Care Home: Newgrove House Care Home

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What the care home does well There is a very relaxed a homely atmosphere in the home, people were observed to be very settled and comfortable in their surroundings. Comments from people who use the service and their relatives include `I`m happy living here at Newgrove, it`s my home and I`m well looked after` and `the home is clean and welcoming`. The staff collect information together about a person before anyone moves into the home to make sure they can meet their needs. People told us that the care workers are very kind and attentive. They also said that they receive the support and assistance they need. Comments include `all the staff are very helpful and do their best to try and meet my mother`s needs` and `they look after all the residents very well and we are quite happy the way our mum is well cared for. She is always saying how good the staff are and what a lovely homely place Newgrove is`. The home was well maintained and very clean and tidy. There had been an ongoing programme of redecoration and improvement. People living in the home were encouraged to actively participate in choosing the decor. People said that they were offered a good choice of meals and that they enjoyed the quality of the food. People told us that their visitors were always made very welcome and they could stay for meals if they wished. The management had consulted with the people who lived in the home and people who visited the home about the quality of care provided and had acted on the information received. The management provided staff training and safety checks of equipment to protect the health and safety of staff and people who lived in the home. What has improved since the last inspection? The manager has completed her development programme and is now registered with CQC. Outcomes from the inspection demonstrate that the overall management of the home has improved, compliance had been achieved towards all the requirements and the majority of recommendations made at the previous visit. A new care recording system has been put in place which better describes people`s care needs and the tasks staff must carry out to meet people`s needs. The records are more person centred and clearly describe how people choose to receive their care. The home has better systems in place to support the management of people`s risks of developing pressure damage. Care staff have received training in this area and new risk assessments have been put in place and care plans developed consistently. The home has dealt with complaints and concerns more effectively, records demonstrate that issues are taken seriously and looked into properly. People can now enjoy more social activities, an activities co-ordinator has been employed and has developed a more diverse range of things for people to participate in. The home has achieved the target of having 50% of care staff qualified at level 2 NVQ. Incidents in the home have been reported properly to the appropriate agencies which better protects people who use the service. Odour control in the home is managed more effectively which promotes people`s dignity and improves the quality of the environment. More up to date recording systems have been put in place in the kitchen to support food safety management. Following a recent inspection from environmental health the home was awarded a five star rating, which is an excellent achievement. What the care home could do better: Provide separate communication records in the care files where staff can record any communications with and input from health and social care professionals. Support the management of falls in the home with individual risk assessments where necessary.This will demonstrate the steps staff have taken to reduce the risk of further falls happening. Key inspection report Care homes for older people Name: Address: Newgrove House Care Home Station Road New Waltham Grimsby North East Lincs DN36 4RZ     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: Jane Lyons     Date: 1 9 0 4 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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: Newgrove House Care Home Station Road New Waltham Grimsby North East Lincs DN36 4RZ 01472822176 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Dryband One Limited Name of registered manager (if applicable) Mrs Maria Urgent Anderson Type of registration: Number of places registered: care home 41 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Newgrove House is situated in the village of New Waltham, four miles from Grimsby. It has large well-maintained grounds with mature trees and shrubs and ample car parking for visitors. The home is on a bus route to Grimsby and Cleethorpes. The home provides accommodation and care for up to forty-one people over the age of sixty-five, including a maximum of twenty people with dementia. There are thirty-seven single rooms and two double rooms based on two floors that are serviced by a passenger lift and stair access. Thirty-two of the bedrooms have en-suite facilities. There is an adequate supply of bathrooms and toilets throughout the home. All rooms have telephone points and a television provided if required. The home has a ground floor Care Homes for Older People Page 4 of 29 Over 65 20 41 0 0 Brief description of the care home lounge with a large screen television and a dining room set out with individual tables. A new conservatory has been provided which is connected to this lounge, it has an air conditioning system in place and can be used all year round. There is a further ground floor lounge, separated into two areas. This is used for family gatherings when privacy is required or for staff training purposes. There is a quiet room on each of the floors. The quiet room on the ground floor has a small conservatory leading from it overlooking the rear garden. Current weekly fees range from: three hundred and sixty one pounds to four hundred and two pounds and sixty nine pence depending on a persons care needs, and that there are no additional charges other that those for hairdressing, private chiropody treatment, toiletries and newspapers/ magazines. A full list of prices for these additional services is available from the manager. 