Care Home: Rose Martha Care Centre

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What the care home does well Overall the staff have managed to push the quality of care to a better standard for all residents than previously. For instance the manager works transparently with CQC and keeps them regularly informed about issues and progress of the home, staff and residents. She works well with other professionals in partnerships (we were told this by professionals) and is positive in her approach to any safeguarding or complaints raised about the home. The manager and the administrator are both highly organised and are good at keeping records up-to-date and accurate. The activity worker who has worked at Rose Martha for a long period of time has built a good rapport with individuals and knows her job well is well trained and carries this role to a good standard. All care staff spoken with were knowledgeable about the residents they look after, are well trained and make visitors feel at ease. The maintenance person carries out jobs quickly and to a good standard. All residents spoken with and surveys returned gave consistency in their high praise regarding their home being always clean, free from bad odour and looking nice. The residents also said that the chefs, who provide their meals, give them a good choice, reflects their tastes and is tasty. Additionally the home has recently developed different areas around the home by putting painted themes on the communal walls that the residents have chosen such as, flowers, fruit and veg stall, a shop and various other themes requested by the residents that held some significants for them. This helps people who suffer from confusion or dementia identifies areas around the home and retains more independence from staff for them. The AQAA returned was written to a high standard giving evidenced based information about how they meet the needs of all people under their care. What has improved since the last inspection? All requirements and recommendations from the last key inspection have been achieved. The service has developed its person centred approaches and now consults, writes down each person preferences and wishes. A care plan is then developed from this person centred approach. Activities are much more varied, frequent and the activity coordinator arranges and monitors this. Quality assurance is to a good standard and is holistic in its approach with outcomes and achievements recorded each year. The management team have improved safety by securing training, induction staff observation, meetings and regular supervisions. What the care home could do better: There are no regulations or recommendations made by CQC at this present time. Key inspection report Care homes for older people Name: Address: Rose Martha Care Centre 64 Leigh Road Leigh On Sea Essex SS9 1LF     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: Sarah Axam     Date: 1 8 0 3 2 0 1 0 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 27 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Rose Martha Care Centre 64 Leigh Road Leigh On Sea Essex SS9 1LF 01702482252 01702716887 rose.martha@ashbourne.co.uk www.southerncrosshealthcare.co.uk Ashbourne (Eton) Limited Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Victoria Jane Richardson Type of registration: Number of places registered: care home 76 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 76. 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: Old age, not falling within any other category - Code OP Dementia - Code DE Date of last inspection Brief description of the care home Rose Martha Care Centre is a purpose built establishment situated in Leigh on Sea. The home is close to local amenities and access to local bus and train routes is good. The home provides residential care for up to seventy-six older people. The registration category also permits the home to provide care for older people who have dementia. The home also offers `step down`, a scheme whereby arrangements exist with the Care Homes for Older People Page 4 of 27 Over 65 0 76 76 0 0 3 0 4 2 0 0 9 Brief description of the care home local hospital where beds are contracted for those patients who are assessed as suitable for residential care. All bedrooms have en-suite facilities for residents. The communal areas consist of two lounge and dining areas on both the ground and first floors. The home also provides a designated smoking area, visitors/hairdressing room and an activities room. Access to the first floor is via a passenger lift. The gardens are well maintained. The home offers parking to the front of the property. Inspection reports are readily available for visitors to the care home and are displayed in the main reception area. Upon request, prospective residents and/or their representatives can have a copy of the last report. A copy of the homes Statement of Purpose and Service Users Guide is also readily available and accessible. The range of fees is £379.00 to £421.00 for a social services bed and £525.00 to £700.00 for a private bed. Care Homes for Older People Page 5 of 27 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 unannounced site visit took eight hours to complete and was carried out as part of the annual inspection programme for this service. This visit was conducted with assistance from the Registered Manager and the local Area Manager. As part of the process a number of records relating to residents, care staff and the general running of the home were examined. We looked at all the information that we had received, or asked for, or what