Care Home: Oaklands Rest Home

Similar services:

• St Vincents
• The Cotswold Home
• Winton House
• Rush Court
• Hillyfield Rest Home
• The Maypole Nursing Centre
• The Briars

What the care home does well Prospective residents are provided with full and accessible information to help them to decide if this care home is able to meet their needs, and a full assessment of their needs, completed by the manager or the deputy manager, ensures that a complete plan of care can be drawn up to meet the new residents` needs. Care planning is detailed and person-centred and clear instructions are included for the staff to follow so they know exactly how to carry out the individual residents` care. Oaklands has a friendly and welcoming ambiance and provides the residents with a homely, comfortable, well-maintained, clean and fresh home, which fulfils their needs. Residents commented, `I am very happy here because everyone is so kind and this is my home`, and `yes, I am happy here and the food is so good and there is lots of it.` The home benefits from having a loyal staff team offering consistency and continuity to the residents, and a high percentage of them have achieved National Vocational Qualifications at level 2 and 3 to support them in their role. Health and social care professionals commented, `Oaklands is a good quality residential home`, `the staff are always very caring and the clients are always treated with dignity,` `I am impressed with the individual care from the staff at Oaklands. One of my clients presents challenges, which are managed very well by the manager and her team,` and `I look forward to visiting Oaklands as I know that I will receive a professional reception and service.` The homes` own compliments log contained a number of letters to the home from relatives of residents, and included, `the care and attention the staff give my mother, and presumably other residents, is excellent. In my mother`s own words, `it`s like a five star hotel, nothing is too much trouble for the carers, the food is excellent, and the atmosphere has a `family feel` to it.` What has improved since the last inspection? Over the last twelve months, the AQAA recorded that care plans had been up-graded to include nutritional tools, to keep residents food and fluid intake under review when weight gain or loss was an issue, Community Psychiatric Nurse`s assessments for residents with mental health needs and the Deprivation of Liberty Safeguards assessment tool had been completed with respect to residents, who may not be able to make their own decisions. Equality and diversity training had been provided for the staff to ensure they treat the residents as individuals and The Mental Capacity Act training had also been accessed to ensure the staff are aware of the actions to take should residents be unable to continue to make their own decisions. The building work on the new extension had just been completed when we made our last visit to the home two years ago. The new extension has provided a new reception area, a large sitting room, five extra bedrooms, a new laundry with new equipment, and storage rooms for the kitchen and for cleaning materials. `Sun-pipes` had been installed to provide more sunlight in the sitting room and some of the corridors, which had been provided with ceiling windows, due to having no outside walls in which to provide conventional windows. A new condensing boiler had been installed for all central heating and hot water needs. What the care home could do better: No areas of concern were noted. Key inspection report Care homes for older people Name: Address: Oaklands Rest Home 216 Stakes Hill Road Waterlooville Portsmouth Hampshire PO7 5UJ     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: Christine Bowman     Date: 1 4 0 9 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 30 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 30 Information about the care home Name of care home: Address: Oaklands Rest Home 216 Stakes Hill Road Waterlooville Portsmouth Hampshire PO7 5UJ 02392266343 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: marilyn_803@hotmail.com Mr Timothy Maloney care home 30 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 to be accommodated is 30. The registered person may provide the following category/ies 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 categories: Old age, not falling within any other category (OP). Date of last inspection Brief description of the care home Oaklands Care Home is a large detached house situated at the southern end of Waterlooville, near Portsmouth, and is close to local shops and the main bus route. The home is registered to accommodate and to provide personal care to thirty older people who have a diagnosis of dementia related behaviours, but do not need specialist care or support. There are twenty-two single and four shared bedrooms. Eleven of the single rooms Care Homes for Older People Page 4 of 30 Over 65 30 0 Brief description of the care home have en-suite facilities. Re-development of the home has provided a new reception area with seating for the residents, a new large lounge and a dining room. There is a passenger lift to provide access to all floors, and a secure back garden and a patio area. Car parking spaces are available at the front of the home. Care Homes for Older People Page 5 of 30 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 report includes information gathered about the service since the previous site visit on 4th