Care Home: Seagull Rest Home

What the care home does well The home has an assessment process which enables the manager to decide whether Seagull Rest Home can meet the needs of the individual. The ones we saw on this occasion were completed and were used to inform the care plan. The care plans were informative and advised staff what the strengths and abilities of the individual are as well as what they need to do support individual needs. Where individuals wished to be self caring or carry out an activity, we saw that there were risk assessments to lessen any identified problems. When we spoke with people using the service they told us they were happy with the activities that are available for them. They enjoy the newsletter about the home and have contributed to it themselves. People who live at the home were generally positive about the food that the home provided and the condition of the accommodation that they occupied. We saw that new staff had been recruited and that the home had carried out checks to protect people who use the service. New staff have begun induction training in working at the home. Staff have received updated training in many areas such as moving and handling. Whilst it was seen that the home is doing well in the areas where action was required for improvement, the areas that have improved are listed in the following section of this report. What has improved since the last inspection? The home carries out assessment visits to prospective residents to ensure that they can meet the needs of the individual. The home has care plans which describe the needs of the individual and what they are able to do independently. The plans describe the support staff have to give. The storage and administration of medication has improved with all staff have undertaken training in medication administration and with the manager having organised roles and responsibilities. Daily routines in the home are now flexible and people who use the service are being encouraged to make choices for themselves and exercise personal autonomy as far as reasonably possible. The homes current recruitment process now protects people who use the service. Staff have undertaken training in most mandatory areas and training that helps support individual needs. A quality assurance programme is underway enabling people who use the service and their relatives to have a say about the running of the home. The responsible individual for the home carries out regular visits to the home and keeps a record of these once a month. The challenge is for the staff at Seagull Rest Home is to imbed these changes into the practice of the home and maintain them. What the care home could do better: Whilst the provider and manager have told us that they plan to imbed the improvements they have made to the service offered at the home, this improvement must be sustained and further planning to improve the service and its future undertaken. Key inspection report Care homes for older people Name: Address: Seagull Rest Home 131 Stocks Lane Bracklesham Bay Chichester West Sussex PO20 8NY     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Val Sevier     Date: 2 5 0 5 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Seagull Rest Home 131 Stocks Lane Bracklesham Bay Chichester West Sussex PO20 8NY 01243670883 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Maniben Odedra Name of registered manager (if applicable) Mrs Sarah Louise Christopher Type of registration: Number of places registered: care home 23 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users to be accommodated is 23 The registered person may provide the following category(ies) of service only: Care Home only (PC) to users of the following gender:Either Whose primary needs on admission to the home are within the following categories : Dementia (DE ) Mental disorder ,excluding learning disability or dementia (MD) Date of last inspection Brief description of the care home Seagull Rest Home is a care home able to provide care and support for up to 23 residents who may have dementia or another related mental disorder. It is situated next to a main road close to the village of Bracklesham Bay near Chichester. Local shops and other community facilities are within walking distance. Care Homes for Older People Page 4 of 28 Over 65 0 0 23 23 2 5 1 1 2 0 0 9 Brief description of the care home The accommodation is a single story building with a car park area to the front of the building and paved areas to the rear. Communal areas include a lounge and a dining area. There are twenty one single bedrooms and one double bedroom. Two bedrooms have en suite facilities. The fees are available on asking the manager of the home. 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: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service 2 star. This means the people that use this service experience good quality outcomes. The purpose of the inspection was to assess how well the home is doing in meeting the key National Minimum Standards and Regulations. The visit was carried out on the 25th May 2010 between the hours of 9:00am and 1:00pm Prior to the visit to the home we reviewed, previous inspection reports and information received from the home since it was last visited in November 2009. The Annual Quality Assurance Assessment (AQAA) was returned to the Commission by the due date before we visited the home. The AQAA is a document that we send to a service once a year, in it they are able to comment on improvements they have made, any barriers to improvement to meeting the standards and how they feel the service is Care Homes for Older People Page 6 of 28 meeting the needs of people who live at the home. We met with the manager, three staff and there were three people who use the service involved in the inspection visit. The registered provider was also at the home whilst we were there. There were 21 people living at the home on the day of the visit. We looked at two pre admission assessments, three care plans, medication records, staff files and training records and fire prevention testing and training records. Several requirements were made following the last visit to the home. It was seen that the home has actioned all requirements and the AQAA for the home stated that the future improvements for the home are embedding these actions into the running of the home and the service offered to people who live there. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? The home carries out assessment visits to prospective residents to ensure that they can meet the needs of the individual. The home has care plans which describe the needs of the individual and what they are able to do independently. The plans describe the support staff have to give. The storage and administration of medication has improved with all staff have undertaken training in medication administration and with the manager having organised roles and responsibilities. Daily routines in the home are now flexible and people who use the service are being encouraged to make choices for themselves and exercise personal autonomy as far as reasonably possible. The homes current recruitment process now protects people who use the service. Staff have undertaken training in most mandatory areas and training that helps support individual needs. A quality assurance programme is underway enabling people who use the service and their relatives to have a say about the running of the home. Care Homes for Older People Page 8 of 28 The responsible individual for the home carries out regular visits to the home and keeps a record of these once a month. The challenge is for the staff at Seagull Rest Home is to imbed these changes into the practice of the home and maintain 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 that use the service can be assured that their needs will be assessed to ensure that the home has an understanding of their care needs. Evidence: The AQAA for the home said:Our pre admission process is undertaken by two senior members of staff to ensure suitability to our home, we encourage a visit to the home before admission for service user to become familiar with our services. We spend time listening to their likes and dislikes and incorporate all information into their care plans before admission to enable an easier transition into their new surroundings. Service users are given the necessary resources to ensure their wellbeing, and to ensure that they are helped to maximise their independence. Resources include physiotherapists, GPs, hairdressers, chiropodists, dentists and opticians. Service users and their families are assured that their needs are being met through constant contact and feedback comprehensive contracts are given to each service user with clear terms and conditions. Care Homes for Older People Page 11 of 28 Evidence: There have been several new admissions to the home since our last visit, the manager or senior staff member carries out the pre admission assessment. We were able to see where this had been carried out and see what is completed at the time of the assessment. We saw that there was information on individual needs based on their present and past medical history for example, history of falls. The assessment offered choices and space for individual issues. For example needs encouragement with food as has lost appetite at home. We saw risk assessments and other assessment tools such as nutritional screening, these were completed after the person had moved to the home. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care plans detail the needs of the individual and support staff are to give. Medication records and administration within the home are carried out in a safe manner to protect the people who use the service. Staff working practice helped to ensure that the privacy and dignity of people who use the service is promoted. Evidence: The AQAA for the home said:We treat each and every service user with respect and dignity and promote these qualities by the care we provide care plans that clearly indicate and highlight the service users needs and how they choose to be cared for and inclusive of any preferences made. Care plans are reviewed frequently by senior staff to ensure that needs are constantly reassessed and highlighted in the care plan. Health care is paramount and all aspects from potential pressure areas and continence are monitored , documented and reviewed frequently and as and when required. Medication policies ensure the safe receipt, recording, storage, handling,administration and disposal of medicine and are followed by staff at all times. Service users privacy and dignity are respected at all times by staff members. Staff are fully trained in the Care Homes for Older People Page 13 of 28 Evidence: event of a service users death and treat the service user and their family with care, sensitivity and respect. Staff have received MUST training and is now implemented in care plans. Requirements were made following our last visit regarding care planning and risk assessments we saw that these had been met. The challenge for the service is to imbed these improvements. We looked at three care plans and saw plans to address individuals needs such as washing and dressing, bathing, mental capacity and epilepsy. We saw that information was available for staff on how they would support individuals with their needs, individual strengths and abilities and what staff needed to do to support them. One care plan for example had information