Care Home: Newton Grange

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What the care home does well This home has demonstrated that it continues to develop and improve services for people and that it responds to any concerns in a professional and safe manner for the benefit of people. Each person who lives at the home had a needs assessment and a detailed care plan file. This helps to ensure their needs were identified and the staff to care and support people in a consistent manner. These care plans had been regularly reviewed to ensure they meet people`s changing needs. Care Assistants were responsible for devising risk assessments to help protect people from harm. These were comprehensive and had been reviewed regularly. Staff were aware of the contents of people`s care plans and were knowledgeable about people`s individual needs. This protects people`s welfare. We asked people who live at the home if they felt they were treated with respect and dignity and whether their right to privacy is upheld. This is what they told us, "Oh yes love, they are very good, they are kind and very respectful to me". "Staff treat me with dignity and call me by my first name as I prefer that". People have a range of activities to take part in if they so wish. People who live at the home told us, "We have got an activities board in the dining room, there is something on each day and usually in the evenings". Another person said, "I spend my time out in the garden or the greenhouse, its one of my hobbies, you see". A relative told us, "My Mother isn`t really interested in some activities but they are there if she wants them. She enjoys going out more than anything and she has recently been to Meadowhall, shopping". One member of staff told us they had taken on the responsibility for coordinating activities for people. She said, "I hold regular monthly meetings with people who live at the home and at the meetings they discuss what activities people would like to take part in". "People have attended the local community centre to see a play, have trips out to shopping centres and also have a range of activities to take part in on site". "People can go out to the local club and we have arranged two trips out to Bridlington". We observed that people are supported to maintain contact with their family and friends as they wish. A relative told us they are made to feel welcome by the staff, they can visit at any time. Two people who live at the home confirmed their relatives can and do visit them regularly. People told us and we observed that that they receive a wholesome and appealing balanced diet, in pleasing surroundings at times convenient to them. One person told us, "The food is good", "We always get a choice of our main meal". Another person told us, "The food is great, we can have a cooked breakfast everyday, if we want to". The menus were varied and offered two or more choices at every meal. Snacks and drinks were available at all other times for people. We checked to see if people and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. This is what we found; One person told us, "I would speak to the manager, Marina will get things for me she is very good that way". A relative told us "I`ve got no complaints with the home it is really good but I would not hesitate if I had a problem, you can always talk to the manager". We took a partial tour of the building with the registered manager to ensure that people live in a safe, well maintained environment. The home was clean, tidy, safe and homely. Each person has their own bedroom, which had been decorated and furnished to a good standard. Each bedroom room has a sink. None of the bedrooms have en suite facilities. People who live at the home told us, "I like it here, the home is always clean, we`ve got good domestics". Another person said, "My bedroom is lovely, I`ve got my own bedroom you know and I brought some furniture from my house". The AQAA report stated that, "The premises have undergone a significant refurbishment which includes facilities for service users, to become more independent". People who live in the home were protected by the recruitment and selection policy and procedures in place. Adequate numbers of staff are on duty to ensure that people`s diverse needs can be met. Staff told us, "We always have enough staff on duty". A relative told us, "staff are good, I don`t have any problems with anyone". People are in safe hands as the staff are trained in how to keep people safe from harm. The staff team were observed to work well together, to meet people`s needs. People live in a home which is run and managed by a very experienced, skilled and committed registered manager. Staff told us that she is, `excellent`, at her job and is always striving to make things better for the people who live in and stay at the home. What has improved since the last inspection? We checked the previous requirement made at our last inspection and found that as care plan information had been improved that the previous requirement had been complied with. What the care home could do better: This service has demonstrated it is continually striving to improve services for people who live in the home. Key inspection report Care homes for older people Name: Address: Newton Grange 1A Horner Close Stocksbridge Sheffield S36 1LN     The quality rating for this care home is:   three star excellent 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: Shelagh Murphy     Date: 0 3 0 7 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 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: Newton Grange 1A Horner Close Stocksbridge Sheffield