Care Home: NewDay Nursing Home

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What the care home does well People are provided with information about the service offered to enable them to make an informed decision about whether they would like to live at the home. Pre admission assessments are completed so that people know their needs can be met before they move in. People who use the service have access to a range of health and social care professionals and this ensures that any healthcare needs are met. There is a range of activities that people can participate in so that they lead an interesting and stimulating lifestyle. A varied menu that reflects individual needs and preferences is offered. People can see their visitors as they choose so that they can continue to have relationships that are important to them. The home creates a friendly and welcoming atmosphere where people can personalise their rooms to reflect preferences and tastes. Staff receive training to provide them with knowledge and skills to meet the needs of the people living at the home. People are involved in meetings so that they are involved in decisions about the home. Small amounts of people`s personal money can be held safely by the home if people choose to use this facility. Health and safety is well managed to ensure peoples safety. People told us: "The home offers great care" "I`ve never been so content, than with the care he gets here. Staff ring and tell me if he`s poorly" "We came for the Christmas party, we had a nice time, the effort the staff put in was excellent" "I`m getting fat because the food is so good" "Staff are always willing to help with all our questions" "It`s an old building and not much to look at from the outside, but the care is good" "We can see by mom`s reaction to staff that she is treated with care and love" "The staff work hard to satisfy the needs of individual clients" What has improved since the last inspection? Previous requirements and recommendations have been met which shows that the management of the home are keen to ensure the home is run in the best interests of the people who live there. The service user`s guide contains fee rates so that people know what they will have to pay to live at the home. People`s privacy and dignity is maintained. Arrangements have improved so that people do not wander into others people`s rooms. Low level complaints are now recorded, along with actions taken to resolve them, so that people know their concerns are listened to. Areas of the home have been redecorated to enhance the environment which people live in. A new boiler has been installed so that people have consistent hot water. A new kitchen has been fitted so that food can be prepared in a safe and hygienic manner. What the care home could do better: The odour in the bathroom should be resolved so that people have a pleasant environment to bathe in. The home must ensure that necessary recruitment checks are in place prior to staff starting work at the home so that people are protected from harm. The numbers of staff and how they are allocated must be reviewed so that there are enough staff to meet peoples needs at all times. Key inspection report Care homes for older people Name: Address: NewDay Nursing Home 45 Wynford Road Acocks Green Birmingham B27 6JH     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: Lisa Evitts     Date: 1 8 0 1 2 0 1 0 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 29 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 29 Information about the care home Name of care home: Address: NewDay Nursing Home 45 Wynford Road Acocks Green Birmingham B27 6JH 01217078525 01217060427 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Huskards Care Limited care home 37 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users to be accommodated is 37. The registered person may provide the following categories of service only: Care Home with Nursing - Code N 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 (OP) 37 Physical disability aged 60 and above (PD) 37 Dementia (DE) 37 Date of last inspection Brief description of the care home NewDay is a thirty-seven bedded nursing home situated in Acocks Green. It is registered to care for older adults who may have physical disabilities and/or dementia. Access to the front of the property is via a ramp. The home is within a short walking distance of shops, bus routes and train services. Limited off road parking is available to the front of the home. Care Homes for Older People Page 4 of 29 Over 65 0 37 0 37 0 37 1 9 0 1 2 0 0 9 Brief description of the care home The home has a choice of lounges, dining rooms and a separate smoking room. Bedrooms are a combination of double and single rooms of which thirteen have ensuite facilities.The home has assisted bathing facilities and equipment for moving and handling people with limited mobility. The corridors in the extension are wide and have handrails suitable for people with mobility problems, so that they can move around the home freely. There is a garden to the rear of the home with a patio area, which has a water feature and seating for use by people when the weather permits, however there are some steps to negotiate. The last inspection report is available at the home on request. Other information of interest is on display. The current fee rates for living at the home are between £363 and £822 per week, excluding nursing fees depending on individual assessed needs. Additional charges include hairdressing, dry cleaning, toiletries, chiropody and telephone calls. 