Care Home: Sandbanks

What the care home does well There is a welcoming and homely atmosphere. The Expert by Experience notes, `laughter and companionship amongst the residents`. Relatives say that their overall impressions of the Service are good or excellent. The Manager consults with people before they move in. This is so that they are confident that their needs can be met. One person says, `there`s a homely feeling to it and I`m glad to be here. I wouldn`t have stayed if I hadn`t liked it when I moved in. My (relative) and I came to see the place first of all and liked it. I`ve not been disappointed since then`. People say that they receive the assistance they need in ways that are right for them. One person says, `the staff are really very good and helpful. They will always have a chat and they`re kind. We all take it for granted I suppose but when you stop and think about it it`s the staff who make this place homely and welcoming. They should be praised for it really more than they are`. There is a good range of special equipment such as hoists to help people who have reduced mobility. People can receive visitors whenever they wish and they can meet with them in private. The Manager keeps in touch with relatives so that they know how things are going. There are interesting and engaging social things that people can do. There are reliable arrangements for the ordering, storage and administration of medication. People are helped to stay in good health. This includes keeping an eye on how everyone is and then calling doctors as soon as they are needed. The kitchen meets the requirements of the local Department of Environmental Health. There is a modern automatic fire safety system in operation. The laundry is well equipped and well organised. Most of the care workers have completed a relevant National Vocational Qualification (NVQ). Security checks are completed on new members of staff. What has improved since the last inspection? A number of improvements have been made since our last Annual Service Review. The Manager has been registered by us. This means that we have confirmed that she has the knowledge and skills she needs to oversee the day to day running of the Service. An activities coordinator has been appointed. She has increased the range of social activities that people can do. A number of bedrooms have been redecorated and have had new furniture. In the lounge, some of the armchairs have been replaced and a new wide screen television has been provided. A new wet room and a new hairdressing salon have been created. Some of the older windows have been replaced with double glazed units. There is a new steam cleaner for deep cleaning the carpets. The improvements recommended by a thorough health and safety audit have all been implemented. All of these things contribute to the Service being better able to care for people in ways that are right for them. What the care home could do better: On one occasion the Registered Provider has not effectively operated parts of its own procedure for safeguarding people who live in the Service. This resulted in the local authority not being promptly invited to contribute to resolving the situation. The written staff roster does not always give an accurate account of who is on duty. This makes it more difficult for the Registered Provider to demonstrate to us that enough members of staff are present. Some care workers are not receiving all of the training that the Registered Provider says that they need. This might result in them not having all of the necessary skills and knowledge. The quality assurance system does not adequately involve all of the people who live in the Service. This means that some people might not have the opportunity to contribute ideas about the improvement of the Service. Key inspection report Care homes for older people Name: Address: Sandbanks St Andrews Road Littlestone New Romney Kent TN28 8RA     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: Mark Hemmings     Date: 1 7 1 2 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 28 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 28 Information about the care home Name of care home: Address: Sandbanks St Andrews Road Littlestone New Romney Kent TN28 8RA 01797366810 01797367216 info@belmontsandbanks.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Belmont Sandbanks Ltd Name of registered manager (if applicable) Ms Zoe Rose Kendall Type of registration: Number of places registered: care home 25 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users to be accommodated is 25 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 category: Dementia (DE) Date of last inspection Brief description of the care home Up to 25 adults who have problems with parts of their comprehension can make their home in Sandbanks Care Home (the Service). All of those currently in residence are older people. The property is a three storey detached building. There is a passenger lift that gives step-free access around the accommodation. Care Homes for Older People Page 4 of 28 Over 65 0 25 Brief description of the care home When full, three of the bedrooms can be shared by two people. All of the other bedrooms are for single occupancy. All of the bedrooms have a private wash hand basin and five of them also have their own toilet. The bedrooms are laid out as bed sitting areas. Each bedroom has a television point. There is a main lounge on the ground floor and a sun lounge that leads out to the garden. There are two bathrooms, a shower room and a number of toilets. There is a call bell system. This means that people can summon a member of staff if they need assistance. There is a cordless telephone that people can use free of charge. At the back of the building, there is a large, enclosed garden. There is a ramp that leads down to it. After that, it is level and it has both lawns and flower beds. There are garden tables and seats. The Service is in a quiet residential street. The road itself is unmade and it is very uneven with large potholes. The building is about one mile from the centre of New Romney. There is a bus stop nearby and there is plenty of on-street and off street car parking. There is a general store about half a mile away. The nearest mainline railway station is in Ashford about 23 miles away. The Service has its own vehicle. The