S36 1LN 01142883879 F/P01142883879 alana.gillott@sheffield.gov.uk None Sheffield City Council care home 33 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 33 The registered person may provide the following category of service only: Care Home only - Code PC, To service users of the following gender: Either, Whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category - Code OP, maximum number of places 33 Date of last inspection Brief description of the care home Newton Grange is a care home providing personal care and accommodation for 33 people over the age of 65 years. Some respite care is offered. The home is owned by Sheffield City Council and is situated in Stocksbridge close the shops and other local amenities. It is on a main bus route. The home is purpose built and the accommodation is on two floors, the upper floor accessed by a lift or stairs. All bedrooms are for single occupancy none have en-suite facilities. On each floor there are lounges, bedrooms, bathrooms and toilets. Care Homes for Older People Page 4 of 29 Over 65 33 0 Brief description of the care home There is a paved internal courtyard where people can sit out. Easy access is available to all facilities for people who use wheelchairs, or have other disabilities. There is a Statement of Purpose, which describes the service and provides information. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is three star. This means that people who use the service experience excellent quality outcomes. Shelagh Murphy carried out this unannounced visit to the service over one day and the total time spent on site was 6 hours. In the report we make reference to `us and `we. When we do this we are referring to the inspector and the Care Quality Commission. We used a variety of information as well as our findings from the visit to assess the quality of service offered to people who live at this home. The Annual Quality Assurance Assessment or AQAA report was sent to the inspector prior to the site visit. This report detailed what the home was doing well, what had Care Homes for Older People Page 6 of 29 improved since the last inspection and any plans for improving the service in the next twelve months. Some information from the AQAA is included in the main body of the report. Some time was spent with the people who use the service. We interviewed two people and spoke informally to several others during our visit, to gauge their views about the quality of the service offered in the home and by the staff. We also spent some time observing a lunchtime meal being served to people who lived at the home to gauge, how staff at the home supported them. It gave us some insight into how staff interacted with people and also an indication of peoples well being. Two staff attended interviews with us. One relative was also interviewed. Due to an administration error at CQC, no surveys were sent to all other stakeholders including people who live at the home, the staff and visiting health professionals. We apologise for this error. However, we have used information taken from interviews with people who use the service, relatives and staff comments as well as our site visit, to base our judgements as to the quality of the service. On the day of the site visit, an opportunity was taken to make a partial tour of the premises, inspect a sample of care records, check records relating to the running of the home and check some of the homes policies and procedures. We checked all the key standards and the standards relating to the requirements outstanding from the homes last key inspection. The progress made has been reported on under the relevant standard in this report. 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 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. The charges for fees at the home are £335.00 per week. Care Homes for Older People Page 7 of 29 What the care home does well: This home has demonstrated that it continues to develop and improve services for people and that it responds to any concerns in a professional and safe manner for the benefit of people. Each person who lives at the home had a needs assessment and a detailed care plan file. This helps to ensure their needs were identified and the staff to care and support people in a consistent manner. These care plans had been regularly reviewed to ensure they meet peoples changing needs. Care Assistants were responsible for devising risk assessments to help protect people from harm. These were comprehensive and had been reviewed regularly. Staff were aware of the contents of peoples care plans and were knowledgeable about peoples individual needs. This protects peoples welfare. We asked people who live at the home if they felt they were treated with respect and dignity and whether their right to privacy is upheld. This is what they told us, Oh yes love, they are very good, they are kind and very respectful to me. Staff treat me with dignity and call me by my first name as I prefer that. People have a range of activities to take part in if they so wish. People who live at the home told us, We have got an activities board in the dining room, there is something on each day and usually in the evenings. Another person said, I spend my time out in the garden or the greenhouse, its one of my hobbies, you see. A relative told us, My Mother isnt really interested in some activities but they are there if she wants them. She enjoys going out more than anything and she has recently been to Meadowhall, shopping. One member of staff told us they had taken on the responsibility for coordinating activities for people. She said, I hold regular monthly