Care Home: Queens Oak Care Centre

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What the care home does well Residents told us: • ‘it is warm, clean, well maintained, food is good and ample (too ample), ….it’s a nice place, so are the people,’ • ‘The home does everything well’ • ‘the home is very clean, it does everything for the clients’ Queens Oak Care Centre DS0000007045.V378387.R01.S.doc Version 5.2 Relatives told us: • ‘The service does very well in all aspects and I am perfectly pleased with the service…..I couldn’t ask for more…no complaints at all.’ • ‘They look after my mother very well and keep me informed of anything that is wrong.’ • ‘My mum is well looked after …… I am happy with the service.’ Staff told us: • ‘the home provides up to date training …all kinds of facilities for us to improve our knowledge’ • ‘Excellent training.’ • ‘The management support is much appreciated’. Professionals told us: • The home provides ‘first class care’ • ‘on the occasions that I have visited Queens Oak I have found that the staff have been wonderfully welcoming and the Care Manager Lorna Thomas to be more than helpful.’ • ‘The home is always clean and fresh’ What has improved since the last inspection? At the last inspection requirements were made about the management, recording and administration of medication. We were pleased to note that all of these issues have been addressed. What the care home could do better: We have not made any requirements of recommendations as a result of this inspection. Key inspection report CARE HOMES FOR OLDER PEOPLE Queens Oak Care Centre 64-72 Queens Road Peckham London SE15 2QL Lead Inspector Alison Pritchard Key Unannounced Inspection 09:00 12th & 26th November 2009 DS0000007045.V378387.R01.S.do c Version 5.3 Page 1 This report is a review of the 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. 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. Queens Oak Care Centre DS0000007045.V378387.R01.S.doc Version 5.2 Page 2 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 Queens Oak Care Centre DS0000007045.V378387.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Queens Oak Care Centre Address 64-72 Queens Road Peckham London SE15 2QL Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 7277 9283 020 7277 9263 lorna.thomas@excelcareholdings .com Lancewood Ltd Lorna Esmay Thomas Care Home 88 Category(ies) of Dementia - over 65 years of age (34), Old age, registration, with number not falling within any other category (54) of places Queens Oak Care Centre DS0000007045.V378387.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing – Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia – Code DE 2. The maximum number of service users who can be accommodated is: 88 Date of last inspection 18th November 2008 Brief Description of the Service: Queens Oak Care Centre is a care home with nursing for older people, built in 2001. It is owned by Excel Care, a large care provider with homes in London and other parts of the country. There are four floors and care for residents suffering from dementia is provided on two of them. Care for residents with physical frailty and for residents requiring nursing care is provided on the other two floors. The home is near Peckham town centre, close to shops and all community amenities. There are train and bus routes near the home and some parking space in front of it. All bedrooms are single and all but four are fully en-suite. Queens Oak Care Centre DS0000007045.V378387.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. This unannounced inspection took place in November 2009 over two days. On the first day three inspectors visited, including the pharmacy inspector who checked the medication and dispensing practices in the home. After our first visit the Registered Manager was on holiday. The second visit took place after her return and was conducted by one inspector. While we were visiting the home we toured the building; had discussions with residents, relatives and staff; we observed care practices, including activity sessions and we joined residents at mealtimes. We checked a range of records while we were at the home including care plans; staff records and building maintenance records. In advance of the inspection the Registered Manager completed a document called an Annual Quality Assurance Assessment (AQAA). The AQAA is a selfassessment that focuses on how well outcomes are being met for people using the service. It also gives us some numerical information about the service. The AQAA was completed and returned in time and was used as part of the inspection. We also looked at the things that the Registered Manager has told us have happened in the service, these are called ‘notifications’ and are a legal requirement. Before we visited the home we sent surveys to a range of people with an interest in the home, including residents, relatives, staff and involved professionals. 47 surveys were returned to us. We also had contact with a range of professionals including the local authority contract monitoring team and specialist health care staff who work with the home. We took all of these views into consideration when forming our opinion of the home. We found that the home offers a high level of care and support to the residents. The manager and staff continue to give a good service. Staff were observed to be competent, caring and respectful. What the service does well: Residents told us: • ‘it is warm, clean, well maintained, food is good and ample (too ample), ….it’s a nice place, so are the people,’ • ‘The home does everything well’ • ‘the home is very clean, it does everything for the clients’ Queens Oak Care Centre DS0000007045.V378387.R01.S.doc Version 5.2 Page 6 Relatives told us: • ‘The service does very well in all aspects and I am perfectly pleased with the service…..I couldn’t ask for more…no complaints at all.’ • ‘They look after my mother very well and keep me informed of anything that is wrong.’ • ‘My mum is well looked after …… I am happy with the service.’ Staff told us: • ‘the home provides up to date training …all kinds of facilities for us to improve our knowledge’ • ‘Excellent training.’ • ‘The management support is much appreciated’. Professionals told us: • The home provides ‘first class care’ • ‘on the occasions that I have visited Queens Oak I have found that the staff have been wonderfully welcoming and the Care Manager Lorna Thomas to be more than helpful.’ • ‘The home is always clean and fresh’ What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. 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. Queens Oak Care Centre DS0000007045.V378387.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Queens Oak Care Centre DS0000007045.V378387.R01.S.doc Version 5.3 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4, 5. Standard 6 is not applicable as the home does not provide intermediate care. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information is provided for potential residents so that they can make an informed choice about whether the home will be an appropriate place for them to live. Enough information is gathered by the home to ensure that they can meet the needs of people coming to live there. EVIDENCE: A resident told us that they had been given information about the home before they had come to live there and we saw there was a copy of the service user guide in their room. Copies of the documents are available in the foyer of the home for visitors to see. The majority of residents who responded to our surveys said that they (or their relatives) had enough information about the home before they went to live there. Queens Oak Care Centre DS0000007045.V378387.R01.S.doc Version 5.3 Page 9 The Registered Manager informed us that the needs of all potential residents are assessed before they move to the home and that they understood the importance of ensuring that they can meet a person’s needs before they are admitted. We also discussed the admission process with staff on the first floor and they confirmed that only people whose needs they can meet are admitted to Queens Oak. We were assured that inappropriate admissions to the home are not made. We saw assessments carried out by senior staff from Queens Oak in the files. We also saw referral and assessment documents from placing social workers. Relatives and potential residents are encouraged to visit the home prior to admission. The home monitors the success of the visits and we were told that, over the last year, all of the people who had visited the home with a view to moving in had chosen to do so. Queens Oak Care Centre DS0000007045.V378387.R01.S.doc Version 5.3 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, 11. People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from good arrangements to meet their health and personal care needs. There is achieved through effective care planning and good liaison with health care professionals. A small team of staff have been trained to provide foot care and they work closely with podiatrists. The arrangements for medication management are good. Residents are treated with respect and regard to their dignity and privacy. Staff in the home are trained to provide sensitive and respectful care to residents and their relatives at the time of their death. EVIDENCE: We looked at a range of care plans for residents. We found that the format was clear and comprehensive and that residents who were able to do so had signed to confirm that they had read and had input to the plan. The plans related to the residents’ assessments of need. The plans included a range of physical and Queens Oak Care Centre DS0000007045.V378387.R01.S.doc Version 5.3 Page 11 medical needs as well as information about aspects of social care and how they would be met. The care plans were reviewed regularly and we saw evidence of auditing by senior members of staff. Notes in files and our discussions showed that there is good contact with specialist health professionals, including the GP service, Community Psychiatric Services, Tissue Viability Nurses and the Older People’s Nurse from the Care Home Support Team. Four of the staff from Queen’s Oak have undertaken specialist training in foot care and work in partnership with visiting podiatrists to provide residents with a quick response to a foot care need. The safe handling of medicines was assessed by a Commission pharmacist inspector. This was because a statutory enforcement notice had been issued after the last key inspection in November 2008 after we found a number of errors on medication records, some dressings, needles and appliances were being stored although out of date, and a medicine was not being stored securely in a medicines cabinet. At this inspection we looked at medication records, medication storage, medication supplies and care plans for a selection of people at the home. We also observed people being given their medicines by the nursing and care staff. At this inspection, evidence from medication records and supplies showed that the home is now meeting the medication standard and residents are receiving their medicines on time and as prescribed. We observed staff giving medication and completing medication records. This provided evidence that staff are now following the homes procedures, ensuring medicines are given safely. After the last inspection, staff had retraining in medicines handling, and all non-nursing care-staff who give medicines on the residential floors have had a medicines competency assessment to ensure they are trained and competent to give medicines. Controlled drugs are stored safely and records are accurate. The