the service has told us about things that had happened in the service since the last inspection. Five staff and six residents were spoken with during the site inspection. Prior to this site visit, CQC (Care Quality Commission) sent out surveys to all interested parties and 22 from residents and 4 from relatives were returned to us. Additionally the manager was sent an (AQAA) Annual Quality Assurance Assessment form by us. This is a self assessment required by law that asked how well the service thinks it is meeting the needs of the people who live at the Rose Martha Care Centre and the information Care Homes for Older People Page 6 of 27 recorded within the AQAA was to an excellent standard. All information obtained was triangulated and reviewed against the commissions key lines for regulatory activity. This helps us to use the information to make judgements about the outcomes for the people who use this service in a consistent and fair way. Care Homes for Older People Page 7 of 27 What the care home does well: 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. Care Homes for Older People Page 8 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 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. A clear and comprehensive assessment process assures people that their needs could be met prior to moving in their home. Evidence: The manager told us in the Annual Quality Assurance Assessment told us that there is a residents guide available, which provides information about the home to help people decide if they would want to live at the Rose Martha Care Centre. When we visited we looked at this information. The guide produced by the management team clearly sets out the specialist services the home offers and what qualifications the staff hold. There was also information about how a person could complain if they were unhappy about the home. Half of the residents who returned surveys to us told us that they felt they knew who to complain to and what the procedure was. Six residents spoken with named particular staff and people they could speak with if need be and all felt (including 3 relatives) that their complaints or Care Homes for Older People Page 10 of 27 Evidence: concerns would be dealt with to their satisfaction. Half of the residents felt that they had no or not enough information about complaints or procedures. We saw by documentation provided in the care plans that people who maybe interested in the home had visits arranged to the home to have a look around, meet other residents and the staff. They could also have meals there and have time to get the general feel of the home. If they were happy to proceed to apply for a placement then an assessment is carried out by qualified staff. All the residents who returned surveys (and that we spoke with, including 3 relatives), told us that they all had enough information given to them before making a decision to secure a placement within the home. When we looked at the assessments we found that they included that persons specific issues, such as diabetes, dementia, wound care etc. And all assessments we saw covered areas such as, mobility diets, weight, nutrition, safety, individual care needs, risks, mental and physical well being. All records viewed showed us that they all gave sufficient detail about individual needs and that all peoples health was being monitored and included health professionals to manage this appropriately and well. Assessments were all in place for all peoples files looked at. All contracts were seen in all peoples files sampled and signed by all parties as expected by us. Care Homes for Older People Page 11 of 27 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. Residents assessed needs are followed through in good care plans that give staff the necessary information to provide good care outcomes. Evidence: All of the residents who returned surveys and the 4 residents and 3 relatives spoken with told us that they felt the care received was to a good standard and they received the support they needed at all times. The manager told us in the Annual Quality Assurance Assessment that the health and personal care needs of all residents are met and that staff are trained to a good standard and specific to all residents needs within their care. We saw by a training matrix looked at and looking through 10 staff files that all staff receive in house training and practical advice and have continuous support and opportunities to discuss any anxieties or concerns. Five staff spoken to at the site inspection confirmed this to us. We saw by looking through 8 residents notes, letters and summaries that the staff and management team work closely with external professionals and specialists (consultants, District nurses etc) for advice and support. Care Homes for Older People Page 12 of 27 Evidence: We saw in 8 peoples files that they all receive effective personal and health care support using a person centred approach with support provided based upon dignity, diversity, equality, fairness, autonomy of that person. Individual plans looked at showed us that peoples personal and health care needs are recorded clearly and detailed to staff in how they wished this to be delivered. Looking through all people care files we found that they all included things such as, water flow charts, fracture risk assessment, skin integrity assessment, behaviour assessment, turning charts and guidance for staff, assessment of physical needs such as, standing, immobilising, bathing and many more issue specific to an individual. All reviews were up to date with the