October 2007 under the Inspecting for Better Lives (ILB) process. An Annual Quality Assurance Assessment (AQAA) was completed by the manager, and returned within the required timescale, giving up to date factual evidence about the running of the home and informing us of what they think they are doing well, how they have improved the service, and of their plans for further improvements. Four staff members completed surveys commenting on the support given to the residents and the support they received as employees at the home. One social care and two health care professionals returned completed surveys informing us of their experience of the service with respect to their clients and their comments have been included in this report. An unannounced site visit, conducted on 14th September 2009, was completed over six hours commencing at 11:00am, to assess the outcomes of the key inspection standards for older people with respect to the people living at the home. The registered manager, Marilyn Collins, assisted with the inspection process by Care Homes for Older People Page 6 of 30 making residents and staff files, the staff training matrix, quality assurance documentation, the complaints and compliments log, the service user guide, the statement of purpose, samples of policies and procedures and other documents and records available to be sampled. The registered provider, Mr Timothy Maloney, was also available for consultation. We sampled the communal living areas of the home and spoke with a number of residents and staff throughout the day. We visited two residents in their bedrooms and observed the staff as they carried out their duties. Care Homes for Older People Page 7 of 30 What the care home does well: What has improved since the last inspection? Over the last twelve months, the AQAA recorded that care plans had been up-graded to include nutritional tools, to keep residents food and fluid intake under review when weight gain or loss was an issue, Community Psychiatric Nurses assessments for residents with mental health needs and the Deprivation of Liberty Safeguards assessment tool had been completed with respect to residents, who may not be able to make their own decisions. Equality and diversity training had been provided for the staff to ensure they treat the residents as individuals and The Mental Capacity Act training had also been accessed to ensure the staff are aware of the actions to take should residents be unable to continue to make their own decisions. The building work on the new extension had just been completed when we made our last visit to the home two years ago. The new extension has provided a new reception area, a large sitting room, five extra bedrooms, a new laundry with new equipment, and storage rooms for the kitchen and for cleaning materials. Sun-pipes had been installed to provide more sunlight in the sitting room and some of the corridors, which Care Homes for Older People Page 8 of 30 had been provided with ceiling windows, due to having no outside walls in which to provide conventional windows. A new condensing boiler had been installed for all central heating and hot water needs. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 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 can decide if this care home is able to meet their support and accommodation needs because full and detailed information about the home is available to them. They can be confident the home is able to support them because a full assessment of their support needs is carried out before a placement is offered. The home does not provide intermediate care. Evidence: The statement of purpose, which had been reviewed since the previous site visit to incorporate the improvements to the environment, and to clarify the category of service user provided for. It recorded that, the management prides itself in offering a highly professional care service for the elderly with the personal touch. Prospective residents were promised, our aim is to provide care of the highest standard whilst maintaining a warm, friendly, homely environment, in which we believe each person has a right to make decisions, and take balanced risks, so as to promote a feeling of self-worth, and to maintain control over their own lives. Individuality is emphasised. Care Homes for Older People Page 11 of 30 Evidence: Staff have time to give attention to small detail and residents have the choice to enjoy the company of likeminded fellow residents. One of the homes many objectives was, to ensure that care is delivered in a non discriminatory fashion whilst respecting the residents right to independence, privacy, fulfilment and the right to make informed choices and to take risks. Another aim was, to ensure that each residents needs and values are respected in matters of religion, culture, race or ethnic origin, sexuality and sexual orientation, political affiliation, marital status, parenthood, and disabilities or impairment. The assessment documentation of two residents admitted since the previous site visit was sampled. Personal information was recorded including health care professionals already providing a service to the resident to ensure continuity. Prescribed medication was recorded, personal care needs, physical wellbeing, diet (allergies and preferences), sensory needs, communication, oral health, foot care, mobility, dexterity, history of falls, continence, personal safety and risk, and weight on admission. A mental health assessment with respect to the