Care Home: Quarry Bank

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What the care home does well The people that use the service always have their needs assessed before they decide whether to move to the home This helps to make sure that the home can support their individual needs in a safe way and also lets the person know how the home can support them. The care staff receive good training and supervision to make sure that they have all of the necessary knowledge and skills to be able to safely support the needs of the people living in the home.Direct observations also showed that the care staff have a good understanding of people`s individual needs and understand how these need to be supported. People that use the service have their health care needs met through the support of health care professionals that are based in the community. This included people receiving support from professionals such as community nurses, General Practitioners, chiropodist and dentists. Quarry Bank provides a homely and comfortable environment for people to live in. What has improved since the last inspection? Peoples individual care plans and assessments of need have improved. They are beginning to clearly show how individuals need to be supported. The environment has improved creating a more homely and comfortable environment for people to live in. The home has a business and refurbishment plan that shows how these developments Will continue over the next year. Individual rooms are now monitored on a more regular basis to make sure that fire safety rules and kept and people that use the rooms are protected from fire. staff are receiving more formal supervision that is recorded. This helps to make sure that they have all of the necessary knowledge and skills to be able to safely care for the people that use the service. The home has had a safety check made on the water systems in the home. this will help to protect the health and safety of the people that use the service. What the care home could do better: The service needs to make sure that all of the written information in the home includes the signature of the people completing them and the date that they were completed. This will help to identify when things have taken place in the home. The torn fly screen in the kitchen needed to be replaced and the oven needed to be cleaned to prevent the risk of infection to the people that use the service. Infection control polices also need to be followed in the homes toilet and bathroom areas. Key inspection report Care homes for older people Name: Address: Quarry Bank Woodfield Lane Hessle East Yorkshire HU13 0ES     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: Stephen Robertshaw     Date: 1 3 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 31 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 31 Information about the care home Name of care home: Address: Quarry Bank Woodfield Lane Hessle East Yorkshire HU13 0ES 01482648803 F/P01482648803 amould@woodlandscare.karoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Anthony Mould,Paul Nicholas Mould care home 23 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Maximum numbers of service users that may be accommodated is : 23 The registered person may provide the following category 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: Dementia -Code DE; Old Age, not falling within any other category-Code OP Date of last inspection Brief description of the care home Quarry Bank is a privately owned care home for older people, some of whom may have dementia. The home is a large, old, detached house, set in its own mature gardens in a residential area of Hessle. The local amenities are further away than easy walking distance. Quarry Bank accommodates both male and female people over the age of 65, and up to three people aged 60 to 65 years with dementia. The accommodation includes two lounges, a dining room and a conservatory. There are five single rooms and nine shared rooms. All areas of the home are accessible to people via the use of a Care Homes for Older People Page 4 of 31 Over 65 0 23 23 0 1 7 1 0 2 0 0 8 Brief description of the care home passenger lift, portable chair lift and ramps. There is a pleasant garden with greenhouse and seating area, which is also easily accessible. A large ramp enables wheelchair access to the front entrance of the home and a small car park is also located to the front of the building. Information about the services provided by the home and the latest inspection report, written by the Commission for Social Care Inspection is kept in an Admissions file, which is made available from the manager on request. The home was last inspected by the commission on 29th October 2007. The manager informed us that the weekly fees to live at Quarry Bank at the time of the site visit were between £362.04 and £414. Additional charges are made for hairdressing, chiropody, personal items and toiletries and trips out from the home. Care Homes for Older People Page 5 of 31 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 Commission made an unannounced site visit to the service on the 13 th October 2009. We were in the home for approximately six hours. This report has been written with the information gained on this day and from the Annual Quality Assurance Assessment that had been completed by the management of the service and had been sent in to us before the site visit. Surveys were also returned from outside professionals that have involvement with the services provided through the home. We also spoke people that use the service, one professional visitor and three relatives. The information that they gave to us has also been used to help to write this report. The Commission also case tracked three of the people that use the service. This also included looking at all of the assessments and care plans that had been written about them. Care Homes for Older People Page 6 of 31 We would like to thank the management and staff working for the home and the people who we met at the site visit for their hospitality and friendly welcome. The quality rating for this service is 2* star. This means