Care Home: Rosebery House

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What the care home does well The standard of direct care observed was good, with positive interaction between care staff and people using the service. The service provides a warm, caring environment where everyone appeared to be happy. An example of comments were " The staff are all very kind and caring". This place feels like home and if I have to be anywhere I am happy that I am here". The general standard of the environment is good, with a variety of areas being decorated and upgraded since the last inspection was carried out. People`s bedrooms reflect their diverse range of interest and have been personalised to a high standard. Staff spoke very positively about the supportive and inclusive management style provided by the registered manager and considered since being in post it had created a positive effect on both the staff team and the people using the service. The service has further improved both the assessment and the care planning systems which now provide a detailed profile and working document for individuals living within the home. Risk assessments are in place and are reviewed. The proprietor carries out all pre-admission assessments and there is an interim care plan devised within two days of the person being admitted into the home and then a more detailed care plan devised once the six week review has been completed. Health and safety practices are carried out effectively and monitored by the proprietor/manager. Rosebery House creates a welcoming and inclusive atmosphere to everyone who lives within the service or who is visiting. This is truly reflected by the comments received from people using the service, staff, visiting professionals and families. " My relative has been very happy here for a number of years and would not change anything about the home". The home is cheerful and homely and the staff are wonderful". The service is well established within the local community and although only one person is able to access the local community totally independently, the staff and manager endeavor to support people on a 1:1 basis whenever possible to access the local shops and amenities. The home is fortunate enough to have a number of families that are are actively involved in their relatives care which means most people have the opportunity to go out of the home on a regular basis. The manager has devised an excellent system for the administration of medication within the home and works tirelessly to maintain high standards and eliminate errors with the introduction of a comprehensive and detailed quality assurance system. What has improved since the last inspection? The manager has worked hard to improve both the assessment and care planning within the home to produce a plan that is more person centered. The environment has improved and both requirements made at the last inspection have now been met. There has been an increase in domestic and maintenance hours in order to enhance the standards of cleanliness within the home and to attend to any general maintenance issues promptly and effectively. What the care home could do better: The service could review the current activities programme to possibly incorporate sometrips out of the home to local places of interest. The manager should endeavour to provide training for all staff in both the Mental Capacity Act and Deprivation of Liberty Safeguards. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Rosebery House 1 Rosebery Avenue Harpenden Hertfordshire AL5 2QT     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Julia Bradshaw     Date: 0 3 1 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2010) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Rosebery House 1 Rosebery Avenue Harpenden Hertfordshire AL5 2QT 01582715600 01582765555 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Fairheart Limited Name of registered manager (if applicable) Mrs Sarah Elizabeth Mills Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The manager must complete NVQ Level 4 in Management and Care within three years of the registration date. Date of last inspection Brief description of the care home Rosebery House is registered to accommodate 14 elderly people. The building is a converted three-storey detached house located in a quiet residential area in Harpenden. The shops and local amenities are a short distance away. There are parking areas on the road in front of the building. The ground floor consists of a spacious lounge, an administrative office, a dining room, a kitchen and a laundry room. The first and second floors are connected by a passenger lift and the bedrooms are all located on these floors. Bedrooms are all offered as single occupancy. Bathing and toilet facilities are nearby and these are wheelchair accessible. 0 Over 65 14 care home 14 Care Homes for Older People Page 4 of 29 Brief description of the care home There is a conservatory at the rear of the premises and this leads on to a patio area. The conservatory is comfortably furnished and serves as an additional lounge for service users. The back garden consists of a lawn area bordered by mature plants and a flowerbed. The garden and patio areas are also accessible to wheelchair users. The home has a service users guide and statement of purpose that are provided to prospective service users. Copies of the latest report on the home from the Care Quality Commission are available within the home. The manager stated that there is a range of fees starting from £608 per week to £658. