the service users ensure that (n) suitable adaptations are made, and such support, equipment and facilities, for service users who are old, infirm or physically disabled. Call systems with an accessible alarm facility must be provided in every room that residents use regularly. 31/12/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 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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