Care Home: Park House Care Home

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What the care home does well There is a warm and welcoming atmosphere on arrival and we can see that staff and people using the service maintain good relationships. Staff spoken with are dedicated to their job roles and are able to discuss the needs of people using the service and how they support them. People using the service speak highly of staff and the care that they receive; saying that they are happy living at the care home. People are assured that their needs will be assessed and that staff can meet these before they make a decision to move into the care home; they can also spend time there and get to know people before they move in. People are supported to access specialist services to ensure that their health and welfare is maintained. Staff support people to maintain contacts with people that are important to them and visitors are made welcome when they come to see their friends and relatives. A wholesome and appealing menu is on offer to people and specialist diets are catered for. People are assured that any concerns or complaints that they may have are listened to and dealt with as soon as possible. Staff training remains at a good standard and staff are able to demonstrate knowledge and understanding in regard to the people that they support. The manager has worked at the care home for many years and is supported by a well developed management and staff team to ensure that the service is run in the best interests of people living there. What has improved since the last inspection? Building works and refurbishment has been undertaken within one wing of the care home since the last inspection, providing a more spacious and well maintained environment. Staff continue to undertake compulsory and additional training to make sure that they are up to date in their knowledge and skills. What the care home could do better: Work on plans of care and risk assessments is needed to make sure that these are in place for people`s highlighted needs so that these are met and people are protected. Slight improvement is also needed in regard to the medication practices to make sure that people using the service receive their medication as prescribed and they areprotected. People using the service need to have more activity and stimulation and work in respect of this needs to take place so they they can offer their own ideas and enjoy a stimulating lifestyle that meets their expectations. The provider must liaise with the local Fire Authority in regard to some practices that take place in the care home so that they can get advice and implement good practice recommendations so that people using the service remain protected. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Park House Care Home Cinderhill Road Bulwell Nottingham NG6 8SB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Karmon Hawley     Date: 3 0 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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 32 Information about the care home Name of care home: Address: Park House Care Home Cinderhill Road Bulwell Nottingham NG6 8SB 01159771363 01159771460 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Eastgate Limited care home 56 Number of places (if applicable): Under 65 Over 65 56 old age, not falling within any other category Additional conditions: 0 The maximum number of service users who can be accommodated is 56. The registered provider may provide the following category/ies of service only: Care home with Nursing - Code N, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following category/ies: Old age, not falling within any other category - Code OP (Maximum number of places 56). Date of last inspection Brief description of the care home Park House is a purpose built care home with 47 places, offering residential and nursing care, which includes specialist provision of palliative care. Situated in the Bulwell area, there is access to bus and tram routes into the City and to various local community facilities. The building is on two floors with lift access to the first floor. All areas are wheelchair accessible. The garden has several seating areas, with french doors leading onto the garden. Care Homes for Older People Page 4 of 32 Brief description of the care home There is ample parking in the large car park with a well maintained, front garden. The weekly fees range from £336.43 to £404. There is a £20 extra charge for en-suite bedrooms. The certificate of registration is displayed in the foyer of the home and copies of the service user handbook and previous reports are made available to anyone who wishes to see them. Care Homes for Older People Page 5 of 32 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 focus of inspections undertaken by the Care Quality Commission (CQC) is upon outcomes for people living at the home and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service delivery that needs further development. A review of all the information we have received about the home was considered in planning this visit and this helped decide what areas were looked at. One regulatory inspector conducted the unannounced visit over 1 day, including the lunchtime period. Care Homes for Older People Page 6 of 32 The main method of inspection we use is called case tracking which involves selecting the care plans of four people and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. The deputy manager, training manager and two members of staff were spoken with during the visit. People using the service and one relative were also spoken with during the visit to gain their views and opinions of the service. We also undertook a full tour of the care home, which included looking at the bedrooms of those people who we case tracked and communal areas of the home. The service has recently undergone changes in regard to the environment so that they may cater for people who are under the fast track scheme (a scheme that caters for people who are terminally ill). We looked at policies and procedures and general documentation in order to determine the quality of care provided. What the care home does well: What has improved since the last inspection? What they could do better: Work on plans of care and risk assessments is needed to make sure that these are in place for peoples highlighted needs so that these are met and people are protected. Slight improvement is also needed in regard to the medication practices to make sure that people using the service receive their medication as prescribed and they are Care Homes for Older People Page 8 of 32 protected. People using the service need to have more activity and stimulation and work in respect of this needs to take place so they they can offer their own ideas and enjoy a stimulating lifestyle that meets their expectations. The provider must liaise with the local Fire Authority in regard to some practices that take place in the care home so that they can get advice and implement good practice recommendations so that people using the service remain protected. 