relevant information to enable staff to support individuals appropriately. We saw that when people needed to have additional support such as, aids and equipment, that they are provided and in place. They are regularly reviewed and replaced to accommodate a persons changing needs. Additionally specialist advice is sought by the home, such as Occupational health, district nurses, tissue viability nurse, GPs to ensure effective use of equipment and care is consistently provided. All people have the opportunity to choose their own GP or have the choice to keep their existing GP and this was clearly recorded within their care plans. Looking through recorded entries it is clear to us that all people have good access to all NHS health care facilities within their local community. Regular appointments or visits made are well recorded by staff and there are systems in place to make sure that they are not missed. There was good information recorded about how medication is managed, for instance, the correct receipt, recording, storage and handling, administration and disposal of medications. When we visited the service the 5 staff spoken to, confirmed to us that they knew procedures well and were aware of individual need. The home has a sustained record of full compliance with the administration, safekeeping and disposal of controlled drugs. Staff who administers medication have the required accredited training. These are some of the statements made to us by the residents and relatives (surveys returned and speaking with them on the inspection day), Looking after residents is to a high standard, Carers take their time with people, carers are very helpful and supportive, staff will call for a doctor straight away if need be, the carers are very kind, it is good that we are reminded by the carers to use our walking frames for our safety, all staff are very friendly, give excellent care and are willing to help out, this home ticks all the boxes, the staff are always very helpful and friendly and Care Homes for Older People Page 13 of 27 Evidence: always have time for you, the staff that carries out our administration of medication are excellent and very organised, the staff meet our care needs and provides a friendly atmosphere. Care Homes for Older People Page 14 of 27 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 the service can be confident that their identified needs will be met appropriately and that they will be able to live the lifestyle they choose. Evidence: The home has an activity worker in place (for many years) and she been able to establish a more person centred approach to the activities provided. For instance the activities information looked at, showed us that all individuals had been consulted about activities, records showed us that they were asked, what they like and what they would like to try or if nothing was recorded from a person because they did not want to participate, of how staff could motivate some people into experiencing some form of interaction or stimulation. Things recorded that people liked to do, such as, having access to daily newspapers, having walks outside of the home and using the local facilities and a variety of games provided, cards, jigsaws board games etc. This was well recorded and outcomes achieved were monitored. The home still continued to provide activities for special occasions such as Easter, Christmas, birthdays and parties arranged when families, friends and significant people in the residents live were invited to. Additionally we saw in peoples individual plans and daily notes, that plenty of visits by family and friends went ahead and that Care Homes for Older People Page 15 of 27 Evidence: people had access to and visits from the local religious faith and ministers of their choice on a regular basis. From the surveys returned all residents felt the activities were appropriate to there needs and relatives confirmed this to us. The manager told us in the Annual Quality Assurance Assessment that each person had a care plan, which was reviewed every month or more often where this was appropriate. They told us that emphasis was put on enabling residents to make decisions and choices about their daily lives including what meals they eat. Feedback from surveys returned and speaking with six of the people who live at Rose Martha confirmed to us that the food provided was of their choice and cooked well. Documentation showed us that the staff supported residents to choose, eat a healthy and well balanced diet and that they monitored weight and fluid intake on a regular basis. Food cooked and looked at on the day of inspection was seen as fresh and was home cooked by the chef on a daily basis. However some residents felt that the meals were sometimes late because of staff shortages. This was discussed with the manager during the site inspection. These are some of the statements made to us by the residents and relatives (surveys returned and speaking with them on the inspection day), I like the activities on offer, I love the music provided, there could be more activities supplied on the high dependency unit, there are plenty of activities to choose from, we receive good quality meals, the meals reflected are of my choice, the meals provided are delicious, there is always a choice of food and drinks available to us. Care Homes for Older People Page 16 of 27 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. There are systems in place to ensure that peoples views are listened to acted upon and support residents to be protected from abuse. Evidence: We were told in the Annual