weekly fee for living in Sandbanks Care Home runs from £396.80 to £520.00. There are extra charges for things such as hairdressing and chiropody. Care Homes for Older People Page 5 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 that the people who use this Service experience excellent quality outcomes. We arrived unannounced at the Service just before nine oclock in the morning. We were there for about seven hours. It was a thorough look at how well things are going. We took into account information provided by the Registered Provider in its self assessment. This is called the Annual Quality Assurance Assessment (the Assessment). We received this on time and it is adequately detailed. Further, we considered any other information that we have recently received about the Service. We did our last Key Inspection on 25 November 2006. In the intervening period we have also done two Annual Service Reviews. We completed the last one of these on 31 October 2008. This was an office based activity when we reviewed all of the information that we had gathered since the preceding Annual Service Review. Care Homes for Older People Page 6 of 28 During the present inspection, we spoke with 10 of the people who currently live in the Service. We spent time in the company of another six of them while they were in the lounges. We also met with one relative. We spoke with the Managing Director of the company that is the Registered Provider. We also spoke with the Manager, three care workers, the activities coordinator, the cook and with two housekeepers. We looked around parts of the accommodation and the grounds. Also, we looked at a selection of key records and documents. These included things like the individual written plans of care, medication records, the activities plan, the menu, complaints documents, the staff roster, staff training records, financial records and various health and safety certificates. Before we visited the Service, we asked some of the people who live there, their relatives, some care workers and some health and social care professionals to fill out a questionnaire for us. We wanted them to tell us what they think of Sandbanks. Five people who live there, three relatives, three members of staff and two health and social care professionals kindly completed them for us. Later on in our Report, we will tell you the main things that are being said in these questionnaires. The Registered Provider has asked some relatives to give their opinion on the Service. We will tell you some of the points they make in their replies. We were joined by an Expert by Experience. She has a thorough knowledge of the special needs of older people. She spent about three hours in the Service. During this time, she observed what was going on in the lounges. She also talked with people who live in the Service and with members of staff. She had a look around the main parts of the accommodation. This included going into some of the bedrooms by invitation. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? A number of improvements have been made since our last Annual Service Review. The Manager has been registered by us. This means that we have confirmed that she Care Homes for Older People Page 8 of 28 has the knowledge and skills she needs to oversee the day to day running of the Service. An activities coordinator has been appointed. She has increased the range of social activities that people can do. A number of bedrooms have been redecorated and have had new furniture. In the lounge, some of the armchairs have been replaced and a new wide screen television has been provided. A new wet room and a new hairdressing salon have been created. Some of the older windows have been replaced with double glazed units. There is a new steam cleaner for deep cleaning the carpets. The improvements recommended by a thorough health and safety audit have all been implemented. All of these things contribute to the Service being better able to care for people in ways that are right for them. 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 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 10 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 are thinking of moving in are asked about what care they need and how they want this to be done. They are encouraged to visit the Service to get a first hand feeling of what it is like. People who want to stay for only a short time will be supported to go home again. Evidence: The records show that the people who are thinking of moving in are asked about what care they need and want. They and their relatives are also invited to visit the Service. This is done so that they can be confident that moving in to Sandbanks is the right thing for them. The Manager also talks with people such as doctors and care managers (social workers). All of this helps her to build up a really good picture of how the person can best be supported. There is a Service Users Guide. This is a brochure that gives lots of useful information about the facilities and the services that people can expect to have when they move Care Homes for Older People Page 11 of 28 Evidence: in. Copies of this document are available from the Manager. One person says, theres a homely feeling to it and Im glad to be here. I wouldnt have stayed if I hadnt liked it when I moved in. My (relative) and I came to see the place first of all and liked it. Ive not been disappointed since then. Care workers say that the Manager shares with them the information she has obtained about someone who is due to move in. This is done so that they know what care they need to provide. One care worker says, we like to help people to settle in. It must be unnerving to come somewhere new to live even after visits and all of the preparations. We reassure people and let them go at their own pace. We want them to feel welcome without being overwhelmed by too much fuss. Most of the people who move in do so with the intention of making Sandbanks their longer term home. However, someone might only need to stay for a shorter time. This might be so that they can recuperate before going back to their own home. The Manager says that when this happens she will carefully liaise with relatives and health and social care professionals. This will be done to help support the person to go home again. Care Homes for