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The focus of the inspections undertaken by the Care Quality Commission is based upon outcomes for the people using the service. We looked at three care plans and tracked the individual care for those people. As part of the planning we look at information we received including the Annual Quality Assurance Assessment (AQQA) This is a self assessment document required by law in which the provider tells us how well they think they are meeting outcomes for individuals. We also looked at any concerns and also feedback from relatives, staff and the people using this service. The last key inspection was carried out on the 25th June 2008. We observed staff at work and how they interacted with the people living at within the home. There was also a tour of the building in which the inspector had the chance to talk to the staff and manager of the service. Care Homes for Older People Page 6 of 29 What the care home does well: What has improved since the last inspection? What they could do better: The service could review the current activities programme to possibly incorporate some Care Homes for Older People Page 8 of 29 trips out of the home to local places of interest. The manager should endeavour to provide training for all staff in both the Mental Capacity Act and Deprivation of Liberty Safeguards. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. 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 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information about the service is kept up to date and provided for all prospective users. Everyone wishing to enter the service has a basic assessment of needs completed. This ensures that all parties can be sure the service can meet individual needs. Evidence: The manager stated that they are currently updating the statement of purpose, which will set out the aims and objectives of the service, and will include a service user guide, which provides basic information about the service and the specialist care the service offers. The service user guide will provide details of what the prospective residents can expect and will give a clear account of the specialist services provided, quality of the accommodation, qualifications and experience of staff and how to make a complaint. All residents will be given a copy of the updated service user guide, when completed. When requested the service can provide a copy of the statement of purpose and guide in a format which will meet the capacity of the resident. Care Homes for Older People Page 11 of 29 Evidence: The documentation of two residents was seen and the pre-admission assessment took into consideration the psychosocial, physical, religious and social needs. Most information requested from Rosebery House is provided upon request (although some is only given when the perspective resident or their family arrive for a viewing of the home). Rosebery House operates an open house policy which allows individual or small groups to view the home upon arrival without the need to pre-book a visiting time. Admissions are not made to the service until a full needs assessment has been undertaken. The registered manager completes the assessment prior to admission to the service. The assessment format is basic in style, however seeks to establish the primary care needs of the individual prior to admission. The assessment explores ten areas of physical health care needs, including personal care tasks. Each defined area is then further explored . For example the section on personal care is further defined and states one carer to assist with personal care. It was evident that the service strives to seek the information and assessment through care management arrangements, prior to admission. A total of two care plans were case tracked. There was a section for the assessor to explore the religious needs of the individual. During the inspection time was spent talking to the people using the service. Several positive comments were received from both relatives and residents including It is just like home from here. I am always very well cared for and the staff cannot do enough for me. My relative always appears well looked after and content and the laundry service is excellent. It was established that the administrative paper work relating to the admission and assessment of the people using the service provides adequate detail and the main outcomes for the individuals are met and that the service has the capacity to support people who use the service and respond to diverse needs. Staff supporting people were seen to interact with total respect and dignity for the individual at all times. Discussions with staff further supported the notion that the knowledge of all staff is detailed, current and accurate to meet the needs, wishes and preferences of the residents. All privately funded people who use the service are provided with a statement of terms and conditions or a contract. This sets out in detail what is included in the fee, the role and responsibility of the provider, and the rights and obligations of the individual. People who are funded receive a social service contract. Contracts are reviewed when there is a change in the needs of the person using the service. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can be assured that their personal care and health care needs are met and that their care plans provide adequate information in order for staff to ensure the care is tailored to individual preferences and needs. Evidence: A total of two care plans were case tracked fully, it was established that people who use the service receive personal and healthcare support using a person centered approach. Personal healthcare needs including specialist health, nursing and dietary requirements are recorded in each persons care plan. The care plan provides clear information and a comprehensive guide for staff to know how to support the person. The care plan is generated from the pre admission assessment and includes, risk assessments for the management of falls, bed rails, manual handling and self medication. The care planning format explores and outlines the individual needs and preferences of a person. The care plan is written from the perspective of the individual and throughout documents the persons own preferences and wishes. For example the persons choice