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 set out 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 32 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 32 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 are assured that their needs will be assessed and that staff can meet these before they make a decision to move in to the care home. The service does not offer intermediate care. Evidence: The manager or area manager visits people within the community prior to admission to carry out an assessment to make sure that staff are able to meet their needs before they make a decision to move in to the care home. People may also visit the care home and spend time there to get a feel for what it would be like to live at the care home before they make a decision to move in. Although no one we spoke with had the opportunity to come and visit the home before they moved in due to personal circumstances, they say that they feel very settled and Care Homes for Older People Page 11 of 32 Evidence: the transition has been very smooth; I have been here for 5 weeks, I did not look around as I came straight from the hospital, but I am settled and very happy here, I intend to stay, and I have been here for 5 weeks I am happy and settled and enjoying it, I am still building up relationships and getting to know staff . Staff spoken with say that they receive enough information about people before they move in so that they can support them as needed. The service does not offer intermediate care services. Care Homes for Older People Page 12 of 32 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. Although some improvement in regard to care planning, risk assessments and medication is needed we are confident that these will be addressed to ensure that peoples needs are met and they remain protected. Evidence: On examining plans of care we can see that people undergo various assessments in regard to highlighting their needs, so that plans of care can be negotiated. Plans of care in place are mainly task focussed and do not reflect peoples personal preferences in all cases to ensure that people receive care in their preferred way. Some plans of care are also brief and do not contain sufficient information; however staff spoken with are able to discuss peoples needs and the support that they require and they say that they receive enough information to know what people need. Within one case file there was no specific plan of care in place for diabetes mellitus, and on speaking with staff they did not know all the signs and symptoms that would Care Homes for Older People Page 13 of 32 Evidence: indicate that a person may be unwell, however they did say they would call registered nurses as soon as there was a problem to make sure that the person receives care and attention as required to maintain their health and wellbeing. Within another plan of care there was no plan of care in place for end of life to show how people are to be supported both psychologically and physically despite the service offering terminal care. However most staff have now attended a course on terminal care and on speaking with them they are able to discuss the care and support that people using the service require. Although risk assessments are in place for a number of highlighted risks for things such as the risk of entrapment when using bedrails we found that some of these did not contain all the necessary information to reduce and manage the risk. Also we found that risk assessments are not in place for all highlighted needs such as diabetes mellitus and the risks associated with wearing a lap belt. One member of staff spoken with was not aware of the risk that may occur when a person uses a lap belt to ensure they remain safe. This was discussed with the deputy manager at the time of the inspection who stated they would deal with this. We can see that evaluations and reviews are taking place, however these are again task focused and do not fully reflect the care and support that people have received. The provider is aware of these issues and in order to address them further training in person centred care planning has been arranged and the responsibility of completing plans of care has been reorganised to ensure that all of the above is addressed as soon as possible. People using the service offer the following comments in regard to the care and support they are receiving; the staff are a good help, if there are any problems they deal with it, I am comfortable, I have seen the chiropodist. The staff are very nice and helpful if I ring the buzzer they come, staff help to clean and change me and do things I cant do for my self, however I am fairly independent and have a shower every day. The night staff are wonderful and look after me well at night, and the staff are very good and help me to have a shower. If I need anything I ring the buzzer and they come in a few minutes. Staff who administer medication have been trained to do so, however we did see that one registered nurse left the medication trolley unattended during the lunch time medication round and some medication that had been administered the night before and the morning of the inspection had not been signed for but had been administered. This was discussed with the deputy manager and the provider who have discussed this with the registered nurses involved to make sure this does not happen again. Care Homes for Older People Page 14 of 32 Evidence: We can see that all other records such as controlled medicines and drug returns are kept as required. We saw a member of staff help