Quality Assurance Assessment that any complaints or safeguarding alerts would be dealt with openly and thoroughly. We could see this by the way the manager has responded and worked with the safe guarding team when issues have been raised. The manager told us that residents and their relatives are provided with information on how to complain and how their concerns would be dealt with. They also told us that staff received information about dealing with complaints and whistle blowing when they commence work at the home. Speaking with 5 staff they confirmed this to us and showed us they knew procedures well. When we visited the home we looked at the policies and procedures. We saw that there was detailed information available for residents to assist them in understanding how to complain if they were unhappy. The complaints procedure was also available within the main area of the home, for all visitors to read and use. We saw by looking through 10 staff files, that there was detailed information made available to staff once they commenced work at the home, which described their roles and responsibilities in reporting bad practice. This included a whistle blowing policy. This helped to assure staff that they would be protected from harassment should they need to raise concerns. Care Homes for Older People Page 17 of 27 Evidence: We looked at how staff were recruited to work in the home and saw that all of the checks such as employment references, Criminal Records Bureau disclosures were obtained before a person started work at the home for all 10 staff files sampled. This helped to ensure that only people who were suitable were employed. We saw by looking at 10 staff training files, that all staff had undertaken training in recognising and reporting abuse or bad practices. There have been no complaints raised about the home since the last inspection. Observation showed us that staff treated residents with respect and that residents were very comfortable and open in the company of staff. These are some of the statements made to us by the residents and relatives (surveys returned and speaking with them on the inspection day), Staff are willing to listen and talk about any problems I have,I have no complaints and if I did I would know who to talk to, I have complained a couple of times and the issues raised have been dealt with to my satisfaction. Care Homes for Older People Page 18 of 27 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 live in a clean and safe environment. Evidence: The manager told us that residents had all of the equipment that they needed and that bedrooms reflected each persons individual personality through their choice of furniture, decor and personal belongings. They told us that there had been improvements to the environment with the redecoration and refurbishment of some areas of the house. Each of the residents who completed surveys told us that the home is always fresh and clean. When we visited the home we were invited by some residents to view their bedrooms. We saw that these rooms were bright, clean and reflected each persons individual taste. Rooms were nicely decorated and decorated in colours, which residents told us they had chosen. Residents we spoke with told us that they were happy with their home. The manager told us that in each bedroom were a nurse call point which was in easy reach for each person to use; these were also provided in all toilets, bathrooms, lounges and the dining room. She told us that all doors within the home are wide enough to accommodate wheelchair users and has two large lifts plus a wide staircase. This was seen by us when a tour of the building was undertaken. We saw that there were procedures in place and that staff had training to promote Care Homes for Older People Page 19 of 27 Evidence: good hand washing practices and to reduce the risk of infection. We saw that the home was well maintained, that checks were carried out regularly to ensure that equipment was in good working order. Rose Martha has a handy-person in place that routinely upgrades, fixes and maintains the outside and inside environment and is employed on a full time basis. These are some of the statements made to us by the residents and relatives (surveys returned and speaking with them on the inspection day), the home is very clean, the home always feels clean, fresh and light, better facilities for the hair dresser service would be appreciated, seating for visitors could be improved upon. Care Homes for Older People Page 20 of 27 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. Residents are offered positive relationships by well-supported and caring staff and are protected by staff recruitment, induction and training. Evidence: Residents who completed surveys said that staff listen to them and act on what they say. When we visited the home we saw by observation that, staff interact well with residents, were motivated, competent and listened to people. The manager told us that all staff had a detailed job description in relation to their jobs, that they had an induction to the home when they started work and that they received both mandatory and specialist training to best support residents. Staff who we spoke with told us that checks such as Criminal Records Bureau disclosures had been obtained before they commenced their employment. Staff also told us that they received training, which was relevant to their roles, helped them understand the needs of residents and kept them up to date with new way of working, although some staff have completed training others are yet to carry this