Care Home: Overton House

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What the care home does well People have their individual and diverse care needs well assessed using specific tools and systems and they are told in writing that their needs can or cannot be met. People are well cared for and supported in line with their care and support plans, they are well protected by the home`s policies and procedures for handling medication, they are treated with respect and their right to privacy is satisfactorily upheld. People have good opportunities for social contact in the home, but could do more in the community. They are able to make choices wherever possible and enjoy good, nutritional, appetising food. People have their complaints listened to, taken seriously and acted upon effectively. People are well protected from abuse with the policies, procedures and practices in place to deal with safeguarding issues. People live in and enjoy a safe, well maintained environment that is clean, comfortable and hygienic. People are well cared for by a skills mix of staff in sufficient numbers, with the recommended qualifications and the right training to meet their needs. Staff are well recruited according to company policy and procedure, and Commission regulations and schedules. People live in a well run home managed by a qualified, experienced manager. There are good, efficient quality assurance and self-monitoring systems in place showing the home is run in the best interest of people living there. People have their financial interests well protected and they and staff have their health, safety and welfare well protected and promoted. What has improved since the last inspection? It is understood that everyone in the home now has a contract of residence, that where carpets were old or soiled they have been replaced, and that there is a new manager in post that is already suitably qualified. What the care home could do better: There are no identified requirements or recommendations made at this key inspection. As an example where things could improve in order to perhaps improve the quality rating of the home, people could be provided with better opportunities to engage in activities in the community, all staff could have their understanding and practice in dealing with safeguarding issues competence checked each year, and the home could make sure environmental improvements are completed on time. Also other areas of the service have to show consistent evidence of exceeding the standards. Key inspection report Care homes for older people Name: Address: Overton House The Garth Cottingham Hull East Yorkshire HU16 5BP     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Janet Lamb     Date: 2 0 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Overton House The Garth Cottingham Hull East Yorkshire HU16 5BP 01482847328 01482840972 manager.overtonhouse@hica-uk.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Humberside Independent Care Association Limited Name of registered manager (if applicable) Mrs Kerry Ann Shepherd Type of registration: Number of places registered: care home 40 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: Admit one service user under pensionable age, on an emergency basis. Date of last inspection Brief description of the care home Overton House provides personal care and accommodation for up to 39 older people some of whom may have dementia. The home may also offer a place to one younger person with a physical disability. Overton House is owned by Humberside Independent Care Association Ltd which is a not for profit organisation. The home is situated in the village of Cottingham, near to the City of Hull. The village has a variety of shops and pubs and there is access to local transport facilities. Overton House is a Care Homes for Older People Page 4 of 29 39 0 1 Over 65 0 39 0 Brief description of the care home single storey purpose built home with a choice of communal areas for people to use. There is a pleasant well-maintained garden and patio area. The home is currently undergoing a three phase refurbishment programme, in which rooms are being converted to modern en-suites. Eventually all rooms will become singles (with an option to have one as a companion room) with en-suite toilet and wash basin. Phase three is about to begin. The standard fees charged by the home are between £410.20 and £490.00 per person per week, with additional charges made for hairdressing, chiropody, toiletries etc. Information about Overton House can be obtained from the home by requesting a copy of the statement of purpose and the service user guide. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The Key Inspection of Overton House has taken place over a period of time and involved sending a request to complete an annual quality assurance assessment (AQAA) in October 2009, asking for information about people who use the service and staff and details of the homes policies, procedures and practices. Unfortunately the Commission did not request the AQAA in advance of the site visit and it has not yet been returned to us. The AQAA must still be completed and returned by the specified date please, as it is a legal requirement to complete and return it annually. Survey questionnaires were still sent out to 12 people living in the home, to 6 health care professionals and to 6 staff working there. Of these surveys none were returned from the people in the home, 1 from staff and 1 from a health care professional. Information received in the returned surveys, in notifications from the home, in safeguarding referrals, in the last random inspection and from contact with the home since the last key inspection was used to suggest what it must