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Care Home: Primrose Hill Care Home

  • Thames Road Huntingdon Cambridgeshire PE29 1QW
  • Tel: 01480450099
  • Fax: 01480454499
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Primrose Hill is a purpose built nursing and residential home for older people in the outskirts of Huntingdon that has been registered with the Commission for Social Care Inspection since November 2003. It is owned by Abbey HealthCare Homes Ltd who operate a number of homes for older people throughout the country. The home offers 60 single ensuite bedrooms all of which meet the required minimum standards of 12 0 0 5 square metres. Accommodation is provided on three floors with the middle floor being a dedicated unit for twenty-three older people with dementia. Each floor contains a large dining/sitting room, two smaller sitting rooms and appropriate bathroom, toilet and shower room facilities. The weekly fees for the home vary between 497 and 775 pounds depending on residents` needs and funding arrangements. A copy of the latest inspection report is on display in the main entrance of the home.

  • Latitude: 52.346000671387
    Longitude: -0.16899999976158
  • Manager: Linda Clare Martinez
  • Price p/w: ~
  • UK
  • Total Capacity: 60
  • Type: Care home with nursing
  • Provider: Abbey Healthcare (Huntingdon) Ltd
  • Ownership: Private
  • Care Home ID: 12534
Residents Needs:
Old age, not falling within any other category, Dementia, Physical disability

Latest Inspection

This is the latest available inspection report for this service, carried out on 5th August 2009. CQC found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

For extracts, read the latest CQC inspection for Primrose Hill Care Home.

What the care home does well The home is a large purpose built property that is situated in its own grounds. There are lounge areas, plus other quiet areas, on each floor for people to use if they wish. There is also a safe well maintained garden at the back of the home. Staff members are polite and talk to people with respect. We talked to people during this inspection and they said the staff are nice, and respect their privacy. Assessments are completed before people move into the home, they have contracts with the home and they say they have enough information before they move in. Care plans are written to tell staff what they have to do to care for people and these are reviewed every month. People or their relatives are able to look at the plans and say if they agree with them. One visitor who returned a survey said, "They seem to be very aware of how my mother may be feeling, and are very aware of any signs she may be giving which is quite impressive as my mother has hardly any communication still left". Risk assessments are completed every month to check if everything that is being done to reduce risk is being done. This makes sure that things like pressure sores and poor nutrition are treated correctly. People are referred to health care professionals, like dentists, opticians and dieticians. These visits are recorded in their care records. There are a lot of trips, events and activities available at the home, which are organised by the activities co-ordinator. We received a lot of positive comments in surveys and 2 people said, "Have had some lovely times out on the trips" and "As a member of the `residents and relatives committee`, I am very impressed by the importance laid down by the manager of the selection of activities co-ordinator. She stresses the importance of movement activities - especially for the very elderly and dementia patients. The motivation of brain activities is very high on her agenda, such as easy quizzes; bingo; songs of praise; sing-a-long and classical music recitals". People can have visitors when they want and there are places where they can meet in private. Visitors said the home helps people keep in touch with them and relatives told us they are kept up to date with issues that arise. People are able to choose whereabouts in the home they spend their day, when they get up and go to bed and what they have to eat. There is a choice of main meals each day and staff members stay with people who need help to eat. Everyone we spoke to said they like the meals and the food is good. There is fresh fruit on each table and people are encouraged to choose and helped to eat it. Comments we received include, "Food is excellent, plenty of variety on the menu. My relatives are always offered refreshments" and "The food in Primrose Hill is very good, a balanced variety and served in clean and pleasant surroundings". There have been 3 complaints made to the home in the last year. These are looked at properly and information to show why the home has taken action, if it needed to, is also kept. People who make complaints have a response in the correct timeframe. People said they know who to talk to and how to make complaints. Staff members have training in how to keep people safe and what to do if they think abuse has happened. There have been 2 safeguarding referrals in the last year.Most people said there are enough staff available at the home, although one person said if there were more they could spend more time individually with people. One visitor told us that there are always staff available and their relative doesn`t usually have to wait very long for help. A quality assurance survey is carried out every year at the home, where people are asked what they think of the care and the environment in which they live. Action is taken about issues that are found, but there isn`t much information to show people are told about this. Records are kept of the health and safety checks that are carried out, which means the home can show if things are in good working order and what they have done to repair problems. What has improved since the last inspection? Primrose Hill has improved in the 3 areas