Care Home: Normanhurst Residential Home

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What the care home does well This is a well run home where the Management takes time to listen to residents and visitors opinions and is quick to respond to any requests or suggestions made. Residents are highly complimentary about the home and say, `Its lovely here, staff are kind, the home is always clean and I`ve never regretted coming to live here`, `You couldn`t wish for more`. People are involved in the day to day decision making at the home and play an active role in planning their care. Records were well kept, up to date and met the required standard. The plans focused on the individual and their aspirations, they were person centred, had been regularly reviewed and were underpinned by effective risk assessment, risk management and guidance. The activity programme is varied and interesting and includes craft work, exercise classes, and themed events. Residents are often escorted to the local shops, places of interest or local parks and gardens. Residents say that there is plenty to do and enjoy taking part. The home is very good at making sure residents can say what they want to participate in and they are always given a choice. There is a very low staff turnover at the home and no use of agency workers. There are sufficient numbers of staff on duty at all times of the day and night to meet the needs of the residents effectively. Residents say that the staff are caring and kind and appear well trained and professional. Residents confirm that they are treated with dignity and respect at all times. From observation of practise it is evident that personal care is provided in a discreet and sensitive manner. The manner of address used by staff to speak to residents is always friendly, respectful and courteous. The staff team are highly skilled and have received the training they need to provide good quality care. Most have achieved professional qualifications in care to improve their skills and knowledge. It is evident that the staff team work well together to provide a happy and cheerful home for the residents. Records are well kept and provide staff with information they need to provide high quality care to residents. What has improved since the last inspection? There was only one recommendation made following the last inspection and this has been fully actioned. Two people sign for all controlled medication at the home. Since the last inspection the home has made a number of environmental improvements to enhance the comfort of residents including a new conservatory, redecoration in parts of the home, new equipment including new chairs and tables, new flooring and a new walk in bath has been added en suite to one of the bedrooms. A new aquarium has been added to the lounge to provide a point of interest for residents. The menu has been improved to promote healthy eating and improve residents nutrition. Ninety per cent of the staff have qualifications in care to enhance their skills and practise including National Vocational Qualifications at levels 2, 3 and 4. There is a new Deputy in post who holds an RMA and NVQ level 4. The majority of the staff have received training in Equality & Diversity, the Mental Capacity Act & Deprivation of Liberty to enhance their knowledge and skills and to improve their awareness of these issues. The home has improved the content and accessibility of its website to provide more information to prospective users of the service. A new software package has been purchased to upgrade the care plan methodology. The gardens have been restocked with therapeutic plants and herbs and residents are more involved with horticulture. The range of activities on offer has been enhanced including the employment of a fitness instructor to promote residents mobility and to facilitate recovery from stroke. There are more visits by outside entertainers including a concert pianist, musicians and entertainers and more trips out to places of interest. What the care home could do better: There are no new requirements or recommendations made as a result of this inspection. Key inspection report Care homes for older people Name: Address: Normanhurst Residential Home 26 High Town Road Maidenhead Berkshire SL6 1PB     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: Julie Willis     Date: 1 6 1 1 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 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 27 Information about the care home Name of care home: Address: Normanhurst Residential Home 26 High Town Road Maidenhead Berkshire SL6 1PB 01628632618 01628824245 info@normanhurst.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Normanhurst Care Limited care home 23 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 23 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Dementia (DE) Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Normanhurst provides twenty four hour care to up to 25 older residents. The building was built in the late 19th century and is set on the corner of a tree lined road within five minutes walking distance of Maidenhead town centre. The accommodation is provided over four floors. A passenger lift and stair lift access various areas of the home. Fees range from 550 to 800 pounds per week. Care Homes for Older People Page 4 of 27 Over 65 0 23 23 0 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: This inspection of the service was an unannounced Key Inspection undertaken on Monday 16th November 2009. It was a thorough look at how well the service is doing. It took into account detailed information provided by the services manager, and any information that the Commission has received about the service since the last inspection which took place on 5th February 2007. Prior to the visit a questionnaire was sent to the Manager along with survey and comment cards for residents, relatives and visiting professionals such as doctors and nurses. Any replies were used to help form judgements about the service. Consideration has also been given to other information that has been provided to the Commission since the last inspection. The inspector toured the building, examined records and met most of the residents