residents ability to organise themselves was included. A full assessment of the residents ability to carry out self-care and domestic tasks independently was carried out to identify supervision or support required. Residents social needs were also assessed and interests, hobbies, religious and cultural needs, family and other social contacts were recorded to enable an individual care plan to be completed. Full assessments of prospective residents needs were carried out by the manager or the deputy manager before admission so the home could be sure the right care would be offered. Local authority assessments and care plans had been obtained where possible, and meetings with residents relatives and representatives, to ensure informed decisions could be made. The admission process, as described by the manager, and recorded in the service user guide, encouraged prospective residents to visit, to take a meal with current residents, and to sample the atmosphere of the home. There were no restrictions on viewing. Care Homes for Older People Page 12 of 30 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. Care plans addressed the residents health, personal and social care needs and safe arrangements were in place for the safe handling of medication to protect the residents and the staff. The residents right to privacy was upheld and their dignity maintained. Evidence: As part of the inspection process the care plans of three residents were sampled. Care plans were bound and indexed, to make finding documents easier, and to prevent important confidential documents from going astray. Each file contained a colour photograph of the resident for easy identification, and the file was set out with personal information at the front including the date of admission, emergency contact details and information with respect to the involvement of health and social care professionals. How the resident would like to be addressed was recorded, in addition to religious, psychological and social needs and interests. One resident enjoyed watching sports and motor racing on the television and were visited regularly by their family and taken out to lunch at the weekends. Care Homes for Older People Page 13 of 30 Evidence: Care plans set out the residents needs and objectives under personal care, physical well being, communication, mobility, dexterity, personal safety and risk assessment, medical history and medication, mental health and cognition, diet and weight, food and mealtimes, dental and foot care, religious observances, skin integrity, social needs and elimination. Care plan action sheets recorded the action care staff were required to take to support the residents to meet their objectives. Residents or their representatives had signed the care plan and the risk taking agreements viewed on the residents files. Moving and handling risk assessment had been completed, where required and a history of falls had been completed. The equipment used to support the individual residents with their mobility needs was recorded with instructions to the staff with respect to the support required. Over the last twelve months, the AQAA recorded that care plans had been up-graded to include nutritional tools, to keep residents food and fluid intake under review when weight gain or loss was an issue. Community Psychiatric Nurses assessments for residents with mental health needs and the Deprivation of Liberty Safeguards assessment tool had been completed with respect to residents, who may not be able to make their own decisions. Residents were informed in the information provided on admission that a visit would be requested whenever needed from their own General Practitioners (GP) practise, but that there was also a GP on call at all times of day or night. The home did not provide nursing care, but if this need was assessed, the district nursing team supplied the support. Residents were referred to specialists such as physiotherapists and occupational therapists, and for specialist equipment, through their General Practitioner. Records completed by visiting health care professionals were viewed in residents files giving information to the staff on the outcome of consultations and instructions to ensure the residents needs were met. Three health and social care professionals, who completed surveys, confirmed that the residents social and healthcare needs are always monitored, reviewed and met by the care service, and that the care service always seeks advice and acts upon it to meet the residents social and health care needs and to improve their well-being. Comments included, I am impressed with the individual care from the staff at Oaklands, the residents, their relatives, friends and carers are treated very well, and with respect and dignity, and this is a well-run care home. Medication administration records inspected had been completed in a satisfactory manner, showing that residents had received the required dosage of their prescribed Care Homes for Older People Page 14 of 30 Evidence: medication, as set out by their medical practitioners, and there were no unexplained gaps in the recordings. The staff, who took responsibility for this task had received training in the safe handling of medication. The staff training matrix and staff members individual training and development logs confirmed this. Individual residents records contained a photograph to identify them and most of the residents medication was blister packed at the pharmacy for safety and convenience. The