Care Home: Ross Court

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What the care home does well Ross Court provides care to up to 42 older people. Before people move in, staff make sure they know what care the person will need. The care people need is written down and kept up to date, and people who use the service are involved with this. People say they can make their own decisions and can live independent lives. Staff help them to do so as safely as possible and allow people to take risks in, and ownership of their normal day-to-day living activities. Daily life is not restrictive. The home provides a good variety of food and caters well for special diets. People like the food. Staff help people to keep healthy and to feel secure. They look after medication safely. Staff are open to listening to any concerns. People feel comfortable with raising concerns and say the home acts on them. The home is run like a 5 star hotel, and the manager adopts hotel standards to provide the best quality care possible for the people using the service. What has improved since the last inspection? Management and staff have worked extremely hard to introduce more robust risk assessments within care documentation, and includes the individual within the care process. Recruitment procedures have been strengthened and the outcomes from quality assurance tools are actioned more speedily. There has been greater emphasis placed on promoting protection within the service. What the care home could do better: The home`s AQAA makes the following comments, and identifies the following as areas whereby further improvement is sought;- `We will continue to work on our refurbishment and development programme`, `I have to work within budget more consistently, in order to achieve this we will need to adopt good financial management due to the world financial situation` and `We will continue to work with employees in order to achieve high standards of documentation practices. The statement `If it is not written down it did not happen` is valuable in reminding employees in the importance of documentation`. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ross Court Overross Close Ross-on-wye Herefordshire HR9 7BQ     The quality rating for this care home is:   three star excellent 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: Nick Richards     Date: 1 1 0 2 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 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Ross Court Overross Close Ross-on-wye Herefordshire HR9 7BQ 01989764349 01989565569 rosscourt@majesticare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Ross Healthcare Ltd care home 42 Number of places (if applicable): Under 65 Over 65 42 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 0 Ross Court is situated at the end of a cul-de-sac in a residential area on the outskirts of the town of Ross-on-Wye. The home sits in its own grounds. It is easily accessed from the town ring road and M50 motorway. The home is registered to accommodate 42 people over 65 years of age who have needs arising from the normal ageing process at the point of admission. There is a commitment to continue providing a service for any resident who develops additional needs as long as these can be met within the Homes resources. Care Homes for Older People Page 4 of 28 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: The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. The visit was carried out over one day - the home did not know we were going to visit. This was the homes first key inspection since the previous one in March 2007. A key inspection is where we look at those areas that we, the commission, consider to be important when providing quality care. The focus of inspections we, the commission, undertake is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of Care Homes for Older People Page 5 of 28 practice and focuses on aspects of service provision that need further development. Prior to the fieldwork visit taking place a range of information was gathered to include notifications received from the home. This included surveys completed by the people living there, staff working within the home and professional people who visit the home. We also looked at the information submitted to us by the home in the form of an AQAA. This stands for Annual Quality Assurance Assessment. An AQAA is a document that the home has to send to us, and helps them to assess their home, identify what they do well, identify the things they are not so good at, and it tells us what they are going to do to help improve things within the home. Three people who live in the home were case tracked. This involves establishing individuals experience of living in the care home by meeting or observing them, discussing their care with staff, looking at care files, and focusing on outcomes. Tracking peoples care helps us understand the experiences of people who use the service. The people who live at the home, the manager and the staff were spoken to. Time was spent observing care practices, interactions and support from staff. We looked at the premises during a walk around the home, and we also looked at care, and health and safety records. 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 28 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 8 of 28 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 who want to move into the home can be confident that their needs will be comprehensively assessed prior to moving into the home, and their rights will be safeguarded after they move into the home. When people are admitted as an emergency admission, the home makes sure peoples rights are safeguarded. Evidence: During our visit we looked at the way the home gives information to people who want to move into the home. People that we spoke to all said that somebody from the home came to meet and assess them before they moved into the home. This is important because the assessment helps the home to decide whether they feel they can meet the needs of people before a decision is made to move in. We talked to several people about their experiences when they moved into the home. Each person was very happy about their Care Homes for Older People Page 9 of 28 Evidence: experience of being introduced to, and moving