and one relative that was visiting at the time of the inspection. The inspector also spent time talking informally to staff and observing how care was being delivered to the residents. Care Homes for Older People Page 5 of 27 From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals with various religious, racial or cultural needs. The inspector gave feedback about her findings to the homes Manager at the end of inspection. There were no legal requirements made as a result of this inspection. The Commission has received no information concerning complaints since the last inspection. Care Homes for Older People Page 6 of 27 What the care home does well: What has improved since the last inspection? There was only one recommendation made following the last inspection and this has been fully actioned. Two people sign for all controlled medication at the home. Since the last inspection the home has made a number of environmental improvements to enhance the comfort of residents including a new conservatory, redecoration in parts of the home, new equipment including new chairs and tables, new flooring and a new walk in bath has been added en suite to one of the bedrooms. A new aquarium has been added to the lounge to provide a point of interest for residents. The menu has been improved to promote healthy eating and improve residents nutrition. Ninety per cent of the staff have qualifications in care to enhance their skills and Care Homes for Older People Page 7 of 27 practise including National Vocational Qualifications at levels 2, 3 and 4. There is a new Deputy in post who holds an RMA and NVQ level 4. The majority of the staff have received training in Equality & Diversity, the Mental Capacity Act & Deprivation of Liberty to enhance their knowledge and skills and to improve their awareness of these issues. The home has improved the content and accessibility of its website to provide more information to prospective users of the service. A new software package has been purchased to upgrade the care plan methodology. The gardens have been restocked with therapeutic plants and herbs and residents are more involved with horticulture. The range of activities on offer has been enhanced including the employment of a fitness instructor to promote residents mobility and to facilitate recovery from stroke. There are more visits by outside entertainers including a concert pianist, musicians and entertainers and more trips out to places of interest. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 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. Residents are fully assessed prior to admission to ensure the home will be able to effectively meet their need. Evidence: The home provides prospective residents with sufficient information prior to admission to enable them to decide if the home will be right for them. The information in the Statement of Purpose and Service User Guides are clear and concise and written in easy to read plain English. The service user guide details what prospective residents can expect from the home and gives clear information about the services provided. It sets out the type of accommodation provided, qualifications and experience of staff, how to make a complaint and a copy of the most recent Care Quality Commission inspection report. All residents are provided with a copy of the Guide on admission. All residents are fully assessed prior to admission. The assessment is highly detailed and comprehensive and is carried out by the homes management who are suitably Care Homes for Older People Page 10 of 27 Evidence: qualified and competent. Additionally, the home receives a copy of any care management assessment, which has been carried out by the Local Authority. Following the receipt of any referral made privately or via Social Services, management of the home visit the prospective resident in their own home or in hospital to ensure that the home can effectively meet the prospective residents need and to provide any information that the user may need about the home. From examination of the pre-admission assessment for three of the most recently admitted residents and discussion with management, residents and relatives it is evident that the home gathers as much information as possible before admitting a new resident to the home. Admission will only take place if the management are confident that they can effectively meet the needs of the individual. Information is gathered from a range of sources including the prospective resident, their relatives, advocates and other health and social care professionals. The pre-admission assessment is thorough and holistic. Information about the residents health and personal care needs are sought, along with information about the residents dietary needs, communication needs, mobility needs, history of falls, continence, medication regime and mental state. An initial care plan is then formulated from the information gathered. From discussion with residents it is clear that the resident and their relatives, friends or advocates are always offered an informal visit to the home where they can meet staff and other residents and observe and experience the routines of the home. A tour of the home is offered, in order that residents may see what services are available. Following admission the residents experience living at the home for a trial period of 6 weeks before making a decision to remain permanently. A resident told the inspector, This is a lovely home. Initially, I was worried about coming into care, but my fears were unfounded, staff here couldnt be more kind. I have no regrets about moving from my home, this place is wonderful I couldnt get better care anywhere. I would definitely recommend it. Another resident said, They really take care of you. Its warm and comfortable and the staff are lovely. Care Homes for Older People Page 11 of 27 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. Residents are encouraged to make choices about their lives and to take everyday risks. The written records accurately reflect the individual needs, aspirations and lifestyle choices of each resident. Evidence: It was evident during inspection that the principles and values that underpin work with