we asked them change at the last inspection. We walked around the building during the inspection and found no offensive smells. Medication is stored in the correct way and inside locked cupboards. Money that is kept and transactions that are made on behalf of people at the home are recorded and receipts are kept. What the care home could do better: Although medication administration records (MAR) are generally completed properly, there is only one area where staff must be more accurate in what they write. The dose of medication that has been given must be written if this is variable, so that people are not given too much by mistake. Medication must not be left unsupervised; it must not be left on the top of the trolley and the trolley must not be left open when staff turn their attention to something else, like helping someone to take their medication. Recruitment checks are not completed properly before people start working at the home, so they don`t know if new staff members are safe to work there. 2 written references must be obtained, the home must ask for these rather than accepting already written references. Gaps in employment histories must be looked at to find out what people were doing between jobs. If Criminal Record Bureau (CRB) checks are not issued before staff start working at the home, a PoVA first (Protection of Vulnerable Adults check) must be obtained. Updates of mandatory training are not given to all staff when this is needed. Fire safety training and moving and handling training must be given at the required intervals to make sure staff know how to safely move people and objects, and what to do if there is a fire. Primrose Hill should tell people what they have done about issues that have come up in the annual survey. They should do this so that people can be sure that something is being done about things they don`t like. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Primrose Hill Care Home Thames Road Huntingdon Cambridgeshire PE29 1QW     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: Lesley Richardson     Date: 0 6 0 8 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 29 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 29 Information about the care home Name of care home: Address: Primrose Hill Care Home Thames Road Huntingdon Cambridgeshire PE29 1QW 01480450099 01480454499 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Abbey Healthcare (Huntingdon) Ltd care home 60 Type of registration: Number of places registered: 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: The age range of service users with the category of PD (physical disability) is 55 to 65 years of age Date of last inspection Brief description of the care home Primrose Hill is a purpose built nursing and residential home for older people in the outskirts of Huntingdon that has been registered with the Commission for Social Care Inspection since November 2003. It is owned by Abbey HealthCare Homes Ltd who operate a number of homes for older people throughout the country. The home offers 60 single ensuite bedrooms all of which meet the required minimum standards of 12 0 0 5 Over 65 23 60 0 Care Homes for Older People Page 4 of 29 Brief description of the care home square metres. Accommodation is provided on three floors with the middle floor being a dedicated unit for twenty-three older people with dementia. Each floor contains a large dining/sitting room, two smaller sitting rooms and appropriate bathroom, toilet and shower room facilities. The weekly fees for the home vary between 497 and 775 pounds depending on residents needs and funding arrangements. A copy of the latest inspection report is on display in the main entrance of the home. 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 quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was a key inspection of this service and it took place over 10 hours and 15 minutes as an unannounced visit to the premises. It was spent talking to the manager and staff working in the home, talking to people who live there and observing the interaction between them and the staff, and examining records and documents. All 3 requirements from the last inspection have been met. There have been 2 requirements and no recommendations made as a result of this inspection. The last key inspection was carried out on 7th August 2007. Information obtained from the Annual Quality Assurance Assessment (AQAA) and from Care Homes for Older People Page 6 of 29 returned surveys was used in this report. The AQAA is a self assessment that focusses on how well outcomes are being met for people using the service. It also gives us some numerical information about the service. We received 5 surveys from people living at the home, 10 surveys from visitors and 6 surveys from staff members. What the care home does well: The home is a large purpose built property that is situated in its own grounds. There are lounge areas, plus other quiet areas, on each floor for people to use if they wish. There is also a safe well maintained garden at the back of the home. Staff members are polite and talk to people with respect. We talked to people during this inspection and they said the staff are nice, and respect their privacy. Assessments are completed before people move into the home, they have contracts with the home and they say they have enough information before they move in. Care plans are written to tell staff what they have to do to care for people and these are reviewed every month. People or their relatives are able to look at the plans and say if they agree with them. One visitor who returned a survey said, They seem to be very aware of how my mother may be feeling, and are very aware of any signs she may be giving which is quite impressive as my mother has hardly any communication still left. Risk assessments are completed every month to check if everything that is being done to reduce risk is being done. This