into the home. People told us that either they, or their relatives visited and experienced the home before they moved in. This helped people to get to know other people who use the service and get a feel about the service before they decided whether or not they wished to move in. Several people who now live at the home permanently initially tested the home on a respite (short-stay) basis. This allowed people to get to know and experience the home indepth, and allowed the home to get to know the person comprehensively before they moved in permanently. The homes management had undertaken pre-admission assessments before people moved into the home. This gives the home the chance to look at peoples needs and decide whether they can offer a service to people that will meet their assessed needs. The pre-admission assessments were comprehensive and provided information that allowed staff to start planning for the persons care before they are admitted into the home. People using the service confirmed that the homes management had visited them before they moved into the home and talked to them about their needs and expectations. People also told us that they had been given a copy of the homes Service User Guide (hereafter referred to as the Guide), and we saw copies of the guide in peoples bedrooms when we walked around the home. The Guide provides people with important information about the home and the service it aims to provide. We looked at both the Guide and the Statement of Purpose. Both documents were easy to understand, and contained the information people would need to help them make a decision about whether they would want to move into the home. The only piece of information missing from the Statement of Purpose and the Guide was the range of fees charged. We talked to management about this and were told that the fees would be included within both documents. Each persons representative had been given a copy of the contract to sign. The home had experienced some problems with contracts being signed and returned, but had made the necessary arrangements to try to encourage peoples representatives to sign and return them. This is important as a signed contract provides legal protection for both the person using the service and the service itself. The home communicates very well with people. People had been told when fees are to be increased, and we also saw documents that explained to people why their fees were being increased. We received completed survey forms from eleven people who use the service. Everybody said that either they or their next-of-kin had received a contract. One person who had moved into the home as an emergency admission said (I) moved in in Care Homes for Older People Page 10 of 28 Evidence: an emergency situation, when a permanent residence became necessary I was well informed. Everybody we spoke to said that they had received enough information about the home before they moved in so they could decide if it was the right place for them. Healthcare professionals spoke very highly about the home. One person said, This is a very well run residential home, another health professional said Ross Court appears to make every effort to offer an excellent service and one person said Everything from the moment I walk into Ross Court feels right. Care Homes for Older People Page 11 of 28 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. Arrangements within the home ensure that the personal and healthcare needs of individuals are effectively met so ensuring and promoting each persons health, well being and dignity. Evidence: During our visit the people we saw had been well supported with their personal care and clothing. All the people living there were well dressed in individual styles that were reflective of their age, their cultural background, the weather and the activities they were doing. People who use the service told us that staff always promote and respect their privacy and dignity. Staff were seen referring to people by their preferred form of address, and we saw staff knocking on peoples doors and waiting for a response before they entered each persons personal space. One person said They (the staff) always let me do what I want. Nothings too much trouble for them. Theyre golden. When you ring the bell, theyre here before you know it. Theyre absolutely fantastic. Records sampled showed that people had been regularly weighed to ensure they were Care Homes for Older People Page 12 of 28 Evidence: not gaining or losing a significant amount of weight, which could be an indicator of an underlying health need. The manager has put into place effective strategies to demonstrate how care is provided over the 24-hour period. For example, at night staff are responsible for recording the precise time they check people to make sure they are safe and comfortable. Night staff perform routine checks every hour. Staff have also taken named responsibility for specific care topics including diabetes, reflexology, reiki healing and infection control. This means that named individuals are identified as lead authorities on specific areas of care. Records sampled showed that each person is registered with a local general practitioner, who visits them if they are unwell. Where appropriate health professionals, such as psychiatrists, dentists, audiologists, chiropodists, community nurses and Parkinsons nurses are involved in the care of individuals. The outcome of any health appointments are recorded and records showed that staff follow the advice given to ensure individuals health and well being. One visiting healthcare professional returned a survey to us and stated As a doctor visiting I feel the care is of a very high standard, while other visiting health professionals made the following observations; Residents (are) always treated in a cheerful, professional manner and Individual clients are relaxed and very well cared for. Several people who use the service confirmed that their physical and emotional health needs were being very well met. One relative said, Ross Court has looked after my husband very well. The care records we examined clearly described the needs of people and the care necessary to promote each persons quality of life and wellbeing. Staff discussed peoples care records each month with either