residents of Normanhurst promotes and values their full involvement in the planning of their care. The care plans for three residents were examined and residents care pathways were case tracked from admission to date. There was evidence that the plans fostered independence and promoted residents choice and autonomy. Residents are provided with a key worker on admission that takes a special interest in their care. Residents spoken with knew who was caring for them and were able to confirm that they have the opportunity to say how they wish to be cared for. The residents are given the opportunity to decide which staff members they want to help them with personal care tasks such as toileting, bathing and showering. The staff group is balanced to enable choice of male, female and age related preferences. Care Homes for Older People Page 12 of 27 Evidence: The care plans are detailed and holistic and consider all aspects of a persons lifestyle including their health and social care needs. The plans are working tools and from discussion with staff it was clear they fully understood the content. Care plans are regularly reviewed and updated and any changes to the plan are discussed and agreed with the resident and their family. All risks to residents are fully assessed using a range of assessment tools and effective guidelines and equipment is in place to reduce the likelihood of occurrence. All care given is documented in the daily records. The need to respect residents privacy and dignity is utmost in staffs minds. Care is provided sensitively and with respect in all areas of the residents life. Observation of practise demonstrated that care was provided in a manner, which maintained the residents right to independence and choice. Residents confirm that they are provided with access to health and social care professionals for advice and support as necessary. They regularly see the GP who visits weekly and are referred to hospital when necessary for further advice and treatment. The local General Practitioners and nurses provide routine screening and preventative treatments to all residents of the home. The home has a robust medication policy, procedure and practise guidance in place. The senior staff spoken with at the time of inspection were aware of their responsibilities in relation to the safe administration of medication and follow best practise guidance. The system used for the safe administration of medication is the monitored dosage system. This system reduces the likelihood of medication error and provides an accurate record of administration. Medication is stored securely and disposal systems are safe. The inspector spoke at length to five residents and to others in small groups in various parts of the home. The inspector also had discussions with a relative that was visiting at the time of inspection. The residents and relative were very positive about the qualities and caring attitudes of the staff. One resident said, Staff here are always kind. Another said, I just ring for attention when I need it and they come to see what I want, its nice to know there is someone there when you need them. Care Homes for Older People Page 13 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A range of activities is offered that provide opportunity for mental and physical stimulation. Residents are encouraged to maintain contact with their family and friends and are able to have visitors at any time. The home provides a varied and nutritious menu designed to meet the needs of its residents. Evidence: From discussion with the management, staff and residents it was evident that residents are offered the opportunity to participate in a range of activities suited to their needs. At the time of inspection a number of residents were taking part in a seated exercise class whilst others chatted and read in the communal lounges. A number of residents choose to spend time in their bedrooms where they entertain family and friends or watch television, read or listen to music. Several residents said that they liked to have time to themselves at various times of the day but would choose to go down to the dining room at mealtimes where they can meet their friends or take part in activities during the afternoon. One resident said that they particularly favoured the conservatory area whilst another said they liked to help in the garden Care Homes for Older People Page 14 of 27 Evidence: during the summer months. There was a relaxed unhurried atmosphere at the home which residents say they particularly like and enjoy. There was evidence that residents have regular trips in the summer months to Cliveden, local shops and parks. Several photo albums contained pictures of residents enjoying particular activities. Photos show outings to garden centres, shopping trips and cinema visits as well as demonstrating the various outside entertainments that have visited the home including pantomimes, a range of musicians, concert pianists and an Elvis impersonator. Residents regularly take part in craft activities and have recently been involved in Christmas card making and flower arranging. The recent introduction of an orchid corner in the newly completed conservatory has been particularly well received by one resident who takes care of the plants on a daily basis. The home employs an activity organiser. The Activity Organiser has drawn up a weekly programme of activities, which includes, painting, sketching, music for healing, music for health, interactive singing sessions, visits by the Salvation Army band and trips out to the local shops, gardens and parkland. Residents confirmed that they particularly enjoyed the new aquarium in the lounge where residents chose the fish and walks down by the river. Service users confirm that their visitors are made most welcome at any time and are offered appropriate hospitality during their visits. A number of social events are held throughout the year which promotes community involvement and which provide residents families with the opportunity to engage with the staff and users on an informal and regular basis. Residents may have visitors at any time and relatives confirm that they are always made welcome and are offered appropriate