makes sure that things like pressure sores and poor nutrition are treated correctly. People are referred to health care professionals, like dentists, opticians and dieticians. These visits are recorded in their care records. There are a lot of trips, events and activities available at the home, which are organised by the activities co-ordinator. We received a lot of positive comments in surveys and 2 people said, Have had some lovely times out on the trips and As a member of the residents and relatives committee, I am very impressed by the importance laid down by the manager of the selection of activities co-ordinator. She stresses the importance of movement activities - especially for the very elderly and dementia patients. The motivation of brain activities is very high on her agenda, such as easy quizzes; bingo; songs of praise; sing-a-long and classical music recitals. People can have visitors when they want and there are places where they can meet in private. Visitors said the home helps people keep in touch with them and relatives told us they are kept up to date with issues that arise. People are able to choose whereabouts in the home they spend their day, when they get up and go to bed and what they have to eat. There is a choice of main meals each day and staff members stay with people who need help to eat. Everyone we spoke to said they like the meals and the food is good. There is fresh fruit on each table and people are encouraged to choose and helped to eat it. Comments we received include, Food is excellent, plenty of variety on the menu. My relatives are always offered refreshments and The food in Primrose Hill is very good, a balanced variety and served in clean and pleasant surroundings. There have been 3 complaints made to the home in the last year. These are looked at properly and information to show why the home has taken action, if it needed to, is also kept. People who make complaints have a response in the correct timeframe. People said they know who to talk to and how to make complaints. Staff members have training in how to keep people safe and what to do if they think abuse has happened. There have been 2 safeguarding referrals in the last year. Care Homes for Older People Page 8 of 29 Most people said there are enough staff available at the home, although one person said if there were more they could spend more time individually with people. One visitor told us that there are always staff available and their relative doesnt usually have to wait very long for help. A quality assurance survey is carried out every year at the home, where people are asked what they think of the care and the environment in which they live. Action is taken about issues that are found, but there isnt much information to show people are told about this. Records are kept of the health and safety checks that are carried out, which means the home can show if things are in good working order and what they have done to repair problems. 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 set out on page 4. Care Homes for Older People Page 9 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 10 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 11 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. Peoples needs are assessed before care starts and they have enough information before moving into the home, which means there is enough information for people to know if they want to live there and whether staff can care for them properly. Evidence: All five of the people who we received surveys from said they had received a contract and that they had enough information before moving to the home. Assessments are completed before people move into the home and assessments by health and social care teams are also obtained to provide more information. We looked at the care records of 2 people who had moved into the home since the last inspection. There was a written assessment completed by the home that included information about the persons needs in both of the files we looked at, and a health care assessment in 1 persons file. We spoke to people living in the home who said either they or their relatives had Care Homes for Older People Page 12 of 29 Evidence: visited before they moved in, or they had asked friends what they thought. The home does not provide accommodation specifically for intermediate care or for rehabilitation purposes. Care Homes for Older People Page 13 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. Care records are completed in enough detail and staff care for people in a positive way, which ensures the health and welfare of people living at the home. Evidence: People who commented in surveys said they get the care and support they need from staff members and during the inspection people told us care staff are nice, are polite and treat them with dignity and respect. We saw this during the inspection; that staff members are gentle, polite and that they knock on doors before entering rooms. People we spoke to said staff are nice and one visitor said that staff look after his relative very well and they noticed an improvement soon after moving into the home. A comment from one of the visitors who returned a survey was, They seem to be very aware of how my mother may be feeling, and are very aware of any signs she may be giving which is quite impressive as my mother has hardly any communication still left. Care plans for 5 people were looked at as part of this inspection. They show that each person has a plan that gives staff members information about what they need to do Care Homes for Older People Page 14 of 29 Evidence: to meet most of the identified needs. Risk assessments, for things like falls and moving and handling, are completed and reviewed regularly. We found the care plans give staff members advice about how to meet most of peoples needs, but that the level of detail varied between different people. Care