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 quality rating for this service is 2 star. This means that the people that use the service experience good quality outcomes. This inspection report is based on information received by the Care Quality Commission (CQC) since the last key unannounced inspection on 10th July 2009 and a site visit to the home, which lasted approximately six hours. Throughout the day we spoke to people that lived in the home and some of their relatives to gain a picture of what life was like at Newgrove House. We also had discussions with the manager, the responsible individual and some staff members. We received surveys from people who live in the home and staff who work there. Comments from discussions during the day and surveys have been used throughout the report. Care Homes for Older People Page 6 of 29 We looked at assessments of need made before people were admitted to the home and the homes care plans to see how those needs were met while they were living there. Also examined were, medication practices, risk management, activities, nutrition, complaints, staffing levels, staff training, induction and supervision, how the home monitored the quality of the service it provided and how the home was managed overall. We also checked to see how people were consulted with in how the home was run and how privacy and dignity was maintained. We also wanted to be sure that people could make choices about aspects of their lives and that the home ensured they were protected and safe in a clean environment. We observed the way staff spoke to people and supported them. The manager had returned their annual quality assurance assessment (AQAA) within the required timescale. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. We would like to thank the people that live in Newgrove House, the staff team and management for their hospitality during the visit, and also thank the people who had discussions with us. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use the services are not being put at significant risk of harm. In future if a requirement is repeated it is likely that enforcement action will be taken. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? The manager has completed her development programme and is now registered with CQC. Outcomes from the inspection demonstrate that the overall management of the home has improved, compliance had been achieved towards all the requirements and the majority of recommendations made at the previous visit. A new care recording system has been put in place which better describes peoples care needs and the tasks staff must carry out to meet peoples needs. The records are more person centred and clearly describe how people choose to receive their care. The home has better systems in place to support the management of peoples risks of developing pressure damage. Care staff have received training in this area and new risk assessments have been put in place and care plans developed consistently. Care Homes for Older People Page 8 of 29 The home has dealt with complaints and concerns more effectively, records demonstrate that issues are taken seriously and looked into properly. People can now enjoy more social activities, an activities co-ordinator has been employed and has developed a more diverse range of things for people to participate in. The home has achieved the target of having 50 of care staff qualified at level 2 NVQ. Incidents in the home have been reported properly to the appropriate agencies which better protects people who use the service. Odour control in the home is managed more effectively which promotes peoples dignity and improves the quality of the environment. More up to date recording systems have been put in place in the kitchen to support food safety management. Following a recent inspection from environmental health the home was awarded a five star rating, which is an excellent achievement. 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. Prospective individuals are fully assessed prior to moving into the home to ensure that their needs can be met. Evidence: We examined three care files for people living in the home. The care files had been renewed since the last inspection and where people had been in the home for some time their original assessment had been archived and a new assessment completed.The care files contained detailed care plans which identified their assessed needs. A care file for a person more recently admitted to the home contained an assessment of needs which had been completed prior to admission. The homes assessments were detailed and included peoples preferences for care delivery.They covered aspects of the individuals health, physical and social care needs and associated risks. Detailed Care Homes for Older People Page 11 of 29 Evidence: care plans had been developed from the information gathered at assessment. The manager said that when she completes the assessment she shares the information with care workers. This is done so that care workers know in advance what support they will need to provide. We asked care workers how this worked out in practice, they said that they are told about people who are about to move in, they also said that as a team they discuss how best to help the person in the first few days, while they get to know them better. The assessments were used to determine whether the home could meet peoples needs and people were informed in writing of the outcome of this process. A relative stated that they had chosen the home after visiting others in the area as they had liked the atmosphere in the home and the friendliness of the staff. The home does not provide intermediate care so standard 6 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. Peoples needs were well set out in an individual care plan and their health and personal care needs were being met. People felt that they were treated with kindness and respect. Medications were well managed. Evidence: During the day we looked at three care plans that had been produced from assessments of need. The home had completed a review of the care plan format after the last inspection and had developed