of clothes, personal hygiene preferences and style of hair. Care Homes for Older People Page 13 of 29 Evidence: It was observed that personal support is responsive and tailored to meet the individual choices, needs and preferences. Staff were observed to respect the privacy and dignity of all people. A good practice example of this was seen at the service, where staff were able to spend time chatting with people and reading magazines and news papers with them. The atmosphere and approach of the service is very friendly and home from home. One person using the service stated, they are like my family here, so friendly and so kind. The service listens and responds to individual choices and decisions about who delivers their personal care. People are supported and helped to be independent and can take responsibility for their personal care needs as appropriate. Residents have access to healthcare and remedial services. The health care needs of residents unable to leave the service are managed by visits from local health care services. Clear evidence was seen in the care plans of specialist health care support services visiting the service and in addition to the care plan there were detailed notes made by the specialist visiting the service for example the District Nursing team and General Practitioners. The AQAA states that The home has links with a visiting optician to ensure all residents have an annual eye test. The manager makes referrals to the intermediate care team for advice and support in moving handling issues, occupational and physiotherapist requests and nutritional and weight loss issues. A number of comments were received directly from people that use the service. One person commented that, The service does every thing to make the residents happy in every way they can, such as caring staff, a lovely environment and lovely food. The AQAA tells us that Rosebery House provides a home where privacy and dignity are integral to the running of our business and the homes success. Residents care plans are tailored to the individual and reviewed on a regular basis. This ensures staff are always working towards providing the best possible outcomes for those using our service. All healthcare needs are recorded and reviewed. Reviews are either conducted by the home or visiting professionals (recorded accordingly). During the inspection it was directly observed that care plans were reviewed on a regular basis. It was observed that one of the documents in place reviews and assesses the persons level of independence. The service has an efficient medication policy supported by procedures and practice guidance, which staff understand and follow. Medication records are fully completed, contain required entries, and are signed by appropriate staff. A total of three peoples medication was case tracked in order to ensure compliance. Room temperatures were being recorded where the medication is stored. Ordering and returns documentation was up to date and accurate. The people using the service are given the support they need to manage their medication, where appropriate. Thought has been given to providing safe but sensitive facilities for keeping medication. The service has a good record of compliance with the receipt, Care Homes for Older People Page 14 of 29 Evidence: administration, safekeeping, and disposal of controlled drugs. Staff have completed and passed an appropriate medication course. An assessment has been carried out to ensure each member of staff is competent to handle, record and administer medication properly. On the day of the inspection it was directly observed that people who use the service were being supported and provided with specialist treatment in their own rooms and in private. The AQAA states that We currently have one person who self medicates and the manager monitors and reviews the risk assessment regularly to ensure the health and welfare of the resident. The manager works extremely hard to ensure that all medication practices are strictly implemented and adhered to. This includes random spot checks on medication records and a complete audit is carried out on a monthly basis. The manager should also be commended on enrolling on the infection control champion training provided by the Health Protection Agency, which has provided a wealth of knowledge and practical advice to the service and has enabled the manager to cascade this knowledge and training to the whole staff team in order to further develop infection control standards. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use services are able to make choices about their life style, and supported to develop their life skills. Social, educational, cultural and recreational activities meet individuals expectations. Evidence: People who use the service have the opportunity to develop and maintain important personal and family relationships. Feedback from people using the service determined that they are able to receive visit from friends and family at any reasonable hour. A number of people that use the service have stated that they the staff practices promote individual rights and choice, but also consider the protection of individuals in supporting them to make informed choices. The service respects the human rights of people using the service with fairness, equality, dignity, respect and autonomy underpinning the care and support being provided. The staff team help with communication skills, both within the service and in the community, to enable residents to fully participate in daily living activities. One person using the service commented Ive been so happy since Ive been here and all the staff are very kind and the food is excellent. Care Homes for Older People Page 16 of 29 Evidence: Residents are involved in meaningful daytime activities of their own choice and according to their individual interests, diverse needs and capabilities. They have been involved in the planning of their lifestyle and