the individual concerned or their representative if the person was unable to discuss their needs, and the outcomes of the discussions were recorded on each persons care file. Peoples opinions and views about their care were actively sought and acted upon. The service works well to promote equality and diversity within the home. Each person is respected as an individual and staff work hard to ensure that their wishes are upheld or promoted. The vast number of staff within the home are female while the majority of people using the service are female. The home has ensured that peoples preferences about the gender of staff providing care has been sought and respected. Within the home, care staff help people who use the service to take their prescribed medication. Several people prefer to take responsibility for their own medication and have been risk assessed by the staff to ensure that they are safe to manage their own medication. We saw comprehensive risk assessments on peoples care files. These aim to maximise peoples independence whilst ensuring that unneccesary risks to peoples Care Homes for Older People Page 13 of 28 Evidence: health, safety and wellbeing are minimised. All medication is administered in accordance with the homes policies and procedures. This ensures that people receive their prescribed medication safely. When people receive their medication, the care staff sign a drug administration record. This allows people to know that their medication has been managed safely, it also shows when, and why, medication has not been given to people. People using the service said that staff always help them with their medication, while one visiting healthcare professional said, The home manages this (the persons medication) very well involving the client as much as possible in the organising and administering of their medication. Four people who use the service described the management of their healthcare as excellent, with one person saying Id give them 10 out of 10. Care Homes for Older People Page 14 of 28 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. People are encouraged and supported to engage in social and recreational activities that refelect their individual preferences. Relatives and visitors are welcomed into the home and daily routines are unrestrictive. A good range of food is supplied, and the home caters well for peoples individual and collective dietary needs. Evidence: People we talked to said that they were happy with the daily routines and activities within the home. We were told that staff within the home respect the decisions made by people using the service. They said that they were free to get up and go to bed whenever they chose. They also said they were satisfied with the range of social and leisure activities provided in the home. These included art and craft sessions, visiting musicians and singers (we witnessed a visiting entertainer during our visit), a rambling group and board games. They are held in different parts of the building to encourage people to move about and get a change of scenery. An Activities Organiser is employed to co-ordinate and organise social, leisure and recreational activities for people at the home. Care Homes for Older People Page 15 of 28 Evidence: Members of the clergy visit the home regularly to hold a service, and one person is supported to participate in religious activities regularly. People using the service said that they were pleased with the range of social, recreational and leisure activities and opportunities afforded to them. Staff develop and implement social care plans which are comprehensive and set out, in detail, the leisure, recreational, social and occupational needs and aspirations of people using the service Several people went out with their family and friends, and we saw people visiting during our visit - all of whom were very complimentary about the home. One person described the service as excellent. People are encouraged, and given the opportunity to continue with their hobbies and favourite pastimes once they move into the home. There is a quiet library facilitiy situated on the first floor of the home, with facilities to listen to music. A seperate hairdressing salon is also provided and a hairdresser visits to cut and style peoples hair regularly. All meals provided are cooked within the home, which has dedicated catering staff. None of the meals provided were fast or convenience foods. The home operates a menu system, and the food provided centres around the preferences of people using the service and alternatives are always provided. One person said Perhaps I dont care for something called Irish stew but the alternative cauliflower cheese is very pleasant. Food provided was nutritionally balanced and varied. On the day of our visit, the lunchtime meal was a choice between scampi or ham and pineapple with chipped potatoes and seasonal vegetables followed by bread and butter pudding or a choice of icecreams. People were seen enjoying the lunchtime meal, and confirmed this during conversation. People were using mealtimes as a social event, which was unhurried. Some people preferred to eat their meals in their bedrooms and staff respected this choice. One person described the food as fabulous, and a relative told us The meals that I have joined my husband with have always been enjoyable. Everybody that we talked to all said that the food was good. Weight records confirmed that people were getting enough food as there was no evidence of any unintentional weight loss. Care Homes for Older People Page 16 of 28 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. People using the service are supported to express concerns, and are safeguarded by the homes open culture, complaints procedure and investment in staff training. Evidence: Each person living at the home has been given a copy of the homes complaints procedure, which is included within each information pack. The procedure had been issued in May 2006, and was to be reviewed in May 2009. People who completed and returned surveys to us all said that they were aware of the homes complaints procedure, and knew who to talk to if they had any concerns. The culture within the home is open and allows and supports people to raise concerns. People that we spoke with said