new formats to improve the care planning in the home. The information recorded in the new care plans was very detailed, the plans covered the assessed needs well and gave staff clear tasks in how to care for people. The care plans stated what the individual could do for themselves and indicated preferences, for example, on the times they liked to rise or retire to bed. All the care plans seen showed evidence that they had been agreed with the person receiving the care or their representative. There was evidence of good practice in moving and handling and pressure area care. A variety of equipment such as portable hoists and profile beds have been provided. The Care Homes for Older People Page 13 of 29 Evidence: manager had worked with the tissue viability nurse to improve systems for pressure area care in the home. Staff had received training and a new risk management process built on a traffic light system had been properly implemented and maintained. Peoples risks of falling had been identified on assessment and care plans to support people in this area had been put in place where necessary, however risk assessments should be developed to show exactly the steps staff are taking to minimise the risks. Evaluations of the care plans were completed regularly and care plans had been updated where necessary. Daily diary records were recorded in detail and included the action taken to meet peoples health and care needs on a daily basis. Care files demonstrated that when people had health care needs, appropriate health care professionals including G.Ps and community nurses were consulted. Care instructions following consultation had always been added to the plan of care however these records were maintained in the evaluation section of the medication care plan and consideration should be given to providing a separate communication record. There was good evidence that the care plans were being monitored regularly to improve consistency, the operations manager had completed audits and these included action plans which staff had signed when deficiencies had been addressed. Surveys from people who use the service and discussions during the day indicated that they were very happy with the care they received. They praised the staff saying they were very kind, courteous and attentive. Comments were the standard of care is very good, they do everything very well, they are all good and would do anything for me, I am very happy here, the staff are all marvellous and I wouldnt want to live anywhere else. The management of medication was good. All medication was signed into the home and on administration; medication was stored appropriately. Handwritten entires on the medication records were clear and had been witnessed. Some people are prescribed medication on an as needed basis to manage their behaviours, there was guidance in place to support staff in determining when the medication should be administered which helps the continuity of care support given to the individual.There were no controlled medications in use at the time of the visit . Staff who administer medication have completed an accredited medication course, some of the staff had completed this training some years ago and are currently completing refresher courses. During the day we observed very positive staff support and interaction, staff Care Homes for Older People Page 14 of 29 Evidence: demonstrated a very kind and patient approach at all times. People are helped to wear neat and clean clothes so they can present themselves how they want. When asked if staff respected privacy and dignity, one person said oh yes, absolutely. Care Homes for Older People Page 15 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. People were well supported to maintain and develop their personal lifestyles at the home. People were provided with a varied nutritious diet and they enjoyed the food they received. Evidence: People could make choices about aspects of their lives and those spoken with told us there were no set times for rising or retiring and relatives and friends could visit at any time. Staff told us that they tried to ensure people made decisions for themselves we ask people if they want to do things and we respect their choices and the care plans tell us how people want to be cared for. Since the last inspection the home has employed an activities co-ordinator for fifteen hours per week. People have had their needs assessed in this area and staff had gathered some information about past hobbies and interests. Records of individuals participation in events was recorded. There was an emphasis on meeting peoples individual needs as well as group activities. An events calendar was in place and daily activities were provided such as nail care, Bingo, games, crafts and music. The manager and staff have introduced some new stimulation such as Pat Dog sessions and have reared some chicks. Church services were held regularly in the home. The Care Homes for Older People Page 16 of 29 Evidence: manager was also arranging more trips out for people and a drive out for an icecream is planned in the near future. People told us they enjoyed the activities, comments included Maria organises lots of entertainment which I enjoy and this a photo of me at the party we had at Easter, we all had a great time. There was a good range of communal space in the home, six rooms are available for people to use which means they have a choice in how they would like to spend their time whether it be sitting quietly, watching television, listening to music or joining in with activities. The majority of people however choose to spend time in the main lounge watching T.V and chatting with each other. Visitors told us that the atmosphere at the home was very welcoming, they were satisfied with the standards of care support and staff always informed them of any changes in their relatives needs. One relative told us that the home arranged regular social events for visitors and relatives to join in with which they enjoyed very much. The atmosphere at the home was very inclusive. All members of the staff team including the catering and housekeeping staff were seen to spend time with people and individuals were seen to respond very well to