be like living in the Care Homes for Older People Page 6 of 29 home. Then on 20 October 2009 Janet Lamb made a site visit to the home to test these suggestions and to interview people, staff, visitors and the home manager. Some documents were viewed with permission from those people they concerned where possible and some records were also looked at. The communal areas of the home were viewed along with several bedrooms. None of the people in the home were fully able to discuss living there, but the manager and three staff were interviewed, and several people were observed interacting and receiving support from the staff. Information obtained on the day of the site visit and gathered from observations and viewing documents was checked against what we though it might be like living there. Judgements were made using the information and some of the evidence recorded at the last inspection to say what it is now like living in the home. This report shows those findings and judgements. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated it is likely that enforcement action will be taken. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. Care Homes for Older People Page 8 of 29 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their individual and diverse care needs well assessed using specific tools and systems and they are told in writing that their needs can or cannot be met. Evidence: Discussion with and observation of people in the home and discussion with the manager and staff, and viewing of files, records and documents with permission where possible, shows there are still good systems in use for determining peoples needs and wishes. All prospective people to the home are given a pre-admission assessment carried out by the manager, where they are visited at home and asked about their needs, where their relatives are also spoken with regarding preferences and information and where they are given some idea of what it would be like living at Overton House. There are then three ways of assessing peoples needs once they have moved to Overton House and all three are used in combination to obtain information in order to be able to Care Homes for Older People Page 11 of 29 Evidence: compile a care and support plan. There is an assessment of strengths and needs carried out, which includes details on such as personal care, dressing, night time care, mobility, leisure, emotions, communication, health, safety, eating and drinking, pressure care, continence and medical issues. There is also information held on a getting to know you form and on a social care assessment form, the latter showing information on the persons senses and the pastimes they have and would like to continue with. The home also obtains and keeps copies of the placing local authority community care assessment document for each person. Assessments on peoples capacity may also be completed under the Mental Capacity Act 2005 if there is a need to establish and determine best interest decisions, though these are only completed as necessary. Overall people have their individual and diverse needs very well assessed. People spoken with are unable to remember the processes of admission and assessment though and are not able to confirm what happens. Staff express the view that people are well assessed as they have good information in care plans to be able to deliver a service of care. The home does not provide intermediate care so the standard on it was not assessed. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are well cared for and supported in line with their care and support plans, they are well protected by the homes policies and procedures for handling medication, they are treated with respect and their right to privacy is satisfactorily upheld. Evidence: Discussion with the manager and staff, observation of interactions between people and staff, and viewing of some documents with permission where possible shows people receive a good service of care and their health and medication needs are met. Care and support plans are complied for everyone in the home based on their assessed needs and any risk assessments carried out. There is a care programme where areas of need that may apply to people are listed as a guide to staff using the care plans, there is a care programme agreement to complete at reviews of care and there is a support plan for each of the assessed areas that are applicable to the person. Support plan areas match those areas listed in a persons assessment. Risk assessments include those on skin care, eating and drinking, nutrition, night care and safety, use of bed rails, mobility, medication, environment, pressure care, moving and Care Homes for Older People Page 13 of 29 Evidence: handling, falls and fall prevention. There is also individual information on whether or not people can handle their medication, finances and room key. To evidence how care and support plans are used there are accompanying records on bathing, weight, night monitoring, fluid and food intake and daily diary notes. There are also separate health monitoring forms that record all details about a persons health care needs and assistance provided to maintain good health, separate night monitoring forms and separate care programme monthly evaluation sheets, that show all areas of the care and support plans being reviewed monthly. One social and health care professional survey returned says the home usually manages to care well for a client group that is difficult to work with, but it could do better with being specifically asked to record things, such as food and fluid intake and incidents of behaviour. There is a company policy, procedure and guidelines on safe handling of medication. Staff have