meetings with people who live at the home and at the meetings they discuss what activities people would like to take part in. People have attended the local community centre to see a play, have trips out to shopping centres and also have a range of activities to take part in on site. People can go out to the local club and we have arranged two trips out to Bridlington. We observed that people are supported to maintain contact with their family and friends as they wish. A relative told us they are made to feel welcome by the staff, they can visit at any time. Two people who live at the home confirmed their relatives Care Homes for Older People Page 8 of 29 can and do visit them regularly. People told us and we observed that that they receive a wholesome and appealing balanced diet, in pleasing surroundings at times convenient to them. One person told us, The food is good, We always get a choice of our main meal. Another person told us, The food is great, we can have a cooked breakfast everyday, if we want to. The menus were varied and offered two or more choices at every meal. Snacks and drinks were available at all other times for people. We checked to see if people and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. This is what we found; One person told us, I would speak to the manager, Marina will get things for me she is very good that way. A relative told us Ive got no complaints with the home it is really good but I would not hesitate if I had a problem, you can always talk to the manager. We took a partial tour of the building with the registered manager to ensure that people live in a safe, well maintained environment. The home was clean, tidy, safe and homely. Each person has their own bedroom, which had been decorated and furnished to a good standard. Each bedroom room has a sink. None of the bedrooms have en suite facilities. People who live at the home told us, I like it here, the home is always clean, weve got good domestics. Another person said, My bedroom is lovely, Ive got my own bedroom you know and I brought some furniture from my house. The AQAA report stated that, The premises have undergone a significant refurbishment which includes facilities for service users, to become more independent. People who live in the home were protected by the recruitment and selection policy and procedures in place. Adequate numbers of staff are on duty to ensure that peoples diverse needs can be met. Staff told us, We always have enough staff on duty. A relative told us, staff are good, I dont have any problems with anyone. People are in safe hands as the staff are trained in how to keep people safe from harm. The staff team were observed to work well together, to meet peoples needs. Care Homes for Older People Page 9 of 29 People live in a home which is run and managed by a very experienced, skilled and committed registered manager. Staff told us that she is, `excellent, at her job and is always striving to make things better for the people who live in and stay at the home. 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 10 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 11 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service had their needs assessed prior to admission to the home to ensure that the staff can meet their needs before they are admitted to the service. The service does not provide intermediate care. Evidence: We checked three peoples needs assessments. All of them had been completed by social workers from the hospital or community teams in Sheffield. The needs assessments checked were all appropriately detailed to ensure the service could assess whether peoples needs could be met at the home. The registered manager confirmed that this service did not offer intermediate care. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. We observed and people told us that they were treated with dignity and respect. People had individual care plans, which contained information to ensure staff knew how to meet peoples complex needs. People were protected by the homes medication policies, procedures and practices. Evidence: We checked three peoples care plans. We found that each persons health, personal and social care needs were set out in a document called an individual, `person centred plan, of care. Since the last inspection it was clear that care plans had improved. Staff told us that a new system of recording peoples health and care needs had recently been introduced. These were all detailed and there was evidence that all of the care plan summaries and monthly reviews were carried out regularly. The staff told us and we saw evidence that each person had an in depth care file, incorporating information on admission, assessment, health and care plans and reviews. The care plans checked showed an in depth knowledge of peoples likes, dislikes and preferences in each individual plan. Care Homes for Older People Page 13 of 29 Evidence: We checked to see if peoples health care needs were fully met. The AQAA report told us that, We work in partnership with The Care Homes Best Practice group to provide specific health care training to our staff. This is good practice. The care plans we checked showed evidence that people have the opportunity to see the G.P as required. There was also support from specialist community health teams such as district nurses, opticians, dentists, social workers and other specialist geriatric health support services. We checked to see whether people had risk assessments in place to protect their health and welfare. These were in place on each of the three care plans checked. The staff told us and showed us evidence