that told staff about how to encourage choice and where an individual had chosen not to have foot plates on their wheelchair we saw that this was recorded with reasons why. We also saw choices regarding bath or shower time of day and how often. We saw risk assessments had been put in place with information on how staff could lessen those risks for example manual handling and falls and nutritional assessments. For weight loss, one care plan said that an individual who had been admitted with significant weight loss was being monitored and there had been a weight increase, which fluctuated so monitoring continues. We saw that the district nursing team was supporting the home with care of wounds following a fall for example. We asked what the issue was as the bandages were in place from foot to knee the manager said that the individual fiddles so the nurse dresses the area fully. We saw instructions on what staff at the home could do and what the nursing teams remit was. We spoke with three individuals who use the service all indicated that they are happy with the care and support they receive. There were risk assessments in place which included mobility, environment, infections, footplates, bed rails, key to room and physical needs such as constipation. We noted that the care plans and risk assessments have been reviewed each month following our last visit. Requirements regarding medication administration, storage and recording were made following our last visit we saw that these had been met. Care Homes for Older People Page 14 of 28 Evidence: We looked at the medication storage and administration records. The records we saw were for the 23rd April to the date of the visit. The home has one trolley to store medicines and additional lockable cupboards to keep medicines safe. These are in the office, there is also a medication fridge also in the office. We saw that there are individual care plans for the use of medication. The manager told us that they have repeated training in medication for staff. We observed that safe practice is followed when giving medicines. The home has Fentanyl and Buprenorphine stored as controlled medication. We saw that controlled drugs are managed in accordance with the regulations and guidance. The home has also introduced in April 2010, a controlled medication audit where medication is checked at times of change over in staff for example morning and evening, and the totals signed by two staff members. Care Homes for Older People Page 15 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 who use the service participate in activities appropriate to their age, peer group and cultural beliefs as part of the local community. Dietary needs are well catered for with a balance and varied selection of food available that meets individual dietary requirements and choices. Evidence: The AQAA for the home said:The home provides a safe and comfortable environment for each and every service user. Activities are designed and tailored to meet the needs of each service user and to promote the social, cultural, mental and physical abilities of all service users. Service users are given a choice in all aspects of their lives from their meals to the activities they would like to participate in, as well as personal care taking into account all preferences and care plans reflect all likes and dislikes to able to provide continuation of care. The home allows and welcomes visitors at any time of the day and encourages visitors to join us for meals and activities. We also look to relatives, friends and their representatives to help us ensure a smooth transition into the home. Service users are given the choice on when and where they would like to eat their meal and a choice given at each mealtime. Each meal is prepared freshly each day and is nutritious, wholesome and appealing and suggestions for the menu are sought each week at the residents meeting. The vicar visits on a monthly basis Care Homes for Older People Page 16 of 28 Evidence: and holds a service for the Church of England, the father visits on a monthly basis to hold communion for Catholics. A requirement was made following the visit regarding choices in daily activities and food. We saw that this had been met. We saw examples of newsletters for the home on the notice board in the hallway which started earlier this year we saw mention of the refurbishment of the home, new staff, trips out and events. We saw notes from the residents meetings and some comment cards that visitors to the service had completed. Comments were about the food, how individuals enjoyed the roast dinners, trifle and apple pie and custard. Someone wanted to do ballet and the manager said a DVD will be purchased so that the person can watch it. People wanted packs of cards to play games and classical music CDs. We saw that the home had met these requests. We saw examples of activities available for people to participate in board games, puzzles, ball games and walks to the beach. We saw photos where people living at the home had participated in line dancing recently either dancing or observing. We also saw that staff had recorded comments from conversation with individuals when spending time with them, about the gardens and the home. We saw that people take an interest in the fish that live at the home and we observed that people like watching them. We observed staff facilitating a quiz before lunch with healthy competition for the prize. People using the service told us that the food was lovely that they could choose from the menu or have something different. There was ample food for their age. Care Homes for Older People Page 17 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. The complaints procedure enables those people using the service to