access to these in the policy manuals and staff handbook. Staff receive trainng on safe handling of medicines through the company training department and their need to update or refresh it is highlighted each year for action. Staff say they are due to update medication administering training shortly. Evidence of training is available in staff training files and the monthly training matrix always flags up what courses are due, so there are good systems in place to ensure staff are properly skilled and trained. The home uses a monitored dosage system that is kept locked in a medicine trolley locked in a medication room. There is a designated fridge for anti-biotics and those items requiring cold store. Temperature readings are taken and recorded twice a day. Any returns are kept in a locked cupboard and are collected by the chemist in the correct return system pouches. Medication administration record sheets are used and signed properly and observation of a senior staff handing out medicines shows practice is good and that a robust audit trail is followed. The controlled drugs that come into the home are well recorded, stored and accounted for. There are policies and procedures on providing personal care, on entering rooms, addressing people, confidentiality and generally on maintaining privacy and dignity for people. Staff are aware of these and people are observed to be well treated and with respect. People spoken with are unable to discuss care plans or risk assessments and medication handling, but observation of people receiving assistance with mobility and medication shows there are good practices and safe systems in operation and that staff follow them. People do express their satisfaction with smiles, a thank you and Care Homes for Older People Page 14 of 29 Evidence: with their cooperation most of the time. Staff in interview confirm they have good care plans and risk assessments to follow, that peoples health care needs are well met, that medication is handled safely and that privacy and dignity are always upheld. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have good opportunities for social contact in the home, but could do more in the community. They are able to make choices wherever possible and enjoy good, nutritional, appetising food. Evidence: Discussion with the manager and staff, observation of interaction between people and between people and staff, and viewing of some documents and records shows there are good opportunities to enjoy social activities and pastimes, to make choices and to eat well, but communal activities could be improved. Routines tend to be set around getting up for the day, bathing, taking meals etc., but people are encouraged to rise late if they wish to, take breakfast late and at a leisurely pace and to choose their own occupation from what may be on offer. People spend one to one time with key workers, this is recorded in files and shows us that people spend time chatting, opening letters or parcels, doing a few exercises, potting up some plants and completing surveys as an example. People also have their hair or nails done, watch old films, reminisce, have a sing-a-long etc. There is an activity coordinator employed to work in the afternoons Monday to Friday. She either spends one to one time with those people who stay in bed or in their rooms, or spends time Care Homes for Older People Page 16 of 29 Evidence: with groups of people in the lounges. There is a new activity programme in place which will involve reminiscing about Hull Fair, doing some gardening and cooking. People tend to stay in the home mainly, and staff confirm they would like to have more one to one time to be able to take people out sometimes. Relatives are made very welcome and there are sometimes visiting entertainers. Staff try to offer occupation in the form of floor games and there is always music being played throughout the home. Information seen in the homes quality assurance and compliance folder reveals relatives would also like to see more opportunities for outings, musical entertainments light therapy and maybe a newsletter. There is evidence that meetings are held for people in the home and for relatives, so they can make suggestions about things and pastimes. It is very difficult to enable people with memory impairment to make their own choices and decisions about daily life and fulfilment, but observations of staff supporting people show choices are offered on whatever scale is appropriate to the person concerned. People were observed being asked what they would like for breakfast and lunch, what drink they would like, whether or not they wished to go to one of the lounges, did they want to listen to music or watch the television, and whether or not they wished to rest in their room and so on. Choices on offer may be mundane but people are free to do as they wish at other times. There are plans underway to fully refurbish the home and this includes the introduction of improved activity facilities. The homes lounges are to become open plan, there is to be a mini cinema, a potting shed, a new hairdressing salon, a reminiscence room and a working kitchen. More toilets and extra bedrooms are to be established from some of the existing building and there may be a new extension. There is very little opportunity for people to handle their own finances because of peoples level of understanding and responsibility. The home uses the company computer system for handling accommodations, finances and personal allowances. People receive a monthly printout of their individual finances and can draw money out whenever they wish to. Records of all transactions are held on computer and are accompanied by receipts where possible. Two