that they updated risk assessments on a monthly basis to ensure they remain relevant and appropriate. This helps to protect people from harm. We checked the homes medication procedures. The services uses, `Boots Monitored Dosage system, cartridges and stores some creams and other medicines in the drug cabinet. The staff told us that currently all of the people who live at the home, need the staff team to administer their medication for them. We checked three peoples medication sheets and found them to be signed correctly. The staff had recorded when people had been given medication and there was a system in place to return and reorder medication to ensure people always had a supply to meet their needs. The Team Leader told us that the controlled drugs were stored appropriately and these drugs were recorded in the controlled drugs book. The entries had been signed for by two staff signatures and we checked to ensure the amounts were correct as recorded in the drug books and found this to be the case. The Team Leader also told us that Boots pharmacy staff come and inspect the homes medication systems on a regular basis. We observed staff interactions with people and at all times saw how people were treated with positive regard. Staff were professional yet informal and friendly with people who used the service. People also told us they were treated well by staff. We asked two people who live at the home if they felt they were treated with respect, dignity and whether their right to privacy is upheld. This is what they told us, Oh yes love, they are very good, they are kind and very respectful to me. Staff treat me with dignity and call me by my first name, as I prefer that. They also knock Care Homes for Older People Page 14 of 29 Evidence: on my bedroom door before they come in and they are discreet when helping me to bathe. They leave me on my own to wash myself and then come back to help me get out of the bath. Another person told us, The staff are great, Ive got some good friends here, they are really pretty good all of them. 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 have lots of opportunities to meet their social, cultural and recreational needs. People receive wholesome and appealing diets in surroundings, which met their needs. Evidence: Overall, we found that people found the lifestyle experienced in the home matched their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. People who live at the home told us, We have got an activities board in the dining room, there is something on each day and usually in the evenings. Another person said, I spend my time out in the garden or the greenhouse, its one of my hobbies, you see. Someone else told us, I like to see the entertainers, we have someone come regularly to us. A relative told us, My Mother isnt really interested in some activities but they are there if she wants them. She enjoys going out more than anything and she has Care Homes for Older People Page 16 of 29 Evidence: recently been to Meadowhall, shopping. From the AQAA report the registered manager told us that, There is entertainment in the home for example we book comedians, magician, old time music hall performers and reminiscence sessions for peoples enjoyment. Staff told us they encourage relatives to attend such events as well. This helps to support peoples social opportunities. One member of staff told us they had taken on the responsibility for coordinating activities for people. She said, I hold regular monthly meetings with people who live at the home and at the meetings they discuss what activities people would like to take part in . People have attended the local community centre to see a play, have trips out to shopping centres and also have a range of activities to take part in on site. People can go out to the local club and we have arranged two trips out to Bridlington. Another member of staff told us that Bingo, is the most popular activity, but a lot of people also enjoy pampering session, where people can have their hands massaged, nails cut and painted etc. All of these activities support peoples social needs. We observed that people were supported to maintain contact with their family and friends as they wish. A relative told us they are made to feel welcome by the staff, they can visit at any time. Two people who live at the home confirmed their relatives can and do visit them regularly. We checked to see if people are helped to exercise choice and control over their lives. We observed people to be offered everyday choices, such as choice of meals and drinks, where people wanted to go in the home and whether they wished to take part in activities. People told us and we observed that that they receive a wholesome and appealing balanced diet, in pleasing surroundings at times convenient to them. One person told us, The food is good, We always get a choice of our main meal. Another person told us, The food is great, we can have a cooked breakfast everyday, if we want to. The menus were varied and offered two or more choices at every meal. Snacks and drinks were available at all other times for people. Care Homes for Older People Page 17 of 29 Evidence: We observed lunchtime in the home, it was well organised. There were four staff supporting people to eat, feed and drink. The meal time was relaxed. Staff were seen to discreetly prompt and coax people to eat. Some people had soft diets and other people were using aids to enable them to eat independently. 