know that any complaints will be taken seriously and responded to. People living at the home are safe guarded by the homes safe guarding adults procedures. Evidence: The AQAA for the home said:Service users, relatives and representatives are made fully aware of our complaints procedure, which is displayed in the main entrance and office. Complaints are recorded acknowledged and responded to quickly and effectively within the 28 day period. Service users rights are protected by staff and management at all times. All staff have received training in safe guarding vulnerable adults and ensures that all safeguarding procedures are in place to protect the service users at all times. Only small amounts of personal money are held in the office for the service users and only the manager has access to these monies, all receipts are kept and available for inspection by service users or relatives at any time. A requirement was made following the last visit regarding training for staff in safeguarding people who live at the home. We saw that this had been met. We saw the home has complaints procedure, which is outlined in the Statement of Purpose and Service User Guide and on display in a number of places around the home; it includes the timescale of response and the address of CQC. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service live in an environment which also has had some adaptations to meet individual needs. Evidence: The AQAA for the home said:The home is aimed at providing a small scale homely environment for service users suffering from dementia. The home provides a unique, safe and comfortable environment for our service users to be able to peacefully live their lives. The home has the correct number of facilities available to the service users, newly refurbushed rooms with improved furnishings, a lounge that is comfortable. A well maintained garden patio area that is open and accessible to service users at all times. Environment audits are compiled fortnightly and maintenance is kept updated and these are undertaken by the manager and proprietor and areas highlighted are dealt with efficiently. Bathrooms have been refurbished and are now cleaner and brighter with new hoists. All emergency lighting has been replaced. Hand washing facilities have been enhanced with new soap and towel dispensers. The majority of staff have received training in infection control and follow the NHS essential steps to safe clean care. In what they could do better the home says:we could put in place further measures that reduce the spreading of infection and improve hygiene. Improve the layout and decor of the home to help the service users to navigate their way around the home. Care Homes for Older People Page 19 of 28 Evidence: Improve outdoor facilitites in all areas of the premises and ensure that they are kept tidy, safe and attractive. Use signs and other communication aids to assist service users. Implement wheelchair ramps in all areas to allow better access to outdoor facilities. A requirement was made following the last visit regarding the environment and facilities that are available. We saw that this had been met. We walked about the home and noted that there were two areas with malodour. We spoke with the domestic who said she had not been to that area yet. She confirmed that there are several people who have accidents and she is equipped now with new cleaning equipment to manage this. We saw the refurbished bathrooms there are now two showers and new bath with new hoist. We saw that there was a tap missing on a sink the manger said this was on the maintenance list. We also saw that there was a heater with no cover. Since our last visit the home has done some work to enable people with memory difficulties to find there way around a home that is essentially cream. The door frames for example for the bathrooms and toilets have been painted blue. There are signs with individual pictures on each bedroom door and written directions at the end of the corridors. The manager told us about the possibility of the home having extended living space with a conservatory and to have themed areas in the gardens. 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. Current recruitment practices at the home help to protect the people who use the service. Staff have received all the mandatory training that is expected each year, and training to help them meet specific individual needs. Evidence: The AQAA for the home said:Each and everyone of our staff treats our service users with dignity and respect, staff welcome guests appropriately and conduct themselves as professionals at all times. The rota consists of a mix of senior and junior staff in addition to management and numbers are appropriate to service users needs. Staff have the necessary training to provide the best possible quality of care and are encouraged to enhance their knowledge by further training. Staff levels are employed and structured in a way that reflects the needs of the residents throughout the day. More than 90 of staff have NVQ level 2 qualification or above and have the opportunity to train for higher levels recruitment procedures have been tightened up and are now thorough and include as much information from the candidate as possible to protect the service user at all times. Requirements were made following the last visit regarding staff recruitment and training. We saw that these had been met. We looked at the rotas for the home for the week commencing 21st March 2010 and the week of our visit. We saw that there were six care staff in the morning, three in the afternoon and two at night. We saw Care Homes for Older People Page 21 of 28 Evidence: that the day staff are supported by domestic staff four days a week and a cook