plans generally tell staff what they need to do, but not always how to do it or what the person is able to do for themselves. For example, one person who is not able to easily communicate has pictures to help them choose their meals. But, the care plan that tells staff they may need 1 or 2 staff members to help the person wash and get dressed depending on the persons mood, doesnt tell staff how to assess the mood or what behaviour the person may be showing that would let them know what sort of mood they were in. Another person who cannot communicate easily has a plan that tells staff to put the persons clothes on properly, but to ask the person how to do this. Most people or their relatives said they are able to look at the plans and say if they agree with them or not. Plans are reviewed monthly and we saw that some information and changes are recorded, and the plans are rewritten to give staff updated guidance. A visitor said they find the plans are a good indication of what care their relative needs and receives. All of the people who returned surveys said they receive medical attention when they need it. There is information in care records to show health care professionals, such as specialist nurses, are contacted for advice and treatment. This happens in most cases, although one persons care records show they should have been referred to a specialist nurse for guidance, but there is nothing recorded to show this has been done. We spoke with one visitor during our inspection about whether their relative gets the medical help they need. The visitor said their relatives dentures had been lost, so staff at the home arranged a hospital appointment to have another set made. We also looked at records that show what people eat and when and which position they are turned to. These are mostly completed in enough detail to show the person is getting enough to eat, or which position they are turned to and how often. However, we noticed that particularly at night turn records are either not always completed when people are turned, or people are not being turned. Records show that pressure sores for both people whose care records we looked at have improved. Medication administration records (MAR) were looked at for all of the people living on one floor. The MAR sheets are completed and there are few records with entries missing. Entries for medications that have not been given mostly show the reason for this, with only a few records not giving explanations. Amounts of medication Care Homes for Older People Page 15 of 29 Evidence: remaining in blister packs of medication tally with the amount the MAR indicates are remaining. Records showing the administration of controlled drugs (CDs) are completed correctly, although the dispensing pharmacy for CDs received into the home is not written into the CD register. Variable dose medications, such as pain killers, do not have the dose that has been given recorded on the MAR sheet. This is important so that people are not given too many of the same medication in too short a space of time. We watched a drug round on one floor of the home and saw the nurse carrying this out was patient, polite and took their time. However, the medication trolley was left unsupervised with medication out while the nurse was administering medication to people. Medication fridge and storage room temperatures are taken and recorded as being at an acceptable level for the safe storage of medication. Although the fridge minimum and maximum temperatures were recorded as being too low and high for safe storage of medication. Temperatures that are too high may be explained if the fridge is being cleaned, but this should not happen every day. Temperatures that are too low must not occur while medication is being stored in the fridge or the medication will become frozen and this may mean it is not safe to use. We talked to staff about resetting the thermometer each day and why this is important. Care Homes for Older People Page 16 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff members have a good understanding of peoples needs, which means they are supported to live as they would like. Evidence: The home has an activities co-ordinator who arranges for entertainers to visit the home, activities and events in the home. Activities charts are displayed around the home showing what is available and in which part of the home they are to take place. We saw a music and movement activity taking place in the dementia unit and a religious service in another part of the home. People from all parts of the home were able to join in with the religious service and it didnt begin until everyone was there. All of the people who returned surveys to us said there are activities that they can take part in. We received a lot of positive comments from people living at Primrose Hill and visitors about the activities that are available. Two comments were, Have had some lovely times out on the trips and Trips out, Christian services, activities, photography. A visitor said, As a member of the residents and relatives committee, I am very impressed by the importance laid down by the manager of the selection of activities co-ordinator. She stresses the importance of movement activities - especially for the very elderly and dementia patients. The motivation of brain activities is very Care Homes for Older People Page 17 of 29 Evidence: high on her agenda, such as easy quizzes; bingo; songs of praise; sing-a-long and classical music recitals. People are able to make everyday choices about when to get up and go to bed, how to spend their days, whether that is in their own room, in the main lounge/dining area. We saw and listened to how staff members interact with people and found they ask what people would like and how they would like it rather than telling people or giving limited options. Staff members we spoke to know the people they care for and were able to tell