Care Home: Rosemere

What the care home does well Residents benefit from being cared for by a stable staff team. The staff are committed to their work and care for the residents very well. They show great respect for residents` privacy and dignity. Residents and relatives say that the staff are kind, caring and friendly. A health care professional says that what the home does well is, "Individual acceptance of clients needs." General practitioners commented, "Friendly efficient team leader who communicates well with GP." and, "Good atmosphere and personal care." Residents and relatives commented in their surveys about the friendly atmosphere, good food, nice staff and that the home welcomes visitors. Residents, relatives and staff that we spoke with during our visit also confirmed this. Staff are well trained and encouraged to maintain and develop their skills. This means that they know how to care for residents well and keep them safe. The home is well managed and promotes residents` best interests. The manager has an excellent understanding and awareness of residents` needs and promotes good practice. About the manager, residents, relatives and staff all say that she is kind to the residents, very supportive to staff and "great to work for." A staff member says, "Everything is good here for the residents. Marcella (the manager) looks after the residents well and the staff." This was reiterated in a staff survey comment, "I think Marcella is the best boss I could ever wish to work for. She is fair, understanding, and very approachable." Good quality monitoring processes have been developed that make sure that any changes needed are promptly made. This means that the excellent outcomes for residents evident at our last inspection have continued. What has improved since the last inspection? They have carried on with the refurbishment of the environment to make it more homely. They have redecorated the dining room and quiet room. They have provided a new wide screen television and DVD system in the lounge, which residents say they are enjoying. They have provided new recliner chairs for some residents and one new profile bed to improve comfort and safety.They have taken residents on some minibus outings during the summer months. They have continued to provide staff with a wide variety of training to help develop their knowledge. Residents can therefore be confident that they will be cared for by well trained, skilled and competent staff. What the care home could do better: They have excellent management practices in place and we are confident that they will continue with the ongoing development of the home. We have not made any requirements or recommendations in this report. Here are some of the things that the manager is committed to achieve. They have plans to continue with the environmental improvements which will include refurbishing both bathrooms and providing a new bath hoist in the very near future. Some armchairs have been identified for replacement as they have become rather stained. They plan to ensure that residents who cannot stand will be enabled to use some sit on scales at one of their other homes close by. They will be making sure that they record any concerns, no matter how minor, and show how they have been resolved. This is to provide written evidence of their good practice, as it is clear that they resolve any issues promptly. Key inspection report Care homes for older people Name: Address: Rosemere 13 Grimston Gardens Folkestone Kent CT20 2PT     The quality rating for this care home is:   three star excellent 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: Christine Grafton     Date: 1 1 1 1 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Rosemere 13 Grimston Gardens Folkestone Kent CT20 2PT 01303255775 F/P01303255775 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Rosemere Care Home Ltd care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users to be accommodated is 12 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental disorder, excluding learning disability or dementia (MD) Date of last inspection Brief description of the care home Rosemere is an older semi-detached property, located in a residential road opposite large gardens that may be accessed by residents of the houses surrounding it. Three of the bedrooms are double occupancy. There is parking available in the road to the front of the property. Public transport, shopping, church and leisure facilities are within walking distance. The home is not suitable for full time wheelchair users. Care Homes for Older People Page 4 of 30 Over 65 0 12 Brief description of the care home Fees are in the range of £396.48 to £450.00 per week. Care Homes for Older People Page 5 of 30 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: three star excellent 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: This report takes account of information received since the last inspection of 16th January 2007, including a visit to the home. We visited the home on 11th November 2009 without telling anyone we were coming so that we could see what it is like for people living there on a usual day. We arrived at 10.30 hours and left the home at 15.30 hours. We spoke to the manager, staff, residents and three visitors. The manager showed us around the home. We observed what was going on, the home routines, staff practices, and if any activities were taking place. We looked at some of the homes records and saw the lunchtime meal being served. We also used the homes annual quality assurance assessment known as an AQAA for short. This is a document that all homes have to send us once a year to tell us how they think they are meeting the national standards, how they have improved in the Care Homes for Older People Page 6 of 30 previous year, what they aim to do and lets us know when they have completed important environmental safety checks. We also looked at relevant information we have received from other organizations and we referred to the last inspection report. We sent some surveys out to a sample of residents