someone taking their medication and due to them experiencing difficulties they passed this information to the registered nurse on duty. One person using the service tells us that they have painkillers on a regular basis and the registered nurses give them these. We can see that people using the service are supported and enabled to access specialist services such as the doctor, district nurse and optician as needed to ensure that their health and wellbeing is maintained. During the tour of the care home we can see that specialist equipment such as hoists, mattresses and cushions are available for those people who need them. People using the service say that they can access specialist services as needed, I have seen the doctor and I am waiting for my new glasses, and I go to the hospital to see my consultant. Staff spoken with feel that people using the service are treated with respect and that their privacy and dignity is maintained; we make sure we keep doors shut and ask people what they want, not assume, and we make sure that we cover people over when offering personal care and knock on doors before entering to make sure it is ok for us to go in, maintaining peoples dignity is common sense With the exception of a person that was not assisted to wash their hands and face after their lunch we saw staff treat people with respect and maintain their privacy and dignity throughout the inspection. People using the service express no concerns in regard to their privacy and dignity and say that staff are kind, helpful and caring. Care Homes for Older People Page 15 of 32 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service feel that more activities would provide them with welcomed stimulation to ensure that they experience a lifestyle that matches their expectations and satisfies their needs. Evidence: As the activities coordinators position is vacant at the moment, staff offer and support people to do activities such as dominoes, board games and reminiscence when they have time to do so. There is also a weekly church service where hymns are sung and prayers are said, one member of staff spoken with tells us that this is popular. During the time we spent in the communal areas, most people were either watching the television or were asleep; the main lounge area was quite dull which offered a subdued atmosphere. Staff spoken with feel that there is not enough time for them to dedicate to activities that are meaningful and individualised so that people get benefit from these. Care Homes for Older People Page 16 of 32 Evidence: People using the service offer the following comments; I generally stay in my room and watch TV I do not want to go to the lounge, there are no activities, that is the only problem, all I have got to do all day is watch the television, I am suffering from boredom, and there is a lack of activities, we used to have a singsong but we dont really have them now. So that people can maintain contact with people that are important to them there are no restrictions on visiting and visitors may be received in private. People using the service confirm this and tell us that their family can visit when they want and they can also take them out. One relative says that they are made welcome when they come to the care home and that they are offered a drink. The questionnaires returned to the service tell us that people feel welcomed when they visit the care home, however it would be nice to be offered a drink on a more regular basis. Staff say that visitors are made welcome as it is peoples home so they can come whenever, the door is always open. Staff spoken with feel that the routine of the care home is flexible and people can spend their time as they wish, they also talk of ensuring that people are offered choices and time to make their own decisions, I treat people as individuals, for example if they like to wear makeup, I am getting to know their likes and dislikes. People can make their own choices; they can get up and go to bed when they want. I like to sit and talk with the residents, reminiscing and building up relationships with them, and I feel that people are able to make their own choices and decisions, people go out into the community and to the shops, they can get up and go to bed when they want to. A varied menu is on offer to people using the service, which offers traditional style food and snacks throughout the day. Although there is no specific choice offered at the main meal of the day, should a person not like what is on the menu, alternatives will be offered and accommodated. Special diets are catered for such as diabetic and liquidised diets to ensure that peoples needs are met. Care Homes for Older People Page 17 of 32 Evidence: We did see after lunch one person who had been moved to sit in the lounge had been left with food down their chin and dirty sticky hands. On speaking with staff they state that this is not normal practice and people are usually helped to wash their hands and face after lunch. This person was eventually helped to get clean and comfortable only after they had spilled a drink down themselves and we sought assistance. People using the service offer the following comments about the food on offer; the food is very good, if we dont like it we can have something else, the food is better than hospital food, the food is good; I have a beer everyday when I sit outside in the garden, and the food is very good and there is plenty to eat. Care Homes for Older People Page 18 of 32 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 using the service are assured that their complaints will be listened to and acted upon and that they are protected from abuse. Evidence: So that people know how to make a complaint should they feel the need to the complaints procedure is on display and also set out in the service user guide. The complaints record shows us that the necessary policies and procedures are in place should a complaint be received, however the service has not received any complaints since the previous inspection. People using the service say that they feel comfortable to make their concerns known if they feel the need; however they do not have any problems at the moment; if I was unhappy I would speak out but I have no problems, and the staff are very good, I could say if I was unhappy. One relative spoken with also