Older People Page 12 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. There are written plans of care that describe care what care is to be provided. People are reliably receiving all of the care they need. They are treated with courtesy and respect. People have access to the medical and health care services they need. There are reliable arrangements for handling medication. Evidence: Each person has an individual written plan of care. These describe what care they need and how they want this to be delivered. The plans are clear and detailed. They are being kept up to date with regular reviews. In their questionnaire replies, people say that they always receive the care they need. They also say that care workers listen to them and act on what they say. One person says, the staff are really very good and helpful. They will always have a chat and theyre kind. We all take it for granted I suppose but when you stop and think about it its the staff who make this place homely and welcoming. They should be praised for it really more than they are. One care worker says, we get to know the residents really well over time and we just know how each one likes to be helped. Whats right for one Care Homes for Older People Page 13 of 28 Evidence: person isnt for someone else. Its a bit like a big family. Youve got to genuinely care about the residents or you wouldnt do this job and the staff here do care. In their replies to the Registered Providers questionnaire all of the relatives say that the care provided in the Service is good or excellent. One relative says, (the care workers are) very patient with my mother who can be difficult. (The care workers are) always cheerful. My heartfelt thanks for looking after my mother so well. Another relative says, when I visit it is always clean and tidy. Staff are always very helpful and friendly. The Expert by Experience says, I was able to observe the interaction between the residents and staff which is good. Residents are spoken to as individuals and the general feeling is of a homely atmosphere. She also says, a good staff and residents rapport exists. Care workers help and support residents without being asked to. Care workers speak to residents as individuals and take time with them. The records show that people are receiving the medical care they need. This includes seeing professionals such as their doctor as and when they are needed. They also see specialist health and social care professionals who give advice to the Service about how best to respond to people who have complicated personal and medical care needs. Care workers manage medication for people. There is a system to check that the correct medicines are received from the chemist. Once in the Service, medicines are stored securely. There is a procedure for administering medicines. This is designed to double check that the right medicines are given to the right people at the right time. There is a record that is completed on each occasion that a medicine is given. These are being completed correctly. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can take part in social activities if they want. People are free to receive visitors and to spend the day as they wish. Good quality meals are served. Evidence: There is a new activities coordinator who is on duty most days. She does both small group activities and one to one sessions with people. The records show that people can choose to do things such as artwork, gentle exercises and games. Once or twice a month someone comes to play music. In the past six months there has been one trip out. The Manager says that she hopes to organise more frequent trips out next summer. In their questionnaire replies everyone says that they always or usually have enough social opportunities. One person says, theres always something to do or to see here. We do games and things, we dont have to join in but it can be fun and I do things. Another person says, we do quite a bit like bingo and things to be interested in. I dont get at all bored, I like the lounge and hearing people and watching people and being part of things. The Expert by Experience observed a social activity in the lounge and noted, laughter and companionship amongst the residents. People are free to receive visitors whenever they want. They can speak with them in Care Homes for Older People Page 15 of 28 Evidence: the privacy of their bedroom if they wish. The records show that the Manager keeps in touch with relatives so that they know how things are going. The Manager says that people are encouraged to make their bedrooms their own private space. They are helped to arrange them as they want them to be. The Expert by Experience says, the double rooms allow for personal space by the erection of a sturdy partition dividing the beds, but allowing easy access between them. This gives the room privacy for the occupants without isolation. All of the bedrooms are large and roomy. None of the rooms are cluttered and they all have personal belongings of photographs and ornaments. Most of them also have televisions. The rooms are nicely furnished with good cupboard space. People can use their bedrooms whenever they want. They can choose to have private time on their own or to be in company. The Registered Provider does not get involved in helping people to manage peoples financial affairs. Most people are helped by their families or by the local authority. The records show that there is a varied menu. The main meal is lunch and the sorts of dishes served are things like braised beef and sweet and sour chicken. There is a set meal but people can choose to have something different if they want. There is a cooked option for tea. There are drinks and cakes and biscuits served mid morning, mid afternoon and later in the evening. People can dine in their bedroom if they wish. In their questionnaire replies people say that they are happy with their meals. One person says, the meals are excellent really and we have a very good cook. I always look forward to my meals and theyre nicely served. The Expert by Experience says, lunch was taken by all the residents (except three) in the dining room. I observed several residents being supported to eat but in a discreet way. The plates are a good size and there is little waste. Those residents who didnt eat in the dining room ate instead in the sun lounge. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a complaints procedure. There are systems in place that are designed to keep people safe. The local authority is looking into an incident in which someones wellbeing may have been compromised. People are protected from prejudice and discrimination. There are reliable systems for helping people to manage their personal spending money. Evidence: There is a written complaints procedure. This explains how someone can raise concerns about the Service. It states, we welcome complaints and see them as a vehicle by which the care we give can be improved and from which we can learn. Since our last Annual Service Review neither we nor the Registered Provider have received any formal complaints. In their questionnaire replies people say that they know how to make a complaint. One person says, I can say anything I want to and the staff are always fine about helping me. I havent got anything to complain about really, Im quite happy here. Another person says, Im fine here and if I wasnt Id speak to someone about it. The girls are all wonderful and kind like friends should be I suppose. People who live in the Service are confident that they are safe and that their wellbeing will be promoted. In their questionnaire replies everyone says that members of staff always treat them well. The care workers are confident that people are being kept Care Homes for Older People Page 17 of 28 Evidence: safe. One care worker says, the residents come first here and nothing would be allowed that got in the way of their wellbeing. The local authority is investigating an incident when someones wellbeing might have become compromised. The matter was first brought to the attention of the Registered Provider. It took immediate steps to ensure the future safety of the person concerned. However, it did not notify us or the local authority as it is required to do. We understand that since then the Registered Provider has cooperated fully with the local authoritys investigation. The Registered Provider has also taken appropriate steps to make sure that the correct procedure is followed in the future. The Assessment commits the Registered Provider to promoting diversity in the Service. This means respecting each person who lives there as an individual. It also means making sure that no one experiences any form of prejudice or discrimination. The records show that care workers receive training about this subject. The Manager says that this commitment to promoting diversity is also expressed in practical terms. For example, in the way that each person receives individualised care in ways that respect their preferences and wishes. The records show that suitable safeguards are in place to protect the interests of people who may need to aspects of their freedom temporarily restricted. People are helped to handle their personal spending money. Usually this means that relatives bring in small amounts of money that are put into safekeeping by the Registered Provider. The money is then used to pay for things such as for seeing the hairdresser. The records show that the system is working in a reliable and transparent way. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The accommodation is well presented. There is a modern fire safety system that is being regularly checked. The kitchen is well equipped. There is enough equipment to help people who have difficulties with their mobility. There is a suitable laundry. Evidence: The building provides a suitable range of facilities for the people who live there. These are in line with what the Registered Provider has committed itself to deliver in its Statement of Purpose. This is a legal document that describes in some detail the facilities and services that are available in Sandbanks. Copies of this document can be obtained from the Registered Provider. The building is well maintained on the outside and the garden is well kept. On the inside, the accommodation is well decorated and furnished. The lounges are comfortable spaces. The Expert by Experience says, the home in general is well decorated with easy access for the residents. Various improvements have been made since our last Annual Service Review. Some windows have been replaced with double glazed units. The wet room has been created and a new hairdressing salon has also been established. In the lounge, 12 new chairs have been provided and there is a new wide screen television. Four bedrooms have been refurbished. They have been redecorated and they have had a complete new Care Homes for Older People Page 19 of 28 Evidence: suite of furniture. A new steam cleaner has been provided for deep cleaning carpets. There is a range of equipment to help people who have reduced mobility. There are special baths that have hoists for easy access. The wet room has a walk in shower. There are mobile hoists that can be used in the lounges and in the bedrooms. There are also other things such as special sheets to help people change position in bed. There is a modern automatic fire detection system. This has been assessed by the Registered Provider to make sure that it continues to meet the national standard. The fire safety equipment is being checked regularly to make sure that it remains in good working order. People say that the accommodation is always comfortably warm. Most of the radiators are fitted with guards. Others are fitted with thermostatic valves. These measures mean that their heated surfaces cannot get hot enough to burn someone. The hot water system is temperature controlled. This has been done so that it does not get hot enough to scald someone. The kitchen is clean and well equipped. The local Department of Environmental Health says that the kitchen meets its requirements. The laundry has a commercial washing machine. This is fitted with a special cycle for items that need a particularly hot wash. There is a large dryer. The area is well organised and clean. There are suitable arrangements for promoting good standards of hygiene. There is a sluice that can be used for cleaning items such as commodes. 