out although the manager has booked courses for the near future. When we visited the home we looked at staffing levels (which are appropriate at the time of the Key Inspection) and how staff were recruited, trained and supported to meet the needs of residents. We looked at the recruitment files for 10 members of staff. We saw that before they commenced work that satisfactory employment references, Criminal Records Bureau disclosures Care Homes for Older People Page 21 of 27 Evidence: had been obtained and a full ten year employment history was checked for both people. Staff who we spoke with told us, that their induction covered everything that they needed to know about the job. In addition we saw that staff had detailed job descriptions and information about their roles and the conduct expected of them. We saw that staff were supported well by the management team and all yearly appraisals, supervisions and staff meeting were regular and recorded and minutes of these held within the premises. There was an ongoing programme for staff training and development. Staff undertook training in a wide range of topics including communication, assessing risks, managing visual impairments, diabetes and safe handling of medicines. Staff were also trained to recognise and report abuse or poor practices and they had specific training in understanding the needs of people who they support. These are some of the statements made to us by the residents and relatives (surveys returned and speaking with them on the inspection day), the staff are caring and well trained, the staff know my support needs well, the staff are always about when you need them, more permanent staff are needed. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management strategies of the home were stable which ensures the health, safety and welfare of all residents. Evidence: The manager told us that there was a system in place for monitoring the quality of the service, including obtaining the views of residents, relatives and other professionals. When we visited the home we looked at the arrangements in place for obtaining the views of the people who live in the home, people who are important to them such as family and other people who are involved in their care. We saw that people were provided with questionnaires and that residents were asked if they were happy with their surroundings, lifestyles and opportunities available. They were asked if staff allow them privacy, dignity, independence and choice. Additionally the homes questionnaires (which are readily available) are used to gain views or any suggestion people would like to use to improve the service in general and of all aspects of the service they are offered and receive. We saw that the quality assurance system Care Homes for Older People Page 23 of 27 Evidence: confirms that the outcomes from them have been followed up and recorded well. The management team possesses good people skills, they have strong leadership of staff, and are seen to be responsive to the needs of all residents. The management in place at present provides a good role model for other employees. Other professionals feedback we received told us they saw the manager as an effective leader who consistently provides good quality services to all people under their care. The management team undertakes regular training and understands and value opportunities for their continuing professional development. The manager ensures that staff practice and performance are discussed during supervision, staff training and team meetings. Spot checks and quality monitoring systems provide management evidence that practice reflects the homes and organisations policies and procedures. Five staff spoken with told us that they felt well supported by management and that they felt that there are clear lines of accountability among the staff group and within the management team. The AQAA provided excellent information that was fully supported by appropriate evidence that we sampled at the site inspection. Information looked through showed us that the management team had a good level of understanding about the importance of equality and diversity and how they listen to residents views and opinions. The home demonstrates a good level of self awareness and recognises the areas that it still needs to improve, and has clearly detailed the innovative ways in which they are planning to do this. Insurance cover ensures that the home or is fully insured to meet any loss or legal liabilities that protects all parties. We looked at the arrangements for ensuring that the home was maintained safely. We saw that regular checks were carried out on equipment such as hot water and heating systems, fire alarms and fire fighting equipment, gas and electrical installations and equipment. All equipment was well maintained and repaired as required. There is full and clearly written recording of all safety checks and accidents, including analysis, and there is no evidence of any failure by the managers to comply with any statutory reporting and other relevant legislation requirements. These are some of the statements made to us by the residents and relatives (surveys returned and speaking with them on the inspection day), The home is well managed, the new manager is approachable and well organised, safety at the home is of major importance,my relative is very happy at Rose Martha. Care Homes for Older People Page 24 of 27 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 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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