temperature of all medicines storage areas are monitored, and records showed that medicines are being stored at the correct temperatures except for one item, see below. Regular medication audits are carried out by the Clinical Care Manager, and the Team Leaders on each floor carry out daily monitoring to ensure medicines have been given and signed for, and these are effective as very few issues were found. Issues are: Queens Oak Care Centre DS0000007045.V378387.R01.S.doc Version 5.3 Page 12 -insulin on one of the residential floors is administered by the district nurse, however the insulin has not been stored according to the manufacturers recommendations. The insulin in use is being stored in the fridge, and the unopened insulin is being stored out of the fridge. The Registered Manager advised that this has been pointed out to the district nurses but they have requested these storage conditions however it would be good practice to store insulin according to the manufacturers’ instructions. -one resident is on warfarin, the medication record states take as directed, and staff have indicated what should be given by marking the medication record with an X and the number to be given below. Records and stock checks show that it is being given correctly, however it would be good practice to add the full dosage onto the medication record. -one resident is prescribed an enema once daily, this is being signed for as given at 9am, but staff informed us that they are giving this at night, so the record is not accurate. We saw throughout the inspection that staff respected residents’ rights, for example by knocking before entering their rooms. We also saw that a note is made in the residents’ files of their preferred name. The staff that we saw and spoke with seemed to have a good relationship with residents who all spoke very highly of them. We also saw staff being respectful of the relationships between residents. A resident told us that the home had helped them keep their independence and they had all they needed. They said they were happy with the choices they were being given. We looked at some care plans relating to end of life care. The home has achieved a commendation in the Gold Standard Framework and Help the Aged Quality Hallmark Award. The assessment report stated that the home’s work was impressive and many of the standards had been exceeded. Staff talked enthusiastically about the training they have undertaken and how this has been implemented in care practice. They have good relationships with staff from St Christopher’s Hospice. The care that the home gives at the time of a resident’s death is also extended to relatives. Family and friends have the option to use a quiet room in the home as a base. It gives them some privacy and a place to stay overnight if they wish. Queens Oak Care Centre DS0000007045.V378387.R01.S.doc Version 5.3 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Activities are provided and residents are encouraged to follow those which interest them. There is good consideration of residents’ spiritual needs. Visitors are welcomed to the home. A choice of meals is available and reflects residents’ cultural and nutritional needs. EVIDENCE: The home has a large number of activities and these are displayed on the notice boards in the communal areas. We saw there was a rolling four week activities programme. This would be amended at festival times such as Christmas to accommodate extra activities that may be arranged. We observed a session of ‘Sonas’ which is an activity to help residents whose communication is reduced because of their dementia and who benefit from stimulation. We saw that residents were engaged in and enjoyed the session and communicated with the member of staff who led the group; there was also some degree of interaction between residents. We were impressed by the skill Queens Oak Care Centre DS0000007045.V378387.R01.S.doc Version 5.3 Page 14 of the staff members who led the group and felt that the residents benefited from it. The session was held in a room which is equipped with sensory equipment. It can also be used for relaxation sessions and is a useful resource for the home. The home has a quiet room that can be used for meditation and prayer. Family and friends have used it as a base at times when a relative in the home is dying. It gives them some privacy and a place to stay. We were told one of the chairs makes into a bed if they choose to stay overnight. This room is also used by a number of local ministers who come on a regular basis to conduct religious services. We were told a number had been booked for over the Christmas/ Holiday period. On the day of the inspection we met a minister who said they came every few weeks to visit a parishioner and would be happy to come to conduct a service for the residents at Christmas. There are two activities coordinators and one goes around the home working with residents who stay in their rooms because they are unwell or perhaps prefer not to join in group activities. We spoke to one resident who said they enjoy the activities but do not always know they are on and where they will take place. They felt the home were great a putting notices up but said they need to tell people. The activities coordinator said they do go around telling residents about the activities and go to get them when the activity is about to start. They said they also ask staff to bring residents to where they are taking place. On the day of the inspection we saw this happening and joined the residents for a short time as they were doing their activities program. The activities coordinator said they keep records of all who refuse to join in the activities. The hairdresser comes in each week and makes it a social event. Residents enjoy their hair being done and meeting other residents