feels that they can speak with staff if they have any concerns, however they have felt in the past that it can be sometimes difficult to find someone that knows what is going on when there are issues that need sorting out. The questionnaires returned to the service tell us that most people know how to make Care Homes for Older People Page 19 of 32 Evidence: a complaint and who to talk to when they need to do this. Staff spoken with are able to discuss how they would deal with a complaint to make sure that this was resolved to the persons satisfaction. The majority of staff have undertaken training in safeguarding adults and those spoken with are aware of their roles and responsibilities in keeping people safe. All members of staff have a Criminal Record Bureau check (a police check to see if a person has a police caution or criminal record) in place to make sure that people using the service are protected from unsuitable people being employed. Care Homes for Older People Page 20 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a safe, clean and pleasant environment, generally well-maintained with private rooms which are personalised and suit the needs of the people using the service. Evidence: Records show us that the maintenance of the home is dealt with promptly to ensure a well maintained and safe environment. There have been some major changes to the environment by way of restructuring and building work to provide additional spacious rooms which are all ensuite. This part of the care home has been completed renovated and new carpets have been laid. The provider is intending to renovate the remainder of peoples rooms later on this year and change the carpets in the corridors which are stained in some places. Specialist equipment and adaptations, such as assisted baths, grab rails and hoists are available throughout the care home for those people who require the use of these. All areas of the care home are clean and tidy and present a homely environment. There are various seating areas which people using the service may access and the enclosed garden is also accessible via French doors from both lounges. Care Homes for Older People Page 21 of 32 Evidence: Peoples own rooms are individualised and there is evidence of their personal possessions being on display. We did see that the kitchen door had been wedged open throughout the day, during this time we also saw a staff member pass the kitchen with several clinical waste bags on a wheelchair, which could be deemed as unsafe practice in regard to infection control. This staff member then returned the wheelchair to a storage area and did not clean this to make sure that it was free of contaminants, when approached they said that they was intending to do this later, however we did not see them do this. People using the service tell us that they are pleased with their rooms and that these are very nice and staff clean them everyday. Care Homes for Older People Page 22 of 32 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 using the service are supported by well trained staff who are competent in their job roles. Evidence: People using the service tell us that there are enough staff available to support them when needed and that staff come quickly to help them when they ring their buzzers. Staff also feel that there are sufficient staff available to support people using the service and they offer the following comments, there are enough staff and we work well together, and there are enough staff unless someone is off sick, the team works well together and the nurses help us on the floor. We can see that staff are available throughout the day and that people using the service are assisted as needed. The results of the questionnaires sent to the service tells us that some people feel that their calls for help are answered quickly whilst others do not; the provider is in the process of addressing these issues. So that new staff are aware of their roles and responsibilities when they first start Care Homes for Older People Page 23 of 32 Evidence: employment they undertake an induction. There is evidence of staff undertaking these within staff files examined. The induction is at a recognised standard and covers all the required compulsory training that staff need to support people using the service. Both staff members spoken with confirm that they have undertaken an induction when they first started working at the care home; I have been here 6 months, I love it I was made welcome and had an induction, which covered health and safety and orientation, its at the induction standards leading up to the NVQ, and I had an induction when I first starting working here. 12 members of staff have undertaken the National Vocational Qualification (a nationally recognised work and theory based qualification designed to enhance peoples knowledge and skills in caring for people) level 2 and 6 are working towards level 3. One member of staff spoken with said that they have completed the National Vocational Qualification level 2 and have nearly finished level 3, which has helped them in supporting people using the service. Domestic and catering staff also doing the National Vocational Qualification in their relevant areas. Staff files examined show us that all the necessary documentation required by law, such as references and proof of identity are in place to make sure that people using the service are protected from unsuitable people being employed. One member of staff spoken with confirmed that they had a Criminal Record Check before they commenced employment. A staff training matrix shows us that staff continue to undertake compulsory training such as fire safety, manual handling and safeguarding adults, to make sure that they have the necessary knowledge and skills to meet peoples needs. Records indicate that staff up to date in all areas except first aid where there are deficits. The manager makes sure that there is a first aider on each shift; however we could not see who this is on the duty rota as it is not highlighted. The training coordinator is currently sourcing further training in first aid to remedy these deficits. The training coordinator has implemented a new training an development strategy which follows current legislation and demonstrates what staff have gained from their training. Further training course