Care Home: Park Lane House

What the care home does well People can get the information they need to help them decide if the service is right for them. They are able to visit and see what the service offers, before making their decisions. People`s strengths and support needs are assessed so that their care and support can be planned properly. They have detailed care plans so that staff get good guidance about how to support them in ways that suit them best. People get the help they need to keep important medical appointments and get support from other health professionals. A District Nurse told us "people get good care here". Staff know how to respect people`s rights to privacy and dignity. People using the service told us "Staff are lovely - they look after me well". People enjoy their meals and mealtimes. Staff ask them what they want so that they can enjoy food they like. The owners, manager and staff ask people and their families what they think about the service. People are confident that their concerns are listened to, taken seriously and acted upon. The staff team works well together and shows a positive attitude towards the people in their care. The home makes sure that there are enough staff to meet people`s care and support needs, and that they are properly trained to do their jobs. People using the service, and their families are generally happy with the support they get. They told us "staff are kind and friendly - I can`t fault them" and "I`ve no complaints". The home is generally well run for the benefit of people who use the service. What has improved since the last inspection? A major programme of building work, extension and refurbishment has been completed to improve the facilities for people using the service to enjoy. All of the rooms now have en-suite toilets and level-entry showers. Other improvements include extra communal space and a new central heating system. People`s rooms have been redecorated refurbished,and new soft furnishings provided. The home has been given two awards from the Local Authority and Health Services for food hygiene and healthy eating promotion. Staff have continued to work towards gaining recognised qualifications, so that nearly eighty per cent of the team now hold these. The manager is updating her skills and learning by enrolling on a course of further training in management. What the care home could do better: Activity opportunities for people using the service could be improved, to ensure that people get the stimulation and support they need.The staff training plan should be developed to ensure that their training and development is managed more effectively. Arrangements for staff to receive formal supervision need to improve, to ensure that they get all the support they need to do their jobs well. Key inspection report Care homes for older people Name: Address: Park Lane House 163 Tipton Road Sedgley Dudley West Midlands DY3 1AA     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: Gerard Hammond     Date: 0 3 0 7 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 28 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 28 Information about the care home Name of care home: Address: Park Lane House 163 Tipton Road Sedgley Dudley West Midlands DY3 1AA 01902884967 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Raganendrano Ramdoo,Mrs Amerion Merion Ramdoo care home 30 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users to be accommodated is: 30. The registered person may provide the following categories of service only: Care Home Only - Code PC; to service users of the following gender: Either; whose primary care needs on admission to the home are within the following categories: - Old age, not falling within any other category - Code OP - Dementia - Code DE Date of last inspection Brief description of the care home Park Lane House is a large detached house that has been extended and converted for use as a care home. A major programme of building work has recently been completed to further extend and upgrade the property. The home is now registered to provide care, support and accommodation for up to 30 older people with dementia. The home is situated close to Sedgley town centre in Dudley Metropolitan Borough. There are good public transport links to the area, and there is car parking for visitors at the back of the home . Care Homes for Older People Page 4 of 28 Over 65 0 30 Brief description of the care home There is ramped access to the home for people using wheelchairs. All rooms are single, with ensuite toilet and level entry shower facilities. Access to the first floor is via a lift or stairways. There are two lounge areas on both floors. The main dining area is located on the ground floor, next to the kitchen anf the homes office. As well as peoples private facilities in their rooms, there are wheelchair accessible toilets on both floors, and there is an assisted bathroom on the ground floor. The home is owned and operated by a married couple who employ a manager to run it on a day-to-day basis. The manager supervises a deputy, seniors and carers as well as ancillary staff (including cook and housekeeper). The home should be contacted directly for details of current fees and charges. Care Homes for Older People Page 5 of 28 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: This is the homes first key inspection during the current year 2009-10. We gathered information from a number of places to inform the judgements made in this report. The Manager sent us a completed Annual Quality Assurance Assessment when we asked for it. This document is a self-assessment about how well the service is doing, and provides us with some numerical information about it. We made two visits to the home. We talked to some of the people who use the service and also met some of their relatives who were there visiting them. We spoke to the Manager and members of staff on duty. We looked at records including personal files, care plans, staff files, previous inspection reports, safety records and other documents. Thanks are due to the residents, manager and staff team for their support throughout the inspection process. Care Homes for Older People Page 6 of 28 What the care home does well: What has improved since the last inspection? What they could do better: Activity opportunities for people using the service could be improved, to ensure that people get the stimulation and support they need. Care Homes for Older People Page 7 of 28 The staff training plan should be developed to ensure that their training and development is managed more effectively. Arrangements for staff to receive formal supervision need to improve, to ensure that they get all the support they need to do their jobs well. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 28 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 the information they need to decide if the service is right for them. Their strengths and needs are assessed, so that their care and support can be planned properly. Evidence: When we last inspected the home, a major programme of building work and refurbishment was underway. No new people were admitted at that time, and only a small number of people were in residence. The work to extend, upgrade and refurbish the home is now complete. When we visited the home had six vacancies. We looked at the homes Statement of Purpose and Service Users Guide. We saw that the documents had been updated to reflect the changes in the service. These documents give information about what the service provides, who it is for, and so on. This is to help people looking for a care home to decide if the service is what they want. Care Homes for Older People Page 10 of 28 Evidence: We talked to the Manager and looked at some peoples personal records. This was to check on what happens before people are admitted to the home. The records we looked at all contained a detailed assessment of each persons strengths and support needs. These had been completed before they came to live at the home. We also saw that peoples assessments had been kept under regular review. This is important as it provides a sound basis for planning peoples care and support. The Manager told us that people are offered the chance to come and visit the home before they move in. We saw letters on the personal files that we checked, showing that this had happened. She told us that sometimes it is peoples family members who visit beforehand, for example if the person is in hospital. In any case, people are offered a placement on a trial basis for the first month. This is to give them the chance to find out if the home is what they want. After this time, a meeting is held (including the person, their family members, social worker or others) and a decision reached about whether or not to take the place. The records we looked at all contained signed copies of the homes terms and conditions. These included details of rooms occupied, fees and items incurring additional charges (chiropody, hairdressing, newspapers and magazines, TV license and clothing). This means that people are clear about what the service provides. Care Homes for Older People Page 11 of 28 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 can be confident that their personal and health care needs will be met in ways that suit them best. People who use this service know their rights to privacy and dignity are respected. Evidence: We looked at peoples personal records to see how their care and support is planned and managed. All of the files we saw contained a detailed care plan that had been reviewed regularly. This is important, as it ensures that staff have clear guidance that is kept up to date. Plans contained details of peoples personal preferences (for example, morning and bedtime routines, how they like to be addressed, how they like to be supported to move around, and so on) This helps to ensure that people get the support they need in ways that they like. Peoples records also showed that they are getting the support they need to maintain and promote good health. Care plans include measures to maintain oral hygiene. These include denture care and dental appointments. Records showed support for continence promotion, tissue viability and pressure area care. Currently two people in Care Homes for Older People Page 12 of 28 Evidence: the home receive support from the District Nurse service for treatment of pressure sores. Records showed that this is monitored effectively, referrals to health professionals made when required, and specialist equipment provided as needed. We met one of the District Nurses during our visits to the home. She told us that she has a good working relationship with the Manager and members of the care team. She said people get good care here, and care staff do what we have agreed is needed. We saw that peoples care plans included risk assessments for mobility, moving and handling and nutrition. Staff have clear guidance about how to support people to move around and minimise risks of falling. We saw staff encouraging people to get up and walk around, to maintain and promote their mobility. Support was given as needed, and in a sensitive and respectful manner. The home also arranges music and movement sessions, to encourage people to get some exercise in an enjoyable way. Peoples records included nutritional screening, and we saw that their weights are monitored regularly. The day we visited was very hot. We saw that staff made sure that people were offered drinks on a regular basis throughout the day, to maintain hydration. Plans included assessments and monitoring of peoples psychological well being, and guidance on giving appropriate reassurance and support. Peoples files showed that they were referred to other health professionals for advice and support when needed. We saw records of appointments with GPs, District Nurses, Dentists, Chiropodists, Opticians, hospitals and specialist clinics. We looked at how medication is administered and managed within the home. We saw that the medication file included a copy of the homes policy and procedures. Senior staff are responsible for administering medication. This is mainly dispensed in blister packs which staff check in on the day it is received. We looked at the Medication Administration Record (MAR) and saw that this had been filled in correctly and medicines given as shown. We also saw records of regular competency checks on staff. The local pharmacist carries out regular audits of storage, administration and recording, disposal of medication, and controlled drugs. We saw a copy of the last audit showing satisfactory practice in all areas. We did a sample audit on medicines not dispensed in blister