from other parts of the home. Residents have meetings every other month and every three months for relatives. These meetings allow residents and their representatives to be consulted and to bring their views about life in the home. We were able to join the residents for lunch. A choice is available at each meal, a pictorial menu is used to assist residents to make a choice. The choices include dishes which reflect the range of residents’ cultures. There was plenty of food but we found the food quite salty and spicy for our taste. When we spoke to the residents they said “you get used to it, you have to” another said “don’t like it, but you can’t do much about it”. Other residents said they were happy with the food. When residents asked what was for pudding the staff said “pudding” and did not explain what kind. It was rice pudding and we would have expected jam or cream to be offered with it, but it was not. Everyone was offered a choice of fruit drinks with their lunch, we would suggest that water should also be available as a choice. Queens Oak Care Centre DS0000007045.V378387.R01.S.doc Version 5.3 Page 15 The Registered Manager told us that a ‘Hospitality Group’ has been formed and are reviewing the meals, especially their presentation. Our comments and those that we received from the residents should be considered here. Queens Oak Care Centre DS0000007045.V378387.R01.S.doc Version 5.3 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. People using the 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 complaints and safeguarding procedures are part of the home’s way ensuring that residents are safe. Residents and their relatives feel able to complain and we have confidence that the issue would be investigated properly. EVIDENCE: The complaints procedure meets the required standard and regulations. We looked at the records of complaints and noted the information given to us on the AQAA. We noted from the records that complaints are investigated thoroughly and promptly. The complaints received are monitored by the Excelcare Quality Assurance department and reviewed by the Operations Manager as part of her regular visits to the home. Over the last year there has been training for senior staff about the management of complaints. There have been no upheld complaints over the last year. The majority of residents and all of the relatives who responded to our surveys said that they knew how to make a complaint if they needed to; one person added ‘no complaints at all’. Staff confirmed that they have received training in safeguarding issues and knew what to do in the event of a concern being raised with them. The Registered Manager is aware of her responsibilities under the deprivation of liberty safeguards legislation and has made appropriate referrals to protect the interests and rights of service users. Queens Oak Care Centre DS0000007045.V378387.R01.S.doc Version 5.3 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 23, 24, 25, 26. People using this service experience excellent quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. The home is accessible to people with a range of disabilities. Refurbishment of some areas has begun and more is planned. It is hygienic and clean. The bedrooms we saw are were homely and meet the residents assessed needs. The communal areas are bright, warm and comfortable. EVIDENCE: The home is located on a busy main road close to public transport routes. Off street parking is available at the front of the building. There are arrangements to ensure that residents are safe from the traffic. Each of the four floors in the home has communal areas and bedrooms. Of the 88 bedrooms 84 have ensuite facilities. The communal lounges look out onto the main road and residents are able to look out and watch the traffic and passers by. On the upper floors are balconies which made safe by high rails and residents can sit Queens Oak Care Centre DS0000007045.V378387.R01.S.doc Version 5.3 Page 18 outside and some choose to smoke in these areas. There are two lifts to allow access between the floors. We toured the building and found that it is well maintained, bright and airy. There were areas that needed some minor maintenance, for example we noted a couple of water problems and they were dealt with immediately. The home is kept clean and was mainly odour free but a couple of times we detected a malodour. When we mentioned it, it was dealt with. All communal areas are cleaned each day. The Service Manager said they were planning a major refurbishment of the home and it was due to start in the next couple of weeks. The flooring was to be changed and more appropriate flooring put in the communal areas. We were shown the garden that is used in both summer and winter. This has been landscaped and has a lovely water feature in a sensory bed of herbs and fragrant flowers. During the warmer weather residents come to sit and listen to the water and enjoy being outside. We did not observe any problems with the ventilation although we found it a little warm. A relative when asked on a survey what the service could do better commented ‘make sure the temperature in the home is not so hot!’ Conversely a resident said that they thought the building was ‘lovely and warm’. There are good arrangements for hygiene in the home. There is an action plan for infection control and the majority of staff have completed infection control training. Anti-bacterial hand gel is available on all of the floors. Queens Oak Care Centre DS0000007045.V378387.R01.S.doc Version 5.3 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are enough well trained staff to meet the needs of the residents. They are well supported for their roles. Recruitment practice is safe and helps to protect residents. EVIDENCE: The staffing levels are adjusted to reflect the number of residents and their needs. For example at the time we visited there were 23 residents on the first floor which caters for people with nursing needs, (at the time there were 4 vacancies on this floor). There is always at least one nurse on duty on the first floor; if numbers rise above 23 an additional nurse is on duty. There are 4 carers on duty throughout the day and at night time there are 3 carers on duty until midnight and thereafter 2 carers work on the floor. Similarly the staffing levels on the other floors are adjusted to meet the numbers and needs of residents. We received a comment that an additional member of staff on the first floor would be useful. Our observations and the majority of staff feedback was that the staffing levels allow residents’ needs to be met. Queens Oak Care Centre DS0000007045.V378387.R01.S.doc Version 5.3 Page 20 The home has a room it uses as a staff training room. There is an over head projector used to group training sessions. The organization has introduced etraining for staff. They can do this as a group in the home on the home’s computer and they have been allocated a pass code so they can access the training from home. They have had training in health and safety; safeguarding; deprivation of liberty and the Mental Capacity Act and manual handling. We were told the pharmacist has provided medication refresher training with staff. Equality and diversity is completed through Distance Learning. Twenty five of the current care staff have achieved NVQ level 2 or above. Others are undertaking the training. Several staff members in the responses to surveys and in discussions told us that the training opportunities available is a very positive feature of the home. Staff said they had regular supervision and feel supported in their work. Training needs were identified and they discussed their development needs with their manager in supervision and at appraisals. There is a meeting every Monday for heads of departments. Staff said they had regular monthly staff meetings and we saw minutes of these. We looked at recruitment records for five members of staff. The files were in good order. We found that the appropriate checks and references had been taken up prior to their appointment. Staff undertake induction training. The majority of staff who responded to our survey said that this prepared them very well for their role. Queens Oak Care Centre DS0000007045.V378387.R01.S.doc Version 5.3 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 38. People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management systems are effective and ensure the smooth running of the service. The quality assurance systems are aimed at ensuring that a high quality of care is maintained and that residents’ and relatives’ views are sought. There are safe working practices in the home and this ensures the health, safety and welfare of residents and staff. EVIDENCE: The Manager has been registered under the Care Standards Act since February 2007. She has substantial experience in the management of care homes and has a management qualification. The Registered Manager updates her knowledge through ongoing training. The Registered Manager is assisted in her role by the Deputy Manager who is a qualified nurse and responsible for all Queens Oak Care Centre DS0000007045.V378387.R01.S.doc Version 5.3 Page 22 clinical matters for those residents who require nursing care. They are an effective team and work closely together for the benefit of the residents. The staff confirmed that the management approach at the home is open and supportive and this benefits the residents. One comment we received was ‘the home takes good care of the residents and employees…they want their employees to provide proper care for the residents’….another was ‘the home management support is very much appreciated’. The Quality Assurance systems in the home include regular surveys of residents and relatives; monthly monitoring of reviews; dependency levels; nutritional assessments; accidents; activities; complaints and safeguarding issues. Visits are carried out each month on behalf of the Registered Provider, they are thorough and focused and include a range of care, management and premises issues. The placing authority (Lambeth Social Services) visit to monitor the contract they have with the service. We had discussions with the monitoring officer and had sight of the most recent report, they have no concerns about the service at Queen’s Oak and are satisfied with the care provided. Their monitoring includes checking residents’ finances and regular audits are also conducted by staff from the managing company as well as by senior staff within the home.. All the appropriate health and safety checks are in place. Saw records that are kept for these and they are up to date. We spoke to one of the maintenance people and they told us they did a visual check of all potential hazards each day, including the fire doors. We were told there are regular weekly and monthly checks that are carried out and a record of this was seen. Each unit kept a book to report faults that have occurred and the maintenance man checks these each day too. Queens Oak Care Centre DS0000007045.V378387.R01.S.doc Version 5.3 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 4 4 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 4 X X 3 3 3 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 4 X 3 3 X 3 Queens Oak Care Centre DS0000007045.V378387.R01.S.doc Version 5.3 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Queens Oak Care Centre DS0000007045.V378387.R01.S.doc Version 5.3 Page 25 Care Quality Commission Care Quality Commission Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: 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. 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