and staff prior to our visit. Their responses have been used to inform our judgements and will be referred to in the report. At the time of our visit there were 12 residents living at the home. The people who live in the home prefer to be called residents and this is the word used to describe them throughout the report. Care Homes for Older People Page 7 of 30 What the care home does well: What has improved since the last inspection? They have carried on with the refurbishment of the environment to make it more homely. They have redecorated the dining room and quiet room. They have provided a new wide screen television and DVD system in the lounge, which residents say they are enjoying. They have provided new recliner chairs for some residents and one new profile bed to improve comfort and safety. Care Homes for Older People Page 8 of 30 They have taken residents on some minibus outings during the summer months. They have continued to provide staff with a wide variety of training to help develop their knowledge. Residents can therefore be confident that they will be cared for by well trained, skilled and competent staff. 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 9 of 30 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 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People considering moving into the home are given the information they need to decide if it is right for them. They benefit from having an assessment that tells staff about them and the support they need. This ensures that only those people who are suited to the home and whose needs can be met are admitted to the home. It is not the general policy of the home to admit residents for specialist intermediate care, so standard 6 was judged as not applicable at this inspection visit. Evidence: Prospective residents are given information about the home that includes looking at the statement of purpose and the service users guide. Both of these documents have been updated during the last year. They contain all the relevant information so that people know what to expect if they decide to move in. Prospective residents are invited to visit the home before making the decision about moving in. Care Homes for Older People Page 11 of 30 Evidence: Responses in four out of the seven surveys returned from people who live in the home indicated Yes that they had received enough information to help decide if this home was the right place for them. The other three indicated that they did not know. This is a good response rate and indicates a satisfaction rate of over fifty percent. The manager says she always tries to make sure that the home will be able to meet the persons needs before confirming the placement. She does this by carrying out her own assessment prior to admission and obtaining a copy of the care management assessment. We saw assessments completed for two residents. These contained lots of details about the persons individual needs and showed that all the activities of daily living had been covered, plus a dependency assessment and mental health risk assessment. A detailed care plan is then drawn up following admission. A trial period of four weeks is offered to check if the resident, their family and care manager are in agreement that the home is suitable for them and also to ensure that the manager and staff feel they can meet the persons needs. Care Homes for Older People Page 12 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be confident that they will have their own care plan that provides staff with all the information needed to make sure that their health, personal and social care needs are met. They are protected by the homes policies and procedures for dealing with medicines. Evidence: At the last inspection, the care plans were judged as good. We looked at two care plans to see if this was still the case and found that it is. Care plans contain a wide range of information covering all the details that staff need to know when they are caring for the residents. For each need assessed, there is a detailed plan of care specifying what needs to be done to meet the persons needs. The records we saw contained lots of information covering a diverse range of needs. These include things such as, personal care, mobility, personal safety and risk, medical history, medication, communication, mental health and cognition, nutrition, dental care and foot care. Residents health is Care Homes for Older People Page 13 of 30 Evidence: closely monitored and other health care professionals are fully involved. Weights are recorded on a monthly basis and action taken if significant changes occur. They currently do not have the facility to access a set of sit on scales for any resident that cannot stand unaided. This was discussed and the manager said they are looking into obtaining a set for their sister home, which is situated across the road from Rosemere. Any non weight bearing resident would then be taken there to be weighed. Discussion with care staff confirmed that they are able to meet the needs of the residents. There is a key worker system in place. This means that staff are linked to individual residents, to spend time with them to get to know their needs, write in their care plans and carry out the monthly care plan reviews. We spoke with a key worker about a resident whose care plan we looked at. We also discussed their needs with the manager and spoke to the resident. We therefore looked at their care from three different aspects and found that what was written in the care plan and what people told us all matched. Three Social and Health Care Professionals Surveys were returned. One from a senior practitioner states under what they do well, Individual acceptance of clients needs. Two general practitioners (GPs) returned their surveys. One states under what they do well, Friendly efficient team leader who communicates well with GP. Another states, Good atmosphere and personal care. The last inspection confirmed that the storage of medicines was secure and that the home had suitable policies and procedures in place