that if they had any concerns they would raise them with either the deputy manager or the manager. This was clearly supported by the record of concerns and complaints retained by the home. The complaints register contained several entries raised by people using the service since the time of the homes last key inspection. The concerns raised resulted in the home contacting and taking advice from Herefordshire Councils safeguarding team, and, on occasions, referring individuals to the POVA (Protection of Vulnerable Adults) register. The records held by the home show what action staff have taken to resolve the concern/s raised. Staff and management are eager to make sure that everyone Care Homes for Older People Page 17 of 28 Evidence: living at the home are happy and receive the service they want. Concerns are used by management to learn and adapt (improve) practice. The procedure states It is the homes policy to welcome complaints and look upon them as an opportunity to learn, adapt, improve and provide better services. One person who visits the home said that they have never needed to raise any concerns. Staff we spoke to all confirmed that they were aware of safeguarding procedures, and the home has a training programme that includes training about the Protection Of Vulnerable Adults (POVA) and Whistleblowing. The home has copies of the local authoritys safeguarding protocol. This ensures that, should the home have need to raise a concern about safeguarding, they know the correct procedures to follow. Safeguarding issues are routinely discussed during staff meetings to ensure that staff are always aware of the procedures to follow if they witness or suspect abuse occuring. We saw evidence to confirm that peoples right to vote in political elections is maintained and promoted. People are provided with support to vote at polling stations whenever a local or national election occurs. Care Homes for Older People Page 18 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from living in a home that has high environmental standards, attractive decor, good quality furnishings and lovely, well maintained gardens. Evidence: The home is very well maintained and has been extended and upgraded to a very high standard. The building is clean, light and spacious with good sized bedrooms, most with ensuite facilities. People moving to the home are encouraged to bring furniture and personal belongings with them (provided they will fit in their room). Some of the new ground floor rooms have patio doors and their own outside space. Fridges are provided in all rooms for people to store drinks and perishable foods and, following a risk assessment, kettles are also provided for people who are able to manage and who want to be able to make themselves a drink. The provision of these facilities help people to retain everyday living skills and helps to promote and maximise independence. The communal rooms are spacious and comfortable and each is furnished differently to promote hotel standards and quality. Many items of seating within the lounge areas are made of leather and are very comfortable. The home has an unlicenced bar, and people using the service are served with an aperitif (such as sherry) at mealtimes. This Care Homes for Older People Page 19 of 28 Evidence: attention to detail helps to further enhance the luxury feel of the service provided by the home. Corridors, toilets and bathrooms in the new extension have been designed to provide as much space as needed for people with mobility difficulties. Bedroom doors are fitted with soft-touch automatic closers which operate when the fire alarm sounds. This makes them easy for people to operate and means they can have their doors positioned as they prefer. One of the communal rooms is fitted with an induction loop to assist people with hearing aids. Outside there are large lawned grounds, flower beds and mature trees. Several people said they get a lot of pleasure from the gardens. Areas such as the kitchen and laundry are well equipped and clean. Protective clothing such as disposable aprons and gloves is provided and there are paper towels and liquid soap dispensors in all bathrooms and toilets. This helps to promote hygiene and reduce the possibility of an infectious outbreak occuring within the home. People that we spoke to all said that the home was always clean and tidy, and everybody said the environment was lovely. One person said that the home was Like a hotel, while another person said Its like home. The AQAA (Annual Quality Assurance Assessment) provided to us by the home confirmed that all regular maintenance tests and checks have been carried out as required and that the requirements of other regulatory authorities have been complied with. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living within the home can be confident that they are in safe hands at all times. Staff are provided to meet peoples needs in suitable numbers and are effectively trained and supported to deliver care to people who use the service. Evidence: We looked at how the needs of people living at the home were met through the provision of appropriately skilled staff. We talked to people using the service and the staff working at the home, and looked at staff records, training records and duty rotas. The duty rotas show staffing levels at the home are good, and staff are deployed in numbers that effectively meet the needs of people using the service. The responses to our survey gave a very positive view of staffing arrangements, with people saying they always get the care they need. One person did express some concern about the time it sometimes took staff to respond to the alarm bell when this was activated. We took note of this comment and monitored how long it took staff to respond to call bells during our visit. We saw no evidence of any undue delay in staff responding to call alarms. In fact, everybody that we spoke with on the day of our visit all commented favourably about the speedy response of staff. People described staff as wonderful, excellent, very good, and one person went on to say that staff do so much for us, everything is perfect and the carers are the greatest I could wish for. Another person Care Homes for Older People Page 21 of 28 Evidence: said that the staff always have