packs, including controlled drugs. We found that the actual stock held by the home tallied with the written records in all cases. Proper arrangements are in place for managing controlled drugs, including separate secure storage and records of administration. We saw that the records were signed by two members of staff on each occasion these medicines were given. We asked staff to tell us about how they make sure that peoples rights to privacy and dignity are respected. They showed us that they understand the things they need to do in order to achieve this. Staff also spoke very positively about the people in their Care Homes for Older People Page 13 of 28 Evidence: care. We were able to see and hear staff interacting with people using the service. We saw that they knocked on peoples doors before going into their rooms. We heard them speaking to people respectfully, in a warm and friendly manner. We saw them supporting people who were confused or distressed with kindness and sensitivity. One person living at the home told us The staff are lovely, they look after me well. Another said Staff are kind and friendly. We also met with relatives who came to visit on the days we were at the home. One told us Staff are so kind, I can call them up any time, even at night. She said they had been very supportive at a very difficult time. Another persons relative said that staff couldnt be better. Since the homes extension and refurbishment programme has been completed, all residents now enjoy the use of single bedrooms that all have en-suite facilities. This means that they are now generally able to have their health and personal care needs met in the privacy of their own rooms. Care Homes for Older People Page 14 of 28 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 some good opportunities for activities and social interaction. The service needs to develop these to make sure that everyone can enjoy opportunities according to their needs and wishes. People get the support they need to enable them to see and keep in touch with friends and loved ones. They have good, nutritious food and enjoy their meals and mealtimes. Evidence: We looked at peoples personal files, talked to some people who use the service, and looked at the homes activity records. This was to help us make a judgement about the lifestyle that people living at Park Lane House enjoy. We saw notices displayed around the home of planned events. These are for the benefit of the residents and also their families. The Manager explained that the home encourages relatives to be a part of the social life of the home as much as possible. The relatives we spoke to during our visits confirmed that they were invited to parties and social gatherings. These have included birthday celebrations, Christmas and Easter bonnet parade in recent months. One person told us that she is able to go out to church regularly, with family support. Since the completion of the refurbishment programme, the home has now re-instated the monthly service provided by a local church, The activity diary Care Homes for Older People Page 15 of 28 Evidence: showed that people had taken part in arts and crafts sessions, playing bingo, music and sing along, exercise sessions with music, playing dominoes, skittles and board games. They also had opportunities to use the services of a visiting hairdresser and to have a manicure. Other entries in the diary showed people watching television, having one to one time with staff and seeing their visitors. One person told us I enjoy spending time in my room, watching my favourite TV programmes and seeing my family when they come to visit me. Another person said that now she is settled in the home, she would like to do some knitting and crochet and some watercolour painting. These are things she used to enjoy doing at home. We saw staff engaging people in arts and crafts and playing board games when we were at the home. Staff are also developing a reminiscence corner in the dining room. There is a display of pictures and books and other objects relating to past times (for example old photographs of local places as they used to be, wartime ration books and so on) to help people remember their personal histories and backgrounds. It is clear that the staff team make positive efforts to engage people and to provide them with opportunities for stimulation, exercise and social interaction. However, records about this are limited, and it is not easy to see how decisions have been made on a day to day basis about what opportunities people can be offered. Some thought should be given to how this might be made more systematic, to ensure that all people using the service can benefit from frequent and regular activity opportunities of their choosing. It has to be acknowledged that the support needs of the people using this service present particular challenges in this regard. Individuals levels of awareness, attention span and so on can differ over short periods of time. Their abilities to take part in group activities may be limited by these and other factors. It may be helpful to consider giving named staff specific responsibility for developing activity opportunities. This is to help prevent this important area of work becoming hit and miss, dependent on who happens to be on duty and what else might be going on at any particular time. However, it should also be acknowledged that the Manager and staff remain positive about trying new things and developing this part of the service. During the inspection we saw that the home makes particular efforts to ensure that peoples visitors are made welcome. We were able to meet with some of them in private, and received very positive feedback from all the people we saw. One person said that the home couldnt be better and that they let the family know if there are any problems. In particular, relatives paid tribute to the support they had received from the staff, Manager and the homes owners. They told us how stressful it is supporting people to move into care and finding the right home for their loved ones. They told us that they had been helped a great deal by the whole care team during these difficult times and afterwards. Care Homes for Older People Page 16 of 28 Evidence: The Manager told us that peoples financial affairs are usually managed with the support of their family members. We saw that