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. People are able to make complaints and this protects their rights. People are safeguarded from abuse and neglect by the robust procedures in place. Evidence: We checked to see if people and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. This is what we found, One person told us, I would speak to the manager, Marina will get things for me she is very good that way. Another person said, Id tell the manager if I had any problems, shes always available. A relative told us., Ive got no complaints with the home it is really good, but I would not hesitate if I had a problem, you can always talk to the manager. From the AQAA report the manager told us, We have introduced a new serious incident reporting system this year. And all senior staff have received training regarding the process and timescales of the complaints procedures. This ensures that staff understand the complaints procedures and deal with issues in a timely fashion. The Team Leader on duty told us, We action all complaints as they are made. We keep a record of all complaints, which details the actions we have taken and the Care Homes for Older People Page 19 of 29 Evidence: outcomes. These were available for inspection. No complaints had been made to the home over the last 12 months. It was clear to us from speaking to people and relatives that the home promotes an atmosphere of open and honest communication and encourages family and friends to make them aware of any concerns or suggestions they may have as soon as they arise. The manager told us, We also provide family and friends with a copy of the complaints procedure, which is also on display in the reception area. This was good practice as it protected peoples rights and fostered good communication between all stakeholders. We checked to see how people are protected from abuse. From staff training records we could see that all of the staff had completed adult safeguarding training over the last two years. From interviews with two staff we know that they understood their responsibilities and the procedures to follow should any allegations of abuse be disclosed to them. From the AQAA report the manager has reported that there is, Robust training of staff at all levels in safeguarding, Mental Capacity Act 2005 and the Deprivation of Liberty, this is also discussed and documented in formal staff supervisions. These practices help to safeguard people. The manager told us that three safeguarding referrals had been made by the home over the last year and all resulted in safeguarding investigations to help protect people from harm. 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. People live in a warm, homely, safe and comfortable environment. Evidence: We took a partial tour of the building with the registered manager to ensure that people live in a safe, well-maintained environment. The home was clean, tidy, safe and homely. Many areas of the home had been refurbished and redecorated over the last year. The AQAA report stated that, The premises have undergone a significant refurbishment which includes facilities for service users, to become more independent. And, The dining rooms have areas for service users to prepare their own snacks and drinks if they so wish. Each person had their own bedroom, each room had a sink. None of the bedrooms have ensuite facilities. The manager told us that peoples bedrooms had recently been redecorated. The two rooms we checked were individually decorated and furnished to their tastes. There were no malodours in the home. Several other communal areas of the home had been redecorated and new furnishings had been purchased, which met peoples needs. Care Homes for Older People Page 21 of 29 Evidence: The garden areas were well managed, tidy and attractive. There was space for people to sit outside. One person who lived at the home told us, I go out and do some gardening. We now have a greenhouse and I can potter about in the vegetable plot when the weather is good. The manager told us they had the greenhouse donated to the service by Stocksbridge Town Council, as she knew one of the people at the home would really enjoy gardening. People who live at the home told us, I like it here, the home is always clean, weve got good domestics. Another person said, My bedroom is lovely, Ive got my own bedroom you know and I brought some furniture from my house. A relative told us, The home is always clean, tidy and never smells. The manager told us and we saw that a new, `smoothie bar, area had also been created in the large dining room. This enabled people to sit and chat, or to invite friends and relatives to join them. There were coffee and tea making facilities as well in this area. These initiatives show the lengths the home has gone to in order to meet peoples collective and individual needs and to make the home welcoming and homely. Staff told us that the home has adequate laundry facilities to meet peoples collective needs and people told us their clothing always returns from the laundry clean and ironed. Care Homes for Older People Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home were protected by the recruitment and selection policy and procedures in place. Adequate numbers of staff were on duty to ensure that peoples diverse needs could be met. People were in safe hands as the staff were trained in how to keep people safe from harm. This staff team worked well together to provide an excellent service to people. Evidence: We checked to see if peoples needs were met by the numbers and skill mix of staff. On the day of our visit there were five residential care assistants, a team leader and an operations manager on duty, They were supported by two domestic staff, an administrator and a cook. This was observed to be an adequate