manager stated that she carried out regular audits to ensure all drugs were accounted for and a random check of two residents controlled drug stock, confirmed that the controlled drug register was correct. Records were kept of medication received and returned to the pharmacy to ensure it was all accounted for and suitable storage, including a refrigerator, was available to ensure the drugs were safely stored and available to the residents at the correct temperature. The manager stated that should residents wish to take responsibility for their own medication, risk assessments would be undertaken and suitable storage facilities in bedrooms were already available, but all the current residents had chosen to have their medication administered by the staff. Observations of the staff throughout the day confirmed that they were respectful and polite in their interactions with the residents, who appeared to be relaxed and happy in their home. Staff were observed knocking on residents bedroom doors prior to entering and addressing residents by their preferred form of address. New staff, whose files were sampled, had completed the Skills for Care common induction standards, which provide an introduction to the caring role and promote the residents rights to be treated as an individual, with respect for their privacy and dignity. Most of the residents had single bedrooms to enable private consultations with health and social care professional, and those in shared bedrooms had been provided with appropriate screening to protect their privacy and dignity. The four staff members, who completed surveys recorded that they always felt they had the right support, experience and knowledge to meet the different needs of the residents with respect to equality and diversity issues. Care Homes for Older People Page 15 of 30 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 variety of social activities and entertainment, the promotion of relatives involvement in the lives of the residents, and the provision of varied and nutritious meals meet the residents needs. Evidence: The home no longer employed an activities co-ordinator, but activity sessions were led by the staff in the afternoons. On the day of the site visit the residents were taking part in a bingo session and skittles were planned for later in the afternoon. The large communal sitting room allowed for the residents to form friendship groups, as the comfortable chairs were not static, but moved around according to the wishes of the residents. Although the activity session was held in the sitting room, there was ample space for the residents, who did not wish to participate, to watch one of the two televisions, look at magazines, newspapers and books, sit and chat or entertain their visitors. A WII games consul was provided to enable residents to participate in their favourite sports, such as tennis, from their armchair. There was an organ in one part of the living area and the manager stated that one of the residents liked to play old time music. Other activities provided at the home included beauty sessions and manicures, Care Homes for Older People Page 16 of 30 Evidence: movement to music, karaoke, quizzes and memory board games and special theme days. A visiting hairdresser provided a service to the residents and there were monthly visits from the local Catholic and Church of England ministers. Library books were available in large print for those with visual impairment. The AQAA recorded that residents were regularly consulted with about activities, menu changes and any other daily activities within the home. Over the last twelve months more craft orientated activities had been included in the schedule and one resident had started growing their own vegetables in the garden. A relative commented in the homes survey, my father is happy because you encourage him to sing and dance, something he has always loved to do. It is hard putting your loved one into a home but I know I made the right decision when I see him smiling when I come to visit. Contact, with family and friends, is encouraged the manager stated, and regular contact by post or telephone is maintained when visiting is not possible. Throughout the day visitors came and went, one relative stayed over lunch to support their relative to eat, another was involved in a review meeting of their relatives care with professionals, and others stopped for a friendly exchange with the manager as they either came or went. The manager stated that a hog roast celebration had taken place over the previous weekend and that many relatives, friends and staff had attended and enjoyed a sociable time. Birthdays and special days throughout the year were celebrated and albums of photographs showed the staff dressed for the occasions and smiling residents having a good time. Over the year the staff had provided a pantomime, organised an Easter hat competition, provided Halloween games, and made a Santas grotto for the entertainment of the residents their relatives and friends. The four-week menu is changed every three months to ensure residents are provided with plenty of variety and choice, the manager stated, and special diets, and soft or pureed diets, are catered for. The menu showed that cooked breakfasts were offered on request and hot or cold drinks, snacks and fruit were provided throughout the day and on demand. Friends and family were invited to eat with their relatives and always offered a cup of tea and light refreshment when visiting. Lunch, on the day of the site visit, was cottage pie with vegetables, which looked and smelt appetising. It was followed by apple crumble and custard or fruit cocktail and ice cream. Fresh fruit was also available, and residents observed, appeared to be enjoying their meal. Those spoken with thought the meal was nice and one resident commented, the food is very good here. Residents could choose to socialise in the dining room over mealtimes or have their meals served in their bedrooms or in the sitting room. Care Homes for Older People Page 17 of 30 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. 