us their preferences and how they like to be cared for. Staff members also have a good rapport with visitors to the home, we spoke with one visitor who told us staff are always available and let them know when things happen and how his relative is. Half of visitors who returned a survey (5 out of 10) said staff at Primrose Hill help people keep in touch and they all said they are kept up to date with issues concerning that person. One very positive comment from a visitors survey was, The nursing and care staff are always able to tell me how my mother has been; they discuss any health worrys with me. They seem to be very aware of how my mother may be feeling, and are very aware of any signs she may be giving which is quite impressive as my mother has hardly any communication still left. The home has an open visiting policy and people can have visitors at any time of the day. The main meal is served at lunchtime and there is a choice of hot meals every day. We saw lunch being served in one of the main dining rooms and watched while people were finishing their meal in another dining room. Food was served appropriately in a relaxed and unhurried way and drinks were offered throughout the meal. Everyone we spoke to said they like the meals and the food is good. Staff help people if they need this and we saw them being attentive and concentrating on what they were doing without being distracted. For example, one person declined gravy when this was offered but wanted to pour orange drink on their meal instead. Staff members discouraged this, but didnt stop the person and they then ate their meal with more interest than before. Another person was asleep when meals were being given out, staff sat with them and persisted in gently trying to wake the person. Once the person was awake staff members left them to eat their meal. There is fresh fruit on each table and people are encouraged to choose and helped to eat it. Comments were received in surveys and during the inspection and include, Food is excellent, plenty of variety on the menu. My relatives are always offered refreshments and The food in Primrose Hill is very good, a balanced variety and served in clean and pleasant surroundings. 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 know how to make complaints and concerns known and can be confident that these will be listened to. Evidence: All of the people returning surveys said they know who to speak to and that staff listen to what they say and act on it, and almost all of them (4 out of 5) said they know how to make a complaint if they have to. People we spoke to during the inspection also said they know what to do if theyre not happy about something. All of the visitors who returned surveys said they know how to make a complaint and they are appropriately dealt with. One visitor we spoke to during the inspection said they have never had to make a complaint, but that details of how to do this is in their relatives room. The home has a complaints procedure and keeps a complaint log to show how they have looked at, and the outcome of complaints that have been made. We were told before the inspection there have been 3 complaints made to the home in the last 12 months. All complaints have been investigated and responded to within the correct timeframe. We were told of two of these complaints and they were both treated as a safeguarding issue. The staff training matrix shows that nearly all staff members have received training in safeguarding (adult protection). We talked to care staff who said they had received Care Homes for Older People Page 19 of 29 Evidence: training in safeguarding people and were able to tell us what should be done if abuse was suspected. Information in the AQAA shows there have been two safeguarding referrals and investigations in the last 12 months. 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. The home is clean and provides a safe environment, giving people a pleasant place to live. Evidence: The home is a large purpose built property on the outskirts of Huntingdon. People living at the home have access to a number of communal areas on each floor, including a fenced garden area at the back of the building. The general decor in most parts of the home is satisfactory, and it was clean and tidy, with no offensive smells. Everyone returning surveys said the home is clean and tidy and people at the home said the home is clean. There were 2 comments from surveys, The handy man does sterling work with the paint brush - gardening - lift maintenance, etc. You name it - he does it and Regular cleaning of carpets to prevent smells. We looked around the home but found no offensive smells at all. Care Homes for Older People Page 21 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are enough staff members most of the time, but recruitment checks are not completed and training is not always updated to make sure staff are safe to work. Evidence: The training matrix shows new staff members are given induction training, which includes mandatory health and safety training and complies with the Skills for Care Common Induction Standards. Staff members who returned surveys said their induction covered everything they need to know very well or mostly. However, the training matrix also shows that not all existing staff have received regular fire safety or moving and handling refresher training. Twenty nine staff have not received fire safety refresher training and we looked at 5 staff files (just over 15 ) to make sure that this was the case. All 5 people had last had fire safety training more than 16 months (1 year and 4 months) before this inspection. Updates of moving and handling training have been given to most staff, but non-care staff havent all had the training. Two staff members working in the housekeeping department have not had the training for the last 2 years. Moving and handling training is important for all staff