a referral had been made to the Court of Protection for one person, to ensure that she received appropriate independent support in these matters. We also saw that information about the Mental Capacity Act and Deprivation of Liberties Safeguards was displayed on the office noticeboard. The Manager told us that she is currently exploring ways of developing the teams knowledge and understanding of these through formal training and information sharing. We were able to observe people eating their lunches on both occasions we visited the home. We saw that the food was well presented and that people were able to enjoy their meals in a relaxed and unhurried way. People told us the food here is good. I have the things I like The cook told us that she had just drawn up a new four week menu cycle, based on what people had told her they liked. She said that she tries to introduce different things to promote variety and choice. Her experiences with the current resident group shows that most seem to prefer traditional cooked meals, of the things they have been used to for most of their lives. Another person who uses the service said I really like the food here, its very good. Put it this way - I never leave anything!. The records we saw showed that people are able to enjoy plenty of variety and choice. We looked at food stocks and saw that these were plentiful and included fresh fruit and vegetables. We saw that the home has been awarded a five star (top) rating by the Local Authority in its Scores on the Doors scheme for food hygiene promotion. They also received a Gold Award from Dudley Primary Care Trust (Food and Nutrition Team) as part of its Food for Health Award programme. This is for action taken to promote healthy eating. Care Homes for Older People Page 17 of 28 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 can be confident that any concerns they have are listened to, taken seriously, and acted upon. They are protected from abuse, neglect or self-harm. Evidence: We saw that the homes new Statement of Purpose and Service Users Guide documents included details of the complaints procedure. There were copies of the complaints procedure (also available in a pictorial version) in all of the individuals personal files that we looked at. We asked people who use the service and also their relatives, if they knew what to do if they have any concerns. All of the people we spoke to told us that they knew they could approach the owners, the manager or members of staff about anything that worried them. It was clear that people know who the owners are, and that they play an active role in the life of the home. We looked at the homes complaint record. No complaints have been received since the last inspection: we have not received any complaints about this service either.Previous inspection reports show that the service takes appropriate action if any complaints are received. The home has an appropriate policy in place for safeguarding (adult protection) linked to local multi-agency guidelines. We talked to staff on duty. They were able to describe the different types of abuse and show us that they know what things they need to watch for. It was also clear that they know what their responsibilities are should they witness or suspect abuse. We looked at staff records. We saw that Care Homes for Older People Page 18 of 28 Evidence: important checks had been carried out with the Criminal Records Bureau before people started work, to make sure they were fit for the job. We also saw that staff have been given training in adult protection, to give them the knowledge and skills they need. Care Homes for Older People Page 19 of 28 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. People enjoy the benefit of living in a comfortable, well maintained environment that is safe and homely. Evidence: We looked around the home with the Manager. As reported above, a major programme of building work, extension and refurbishment has recently been completed. There is no longer any shared accommodation. All of the bedrooms have en-suite facilities that include toilets and level entry showers. This means that people can generally receive their personal care in the privacy of their own rooms. There is an assisted bathroom on the ground floor. There are a further two toilets accessible with wheelchairs on the ground floor and another one on the first floor. A new central heating system has been installed and rooms all have low surface temperature radiators. Bedrooms have been refurbished and new bedding and soft furnishings provided. One person told us Im very pleased with my room, its very nice. We saw that people had their own things including pictures, ornaments, family photographs, televisions and so on, to make the room personal and their own space. Another person said I enjoy being in my room for a bit of peace and quiet when I want it. There are two lounges on the ground floor, and another two lounge areas on the first floor. One of these is a conservatory-style room, providing a particularly light and airy place to relax in. When we visited, this room was very warm, due in part at least to the hot weather conditions that day. The Manager said that she had requested that Care Homes for Older People Page 20 of 28 Evidence: the builders returned to review the arrangements for ventilation and temperature control. The upstairs lounges are not yet in use: the Manager explained that it is proposed to split the care teams between the two floors, so that people can enjoy the benefit of the extended areas now available. This proposal is to be discussed with residents and their families in the near future. Access to the first floor is via a passenger lift or stairways. The homes laundry is located in the basement. The home employs staff specifically to look after the laundry and domestic cleaning. An additional new washing machine has been installed as part of the refurbishment programme. Both machine have a sluice cycle and programmes to allow laundry to be washed at the appropriate temperatures. We saw that the home was clean and fresh, with good standards of hygiene maintained throughout. Care Homes for Older People Page 21 of 28 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 can be confident that the home provides enough trained staff to meet their care and support needs. Also that the service