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: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The focus of our inspections is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provisions that need further development. The visit to the home was undertaken by two inspectors over one day. Our Regional Director accompanied the inspectors during the morning of the visit to observe fieldwork in practice. We, the commission were assisted throughout the day by the acting manager. The home did not know that we were visiting that day when there were thirty four people living there. One inspector completed a Short Observational Framework for Inspection (SOFI) over two hours. We completed a SOFI because some of the people in the home are unable to verbally tell us about their experiences. We use a formal way to observe people to Care Homes for Older People Page 6 of 29 help us understand their experience of living at the home. The SOFI involved us observing five people who use the service for two hours and recording their experiences at regular intervals. This included their state of well being, and how they interacted with staff members, other people who use the service and the environment. The results of this observation are included within the report. Information was also gathered from speaking to three people who live at the home and observing them. We also spoke to two staff. Two people were case tracked and we partially looked at three other peoples files. Case tracking involves discovering individual experiences of living at the home by meeting or observing them, discussing their care with staff, looking at medication and care files and reviewing areas of the home relevant to these people, in order to focus on outcomes. Case tracking helps us to understand the experiences of people who use the service. Staff files and health and safety records were reviewed. Prior to our visit we sent out random surveys to ten people who live at the home and five staff. Eight people who live at the home returned the surveys and five staff. Following our visit we contacted one relative who wanted to speak to us by telephone. Comments were positive about the home and are included in this report. We were sent an Annual Quality Assurance Assessment (AQAA) by the home. This tells us about what the home think they are doing well and where they need to improve. It also gives us some numerical information about the staff and people who live at the home. Before our visit we reviewed any notifications received about the home, these are reports about things that have happened in the home that they must tell us about. Care Homes for Older People Page 7 of 29 What the care home does well: People are provided with information about the service offered to enable them to make an informed decision about whether they would like to live at the home. Pre admission assessments are completed so that people know their needs can be met before they move in. People who use the service have access to a range of health and social care professionals and this ensures that any healthcare needs are met. There is a range of activities that people can participate in so that they lead an interesting and stimulating lifestyle. A varied menu that reflects individual needs and preferences is offered. People can see their visitors as they choose so that they can continue to have relationships that are important to them. The home creates a friendly and welcoming atmosphere where people can personalise their rooms to reflect preferences and tastes. Staff receive training to provide them with knowledge and skills to meet the needs of the people living at the home. People are involved in meetings so that they are involved in decisions about the home. Small amounts of peoples personal money can be held safely by the home if people choose to use this facility. Health and safety is well managed to ensure peoples safety. People told us: The home offers great care Ive never been so content, than with the care he gets here. Staff ring and tell me if hes poorly We came for the Christmas party, we had a nice time, the effort the staff put in was excellent Im getting fat because the food is so good Staff are always willing to help with all our questions Its an old building and not much to look at from the outside, but the care is good We can see by moms reaction to staff that she is treated with care and love The staff work hard to satisfy the needs of individual clients Care Homes for Older People Page 8 of 29 What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 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 10 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. Arrangements are in place to ensure that people have the information they need and can be confident that their needs will be met if they decide to live at the home. Evidence: The home has a statement of purpose and service user guide which are available in large print, so that people with visual impairments can access this information. People are given a copy of this when they visit the home and there is a copy in each bedroom. The service user guide gives people information about the home and its fee rates so that they know what to expect before they move in. In the surveys returned to us six people said that they had enough information about the home before they moved in, one person said they didnt have enough information and one person wasnt sure. A notice is displayed informing people that they can get a copy of the last inspection report from the office, so that they can read this if they choose to. Care Homes for Older People Page 11 of 29 Evidence: Before anyone comes to live at the home, comprehensive pre admission assessments are undertaken. We looked at three peoples assessments and they contained enough information, so that the person and the home knew that their individual needs could be met before they moved in. The AQAA told us that people can visit the home before they move in so that they could sample what it would be like to live there. In a survey we received one person told us the home offers great care. The home does not offer intermediate care facilities and therefore this standard does not apply. Care Homes for Older People Page 12 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The personal care and health needs of the people living there are met so ensuring their well being. Evidence: Each person had a written care plan. This is a plan about the individual. It states what they can do independently and what support staff need to