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 ensures their best interests are protected. Evidence: The complaints procedure was included in the information available to the residents and their representatives and was also displayed on a notice board in the home for all to see. The home promised to deal with concerns promptly and encouraged residents to approach any member of staff. The procedure displayed had been updated to include the most recent contact details of the Care Quality Commission (CQC) to inform the residents, their relatives and staff, should they wish to speak to the homes link inspector. The AQAA recorded that three complaints had been received since the last site visit, two of which had been upheld, and all had been responded to within twenty eight days. The four staff, who completed surveys, confirmed they knew what to do if someone has concerns about the home. The home held a copy of the local authority Safeguarding Adults policy and procedure to inform the staff of the referral process should they need to use it and the manager confirmed that the Protection of Vulnerable Adults (POVA) training was included in the induction programme, and that she had attended the local authority train the trainer Care Homes for Older People Page 18 of 30 Evidence: Safeguarding Adults (SA) training, so that she would be able to pass this on to the staff. However, the staff training matrix did not include either the POVA or the SA training to confirm that all the staff had been appropriately updated. All the staff, who completed surveys, confirmed that their employer had carried out checks such as Criminal Record Bureau (CRB) and references before they started work to ensure only those suitable to work with vulnerable adults had been employed. The staff training matrix showed that the majority of the staff team had received training in the Mental Capacity Act, and the manager and deputy manager had attended training in the Deprivation of Liberty Safeguards, to ensure that all the staff would be aware of how to proceed if they were concerned that a resident had ceased to be able to make their own decisions. The AQAA recorded that no safeguarding referrals had been made over the previous twelve months. Care Homes for Older People Page 19 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a homely, comfortable, safe and well-maintained home, which fulfils their needs and is clean, fresh and odour free. Evidence: The home was located on a busy road close to the town centre of Waterlooville and within easy reach of all public amenities and services. There was a large car parking area at the front of the building, which had originally been two adjacent houses, and a new modern extension had also been added. The exterior of the building was well maintained with double glazed windows, to keep the warmth in and to reduce the need for extra heating and the production of green house gasses, and to protect the residents from the noise of the traffic. An area of garden to the front of the property had been planted with colourful flowering plants and there was a welcoming display of brightly coloured potted plants close to the entrance. There was a welcome notice on the door and another notice to visitors to be aware if they had been in contact with the swine flu to protect the residents. There was a warm and welcoming ambiance to the home and the carpeted entrance contained a large comfortable sofa and potted plants, making this a comfortable waiting room. This room was part of the new extension. Communal areas viewed, consisted of a spacious living and dining room, which were open-plan. The living room contained a large number of comfortable chairs for the Care Homes for Older People Page 20 of 30 Evidence: residents and occasional tables to conveniently place their drinks. This room did not have windows in the walls, but skylights in the ceiling, giving light and fresh air as required. The manager wrote in the AQAA that sun-pipes had been installed to provide more sunlight in the sitting room and corridors. There was a plentiful supply of resources for entertainment in this area including an organ, two televisions, a games consul and a variety of WII games, newpapers, books, music, and conventional games. There was a kareoke machine in the dining room, which the manager stated, the residents enjoy very much. Residents were observed engaging in a bingo session with the staff in the afternoon. There were framed pictures on the walls, wall lights, fresh flowers and potted plants, giving the room a homely feel. A wheelchair and other mobility aids parking area, was provided to ensure this useful equipment was not an obstruction to the residents when not in use, and the AQAA recorded that two new adjustable beds, two new hoists and a Stedy had been purchased over the previous twelve months. Equipment provided to support the residents