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. There are enough care workers on duty. The written staff roster is not always accurate. Care workers are receiving most but not all of the training they need. Security checks are completed on new members of staff. Evidence: The records show that there are usually four care workers on duty from early in the morning until later in the evening. There is a waking staff presence at night. During the day there are other people who do the housekeeping, the laundry and who work in the kitchen. In their questionnaire replies members of staff say that there are always or usually enough care workers on duty. One person says, we normally have four (care workers) on in the mornings when its busiest but some days when we have only three on it can be very busy even hectic. Really, we could do with some more staff so that if someone is sick their hours can be covered without us having to rush so much. One relative says, the staff are very kind and always speak to me. They could do with more help though. The written staff roster does not always give an accurate account of who is in duty. The Manager says that this problem will be addressed without delay. The records show that the necessary security checks are being completed for new care workers. These include things such as confirming their identity, taking up references Care Homes for Older People Page 21 of 28 Evidence: and doing a police check. This is done to make sure that they are trustworthy people to work in the Service. The records show that care workers do introductory training before they join the roster. In their questionnaire replies people say that this training met their needs very well. After their introduction, there is ongoing training in key subjects such as first aid, health and safety and how to help people who have reduced mobility. Most but not all of the care workers have had the training that the Registered Provider has committed itself to provide. The records show that more training is planned for early 2010. This should address some of these shortfalls. One care worker says, the training is good actually. We seem to do quite a lot and I have done training in how to safely move people and in adult protection. Weve got some more planned for next year and there always seems to be courses to attend. Most of the care workers have completed (or are completing) a relevant National Vocational Qualification (NVQ). This Award is designed to further develop their ability to provide people with the assistance they need. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Manager is registered with us. The quality assurance system does not fully involve everyone who lives in the Service. There are reliable health and safety arrangements. Evidence: Since our last Annual Service Review, the Manager has been registered in her post. This means we have confirmed that she has the knowledge and skills necessary to ensure that people reliably receive the care they need and want. She has both of the formal management qualifications that are recommended by the National Minimum Standards. In their questionnaire replies members of staff say that there is good team work in the Service. One care worker says, the teamwork is very good. Some people have worked here a long time and we have all got to know each other and we help each other out. (The Manager) is a good manager because she works with us and its a friendly place to work. I wouldnt want to work anywhere else. Someone else says, this is a really good place to work and Im completely sure that the residents get very good care. I Care Homes for Older People Page 23 of 28 Evidence: always say that we treat people the way we would like to see our own family treated. The Expert by Experience says, the staff work well together and share a relaxed humour which transmits itself to the residents. There are handover meetings at the beginning and end of each shift. These are when care workers discuss how things are going so that they can plan what needs to be done. There are also regular staff meetings. As noted previously, visitors to the Service are invited to complete a questionnaire. There is no system to give feedback to people who have completed them. There are no house meetings or other organised arrangements to consult with people who live in the Service about the day to day running of their home. The Managing Director and the Manager recognise that much more now needs to be done to develop this aspect of the quality assurance system. There is a health and safety policy. This commits the Registered Provider to maintaining a safe environment in the Service. As part of this the cook regularly checks that the refrigerators and freezers are cold enough to store food safely. She also checks that hot foods are cooked through. There is a system to date mark food so that it does not go beyond its use by date. The records show that most members of staff are receiving annual fire safety training. The Manager is going to strengthen this arrangement by making sure that everyone has fire safety training at least once every six months. This is going to be done by 1 March 2010. Fire drills are being held regularly. The records show that items of equipment such as the passenger lift, the hoists, the electrical wiring installation and gas fire appliances remain in good working order. There have not been many significant accidents in the Service since our last Annual Service Review. The records show that the Manager monitors the occurrence of accidents. This is so that she can see if anything needs to be done to help prevent them from happening again. She says that nothing particular needs to be done at the moment. In the course of the past year, there has been a thorough health and safety audit of the building. The records show that there were a small number of recommended improvements. The Managing Director says that all of these have been completed. For example, the wardrobes in the bedrooms have been secured to the wall so that they cannot topple over. The Manager also completes a monthly health and safety audit. Care Homes for Older People Page 24 of 28 Evidence: This is done to help make sure that there are no minor hazards that might result in someone having an accident. The Manager says that there are no particular hazards that need to be dealt with. We did not notice any either. 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: 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 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!