give them to meet their needs. We looked at two peoples care files in detail and partially looked at three others. We found that people had care plans in place which provided staff with most of the information about how to meet peoples needs in a way that they preferred. Each person had a summary of their daily routine which provides staff with details about the person and their needs. Care plans were updated when changes occurred so that staff had current information. Wound care plans and assessments were completed if people had any sore areas of Care Homes for Older People Page 13 of 29 Evidence: skin. If dressings were needed, the type and frequency of changes were clearly recorded. A healthcare professional told us the home is very proactive with tissue viability (sore skin); they have a low prevalence of pressure ulcers. Risk assessments are completed each month for nutrition, risk of sore skin, falls and moving and handling. Individual risk assessments are completed if risks are identified. One persons risk assessment said that they should be escorted by two staff when they went outside of the home. On the day of our visit the person went out with one member of staff. This places people in a vulnerable position and the home should ensure that they follow the guidance in the risk assessments to keep people safe. One person had a plan in place for depression but no risk assessment in place for self harm and this was discussed with the manager on the day of our visit. People are seen by external healthcare professionals such as the GP, social workers, dentist, optician, chiropodist and tissue viability nurse. This means that people receive specialist advice when required. One person told us Ive never been so content, than with the care he gets here. Staff ring and tell me if hes poorly. We looked at the medication management in the home and found that this was managed very well and ensures that people receive their medication as prescribed. All of the audits undertaken were correct and records were accurate. Controlled drugs were stored appropriately and records were accurate. Since our last visit a new medication fridge had been purchased. Fridge and room temperatures were monitored daily to ensure that medication was stored at the right temperature. People were well supported by staff to choose clothing appropriate for the time of year, which reflected individual cultural, gender and personal preferences. Staff were observed to maintain peoples privacy and dignity. Care Homes for Older People Page 14 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Activities offered and meal choices should mean that people experience a meaningful lifestyle. Evidence: The home has an activity coordinator and another member of staff covers when the activity coordinator is on leave, so that activities are always available. There is a weekly activity programme which consists of quizzes, games, karaoke, shopping and one to one time. External visitors come to the home and include a musician. Progressive mobility visits the home each fortnight to help people to exercise to music. Holy Communion is held at the home so that people can continue to follow their chosen religion if they want to. A hairdresser visits every fortnight so that people can have their hair styled in a way that they prefer. There is monthly pet therapy and a clothes show is held every three months so that people can choose their own clothes. Some people go outside of the home and go to coffee mornings, the cinema, bowling, a lunch club, an art and craft centre and out for meals and shopping. There is also a sensory room at the home which some people choose to use. Care Homes for Older People Page 15 of 29 Evidence: During our visit we saw that one person was assisted to go out shopping with the activity coordinator. During the day we observed people completing puzzles, reading magazines and newspapers, and playing games. It was pleasing that staff had sought reading material in Bangladeshi to meet the needs of one person living at the home. One person told us Im going to McDonalds tomorrow. One person had written in the compliments book We came for the Christmas party, we had a nice time, the effort the staff put in was excellent. There is an open visiting policy, which means that people can see their friends and relatives as they choose and can continue with relationships that are meaningful to them. One relative told us I visit at all different times, sometimes when they least expect it. The home has a four week rolling menu. There are two choices of hot meal at lunchtime and soup and sandwiches or hot lighter meal in the evening. Breakfast is a choice of cereals, toast or cooked breakfast. Milkshakes, biscuits and snacks are available throughout the day. People discussed menus during their meetings and menus were changed so that people received the foods they liked to eat. One person we spoke to said they would like more pasta and this was brought to the attention of the manager at the time of the visit. We observed the evening meal and people were assisted to eat their meals by staff as required. People had chosen various meals to meet their individual choices. We sampled the chicken curry at lunchtime and this was well presented and appetising. In the surveys we received five people said they always liked the meals, one person said usually and one said never. One person told us Im getting fat because the food is so good. Care Homes for Older People Page 16 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. Arrangements are in place to listen and act upon people views and to safeguard people from harm. Evidence: The complaints procedure is displayed in the home. It is available in a number of languages and in large print, making it accessible to people at the home. The procedure is included in the service users guide so people know how to make a complaint. We had received two complaints about the home and these were passed to the home to investigate using their own complaints procedure. Since our last visit to the home, a