with their mobility needs was provided throughout the home, and included an electric bath, hand rails, assisted toilets, and adjustable beds in all bedrooms. Bedrooms viewed were equipped with televisions, and telephone points to enable residents to have a private telephone line fitted should they wish to do so. Shared bedrooms were provided with a curtain to protect the privacy and dignity of the residents when receiving personal care. The furniture provided was modern, solid and attractive and some residents had brought pieces of their own furniture to make their rooms more familiar and homely. The bedrooms sampled had been personalised with photographs, pictures and other personal items and a lockable space was provided to enable residents to lock away valuable items and medication. The majority of bedrooms were supplied with en-suite facilities for the convenience of the residents. The manager stated that, residents choose the decor, paint colours and soft furnishings for their own bedrooms. In addition to the provision of the new entrance hall, the new large living area and five extra bedrooms with French windows opening onto a courtyard, new storage for the kitchen and the COSHH (Control of Substances Hazardous to Health) materials had been provided. A pleasant garden, planted with colourful plants and provided with seating areas, was accessible to the residents. One resident, who was sitting in the garden, proudly showed us the vegetables they had grown. The home was beautifully clean and fresh smelling on the day of the site visit. Liquid soap, paper towels, anti-bacterial gel, gloves and aprons were available throughout the home to promote effective infection control. The AQAA confirmed that Care Homes for Older People Page 21 of 30 Evidence: all the staff had received training in the prevention and control of infection and that the home had an action plan to deliver best practice in this area. The laundry was suitably equipped with industrial washing machines and dryers for laundering the residents personal clothing. Hand washing facilities were available in this area to ensure good hygiene practices. Care Homes for Older People Page 22 of 30 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. A stable, committed and well-trained staff team, which had been safely recruited to ensure the residents protection, provide their care. Evidence: The AQAA recorded that seventeen care staff were employed at the home, three of which were part time, and that nine other staff were employed, including five housekeepers to keep the home clean, three cooks to provide meals and a gardener to plant up the outside areas with colourful plants, and to carry out routine maintenance duties. Colour photographs of all the staff were displayed on a notice board in the home, to help new residents to recognise them and to learn their names. The four staff, who completed surveys, thought there were always enough staff to meet the individual needs of the residents. A care staff turnover of four staff members over the previous twelve months was recorded in the AQAA, confirming that the residents benefited from the consistency and continuity of a loyal staff team, who know them well and have been able to build relationships with them over time. Two thirds of the care workers were of the same ethnic origin, which does not reflect the ethnic and cultural diversity of the geographical area or of the residents. Although the majority of care workers originated from abroad, all the staff spoken with had an excellent knowledge of the English Care Homes for Older People Page 23 of 30 Evidence: language, promoting good communication with the residents. Comments from residents in the surveys they completed for the home included, the staff are friendly and polite, and lovely staff, your most valuable asset. The AQAA recorded that fourteen of the seventeen care staff had completed a National Vocational Qualification (NVQ) in Care or Health and Social Care at level 2 or above to support them in their role. The AQAA recorded that the level of staff trained to NVQ level 3 had increased and that the intention over the next twelve months was to ensure that all the staff complete this course. New staff had all completed the Skills for Care common induction standards, which provide an introduction to the caring role and promote the residents rights to be treated as an individual with respect to their equality and diversity issues. The induction records of two staff sampled, confirmed this, and the four staff, who completed surveys recorded that their induction covered everything they needed to know to do the job when they started, very well. The personnel files of two recently recruited staff, sampled, confirmed that the recruitment process was carried out safely. Staff had not been confirmed in post until the appropriate checks and references had been received, informing the home that the prospective employees were suitable to work with vulnerable adults. The four staff, who completed surveys, also confirmed that their employer had carried out checks, such as Criminal Record Bureau checks and references, before they started work. The staff training matrix showed that the staff had been updated appropriately with respect to mandatory training, including moving and handling, fire safety, first aid, food hygiene, health and safety, the control of substances hazardous to health (COSHH) and infection control. Most of the staff had also attended training in the care and