seven days a week who prepares and cooks the daytime meals and prepares the meal for supper. The manager advised that there is now a maintenance person working at the home. The manager also said that she hopes that she will be able to have three staff at night. We looked at three files of people have been employed to work at the home recently and we saw that there were two references, there was evidence that a CRB had been requested or received and that an ISA check had been carried out and they were dated before the employee commenced work at the home. We saw that the individuals had commenced an induction process. All staff information is kept at the home in the managers office. There were concerns following the last visit to the home about training that had not been undertaken by staff. We saw a training plan for staff for 2009 and 2010 we could see what staff had done and what was planned. Staff have undertaken medication administration training, fire safety, emergency first aid, infection control, manual handling and moving and handling. The manager and deputy have attended training such as end of life care and are cascading this to other staff. We saw that there is training planned in dementia care for the manager and deputy, care planning, falls prevention and in house training in good night care, personal care and intervention. The manager told us that two staff were on training the day of our visit in activities for dementia. New staff undertake induction training which includes and introduction to the home for example fire procedures. The individual works through a pack with questionnaires on areas such as the home, safeguarding and their own personal development. 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 systems and procedures monitor and maintain the quality of the service provided and which, promote the safety and welfare of those living and working in the home. Evidence: The AQAA for the home said:The home is run by a manager that has an open approach and is fully capable of discharging her responsibilities and sets an example to staff members by being welcoming, responsible and professional at all times. She has spent 20 years in the care industry and regularly attends training sessions in all aspects of care, and is currently training towards her registered managers award. Service users and their relatives or guests feel included and welcomed by the management and know that management is open to suggestions. Feedback from service users and their relatives are encouraged by the completion of questionnaires and comment cards on a regular basis, the results of which are implemented. The owner visits the premises regularly with Regulation 26 reports being completed monthly and thorough investigations into how the home is meeting its objectives. These are documented to ensure the level of quality is maintained throughout. Care Homes for Older People Page 23 of 28 Evidence: Investigations are carried out by seeking the views of service users their families and the care staff to get as much insight into the home as possible. Maintenance and environmental audits are conducted regularly as a quality assurance mechanism and any issues discovered are dealt with as soon as possible. Service users are given the option to either keep their pocket money in their possession or given to the manager for safe keeping in the office, where all monies are documented and receipts kept to ensure correct accountability at all times. Staff are supervised regularly, more often with new staff members to ensure that policies and procedures are followed at all times. The manager ensures that safe working practices are followed and that the home is safe, clean hygienic and either minimises or eradicated the threat of diseases. Requirements were made following the last visit regarding training and fire safety. We saw that these had been met however the training for staff in fire safety had taken place in February 2010 and the requirement date had been January. The manager has been at the home for several years. Mrs Christopher has attended training to update her self in areas such end of life care and is currently studying for her managers award. We saw that the certificate related to the homes registration was displayed in the hallway and displays the details of the core registration for the home. We saw that the manager has undertaken staff and resident meetings and resident and relatives meetings. The residents commented on food, staff, activities and the homes environment. One resident requested a greenhouse; we saw that this had been provided the manager said plants were going to be bought the week of the visit. Feedback from comment cards included: everything is adequately provided with easy access to all areas. Building feels safe and secure. Everybody is helpful and friendly. The local Environmental Health Officer visited the home in March 2010 and stated that there were two areas that needed work to be completed by the 1st July 2010. The home looks after personal money for people who live at the home. We saw that the home keeps records of spending and that the records matched the money available for three that we sampled. The manager informed the commission in the AQAA that the servicing of all utilities and equipment used in the home has taken place. Care Homes for Older People Page 24 of 28 Evidence: We looked at the records for fire safety training and monitoring of equipment we saw records that indicated that fire safety equipment and emergency lighting has been tested regularly. Fire training records indicated that staff have had fire training once since our last visit. 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. 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