low level complaints book has been introduced to record peoples grumbles. The home had recorded eight grumbles and they had received two complaints. These included areas such as laundry, care provision, staffing levels and broken equipment. There were good records of the investigations and actions taken to resolve the concerns. People told us: Ive had no complaints lately Ive never needed to complain Care Homes for Older People Page 17 of 29 Evidence: Staff are always willing to help with all our questions In the surveys returned to us, people said that there was someone they could talk to and knew how to make a complaint if they needed to. The home has a compliments book and two compliments had been recorded. The AQAA told us that policies and procedures had been updated with new initiatives. We did not look at these on this visit. The home had raised three safeguarding referrals, two of these were closed and one remained open as it was being investigated. The reporting of concerns to the relevant people means that people should be protected from harm. Staff receive training in the protection of vulnerable adults and staff spoken to were able to demonstrate a good understanding of what they should do in the event of an allegation being made. The minutes of staff meetings showed that safeguarding procedures were also discussed at some meetings to ensure that staff had the knowledge to protect people from harm. Care Homes for Older People Page 18 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with a comfortable environment in which to live that meets their individual needs. Evidence: The home is accessible to people in wheelchairs via a ramp. There is a passenger lift to the first floor. A partial tour of the home was undertaken on the day of our visit. There are two lounges that are adjoining the dining room/conservatory in the extension plus a further dining room that is adjacent to the kitchen in the original building. There is a quiet lounge with sensory equipment and a smoking room if people want to use these. People were seen to move around the home as they chose to. Corridors are wide and have handrails to enable people to move around the home with any aids they require. The home has a mixture of shared and single rooms, and the owner plans to make some of the double rooms into single, so that more people can have the option of choosing their own room. Thirteen of the rooms have ensuite facilities. Some of the rooms we looked at had been personalised with items that were familiar to people. People are encouraged to bring in their own possessions in order to have familiar items around them to make their rooms as homely as possible. Care Homes for Older People Page 19 of 29 Evidence: We noted that the assisted bathroom on the ground floor had a strong odour and was not pleasant for people to use. In one bedroom we found a strong odour of air freshener which was masking another odour rather than eliminating the problem. We discussed this with staff at the time of the visit. The bathroom odour had been identified on the homes audit the previous week and the manager was to discuss what action to take with the owner. Since our last visit a number of improvements have been made including painting of some bedrooms and the corridors. The flooring in the corridors was covered with specks of paint and the owner showed us samples of new flooring that was to be put down. A new boiler has been installed so that people have consistent hot water. A new kitchen has been fitted so that food can be prepared in a safe, clean and hygienic environment. The last report from the Environmental Health Officer stated Excellent practices in place at the time of inspection. There is an action plan in place for further refurbishment of the home. These improvements will enhance the environment in which people live. One person told us Its an old building and not much to look at from the outside, but the care is good. Care Homes for Older People Page 20 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There may not always be enough staff to support people to meet their needs. Lapses in recruitment may not fully protect people from harm. Evidence: There are six care staff and two trained nurses on duty throughout the day and three care staff and one trained nurse during the night. In addition to nursing and care staff the home also employs domestic, maintenance, kitchen and activity staff to meet all the needs of the people living at the home. The home maintains a stable staff group and people know who will be assisting them to meet their needs. Since our last visit to the home, an extra carer is now on duty during the day, this was following concerns about the numbers of staff being available to meet peoples needs. In the surveys returned to us five people said staff were always available to meet their needs, two said usually and one said never. During the SOFI we saw that sometimes there were no staff available in the lounge to supervise people, sometimes for up to 15 minutes. We saw one person take another persons piece of toast and attempt to eat it. The nurse came into the lounge and took the toast away informing us that this person was not supposed to eat solid food. This could have placed the person at potential risk of choking. It is required that staffing levels and how staff are allocated is reviewed to ensure that staff are available to supervise these areas. Care Homes for Older People Page 21 of 29 Evidence: We saw some good interactions with the staff and people who live at the home. The majority of interactions from staff during the SOFI were positive and we did not see any poor interactions. Most people appeared to be content and happy throughout the observation. One person was withdrawn for the majority of the observation. They had only 5 engagement with staff. We discussed this with the manager at the time of the visit and we were told about how this person had become unwell and their condition had deteriorated recently. People told us: Staff there are always on the ball Staff are on