administration of medicines, the Mental Capacity Act, dementia care, diet and nutrition, and equality and diversity to support them in their role. Other specialist training accessed by the staff to support the specialist needs of the residents included, Aspergers syndrome, diabetes, dealing with aggression, skin and pressure area care, and continence care. All the staff, who completed surveys, confirmed that they were being given training which is relevant to their role, helps them to understand the individual needs of the residents with respect to equality and diversity, and keeps them up-to-date with new ways of working. The manager stated that community nurses could be accessed through the residents General Practitioner, should any nursing input be required, and that the staff receive specialist training in accordance with residents developing needs. Care Homes for Older People Page 24 of 30 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. Residents live in a well managed home, in which their opinions are sought and acted upon for the improvement and development of the service. Effective systems are in place to promote the residents health, safety and welfare creating a safe environment for them to live in. Evidence: The registered manager had been in post for more than five years and was a registered general nurse, who had been working with the elderly for fifteen years and had thirteen years of management experience. She had undertaken the Registered Managers Award (RMA) and completed a National Vocational Qualification (NVQ) at level 4. More recently she had undertaken a course in Leadership and Management and continued to upgrade her knowledge by attending relevant courses, through personal study of professional journals, and seminars to keep her nursing registration active. The manager was supported by a deputy manager, who had completed a NVQ at level 4 and the RMA over the last twelve months. The manager recorded in the AQAA that she, maintains an open-door policy for staff, residents, visitors and family Care Homes for Older People Page 25 of 30 Evidence: for access to management for any enquires. The manager stated that the home was independently audited on an annual basis by an external company, and that accreditation had been achieved for the current year. The home conducted a quality assurance process for the residents on admission by requesting them and their relatives to complete a questionnaire on their experiences. An annual questionnaire was also completed by the residents. This document was provided in large print for those with visual impairment and consisted of sixty questions covering food and drink, the environment, care and staff responses, and communication. The results of the most recent survey had not yet been collated to be included in this report, but the home published comments from previous surveys in the service user guide including, I am very happy here because everyone is so kind, I have been here a long time and this is my home, and I am so pleased my daughter found this home for me. I have been here for two years and I would not like to be anywhere else. Many letters and cards of appreciation had been received from the relatives of the residents and some of the comments included, the care and attention the staff give my mother, and presumably other residents, is excellent. In my mothers own words, its like a five star hotel, nothing is too much trouble for the carers, the food is excellent, and the atmosphere has a family feel to it, my sister and I were impressed recently when we found that our relative could continue to remain in her private room, even though the funding is at a lower level than for the previous four years. It is to their credit that their policy is not to move residents, as it would be too disruptive. We are grateful our relative is cared for so well, and we would like to thank you for all your professional and devoted care to our relative, giving so much attention to them over the past three years. We could not have wished for better care, with all the staff going above and beyond what was expected of them. Youre a team to be proud of and it has been a privilege to know you. The health, safety and welfare of the residents was promoted by staff training in moving and handling, fire safety, first aid, food hygiene, health and safety, the control of substances hazardous to health (COSHH) and infection control. The staff training matrix showed that the staff had been updated appropriately to ensure they were conversant with current practise. The Annual Quality Assurance Assessment, completed by the manager, confirmed that policies and procedures with respect to health and safety were in place to keep the staff informed, and that the essential maintenance of equipment had been carried out according to manufacturers recommendations to ensure it was safe to use. A sample of certificates, seen on the day of the site visit, confirmed that maintenance checks had been carried out in a Care Homes for Older People Page 26 of 30 Evidence: timely fashion. The manager also recorded in the AQAA that improvements over the previous twelve months included the extension of the fire detection system and that the fire doors and closers had been upgraded to protect the residents. Care Homes for Older People Page 27 of 30 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 28 of 30 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 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!