have also been booked in areas such as medication, person centred care planning, the deprivation of liberty and challenging behaviour to continue to develop staffs knowledge and skills. Staff spoken with tell us that they feel supported in their training and development; I feel supported in my training and if I need help I can ask, and I have done quite a bit Care Homes for Older People Page 24 of 32 Evidence: of training, I feel that I done enough to do my job, I have done palliative care, 1st aid and dementia. The dementia course helped me to learn that each person is an individual and a person in their own right. The questionnaires returned to the service tell us that people feel that staff are well trained, helpful and polite. Care Homes for Older People Page 25 of 32 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 care home that is well managed with an approachable and open management style, where they are enabled to express their views and opinions about the support they receive and the service on offer. Evidence: The manager has been in post for a number of years and she has well developed knowledge and skills in caring for and supporting people who use the service. Staff spoken with feel that the care home is well run and they offer the following comments in regard to the manager; the manager is fine, she is approachable, sociable and friendly and you can talk to her, and the manager is very approachable. People using the service also feel that the care home is well run and managed. Care Homes for Older People Page 26 of 32 Evidence: People using the service can have their say about how the care home is managed by way of questionnaires. We saw the findings of the most recent questionnaires that have been completed. These offer mainly positive comment, nevertheless and action plan has been devised to address the areas that could be improved upon. Resident and relative meetings are currently not held, as these have not been popular in the past, however the manager is looking into restarting these in the near future. The training manager carries out monthly audits in areas such as falls and falls prevention to ensure that any areas of concern are highlighted and dealt with quickly to ensure peoples health and wellbeing is maintained. To ensure that peoples personal finances are protected, no one at the service is responsible for these, if a cost is incurred for example the hairdresser relevant others are invoiced for this. The training manager carries out supervisions with staff usually 3 to 4 times a year, we can see that during this time staffs training and development is discussed alongside any areas where improvement is needed. Staff spoken with confirm that they have regular supervisions and they say that these are helpful as it points out areas that they need to develop. On examining the accident records we can see that accidents occurring within the care home are minimal and when they do occur staff are dealing with these in the appropriate way to make sure peoples health and wellbeing is maintained. We did however see that two members of staff have slipped on wet floors, during the tour of the building we did see wet floors when there are no signs in place to alert people of this. We saw that staff are using these signs, however it was felt that insufficient signs are available to move around the care home when cleaning is taking place. The fire log book shows us that although emergency lights are tested as required the fire alarm system is not tested on a weekly basis to ensure that this is always in good working order. Care Homes for Older People Page 27 of 32 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 32 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 1 7 13 Risk assessments must be in 13/08/2009 place for peoples identified risks and contain sufficient information. This will ensure that risks are managed and people are protected. 2 7 15 Plans of care must be in place for all highlighted needs and contain sufficient information for staff to be fully informed of peoples needs. This will ensure that peoples needs are fully met. 13/08/2009 3 9 13 You must ensure that people 13/08/2009 receive thier medication as preseribed and that staff sign for these when they are adminstered. This will ensure that peoples health and wellbeing is maintained. Care Homes for Older People Page 29 of 32 4 9 13 You must ensure that staff do not leave the medication trolley unattended. This will ensure that people using the service are protected. 13/08/2009 5 12 16 You must consult with people using the service about the programme of activities arranged and provide facilities for these. This will ensure that people using the service experience a satisfying and stimulating lifestyle. 28/08/2009 6 19 23 Consult with the Fire Authority in regard to the practice of propping open fire doors. This will ensure that people will be protected from the risk of fire. 13/08/2009 7 38 23 You must liaise with the Local Fire Authority in regard to the required testing of the fire alarm systems. This will ensure that people using the service are protected form the risk of fire. 20/08/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 Plans of care are developed to become more person Page 30 of 32 Care Homes for Older People centred so that peoples person preferences are fully considered within the plan of care. 2 8 Staff receive further input and training on peoples specialist needs such as diabetes mellitus to ensure that they can recognise the signs of ill health. Handwritten entries on medication charts are always signed by two members of staff to show that these have been checked as correct. Make sure that people are assisted to wash their hands and face following meals to ensure that their dignity is maintained. Revisit infection control practices to ensure that good practice is maintained at all times. Staff undertake a minimum of 6 supervisions sessions a year which offer them the opportunity to discuss their training and development. Further wet floor signs are purchased to make sure that there are sufficient to put on display when there are numerous wet floors around the care home. 3 9 4 15 5 6 26 37 7 38 Care Homes for Older People Page 31 of 32 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. 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