staffing level to meet peoples needs. Staff told us, We always have enough staff on duty. A relative told us, Staff are good, I dont have any problems with anyone. It was clear to us that the service has a highly developed recruitment procedure that has the needs of people who use the service at its core. We checked three staff recruitment files and all had been checked to ensure the service had all of the appropriate records to meet the regulations in order to keep people safe. Care Homes for Older People Page 23 of 29 Evidence: After talking to the operations manager and meeting numerous members of care and ancillary staff it was clear, the registered manager clearly sees that the recruitment of highly skilled and experienced carers and ancillary staff is integral to the delivery of this excellent service. From the AQAA report and other records checked we can see that the service is proactive rather than reactive in its staffing, recruitment and training. The result of this is a diverse staff team that has a balance of skills, knowledge and experience to meet peoples needs. There was evidence from staff interviews that they are able to demonstrate a thorough understanding of the particular needs of individuals. The home had an internal developmental training programme and we were shown the formal training plan. This showed that all of the mandatory training required, had either been completed or booked for this year. And that over 60 of staff had completed the NVQ2 in care awards. Specialist training for staff included topics such as challenging behaviour, care planning, pressure care, dementia care, nutrition and other specialist health care needs . This shows the service was committed to ensuring they have a skilled and trained workforce to meet peoples needs. Staff told us, We get lots of training, its really good. And, Any training I need, we get. From our observations it was clear that staff have the skills to communicate effectively with people who live in the home. This included both care staff and ancillary staff who come into regular contact with people. Staff showed respect for people, their relationships were informal and friendly at all times. Staff told us that they had regular team meetings and were encouraged to be involved in the development of the service. Agendas were developed, minutes were taken and relevant information was made available to staff and people or their representatives. Staff went on to tell us that they had individual supervision sessions which take place regularly and staff say that they find them useful for their development. This suppots staff development. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were living in a well run service. They were receiving appropriate levels of care and support to meet their individual and diverse needs. People were confident in the management of the home and everyone found the manager approachable and professional. People were safe because the home makes sure all of the proper quality assurance checks were undertaken. Evidence: People live in a home which is run and managed by a very experienced, skilled and committed registered manager. Staff told us that she is, `excellent at her job and is always striving to make things better for the people who live in and stay at the home. The registered manager told us that she had completed the Registered Managers Award or RMA. From speaking to people who live in the home, staff and a relative, it was clear that she leads the staff team in a calm and quiet manner, is fair and thorough in her approach. She is respected and liked by all of the stakeholders we spoke to. Here are just a few of the comments people made to us, Care Homes for Older People Page 25 of 29 Evidence: A person who lives at the home told us, Marina is marvellous, very easy to talk to.. Another person told us, The manager is a lovely lady. A relative told us, Marina is fine, no problems with her and I feel I could talk to her if I had any problems. A member of staff said, The manager is always fair, she is so committed that even when she was in hospital, she was ringing us up to make sure people were getting what they needed. We checked to see if the home was run in the best interests of people who live there. Relatives told us, I am happy that the staff and manager treat my Mother well. I wouldnt want my Mother to be anywhere else. We then checked three people finances, which were kept by the home. All transactions were recorded by two signatories and receipts given. The finance records maintained were clear and the Team Leader told us, It is regularly audited by the administrator and the manager. This protect peoples rights. One person told us their son managed their finances, but they managed a small amount of their own money and were quite happy with this. We saw evidence that the service had health and safety policies and procedures in place, this ensures peoples safety and welfare. As part of the site visit we examined some of the maintenance and servicing records. All were up to date and these included, Electrical circuit check certificate was in place and dated July 2008. Fire detection and fighting equipment had last been checked in May 2009. Fire drills had been undertaken 6 monthly. Fire alarm had weekly tests undertaken. Water temperatures were checked on a weekly basis and records of this were kept. All of these checks help to keep people safe from harm. 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 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. 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. 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