this. Regular meetings are held about the running of the home, recently individuals have been involved in choosing the decor for their rooms. The manager produces a regular newsletter. A fund raising committee has been set up which includes staff, people who use the service and relatives. We spoke with one of the relatives who is on the committee , she told us that it was very positive the management were involving relatives in some of the decision making and she enjoyed being more involved. People spoken with enjoyed the food and comments included all the meals are lovely, we always have a choice, I enjoy all my meals, we get plenty to eat and drink and the cook comes round every day and asks us what we want, there is always something I like. There were at least two choices for the main meals of the day but staff confirmed that people often made requests that were not on the main menu, especially at tea- time and these were provided where possible. Visitors are able to stay and have meals at the home, one relative told us that he regularly joined his wife for lunch which they both enjoyed. We observed the lunch being served, the mealtime was relaxed and individuals were given time to eat their meals. Where people required support this assistance was provided in a manner which maintained peoples dignity. A small number of people chose to have their meal later which was well accommodated by the staff. Care Homes for Older People Page 17 of 29 Evidence: Specialist diets are provided where necessary. Individuals weights are recorded monthly and these monitored through audits and appropriate referrals made to the G.P. and dietetic department when required. The kitchen was well maintained and very clean. The home had achieved the best score available, with five stars having been awarded, in a recent kitchen assessment by the environmental health department. 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. Complaints were taken seriously and people were provided with information on how to make a complaint. The home has more robust systems in place to protect people from abuse. Evidence: Complaints policies and procedures were in place and were displayed in the home. Staff spoken with and surveys received from them indicated that they were aware of what steps to take should people raise concerns with them. People who lived in the home and visitors stated that they knew how to make a complaint but were very happy with the services and care at the home. The home had not received any formal complaints since the last inspection. The manager had received a small number of concerns, records showed that she had addressed these properly with records maintained of any investigation carried out and action she had taken. This is an area of improvement from the last inspection. To protect people living in the home from abuse the home had safeguarding policies and procedures in place and staff had received external training in safeguarding adults. All of the staff spoken with were aware of the policies and procedures and what amounted to an allegation of any abuse. Care Homes for Older People Page 19 of 29 Evidence: There was good evidence that the manager is now making appropriate referrals to the local authority, two incidents in the home had been reported. Using the procedures to keep the local authority aware of issues means that care management staff can visit the people who use the service and check out the systems in place to protect people. Senior staff have received training in the mental capacity and deprivation of liberty safeguard legislation. There was good evidence that they had involved advocates and representatives from the local authority in capacity assessment and decision making for one individual residing in the home. 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 clean, tidy and homely environment, which was suited to the needs of the people living there. Evidence: The home offers spacious and comfortable accommodation. People told us that they are happy living at Newgrove and they liked their rooms. On the outside, the building is well maintained and the gardens are quite neat. The manager confirmed that she has plans to develop the garden areas to provide more flowers, trees and shrubs which will improve the outlook for people using the service. Internally the home was undergoing a continuous programme of redecoration and improvement. The corridors and hallways had been redecorated since the last inspection and some of the bedrooms. The people who lived in the home had been involved in the decision making processes about the decoration, which they told us they had enjoyed. The home was very clean and tidy and fee from offensive odours and it provided a very homely feel. Improvements were noted in odour management, the housekeeper told us how the cleaning regimes in some of the areas had been reviewed with good effect. Comments in surveys from people included the home is always very clean and tidy. The home provides a good range of communal space, people were observed spending Care Homes for Older People Page 21 of 29 Evidence: time in a variety of rooms at different times of the day. The conservatory was a very pleasant area for the people who lived there to use and take advantage of the views of the garden. The bedrooms had been personalised and lockable storage was provided. The home provided specialist equipment to assist people with poor mobility such as portable hoists and profile beds. We asked people about the laundry and everyone we spoke with said they were very happy with it. Surveys carried out by the home identify a high level of satisfaction in this area. There were systems in place to prevent the spread of infection in the home and staff confirmed that they had received training and that they had all the equipment they required to assist this process. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were protected and their needs met by the number of staff provided. Checks for safe recruitment had been completed prior to employment. Staff were trained for their role. Evidence: The surveys that were returned and the conversations during the day give a clear indication that the people who use the service and their relatives think there are enough staff on duty and that they are trained and competent in their work. Staff told us that they have enough time to care for people and to spend time with them, this was observed during the day. The home is utilising the Residential Staffing Forum to confirm the staffing hours needed. The home also employs a range of support staff including housekeepers, cooks, kitchen assistants and laundry staff; this enables care staff to concentrate on personal, physical and emotional care with the people who use the service. Many of the staff have worked at the home for some time, which provides continuity of care support. Conversations with staff show that they enjoy working with each other and have a good team approach to the delivery of care. All staff spoken with during the visit were enthusiastic about their work, they feel that they provide a good standard of care to people and that they are well supported by the management and the training that they are given. Good practice was seen in the support to people with Care Homes for Older People Page 23 of 29 Evidence: dementia and further in -depth courses are currently being arranged. People who lived in the home were very complimentary about the staff. Comments included the staff are very good and they are all lovely and kind. A visitor said the staff are extremely kind and helpful, they communicate very well with us. Three staff recruitment files were checked. Employment had commenced following receipt of the full CRB(Criminal Records Bureau) and a POVA First Check (Protection of Vulnerable Adults). Proof of identity and references had been obtained and photos were held. The manager stated that induction training was provided to skills for care standards and there was evidence that staff completed the skills for care workbooks. All new staff work alongside more experienced staff as part of their induction which was confirmed in discussions.There were also certificates to indicate that new staff had completed training in such areas as moving and handling, fire safety and safeguarding vulnerable adults. There was a training plan in place and records of training were maintained. Staff had received mandatory and service specific training including dementia, pressure damage, nutrition and diabetes.There was evidence of training updates, many of the senior staff were completing refresher courses in areas such as medication. The home has now achieved the target of having at least 50 of the care staff trained at NVQ level 2 , the manager confirmed that NVQ training is ongoing. 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. People who use the service were very satisfied with the way the home was run, improvements have been made to the overall management of the service. The home was run in the best interests of the people living there and the management was proactive in ensuring that peoples health, safety and welfare were protected. Evidence: The manager Maria Anderson had commenced work as acting manager at the home in May 2008. Maria is experienced in the care field and this is her first managers post. She has completed her NVQ level 4 in care and leadership/ management. The manager completed the registration process and following interview on the 6th April 2010 has become the registered manager. The manager had also completed her personal development plan put in place by the homes senior management. There was good evidence that the manager had worked closely with senior management to make the necessary improvements to aspects of the management and administration systems in the home, with positive results. Care Homes for Older People Page 25 of 29 Evidence: The home regularly consulted with with people about all aspects of the service provided through regular meetings. A committee has been formed to look at quality issues and relatives have been invited to join, this has helped improve communication and consultation. The home had gained the Investors in People Award last year. People who lived in the service, staff, visitors and other interested parties had been surveyed regularly about the quality of the care and services in the home, the results had been collated and showed a high level of satisfaction. A new quality programme had recently been implemented in line with other homes in the company, the focus of the new programme is improved consultation with people. There were very positive comments received about the quality of the care provided from both the people who lived there and relatives. Comments included they could do no better, its lovely here, Im well cared for and wouldnt wish to move and Maria has completely turned this home round for the better, I cannot describe all the improvements she has made, we are very happy with all the staff and the care they provide. There was good evidence that care staff received regular formal supervision with their manager. In discussions and surveys staff told us they felt well supported and could talk to the manager or senior management at any time. Some people were assisted with their finances. Clear records were maintained and receipts were held for purchases on behalf of people. The home was a safe place for people to live in and staff to work in. Fire equipment was checked routinely and gas and electrical equipment serviced. Staff participated in mandatory training and had policies and procedures to guide their practice. Integral bed rails are provided with three of the profile style beds, there were no other bed rails in use at the home. The kitchen facilities and food management systems had been inspected in April 2010 by the Environmental Health Team, the home had been awarded the highest score, with five stars, which is an excellent achievement. 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 7 Provide separate communication records in all individuals care files where staff can detail any communications with and input from health and social care professionals. Peoples risks of falling in the home should be supported by risk management systems which would demonstrate what steps staff had taken to manage this effectively. 2 8 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). 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