to things straight away We can see by moms reaction to staff that she is treated with care and love The staff work hard to satisfy the needs of individual clients All staff have completed a National Vocational Qualification (NVQ) Level 2 in care. This should ensure that the staff have the knowledge and skills to care for people individually and collectively. We looked at three staff files. All staff had references but had started work at the home prior to a Protection of Vulnerable Adults (POVA) first check being completed. The resource manager advised that staff came into the home for training but this does not ensure that people are safe from harm. A POVA first check and a risk assessment should be in place and staff should be supervised until a full Criminal Records Bureau (CRB) check has been received. There is a training programme in place and staff have received training in moving and handling, fire, infection control, POVA, health and safety and dementia. Some staff have had diabetes training and Deprivation Of Liberty. Training was booked for care staff in tissue viability. These topics meet the needs of the people who live at the home. There is an induction programme in place, which covers skills for care to ensure that people have a basic induction into their role. Each member of staff had a training needs analysis which identified areas that they should have training in to improve their knowledge and skills. Care Homes for Older People Page 22 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 run in the best interests of the people who live there. Evidence: Since our last visit to the home, the previous registered manager has left. An acting manager has been in post and has made improvements to ensure that the home is run in the best interests of the people who live there. The acting manager is a Registered Nurse and has worked at the home for a number of years. People told us: She is marvelous, she is the most dedicated person there is She holds the home together and makes sure that things get done A new manager has been appointed and is waiting for recruitment checks to be Care Homes for Older People Page 23 of 29 Evidence: received prior to starting work at the home. There are meetings for people who live in the home and their relatives so that they have an opportunity to voice any concerns or raise any ideas about how the home could improve. There were details on the notice board of dates for the monthly meetings so that people know when they are to be held. Minutes of the meetings were displayed on the notice board so that people who didnt attend are able to read about the meeting and know what was discussed. The home has a system in place to monitor the quality of the service provided by the home. This includes audits of care plans, medications, infection control and accidents. A home audit is also completed where the manager is able to identify things that need to be improved with the environment. An annual action plan has been written which identifies things that the home will do to further improve over the next year. Satisfaction surveys are sent out to people living at the home and a report is produced annually. This report includes an action plan to address any negative comments received. The owner continues to visit the home each week and writes a monthly report about the service offered. Some of the things that we identified during our visit, that could be improved, had been identified during an audit the previous week. This shows that the managers try to identify concerns and act upon them proactively, to ensure that the home is run in the best interests of the people who live there. Prior to the inspection the owner had completed the Annual Quality Assurance Assessment (AQAA). This gave us information about how the home thought they were performing, what they do well and how they could improve. The owner had identified areas where improvements could be made and had plans how to achieve this. The information in the AQAA was consistent with our findings on the day of our visit. The home is able to hold small amounts of personal money for people. Each person has an individual record and receipts are kept which matched the entries made. All of the money we audited was correct and this means that peoples money is held safely. A sample of records in relation to health and safety and maintenance checks were looked at and we found that checks had been undertaken to ensure that the equipment was safe and in full working order. Staff attend fire drills and training to ensure that they know how to keep people safe in the event of a fire. Water temperatures are now checked monthly to ensure that they are at the correct temperature. Following our last inspection, West Midlands Fire Service visited the home and gave some advice about the half gates which some people had on their Care Homes for Older People Page 24 of 29 Evidence: bedroom doors. These had since been changed and agreed with the fire service as being safe. Care Homes for Older People Page 25 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 26 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 1 27 18 Staffing levels and allocation 26/02/2010 must be reviewed. To ensure that peoples needs can be met and people are safe. 2 29 19 Systems must be in place to ensure that staff have necessary recruitment checks prior to starting employment. To ensure that people are protected from harm. 19/02/2010 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 7 Risk assessments should be written with care plans where people are at risk of self harm, so that people can be protected. Staff should follow guidance in order to minimise potential risks and to keep people safe. Offensive odours should be resolved so that people live in a Page 27 of 29 2 3 7 21 Care Homes for Older People 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 homely and fresh environment. Care Homes for Older People Page 28 of 29 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. 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