the people who use this service experience good quality outcomes. Care Homes for Older People Page 7 of 31 What the care home does well: What has improved since the last inspection? What they could do better: The service needs to make sure that all of the written information in the home includes the signature of the people completing them and the date that they were completed. This will help to identify when things have taken place in the home. The torn fly screen in the kitchen needed to be replaced and the oven needed to be cleaned to prevent the risk of infection to the people that use the service. Infection control polices also need to be followed in the homes toilet and bathroom areas. Care Homes for Older People Page 8 of 31 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 31 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 31 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 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. This means that the people that use the service have their need fully assessed before they agree to move to the home. Evidence: At the time of the site visit the site visit there were 20 people living at Quarry Bank. The Commission observed all of the documentation that related to the assessment of three of these people that had been completed before they were admitted to the home. These assessments included the homes pre-admission assessments and where appropriate included care management or health authority assessments of care needs. Care Homes for Older People Page 11 of 31 Evidence: This makes sure that the service finds out about peoples individual personal and health care needs and understands if the service has the knowledge, skills and capacity to safely care for them if they are admitted to the home. Records in the home also demonstrated that people are given the opportunity to visit the home before they make a decision to move there on a more permanent basis. One person spoken to by the Commission stated I used to visit a friend here before, so I knew when I needed to be looked after i would come here. If individuals are identified as being interested in a placement at the home, then the service sends them an introductory brochure, statement of purpose and service user guide. These documents help a person to see what services would be available to them if they were admitted to the home. Quarry bank do not provide intermediate care to the people that use the service. Care Homes for Older People Page 12 of 31 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 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. This means that peoples individual health and personal care needs are met through the services provided at the home. Evidence: The Commission looked at three care files for people that were living at the the home. This included looking at peoples individual care plans. The care plans described the support that individuals needed in their daily lives and activities, There was evidence that the quality of information included in peoples care plans had improved to some extent, however some of this information was only basically recorded. This could result in people not receiving all of the support that they need or they may not receive it in a way that is acceptable to them. The manager of the home needs to develop the care plans further to offer more person centered care to the people that use the Care Homes for Older People Page 13 of 31 Evidence: service. an example of this is current care plans may identify how many people are required to support a person to have a bath, however they dont necessarily identify how that support should be offered to the individual. The manager should make sure that all of the documentation completed by the staff in the home is fully signed and dated so that an audit trail can be established. This includes care plans, care plan evaluations and the homes key worker support notes. Peoples care files identified when they are supported with their health care needs provided through professionals that are based in the community. This included General Practitioners, community nurses, chiropodists and psychiatrists. The home needs to record the outcome of these contacts in a clearer and more accessible way. This will help to keep a clear audit trail of any health care support that people may receive and the reason for it. One person said I always see the nurse in my room. Where appropriate individual are plans were supported by risk assessments. The risk assessments that were observed were clear and where much more person centered that the original care plans. Areas of risk that were identified included, bathing, incontinence, skin integrity, nutrition, use of toilet, mobility and dexterity and use of wheel chairs. The medication practices in the home were observed during the site visit to the service at and all legislation and good practice guidelines were followed. all of the prescribed medication in the home is provided through a national chemist chain. They also provide medication training for the care staff that administer prescribed medication in the home. the medication provider also carry out regular audits of the medication that is stored in the home and have also provided the home with a new drugs trolley and a fax machine to enable the home to fax new requests, or identify misses on their deliveries. There were no drugs that required refrigeration at the time of the site visit, however the home did have facilities to safely keep medications safe if they need to be stored in a fridge. There were no controlled drugs in the home at the time of the inspection, however the home did have a prescription for Temaxepan and as good practice this was stored ad recorded as a controlled drug. Direct observation showed that the people that live at the home are well cared for and looked after. It was obvious from the observations that the care staff and the people that use the service have very good working relationships and the staff clearly understand their needs. This evidence was also supported through the homes training records. Care Homes for Older People Page 14 of 31 