hospitality during their visits. The routines at the home are flexible and are designed to offer residents choice and autonomy. Residents can rise and retire at a time of their choosing. They can choose whether to be alone or in company and may wander freely around the home and gardens. Policies, procedures and practise guidance at the home focus on residents being empowered to take control over their own lives. The food is considered by residents and their relatives to be of good quality. Residents are encouraged to take meals in the dining room to aid socialisation. All residents are offered a main course and dessert. They may have wine with their meals if they want it. There are many alternatives to the main course each day and these are displayed on a menu board in the dining room. Special diets can be catered for including soft diets, diabetic and vegetarian meals. The menu is continuously updated Care Homes for Older People Page 15 of 27 Evidence: to meet the choices and preferences of residents and to promote healthy eating. Low fat olive oil spread and pro biotic yogurt are on offer and there is more variety of foodstuffs including more beef and fresh fish. The home provides residents favourite snacks including kit Kats, crisps and fudge. One resident told the inspector about a recent firework night event, the resident said, I like to sit in the conservatory, its bright and airy. I watched the fireworks from here the other evening. They were lovely, we all had such a nice time. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a satisfactory complaints system. Residents feel their views are listened to and acted upon. Residents are protected from abuse and exploitation by well trained and competent staff that can demonstrate knowledge of the homes abuse of vulnerable adults and whistle blowing policies. Evidence: The home has a robust complaint procedure in place which is available to residents of the home. Residents spoken with at the time of inspection said that that they felt confident that any concerns or complaints would be taken seriously by the home and efforts would be made to remedy any problems in a timely fashion. The majority of residents confirmed that they had never had to make a complaint because they felt that management were approachable and operated an open door policy. The residents felt that concerns would be addressed quickly before problems escalated. The complaint policy in the home meets the requirement of Standard and Regulation. Residents and relatives are provided with information on how to make a complaint to the home and the formal stages in procedures. Examination of the complaint records indicated that there have been no complaints made to the home since 3rd January 2007. Care Homes for Older People Page 17 of 27 Evidence: There has been no information about complaints reported to the CQC about the home since the last inspection. There was evidence in staff files and from discussion with staff, that they receive training in Safeguarding Adults as part of their formal induction to the home which is later consolidated when undertaking National Vocational Qualification training in which it forms a core module. Safeguarding Adults refresher training is regularly provided to all of the staff. Management of the home have undertaken Mental Capacity Act and Deprivation of Liberty training. It is planning to cascade the training to all of the staff in the new year. Observation of care practise concluded that staff were patient and understanding when dealing with residents and appeared mindful of the need to respect their privacy at all times. Staff interviewed were aware of the homes whistle blowing policy and understood the importance of protecting residents from abuse and exploitation at all times. The residents confirmed that they felt safe and well cared for by caring staff. One resident said, Its wonderful to be cared for by such kind and genuine people, its lovely here. Care Homes for Older People Page 18 of 27 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 standards of decor and furnishings in this home offer residents a comfortable and homely place to live. Standards of hygiene are good throughout. Evidence: The home is well maintained, well decorated and is very homely. Various parts of the home have been recently extended, redecorated and refurbished to provide a safer environment for the residents. There is a large conservatory to the rear of the property which is a popular sitting area for a number of residents who enjoy a quieter environment. This area has been recently enhanced by providing an orchid area which is tended by one the residents. Residents said that the conservatory gave a good view of the fireworks on bonfire night for those people who wanted to view them in comfort. The AQAA states that the dining room has been repainted in the residents choice of colours. A new walk-in en suite bath has been fitted to one of the bedrooms, which has also been redecorated. A new washing machine has been purchased for residents laundry. A new sideboard is in situ which houses activity equipment. There has been a new wide screen television purchased for the lounge and new tables have been provided for coffee and craft activities. New non slip flooring has been added to shower rooms, conservatory, the kitchen and utility room. Care Homes for Older People Page 19 of 27 Evidence: The bedrooms seen by the inspector were all highly personalised and were warm spacious and comfortable. The home has a range of aids and equipment available to maintain residents independence and to promote safe care. There is a choice of bathing and showering facilities both assisted and unassisted and there are sufficient toilets placed strategically around the home to meet the needs of residents. All bathrooms, toilets and sluices have a supply of liquid soap and hand towels to maintain satisfactory infection control standards. The home was clean and hygienic throughout there were no residual odours noted. Residents confirmed that the home is always clean and well maintained and staff work hard to provide a pleasant environment for the residents. Discussion with staff and examination of the staff training records evidenced