peoples finance records were viewed but we were unable to check individual balances. The system works well and is well maintained. There are weekly menus compiled on a rotating basis, all food is freshly prepared and Care Homes for Older People Page 17 of 29 Evidence: cooked and people are provided with a choice of two meals at lunch time and several options at tea time. The day of the site visit saw home made steak and kidney pie with broccoli, swede and mashed potatoes on offer, with omelette or any other egg preparation as the alternative. People sit together in the main dining room, which is pleasant and homely. A full time cook is employed but is soon to retire and is therefore being covered by a company employed bank chef at the present. The kitchen is well equipped and the chef says there are plenty of stores and provisions. Food is well presented, offers good variety and is nutritious. Care Homes for Older People Page 18 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their complaints listened to, taken seriously and acted upon effectively. People are well protected from abuse with the policies, procedures and practices in place to deal with safeguarding issues. Evidence: Discussion with the manager and staff and viewing of some of the documents in the home shows the systems for handling complaints and abuse referrals are understood and used well by staff. There is a company policy and procedure in place for dealing with both complaints and with safeguarding adults issues. There are also company records maintained of any complaint made or suspected abuse referred. Staff have good understanding of how to handle complaints and where to direct them and of making referrals to the safeguarding adults teams in local authorities. Complaints received since the last inspection number two while there has been eleven referrals to safeguarding since October 2008. These have mainly been arguments and scuffles between people, with one person pushing another from a wheelchair and two incidents involving someone external to the home. All have been resolved. Staff complete company safeguarding training as part of their induction and further training is done which involves the local authority safeguarding team coming in to do a Care Homes for Older People Page 19 of 29 Evidence: session. Staff receive refresher courses as necessary and the date of training seen for two people is September 2009, so training in safeguarding adults is well monitored and updated. Survey information shows people know how to make a formal complaint, that staff are willing to give of their time, staff know people very well and treat them as individuals, with respect and care, and finally that people are well protected. Care Homes for Older People Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in and enjoy a safe, well maintained environment that is clean, comfortable and hygienic. Evidence: Discussion with the manager and staff, observation of the premises and viewing of some documents and records shows the environment continues to be suitable for its stated purpose, well maintained, clean and hygienic. Overton House is situated in a residential area of the village of Cottingham very near to a primary school and in walking distance of the main shopping area. Local busses are available to and from Hull and Beverley. The building is a purpose built residential home that is now approximately 40 years old. There are a number of lounges, one large dining room and several bedrooms, which have been altered over the years into all single accommodation, some with en-suite toilet. There is a designated hairdressing salon, medical room, laundry and kitchen and staff room. The home is soon to undergo a full refurbishment of the internal rooms and facilities to include open plan lounges, all bedrooms with en-suite, a new medical room, a mini cinema, a reminiscence lounge, a potting shed, a working kitchen and a new hairdressing salon. The home is possibly to increase the number of places. Care Homes for Older People Page 21 of 29 Evidence: At the moment there are parts of the home that are very pleasant, being redecorated and refurbished, but there are also some areas still to be modernised. Work on these areas and on improving the facilities is imminent and should be completed by May 2010. Generally the home is clean, comfortable and homely. Carpets identified and recommended for replacement at the last inspection have been replaced where appropriate but not where major work is due. The laundry is suitable for its intended purpose and meets the Water Supply (Water Fittings) Regulations 1999. Surfaces are easily cleaned and there is suitable equipment to deal with the volume and type of laundry that comes through. Staff complete infection control training, which is evidenced in training files and on the staff training matrix. Care Homes for Older People Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are well cared for by a skills mix of staff in sufficient numbers, with the recommended qualifications and the right training to meet their needs. Staff are well recruited according to company policy, procedure, regulations and schedule 2. Evidence: Discussion with the manager and staff and viewing of files, documents and records on staffing shows the home continues to operate robust recruitment and training practices. According to the rosters seen and information from the manager about changes in staffing numbers and about the make up of care and cleaning staff, there appears to be enough staff on documentation and in reality to do the job, when each day there is one shift leader, two or three care staff and the manager available. Ancillary staff include a handyman, a chef, a kitchen