time to listen, and this was confirmed by staff when we spoke with them. We observed staff interactions with people using the service. Everybody we saw were friendly, polite and respectful. Staff generated a warm, relaxed feel, and this, in turn, created humour. People said there are always enough staff on duty. Staff receive training in a range of mandatory health and safety and care related subjects including moving and handling, fire safety, infection control, first aid, palliative care and the management of diabetes. This means that staff are well equipped to provide care for the people using the service, and people using the service are reassured to know that they are in safe hands. The manager has developed a staff training matrix, which sets out topics that staff will be trained in over the next 12 months. This helps the manager to co-ordinate and plan training, and also to see when, or if a member of staff is in need of training in a specific area of care or health and safety. Staff spoken to confirmed they attend courses and the manager keeps copies of their certificates in a file. Staff induction training is provided at the start of their employment, and records show the content of the induction - which is comprehensive and helps to equip new staff in delivering care to people using the service. Examples were seen of induction courses being signed off as completed with the specific date against individual topics and it was clear who the trainer was. There was supporting evidence of the course content kept with this record. The homes AQAA stated that over 90 per cent of staff have achieved or are working to achieve a National Vocational Qualification (NVQ) in care. We looked at how well people are protected through the homes recruitment process. Staff recruitment files for four staff were examined during our visit.The staff files we examined all proved that the home has taken the correct steps to ensure that only people who are suitable to work with vulnerable adults work at the home. People living at Ross Court are effectively protected by the homes recruitment process. Care Homes for Older People Page 22 of 28 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. The management arrangements ensure that the people living at Ross Court benefit from an extremely well run home and their views are considered, taken into account and acted upon. The health, safety and welfare of the people living there is promoted and protected so ensuring their safety and well being. Evidence: Mrs Auty is the registered manager of the service and is suitably qualified and experienced to manage the service. The management arrangements within the home are relatively unique as Mrs Auty resides at the home. This means she is available at short notice if she is needed, but also has to ensure that she promotes a healthy work-life balance. Mrs Auty prides herself in having a very hands-on approach to care - this results in her being able to create and maintain close professional relationships with the people using the service. She promotes a hotel ambience and quality to the service provision at the home, and is keen to promote quality through the application of 5 star hotel standards. Care Homes for Older People Page 23 of 28 Evidence: People using the service rated Mrs Autys management style as 10 out of 10, and staff described her as having an open, approachable style - someone you can talk to was how one staff member described her. The home is part of an organisation called Majesticare, which has internal quality assurance processes that take into account the views of people using the service. Reviews undertaken by the organisation indicate very high levels of satisfaction with the overall service at the home. These results are summarised within the homes Statement of Purpose. One survey returned to us by a healthcare professional stated under the section What do you feel the care service does well?, Respect for patients privacy and dignity, while another visiting professional stated This is a very well run residential home. The home has up-to-date records detailing how its responsibility to ensure the health and safety of people using the service has been met. Risk assessments are conducted on a specific basis for each person using the service and there are generic risk assessments available within the home. All accidents and incidents are monitored closely and action is taken to prevent further accidental occurences happening when or should an accident occur. This helps to ensure that people are protected from avoidable harm, but they are also allowed and supported to take risks which promote their independence. The home has minimal involvement in the management of peoples personal finances; either people attend to this themselves, thus maintaining their independence, or relatives are asked to assist them. There is a framework for individual and group supervision, including a calendar for scheduling supervision sessions during the year. There is a formal written agreement with staff about the content and format of supervision and written notes of meetings are kept. Representatives from Majecticare undertake unannounced visits to the home each month and look at how well the home is operating - taking into account the views of people using the service. A report is produced for the manager following each visit and any issues arising that need addressing are clearly specified within the report. Mrs Auty organises residents meetings four times each year and minutes the contents. These meetings provide a formal arena whereby people using the service can raise agenda items about anything they feel they want to discuss. One person who visits the home in a professional capacity summarised the home by Care Homes for Older People Page 24 of 28 Evidence: saying I am always full of praise for the home and all associated with it. I dont think they can get any better. Care Homes for Older People Page 25 of 28 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 26 of 28 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 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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) 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. 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