as it is not only people who are moved, but also equipment and stock. Additional training is given to staff so that they are able to properly meet peoples needs, including prevention of pressure sores and continence care. Two comments made by staff members were, A lot of opportunities for training and is all very Care Homes for Older People Page 22 of 29 Evidence: helpful, and gives opportunities to further our careers and the home provide trainings and NVQ to all its carer. A person living at the home who returned a survey also said, Staff well trained. Information in the AQAA tells us that approximately 85 of non-nursing qualified care staff have a National Vocational Qualification (NVQ) at level 2 or above. Two of the new staff members whose files we looked at for recruitment checks are also completing NVQs. The recommended number of staff with a NVQ is 50 . All of the people who returned surveys said staff members are available when they are needed and that they get the care and support they need. However, one visitor who returned a survey said, More staff would mean more one to one. People we spoke to during the inspection said there is usually enough staff on duty. This person visits their relative 2-3 times a week and there are always staff available when his relative needs something. We looked at recruitment records for 3 staff members employed since the last inspection. They show that the appropriate recruitment checks and documents were not all obtained before these staff members started working at the home. Gaps in employment histories were not obtained for 2 staff members. Although 2 written references are available for all 3 staff members, both references for 2 people and 1 reference for the 3rd person had been written before they traveled to work in this country. The references have not been requested by and are not addressed to the manager or owner of the home. None of the staff files contained information to show the references had been checked and therefore the authenticity of the references has not been confirmed. All 3 staff members have Protection of Vulnerable Adults (PoVA first) checks and Criminal Records Bureau (CRB) checks available. However, these have been issued after 2 staff members started work at the home. There is no date on the 3rd persons PoVA first check, and the reference number does not match that on the CRB application form. This persons CRB was also issued after they started working at the home. Care Homes for Older People Page 23 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. Health and safety checks are completed and records kept, which shows the home is a safe place for people to live. Evidence: The manager is a nurse and is registered with the Nursing and Midwifery Council. She has been managing the home since 2005 and has experience and qualifications in caring for older people. An annual quality assurance survey was carried out by the home in January 2009, a report has been written and shows the issues that were found. There was one issue where more than half the people who completed the survey said they didnt always have a choice in whether they had a bath or shower. We received no specific comments about lack of choice in this area in our surveys. The manager told us that the results of the annual survey are given to people in newsletters and meetings. However, we read the newsletters for April 2009 and the minutes of the resident/relative meetings and nothing was mentioned in these about the survey Care Homes for Older People Page 24 of 29 Evidence: results. We spoke to a visitor during the inspection who told us questionnaires were available for visitors to complete although they werent asked to do this. The visitor didnt know about resident and relative meetings and said they would find it difficult to comment about how well the home responds to issues that are found, although this visitor said the home cares well for their relative. We asked the home to complete and return an Annual Quality Assurance Assessment (AQAA) before the inspection. They did this within the time we asked for it and they gave us the information we asked for. The home keeps some money on behalf of people who live there. Accounts are kept of transactions of money put in and taken out. We looked at 3 of these records; all three are clearly written and show how money has been spent. Information provided before this inspection shows equipment, like hoists, lifts and firefighting equipment has been serviced or tested as recommended by the manufacturer. We looked at fire safety checks, which show that emergency lighting and fire alarm checks have been completed as required. Records also show fire drills are carried out every 2-3 months and include night staff. Care Homes for Older People Page 25 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 26 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 1 9 13 MAR sheets must be completed accurately and medication must not be left unsupervised. This is so that medication is administered and stored correctly and people are not put at risk. 30/11/2009 2 29 19 Required recruitment checks 30/11/2009 must be completed before new staff members start working at the home. This is so the home can be sure new staff are safe to work with vulnerable people. 3 30 18 All staff must receive mandatory training (moving and handling, fire safety) at the required intervals. This is so that staff are able to care for people correctly, that they have the skills and knowledge to safely move people in their care and to 30/11/2009 Care Homes for Older People Page 27 of 29 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 keep people as safe as possible in the event of a fire. 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 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. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!

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