assistant, one or two cleaners and an administrator and a receptionist. There is currently one care staff vacancy, which has been externally advertised and should soon be filled. No one makes any adverse comments about staffing shortages, but staff do comment in interview that there has been some unpopular changes made to contracted and working hours that has resulted in some staff taking a cut in hours. These issues have now settled and generally staff feel the team is working well. Care Homes for Older People Page 23 of 29 Evidence: The number of care staff totals 28 and all but four of them now have the recommended qualifications at NVQ level 2, giving 86 with the award. Two senior staff already have and three are soon to start doing the NVQ level 3 award. Qualification achievement is very good. The home uses and follows the company policies and procedures on recruitment and selection of staff, so two files seen show there are application forms, references, security clearances and inductions. There are also forms for changes made to employment such as contract changes, pay increases, change of address etc., and there are copies of terms and conditions of contract, annual leave and sickness records. Staff confirm in interview the circumstances of their recruitment and selection. Staff are expected to complete company mandatory training courses that include moving and handling, medication administration, fire safety, first aid and safeguarding adults. They also complete courses such as bucal midazolam administration, use of the hoists, back care, health and safety, continence, bild physical intervention, dementia care, Parkinsons disease and care of the dying. The home maintains a training matrix and the company flag up any shortfalls where staff need to refresh a course. Certificates of attendance and confirmation in staff interviews are evidence of the courses and training completed. Care Homes for Older People Page 24 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well run home managed by a qualified, experienced manager. There are good, efficient quality assurance and self-monitoring systems in place showing the home is run in the best interest of people living there. People have their financial interests well protected and they and staff have their health, safety and welfare well protected and promoted. Evidence: Discussion with the manager and staff and viewing of some of the homes documents, certificates and maintenance records show there is good protection and promotion of people and staff health, safety and welfare. There is a newly appointed manager since April 2009. She has NVQ level 4 in Care and NVQ level 4 Registered Managers Award. She has experience of managing care services for older people and is enthusiastic. She has already made an application to the Commission to become the registered manager of the service and has a date for her interview. Care Homes for Older People Page 25 of 29 Evidence: Quality assurance systems, that are organised and implemented by the company and have not changed in their content since the last inspection, are in place to ensure that people living in the home may be involved in decisions about their lives. The quality assurance system includes surveying people in the home and relatives, reviewing areas of the service such as training in safeguarding adults, complaints and compliments, admissions, care programmes etc., holding meetings for people in the home, for relatives and for staff, and completing quartely health and safety audits. Finally there is an annual service review which is published and distributed. There is very little opportunity for people to handle their own finances because of peoples level of understanding and responsibility. The home uses the company computer system for handling accommodations, finances and personal allowances. People receive a monthly printout of their individual finances and can draw money out whenever they wish to. Records of all transactions are held on computer and are accompanied by receipts where possible. Two peoples finance records were viewed but we were unable to check individual balances. The system works well and is well maintained. Records in the home are being regularly updated and inspection of the homes maintenance documents confirmed that appropriate safety checks are being carried out to ensure the health, safety and welfare of staff and people living in the home. Some areas sample checked include fire safety, electrical and gas services, water temperature controls and legionella testing and hoisting and lifting equipment. There are weekly fire safety equipment checks and monthly fire safety drills, three are held each month to ensure all staff are included, and all of these are recorded. Annual maintenance checks on the fire system and equipment are carried out under contracts and staff are appropriately trained in fire evacuation and safety procedures. They view a DVD and complete a booklet and also complete fire safety instruction with the company. There are currently four official fire safety wardens amongst the staff and others are booked to do the training. There is a fire risk assessment document in place and individual ones for each area of the home, which were all updated 28/07/09. Electrical and gas safety certificates are up to date, water temperature control valves are in use and tests on water outlets are carried out and recorded by the company that services the gas central heating and there is a current legionella certificate dated 27/03/08. All lifting and hoisting equipment is serviced regularly and certificates maintained. Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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