Evidence: The observation also helped to support the evidence that peoples dignity, respect and privacy was upheld at the home. A visitor to the home said that when we visit we can either see her in one of the lounges or go to her room if we want more privacy. The manager of the home stated to the Commission that the home has worked hard with the people that use the service to identify what their last wishes are in the event of their deaths. he stated that this has been difficult to approach with some of the people that live at the home, however she produced evidence that the home have supported individuals to take out funeral bonds that included any service that they required and any music that they would prefer to be used at their funerals. Care Homes for Older People Page 15 of 31 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 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 that live at the home are encouraged to maintain and develop the interests and hobbies that they had before they were admitted to the home. Evidence: People that live at the home are encouraged to take part in activities that the home arranges both in the home itself and in the general community. Individual care plans identify peoples interests and hobbies and care staff spoken to by the Commission said that they organised regular activities in the home to keep the people that live there active, motivated and interested. . The activity plans for the home were preparing everyone for the run up to Christmas.There is a planned programme of events and this is displayed in the home. Direct observations also identified that the care staff talk to individuals living at the home to try and encourage them to become involved in the activities that were being arranged. One person told the Commission We are going to Hull fayre tomorrow, Im not going on the rides though, but I like the Care Homes for Older People Page 16 of 31 Evidence: fayre. The home has access to a minibus. This means that people can have the opportunity of traveling to and from activities without too many problems. The mini-bus is also suitable for the use with wheelchairs. Entertainers from outside the service are also invited in to the home to provide s to the people that use the service. This included musical evenings, hairdressing and religious services. The religious services are held on a monthly basis at the home. At the time of the site visit the only religious services were for the Church of England, however the manager stated that if anyone was admitted to the home and had different religious needs then appropriate arrangements would be made to support them with their religious needs. She went on to say that a catholic priest had previously visited people at the the home if they were Catholic. The care plans that were observed by the Commission included personal profiles. This detailed peoples individual likes and dislikes and included the identification of any interests that the person had before they were admitted to the home. Direct observations showed that several different daily newspapers were in the lounges of the home. The staff confirmed that most of these were provided by the home, however they added that some people want their own newspapers so they order them for them. Large print newspapers are also made available to anyone that needs them. The direct observations also showed that people can choose to walk around the home as they wish and use any of the communal areas or their own rooms. Information boards were strategically placed around the home to remind the people that live at the home which staff are on duty. The staff that work at the home have name badges, however on the day of the site visit some of the staff did not wear them. This could cause problems for some of the people that live at the home as they cant remember peoples names and this could lead to them becoming frustrated, or withdrawn because they dont know who they are talking to. Visitors are encouraged to visit the home at any reasonable time. One persons relatives that live abroad regularly contact them at the home and also speak to the staff to get an update on the persons care. The dining room in the home was well organised, however there was not a lot of room in it when everyone was seated and this included several wheelchairs. The care staff were observed supporting individuals through one of the meal periods at the home. Care Homes for Older People Page 17 of 31 Evidence: The staff were very sensitive to the needs of the people that they were supporting, whilst at the same time supporting their dignity and respect. One person with dementia care needs soon after finishing their meal questioned when they were going to be fed, the staff re-assured them that they had already eaten, arranged for them to have a hot drink and biscuits and diverted their attention to something else.The mealtime was quite a relaxed. On the day of the site visit the homes cook was on leave. The meals were prepared by an additional member of the care staff that has received food hygiene training. The meal was well presented and people spoken to by the Commission said that they had enjoyed their meal. There was no alternative meal available however the cook explained what alternatives could be provided at short notice. There were no special diets required at the home at the time of the site visit except for low sugar, or low fat diets. Care Homes for Older People Page 18 of 31 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using 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. This means that the people that use the service are protected from abusive situations and the home has a clear complaints policy and procedure. Evidence: The home has a clear complaints policy and procedure. This is displayed in public areas of the home. One complaint had been received by the home since the last inspection of the service. This was investigated by the management of the home and was unfounded. Observation of the homes complaints records identified that no other complaints had been recorded in the home. The manager stated that when people that live at the