to protect the residents. The last report states that all staff receive medication training and are then subject to in house supervision before they are allowed to administer any medication. We saw the manager give out the lunch time medications. We noted that this was done in a safe way. The staff training matrix indicates that eight staff have completed medication training. Staff were observed treating residents with kindness and respect. This was confirmed in a relatives survey returned and in discussion with two visitors to the home. Under what the home does well, the relative commented, friendly atmosphere, staff know that my Mum used to like dressing in a co coordinated way and they do that. In spite of incontinence residents are kept clean. Care Homes for Older People Page 14 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from having opportunities to take part in activities that suit their needs and from being able to keep in contact with families and friends. Residents benefit from the relaxed mealtimes and enjoy their food and the choices available to them. Evidence: Care plans contain details of the residents life history, which means that staff know about their backgrounds and past interests. A highly informative personal profile was seen for one resident that gives a real insight into their character and past life. This had been very well written and forms a component part of the whole care plan, which is highly person centred providing a complete picture of the resident. The hairdresser was at the home during our visit and we saw her talking to the individual residents while she was doing their hair. She told us that she has been coming to Rosemere for ten years. She says, This is a friendly home. Marcella (the manager) is good. Ive seen a few different homes but this is a good one. Marcella knows the residents. The staff are friendly. Care Homes for Older People Page 15 of 30 Evidence: Residents religious and spiritual needs are identified within their care plans and visits from ministers of religion are arranged for those who wish this to happen. Currently a Roman Catholic priest visits the home regularly. Staff are encouraged to spend time with the residents, listening to them and doing various different activities with them. They keep a record book showing what activities have taken place each day. Examples of things people have done include, reading the newspaper with staff and discussion about current affairs, playing CDs and listening to music, sing-alongs, ball games, manicures and occasional visits from outside entertainers. During the summer months several minibus outings were arranged to various places of interest. The manager said they have organized a Christmas party with a visiting entertainer. We spoke with three visitors who all say that staff are very friendly and welcoming, there is a nice atmosphere and they feel their relatives or friends are being well cared for. We received seven service user surveys back from a sample of residents living in the home. Their comments under what the home does well included, Good Food, Cooking meals and tending to difficult patients, Everything, Make you welcome, Looks after us, like going on the outings., Very happy here, no complaints and do not want to live anywhere else. Care staff take it in turns to do the cooking. A staff member confirmed that they had completed food hygiene training and the staff training matrix confirms that all staff that prepare meals have completed this training. They follow a four week menu plan that provides variety and makes sure that meals are nutritious. They have a wide choice at breakfast time, two choices for dinner and tea, but staff say that residents often have more choices as well. Residents can have their breakfast when they want and we were told that this can be any time between 07.00 hours and about 09.00 hours or later, according to individual choice. We saw the lunch time meal being served. Residents can choose where they eat their meals, for example, in the dining room, the quiet room, the lounge, or in their bedrooms. Residents were being served their meals in a calm unhurried way. Where residents needed help with eating, staff were sitting with them, patiently assisting them, engaging in conversation and offering encouragement where necessary. Care Homes for Older People Page 16 of 30 Evidence: Nutritional assessments are completed for each resident. The staff training matrix indicates that six staff had recently attended training on nutrition in older people and two staff (plus the manager) had already done this course, making a total of nine staff. Care Homes for Older People Page 17 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be confident that any complaints will be listened to and acted upon. They can be assured that they will be protected by the homes procedures and practices to safeguard them from abuse. Evidence: The complaints procedure is prominently displayed in the entrance hall and is included in the service users guide. We discussed with the manager how this works in practice. The manager said that they have not had any complaints in the past year, that they know the residents well and deal with any issues on a day to day basis. This way, things do not usually escalate to become complaints. The managers husband, who is the responsible individual for the organization, visits the home at weekends when she is off duty. This provides residents and staff with the opportunity to talk with either of them. Therefore any issues raised are promptly dealt with. A complaints and compliments book is kept, but there is nothing recorded in it. We discussed the importance of recording all concerns or complaints, no matter how small or minor they may seem at the time. The manager said she would address this. The staff training matrix shows that staff are trained in adult protection. The manager is a trained trainer for this and has just updated her training. We also saw that eight staff have done training on the Mental Capacity Act, plus three have covered this subject as