quality of life. On the day of the inspection a few people were observed sitting in the lounge area chatting with staff or fellow residents. One resident was on her way out for lunch and one person was receiving a visit from the community physiotherapist. Everyone seen on the day looked warm, relaxed comfortable and well cared for. The AQAA tells us Activities are provided to suit the individual and also as a group. Members of staff are designated to provided activities and a record of activities is held within the main office. The hairdresser visits every week and also the local clergy visits on a monthly basis, for those who want to attend. A harvest festival service was held at the home in October and the choir from one of the local school attends the home during festive occasions. People also have the opportunity to attend the residents meetings (last meeting held on 15/5/09) where they can raise any issues or concerns. The minutes from this meeting were seen and an action plan provided. One issue raised was about how people would like less meat and more fish on the menu. The manager had actioned this by holding a meeting with the cook and new additions were added to the menu to incorporate peoples requests. Also there was a request for the the sherry and shop event to reinstated as this was a popular event with several of the residents. The manager stated that this would be provided. The manager has also arranged for a taster exercise class to be held to see if people would be willing to participate. A seasonal entertainer also visits the home on a two monthly basis and a Christmas party is planned for the 16th December, where all residents and families will be invited to attend. Generally people were happy with the level of entertainment provided although two people stated that they would like more variety within the current programme and the possibility of going out to visit local places of interest. One person currently goes out independent but others require staff support. The menu is varied and incorporates healthy eating. The meals are balanced and nutritious and cater for the varying cultural and dietary needs of individuals. People using the service commented that they have choices of the meals they are provided with and are supported to draw the menu up. A recent residents meeting requested that people have more fish on the menu. The manager stated that this will be implemented with the introduction of salmon/prawns as a main course and sardines and pilchards as part of the supper menu. People have a choice to either eat in the dining room or in their own rooms. On the day of this inspection five people chose to eat within their own rooms. The inspector had the opportunity to join four residents for their mid-day meal which was found to be both flavorsome and nutritionally well balanced. The manager contacts the intermediate care team for advice on nutritional and dietary advice. Care Homes for Older People Page 17 of 29 Care Homes for Older People Page 18 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has a robust complaints procedure in place, good staff awareness and attitude towards safeguarding issues so people who use the service are safe and protected. Evidence: The service has an open culture that allows residents to express their views and concerns in a safe and understanding environment. People who use the service have commented that they are happy with the service provided, feel safe and well cared for. A number of comments received determined that people who use the service and relatives and friends are aware of what to do if they have any concerns. If I have a problem I always go and speak to the manager and they sort it out for me. The six surveys received back from the service confirmed that people knew how to complain and who to speak to. The service has a complaints procedure that is clearly written and easy to understand. The complaints procedure is supplied to everyone living at the service and is displayed in a number of areas within the service. The AQAA tell us that Complaints are responded to immediately and there is a complaints record to review, respond and record the outcomes. There have been no complaints to the service within the last year. Rosebery House operates a clear and well understood policy on concerns and complaints whistle blowing and bullying. All residents are informed of these policies on arrival into the home and reference to these is in the service users guide. Care Homes for Older People Page 19 of 29 Evidence: The policies and procedures for safeguarding adults are available and give clear specific guidance to those using them. Staff commented that they have received training in safeguarding and felt confident in reporting any issues as they occurred. Staff had a clear understanding of whislteblowing and when the use of this policy may be put into practice. The service understands the procedures for safeguarding adults and attends meetings or provides information to external agencies when requested. Care Homes for Older People Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service provides a well maintained, safe and comfortable environment in which people can live. Evidence: The service provides a physical environment that is appropriate to the specific needs of the people who live there. The well-maintained environment provides specialist aids and equipment to meet their needs, where necessary. The service is pleasantly decorated throughout and both the bedrooms and communal rooms provide a personal homely feel. The AQAA states that Residents are invited to bring their own furniture and personal possessions if they wish to. In the absence of their own furniture the rooms are furnished to high standard with pictures and ornaments added. Several people were happy to show the inspector their rooms, all of which appeared comfortable and had been personalised in order to make them more homely. Improvements to the environment