that staff have received refresher training in infection control and health & safety. One resident told the inspector I think the home is lovely. Its always very clean. Care Homes for Older People Page 20 of 27 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. There were sufficient numbers of staff on duty at the time of inspection to meet the needs of residents effectively. The skill mix of the staff team was appropriate for the size, layout and purpose of the home. Recruitment policies and procedures at the home are robust and transparent and ensure the safety of residents. Evidence: Examination of three staff records and discussion with staff and management indicated that all necessary checks are undertaken on prospective staff to ensure the safety and protection of residents. Records were well kept and met the required standard. It is clear that the homes policy on recruitment is robust, transparent and meets the requirements of current good practise guidance and legislation. Examination of the staff files and training records evidenced that over 90 of the current staff have either gained or are in the process of attaining NVQ qualifications at levels II & III & IV. Two staff are RMA qualified. The Registered Manager provides the necessary support and guidance to candidates and provides regular opportunities for one to one meetings and supervision to discuss on going training needs. Staff turnover is low at the home and there is no use of agency workers. This provides a level of continuity for residents. Evidence in staff files confirms that all newly Care Homes for Older People Page 21 of 27 Evidence: employed staff have been properly inducted. They complete a period of shadowing more senior staff to ensure that they are confident and competent to carry out the tasks of the job. Staff confirmed that they had undertaken an in house induction and foundation training to Skills for Care specification. The staff records were well kept and contained confirmation of police & POVA checks, copies of induction training, job descriptions, application forms, two written references, training certificates, supervision and appraisal records. These were examined to evidence compliance with good practise. The home has an up to date training record, which provides the dates of all training that has been undertaken by staff. The Homes Manager undertakes regular audits of the training records and identifies future training needs and requirements linked to fulfilling the business and financial plan for the home. Staff have attended training in dementia care, dealing with challenging behaviour, food hygiene, health & safety, fire safety, manual handling, continence promotion, skin care, ageing issues, equality & diversity, dignity initiative,medication handling, safeguarding, strokes, diabetic care, visual impairment, infection control, palliative care, nutrition and healthy eating, Mental Capacity Act, Excellence in care at end of life and deaf awareness. Staff confirmed that they felt well supported by management of the home and had plenty of opportunity to learn new skills to enhance their practise. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents benefit from living in a well managed home, where there is evidence that there health, welfare and safety is of primary importance. The registered person is qualified, competent and experienced to run the home for the benefit of residents. Evidence: The Homes Manager Mrs Yuen Law is a widely experienced nurse who has attained management qualifications and the Registered Managers Award to further enhance her knowledge and skills. She is supported by an experienced Deputy and team of NVQ qualified carers who are well trained and highly motivated. From discussions it is clear that the Manager keenly supports and encourages the staff to achieve further qualifications to enhance their own professional development. The staff confirmed that the Homes Manager demonstrates effective leadership skills and vision and communicates a clear sense of direction and purpose. From Care Homes for Older People Page 23 of 27 Evidence: examination of records and discussion with staff it is evident that they have the opportunity to express their opinions openly in staff meetings, which follow a shared agenda. These meetings, supervision sessions and staff handover times provide plenty of opportunity for the staff to feel included and involved in the way the service is delivered. The residents are highly complimentary about the management of the home and feel that the office is always open and accessible. One resident said, You know they are doing their best for you, nothing is too much trouble and another said, Ive never complained about anything, after all what could be better. From discussion with the residents it was evident that they are regularly consulted on issues that affect them and feel that their views are taken into account on a day to day basis. From examination of the minutes of residents meetings there was evidence that when requests are made or concerns expressed in the meetings the issues raised are followed up promptly by management. The home regularly carries out a range of home audits and health & safety checks to ensure that the home is operating safely and effectively. The home carried out a customer satisfaction survey in July 2009 with the residents. The results have been collated by the Manager to identify trends and to measure the homes success in meeting its stated aims and objectives. From examination of the surveys it is clear that residents are satisfied with the quality of care provided by the home. Examination of a sample of health & safety records indicated that they were up to date and in good order. Routine servicing and maintenance of equipment is undertaken at appropriate intervals to maintain the home as a safe and risk free environment for residents. All risks to residents are effectively risk assessed and managed. Care Homes for Older People Page 24 of 27 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 25 of 27 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 26 of 27 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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