has taken the action it should to make sure that staff are fit for their jobs. Evidence: We spoke with staff on duty and were able to observe them interacting with residents, during our visits to the home. We also looked at staff records, to see how they were recruited and how their training is managed. We saw that there were enough staff on duty to meet the needs of the people who currently use this service. At the moment there are normally four staff on duty (in addition to the Manager) during each day shift, and three waking staff during the night. The Manager told us that the home is actively recruiting new staff, in anticipation of remaining vacancies being filled. In the Annual Quality Assurance Assessment (AQAA) she told us that 79 of the current staff team hold qualifications At NVQ level 2 or above. The home does not currently employ any agency staff. We looked at staff records: all the files we checked had completed application forms with full employment histories. They all also included staff contracts / terms and conditions, two written references, and evidence of checks with the Criminal Records Bureau (CRB). These things show that the service takes action to make sure that people employed to work at the home are fit for their jobs. Care Homes for Older People Page 22 of 28 Evidence: Staff we spoke to told us that they have lots of opportunities for training. Their records include copies of certificates for training completed. The AQAA shows that training in equality and diversity, and understanding the Deprivation of Liberties Safeguards needs to be planned for. Training records showed that staff have completed required training (including refreshers. We suggested that the Manager produce the training and development plan in spreadsheet or chart format. This should show (for each member of staff) training completed and qualifications gained (with dates), as well as when refreshers are due. Doing it like this should provide the Manager with a useful tool for planning future training, as well as providing an instant overview of training and development needs. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well run for the benefit of the people who use the service. Evidence: We talked to the Manager about how the service is run. She is qualified to NVQ level 4, and has now enrolled on a Leadership in Management course to further her training. She has several years experience of caring for elderly people, gained by progressing through the ranks at the home. She said that the homes owners are very supportive, and play an active role in the running of the service. People living at the home, their relatives and the staff working there all told us that the owners and the manager are familiar faces and that they are involved and approachable. We saw staff approaching the Manager for support and advice during our visits. It was clear that they have a good working relationship. One of the staff we spoke to said Shes a very good Manager - I can talk to her about anything. There is a system in place for quality assurance and monitoring of the service. We saw a copy of last years report (2008)about this, as well as the homes last inspection Care Homes for Older People Page 24 of 28 Evidence: report on display. This years survey is currently underway. We saw a small number of surveys that have been returned to date. Some of the residents comments about the quality of care received included No complaints at all and care is always provided to a good standard. Relatives expressed mixed views about the range and quality of activities provided. One wrote: Activity sessions need to be more of a variety. Stimulation and motivation is an important issue. Another said that the range of things to do was only just acceptable. However, other responses said that the range of activities was good and excellent. Other comments received said The home is clean warm and comfortable and Staff are very polite and helpful. Responding to a question asking what you think is best about the home one person said: Friendly caring staff and quality of the accommodation. Three people thought the overall standard of care is excellent and the other three said good. We saw that records in the home were generally well maintained and up to date, and that they were stored securely in the office. Staff records we looked at showed that formal supervision is not up to the required standard. The Manager acknowledges this and is taking action to address the issue. It is intended that some of the responsibility for staff supervision be delegated to senior staff. The Manager is arranging for them to receive training to enable them to take on this role. This presents a positive opportunity for staff development. It should be acknowledged that staff we spoke to said that they received supervision and felt generally well supported to do their jobs. We sampled some of the records relating health and safety matters. We saw that the fire alarm and emergency lighting systems had been serviced and were routinely checked. Fire fighting equipment had also been serviced, and staff had received fire safety training. Certificates for gas and electricity services were available and up to date, and portable electrical appliances had been checked. Other equipment around the home had been serviced as necessary, and there was a workplace risk assessment in place. These things show that the home takes action to make sure that people living and working there stay safe. Care Homes for Older People Page 25 of 28 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 26 of 28 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 1 12 Review arrangements for providing activities and social interaction. This is to make sure that everyone using the service has activity opportunities that meet their needs and wishes. Produce the staff training and development plan in spreadsheet or chart format, to help manage and plan training more effectively. Ensure that staff receive all the training they need, so that they have the knowledge and skills to do their jobs well. Ensure that staff receive regular formal supervision, so that they get all the support they need to do their jobs well 2 30 3 36 Care Homes for Older People Page 27 of 28 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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