home raise concerns to her she tries to find a solution for them before they become a formal complaint about the service. Most of the people that were spoken too by the Commission didnt really understand the homes complaints policies and procedures. This was due to their levels of understanding and not due to the quality of the information that was available to them, however they said that if they were not happy about anything then they would tell the matron, or the staff. One person saidmy family would make sure that i am Care Homes for Older People Page 19 of 31 Evidence: alright Staff training records showed that all of the care staff receive training in relation to safeguarding adult and their NVQ training includes a unit in relation to safeguarding adults. The staff that were interviewed by the Commission all understood how to report any alleged allegations of abuse. There had been one referral made about the home to the local safeguarding adults team since the last inspection of the service. The allegation was investigated by the local authority. The issues were resolved and no actions were taken. Staff employment records also showed that they had completed appropriate safety vetting before they had been employed to work with the people at the home. Care Homes for Older People Page 20 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People 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. This means that the environment is suitable to meet the needs of the people that use the service. Evidence: As part of the site visit to the service, the Commission made a tour of the premises and its grounds. Quarry Bank is an old detached house that has been adapted to provide residential accommodation. The access to the building is suitable to people with mobility problems. The gardens around the building were well maintained. People that use the service have the choice to use their own rooms or any of the three communal areas of the home. The home also has a large conservatory that can be used. One person said I like to use this room because it is quiet and not too many interruptions. The home is furnished and decorated to create a homely, friendly and warm environment. Many of the period fireplaces and wall coverings have been preserved to Care Homes for Older People Page 21 of 31 Evidence: create a style similar to a country manor. The bedrooms in the home are provided over two floors and there is a passenger lift available for use. Most of the bedrooms in the home are for two people, however the people spoken too by the Commission appeared to be happy with these arrangements. The Commission advised the manager of the home that peoples care files should include agreement to sharing a room with another person and these should regularly be evaluated to make sure that they are still relevant. On the day of the site visit the Commission also looked around the homes kitchen. One of the fly screens on the window was ripped. The manager stated that this had been reported and a new one had been ordered. The oven in the kitchen also needed attention. It was dirty on the inside and needed cleaning. The bathrooms and toilets in the home are well placed around the building and are easily assessable. All of these areas were free of any offensive smells and odours. However in bathroom 9 there were some infection control concerns. There was an open shelf unit where towels and bedding were stored. Therefore multiples of people could be making contact with these materials. Some of the towels in this area also needed to be replaced as they were worn out and ragged. The manager had these towels removed immediately and said that they would be replaced. The treatment room at the home was very cluttered on the day of the site visit and would not have been available to use if it was required. The manager stated that she would have this area cleared up. The general decoration of the home was good, however there were some area of the home where wheelchairs had damaged the skirting boards and doors, these areas should be redecorated to maintain a homely and comfortable environment for the people that use the service. Since the last inspection of the service the management of the home have continued to improve the quality of the environment and this has included: new bedroom furniture to two rooms, three new beds, new curtains in two rooms, new toilet floor fitted, passenger lift upgraded and replacement of the units and worktops in the kitchen. All of the appropriate maintenance and service records were up to date in the home. This included the records for the service and maintenance of wheelchairs, landlord gas safety certificate, electrical hardware installation certificate, legionella certificate. Care Homes for Older People Page 22 of 31 Evidence: There were also appropriate contracts for the collection of waste and controlled waste from the home. Care Homes for Older People Page 23 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using 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. This means that the people that use the service are supported by staff who are well trained and have the knowledge and skills to be able to safely care for them and the staff have been recruited to the home using appropriate safety vetting procedures Evidence: During the site visit to the service the Commission observed the interactions between the care staff and the people that use the service. It was obvious from these observations that all of the staff had very good working relationships with the people that use the service and clearly understood their needs and how they wanted to be supported with them. The atmosphere in the home was very calm and friendly. The staffing levels were appropriate to the needs of the people that use the service. The ratios for staff were three staff working in the day and to staff were on duty on a night time. The service also employs a domestic member of staff and a cook. Care Homes for Older People Page 24 of 31 Evidence: The management and care staff working at the home are very positive in relation to National Vocational Qualifications (NVQ). At the