since the last inspection was carried out include, repairs to the kitchen ceiling where there had been a leak and some water damage and effective hand washing facilities are now provided throughout the home, to prevent the spread of infection. The AQAA states that All staff have received refresher training in infection control provided by the Health Protection Agency since the last inspection was carried out. The service has an effective system in place to ensure all health and safety standards are maintained. Fire records on the day of this Care Homes for Older People Page 21 of 29 Evidence: inspection confirmed that regular checks are being carried out. These included, both the fire alarm check and emergency lighting check carried out on the 9/10/09, the lastest fire drill was carried out on the 2/7/09 and the latest annual fire check was carried out on the 17/4/09. Staff last received fire training on the 11/3/09. The manager has embarked on the Health Protection Agencies training to become a champion in infection control standards in order to further benefit the service in maintaining the highest infection control standards. This training will also be cascaded down to the whole staff team in future months. The manager has also enrolled on the Care home prevention and control accreditation programme with the Health Protection Agency. The service will be audited by the HPA as part of this programme in February 2010. The manager has increased the domestic and maintenance hours to the service to a full time post. Care Homes for Older People Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has effective management systems in place to support staff by providing the necessary supervision and training to ensure an effective staff team are able to support people living within the service to lead safe and fulfilling lives. Evidence: The people spoken with and from information gathered from a number of surveys returned to the Commission determines that they have confidence in the staff who care for them. Rotas were seen and displayed adequate staffing numbers on duty to meet the needs of the people using the service. Specific attention was given to the busier periods of the day. The manager workers a variety of hours that cover both the day and the evening to ensure they have a regular overview of the service being provided. On the day of this inspection there were 3 care staff on duty plus one cook and one domestic. The service provides 2 waking night care per night. Accurate job descriptions and specifications clearly define the roles and responsibilities of staff. People who use the service report that staff working with them are skilled in their role and are consistently able to meet their needs. The service benefits from having a long standing and loyal staff team, some of which have worked at the home for several years. There is a good recruitment procedure that clearly defines the process to be followed. Care Homes for Older People Page 23 of 29 Evidence: This procedure is followed in practice with the service recognising the importance of effective recruitment procedures in the delivery of good quality services and for the protection of individuals. A total of three staff files were audited and were seen to contain all the required documentation. Recent training includes, moving and handling, infection control, fire awareness and first aid. The manager stated that there were plans to provide training in both the Mental Capacity Act and the Deprivation of Liberty Safeguards within the next three months. There are also 5 staff currently doing NVQ level 2 and 2 staff currently doing NVQ level 3 training. The manager also has their NVQ level 4 and has recently enrolled on a leadership and management course. Staff confirmed that they receive supervision at least six times per year and they also attend staff meetings on a two monthly basis. Care Homes for Older People Page 24 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can feel assured that the manager is suitably qualified and competent to run the service and provide trained competent staff in a safe and well managed environment. Evidence: The Registered Manager has the required qualifications and experience and is competent to run the service. The Registered Manager has a clear understanding of the key principles and focus of the service, based on organisational values and priorities. They work to continuously improve services. The AQAA tells us that Rosebery House is run in the best interests of the residents and residents benefit from the ethos, management and leadership of the home. When asked the residents stated that the home meets their expectations and that they feel valued and respected and are happy living there. This was also confirmed in the six questionnaires that were returned to the Commission prior to the inspection being carried out. One person using the service commented that the manager is really caring and is always here if we Care Homes for Older People Page 25 of 29 Evidence: need them. The manager was directly observed throughout the inspection to lead by example and manage the service efficiently. The Registered Manager leads and support a stable staff team who have been recruited and trained satisfactory levels. The manager promotes equal opportunities, has good people skills and understands the importance of person centered care and effective outcomes for people who use the service. The service has sound policies and procedures, which are internally reviewed and updated, in line with current thinking and practice. The manager ensures staff follow the policies and procedures of the home. The staff team are positive in translating policy into practice and showed good knowledge of care principles, health and safety and safeguarding issues. Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2010) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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