part of their National Vocational Qualification in care (NVQ) level 3. Care Homes for Older People Page 18 of 30 Evidence: We talked with a staff member who confirmed that they had done this training and demonstrated a good understanding of residents needs. They spoke about their key worker duties and implied that this also helps to protect residents, as they get to know residents well and soon pick up if anything is wrong. They indicated that they would report anything suspicious to the manager, or go to social services. The staff member said that all the staff have a good working relationship and discuss things at their staff handovers. They also said that as the manager is very approachable, they know they can go to her about anything and have confidence that it would be dealt with properly. We saw residents talking to staff in a comfortable and friendly manner and staff listening to what they were saying. The residents that we spoke with said they have no complaints and knew that they could speak with any of the staff, or with the manager whenever they wanted. This was reiterated in the survey responses from residents and the visitors that we spoke with. Care Homes for Older People Page 19 of 30 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. Residents benefit from living in a comfortable, homely environment that suits their individual and collective needs. Good practices are in place to maintain hygiene and prevent the spread of infection within the home. Evidence: We looked round the home with the manager. All areas seen were very clean and fresh smelling. At a previous inspection we asked them to carry out a plan for the refurbishment and redecoration of the home. At our last inspection it was noted that this had not been fully completed, but that they were working through their planned programme. At this visit, the manager indicated that they have continued making improvements. They share a maintenance person between their three homes who deals with any repairs and decoration work. External contractors deal with any major works. During the last twelve months they have provided new recliner chairs for some residents and one new profile bed. They have redecorated the dining room and quiet room. A new wide screen television and DVD system has been installed in the lounge and we saw residents enjoying both these facilities throughout the day of our visit. Care Homes for Older People Page 20 of 30 Evidence: The office had recently been totally rebuilt and refurbished to repair the damage caused by last years earthquake in the area. The manager stated that dates had been set for the two bathrooms to be refurbished. Work on the first one was due to be started the week following our visit and will include a new bath hoist. A staff member said, The new bath hoist when it comes will be better. There is a dedicated cleaner that works five mornings a week. Good hygiene procedures were observed throughout the home with sensor hand gels and soap dispensers. The laundry is equipped with a professional washing machine with sluice cycle and there is a separate tumble drier. We discussed that the walls and flooring need repainting to ensure that they remain impervious. The manager said they have already identified this in their future plans. In their survey comments under what the home could do better, the following comments were made by some of the residents and relatives, Provide some outdoor space for the summertime. Accelerate the refurbishment. Rosemere may not be the most modern, state of the art home, but I think it performs well within the boundaries set by government and local authority. My Nan was in another home before here. The decor is not as posh here but it is much more homelier here. The lack of external space was discussed. There is not much more that can be done about this, but there is a park across the road that residents may use. Overall it is clear that although there are still some areas that need refurbishment, the providers are committed to working through their programme to make sure that the home continues to provide a comfortable and homely environment for the residents. Care Homes for Older People Page 21 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be confident that they will be supported by competent and qualified staff, knowing there will be enough staff on duty at all times to meet their needs. They can be assured that the homes recruitment procedures and practices will protect them. Evidence: We looked at the staff rota and discussed staffing levels with the manager. Rotas are arranged so that there are three carers on duty during the day until 17.00 hours. This includes a middle shift between 11.00 hours and 17.00 hours. The manager works alongside the care staff during the week and starts at 07.00 hours to work with the night staff. There are two staff on duty in the evenings and at night there is one staff member on waking duty and one person sleeping in. The sleeper works on the floor until 22.00 hours and then sleeps in on call, starting work again in the morning at 06.00 hours. They employ a training manager who is a retired senior lecturer for nurses that organizes and carries out the training for their three homes. They have a comprehensive staff training programme that includes a thorough induction programme. Next staff are supported to achieve their National Vocational Qualification (NVQ) in care level 2 or above. Information in the AQAA indicates that all thirteen staff have their NVQ level 2 or above. The staff training matrix indicates a wide variety of Care Homes for Older People Page 22 of 30 Evidence: courses that staff have completed. As well as the mandatory health and safety related courses, these include, dementia care, loss and bereavement, challenging behaviour, infection control, care plan training and person centred care. A number of security checks are carried out on new staff before they start work at the home. We looked at two staff files and saw that the checks specified in the National Minimum Standards and legislation had been