time of the site visit there were fourteen care staff working at the home. Fourteen of these had completed NVQ 2 in care. This equates to approximately 78 of the staff that have achieved this qualification. The remaining four staff are registered on the NVQ 2 award and are working towards it. Some of the staff have also completed NVQ 3 and NVQ 4 qualifications in care. The service also has incentives for the staff. They can receive monetary regards for consistency of work, introducing new staff to the service and introducing new residents to the home. There is also a payment made to staff that act as mentors to new members of staff. The staff training files showed that they are all up to date with their mandatory training. The records also showed that the at staff receive training in relation to the needs of older people including dementia care needs. The homes training plans also identified that the staff have been booked to attend person centered planning training provided through East Yorkshire council. One member of staff stated It seems that we are always training, but its good and keeps us up to date on things. The Commission looked at recruitment files for three of the staff that work at the service.were looked at. These all identified that appropriate safety vetting had been completed before they had begun to work at the home. This included application forms, two written references, health declarations and appropriate enhanced Criminal Record Bureau Checks. Care Homes for Older People Page 25 of 31 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People 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. This means that the management of the home understands and supports the needs of the people that live and work in the service. Evidence: The manager has worked at Quarry Bank for approximately eight years. prior to that she had been employed as a deputy manager of another service where she had worked for twelve years. She has completed the Registered Managers Award and is the registered manager of the home as accepted by the Commission. The manager of the home undertakes regular training with her staff to make sure that her knowledge and skills are kept up to date. Care Homes for Older People Page 26 of 31 Evidence: Direct observations and discussions with the homes manager identified that she likes to spend some of her time around the home mixing with the staff group and with the people that use the service. The manager stated that this helped her to understand the needs of all of the people in the home and helped to identify any changes that may be required in the service provision, to improve the quality of lives for the people that use the service. The management of the home was seen to be open, positive and inclusive. One person said to the Commission shes the boss here, but she always speaks to me, and a member of staff commented we have supervision about every two weeks, but the manager is supervising us and giving us advise every time that she is in the home. The service has a quality assurance and monitoring system, however this is shared with a sister company and the results of any survey are not published in relation to the individual homes. This could mean that the home may not be identifying improvements that are required to improve their own services and only get a corporate responce. The homes quality assurance programme is supported through regular staff and service user meetings. These meetings give people the opportunity of airing their views in relation to the improvement and development of the services that are provided through the home. The home has also attained the Investors In People award. Since the last inspection of the service the home has had a legionella test completed on the water system and the homes gas, electricity and lift safety certificates were up to date. The homes fire safety records were also up to date and had been accurately recorded. Also since the last inspection there are no longer any beds in the home that include bed rails. The manager of the home needs to make sure that when any documents are completed, the full names of the people that created them and the full date must be included. This will help to provide a clear audit trail for all of the paper work in the home. Care Homes for Older People Page 27 of 31 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 26 13 The floor covering in the 31/12/2008 toilet near to the office must be replaced. Then it will not be a potential trip hazard and it will be a more pleasant room too. Care Homes for Older People Page 28 of 31 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 26 16 The registered person must 06/11/2009 make sure that the homes infection control policies and procedures are followed. This will help to support the health and safety of the people that use the service. 2 26 16 The registered person must make sure that the oven in the kitchen is well maintained and clean. This will help to support the health and safety of the people that use the service. 06/11/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 The registered person should make sure that all of the individual care plans in the home are person centered. This will help to make sure that peoples needs are supported in a way that is safe and is acceptable to them. Care Homes for Older People Page 29 of 31 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 2 26 The registered person should make sure that the treatment room is uncluttered and is accessible to use when it is required. The registered person should make sure that the torn fly screen in the kitchen is replaced. This will help to support the health and safety of the people that use the service. The registered person should make sure that all of the records in the home include the full name of the person that completed them and include the full date for when the record was completed. This will help to keep a clear audit trail of the paper work in the home. 3 26 4 37 Care Homes for Older People Page 30 of 31 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. 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