done, including past employment checks, two written references and police checks. This helps to make sure that staff are trustworthy and safe to be around the residents living in the home. They state in their AQAA that they have a low staff turnover. This was borne out in the responses about the good staff morale, team working and good manager in the six staff surveys returned. Here are some of their comments under what the home does well, The care home is doing well we have good communication and working relationship. The owner manager is approachable. We work well as a team to provide a good quality of care. Everything We have an excellent rapport with fellow staff mates and our managers. I think Marcella is the best boss I could ever wish to work for. She is fair, understanding, and very approachable if the staff or the residents have a problem. I have worked at Rosemere for nearly 10 years. Mr and Mrs Permall are very nice people to work for, the home is run well and has a good atmosphere. We look after the residents very well. (Mrs Permall is the registered manager and Mr Permall is the responsible individual for the organization). Friendly environment. They go on to say that it treats everybody well. We spoke to two staff members. One commented on the excellent training provided and said, Everything is good here for the residents. Marcella (the manager) looks after the residents well and the staff. Another staff member that has worked at the home for ten years commented, Care Homes for Older People Page 23 of 30 Evidence: Marcella and her husband are great to work for. Care Homes for Older People Page 24 of 30 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 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 living in a home that continues to be well managed in a way that safeguards their best interests, promoting and protecting their health, safety and welfare. There is an atmosphere of openness and respect where residents, relatives and staff views really matter. The manager has an excellent understanding and awareness of residents needs and keeps up to date with good practice by attending regular training courses on a wide variety of topics pertinent to her role. Good quality monitoring processes have been developed to ensure that any changes are made by management as things are identified, or as a result of listening to people. This means that the high standards evident at our last inspection are being maintained and developed. Evidence: The manager is a Registered Mental Nurse (RMN), has a Diploma in Care Home Care Homes for Older People Page 25 of 30 Evidence: Practice and a Diploma in European Business. She is also an Adult Protection Trainer, Moving and Handling and Risk Assessor Trainer, Health and Safety and Infection Control Trainer, a Food Hygiene Trainer and has completed the Registered Manager Award. She is a well qualified and experienced manager and the home continues to benefit from her vast experience and knowledge in caring for older people with mental health needs. The manager keeps her own nurse practice up to date by attending other relevant courses and study. She provides good leadership and has a strong presence in the home, being readily available for staff, residents and relatives as needed. She carries out care duties as well as management and leads the staff team in furthering their understanding, knowledge and skills. Staff say that the manager is very supportive and always ready to listen to them to discuss and sort out any issues promptly. Information is passed on between staff during the daily handovers and regular staff meetings are held. The minutes of the most recent staff meeting and residents meeting were seen. These showed discussion about the complaints procedure, menus, outings, the bathroom refurbishment, key working and arrangements for the forthcoming Christmas party. The concluding statement on the residents meeting minutes states, Marcella thanked all the residents for making it such a pleasure to come to work and on the staff meeting minutes it states, Marcella thanked all the staff for all the care they give to residents. Quality assurance questionnaires are collated and recommendations acted upon. The most recent survey completed in June shows an analysis of the results and the percentages of responses that were favourable, satisfactory or negative. The majority of the comments were favourable and evidence seen indicated that any negative comments had been followed up. The AQAA was well completed and submitted on time. The manager has a good understanding of the Mental Capacity Act and Deprivation of Liberties Safeguards. Currently there are no residents for whom an authorization has been needed. The home has sound financial procedures in place regarding the management of residents personal monies. The majority of the residents have a family member, solicitor, court of protection, or support from the county council financial officer to manage their finances. Where the home does hold monies for residents, good records Care Homes for Older People Page 26 of 30 Evidence: are kept of any amounts spent, balance, residents signature plus two staff signatures. Residents have a lockable facility in their rooms to keep their valuables, or small amounts of money if they wish. The home is a member of a health and safety and employment consultancy. Environmental risk assessments are carried out and the manager does regular walking checks of the home. No safety risks were observed during our visit. The manager ensures safe working practices by keeping staff mandatory training up to date. The AQAA indicates that the homes equipment is regularly serviced. The fire safety log book shows that staff carry out weekly fire bell tests from different call points. The records were well kept. Care Homes for Older People Page 27 of 30 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 28 of 30 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 29 of 30 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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