Care Home: Sedgemoor Care Home

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What the care home does well The findings of this inspection were positive. The home is providing good quality care and support to people. People who live at the home were positive about the service. Their comments included `we are well cared for here` and `They make sure I get what I need`. People told us that they felt respected by staff and that their privacy was upheld when they were being supported with their personal care. Activities are taking place on a regular basis and people are included in a good level and range of activities within the home. People are well supported with their health care needs and are supported to see a GP, nurse or other relevant health professional when appropriate. The catering arrangements are well organised and people gave good feedback about the quality and choice of food and meals. Meals are prepared from fresh ingredients. The home is clean, comfortable and spacious. Aids and adaptations are in place to promote people`s independence and to ensure staff carry out safe practices when assisting people with moving and transferring. The staffing levels are good and allow for some one to one time to be spent with the people living at the home. The staff turnover is low and staff therefore have the opportunity to get to know the needs of the people living at the home well. Staff were seen to be warm and familiar with people living or staying at the home. A high percentage of staff have attained a relevant qualification for example a National Vocational Qualification (N.V.Q) in Health and Social Care. What has improved since the last inspection? Each of the people living at the home or using the service has a new and up to date care plan. The manager has introduced new systems for documenting and accounting for money held on behalf of people living or staying at the home. The manager told us in the self assessment of the service (AQAA) `Over the past twelve months we have made improvements in accessing local facilities and through regular meetings with service users we continually strive to improve our service by taking a pro active approach and listening to all people that reside at Sedgemoor either temporary or permanent who have any ideas in us improving the quality of the service we already provide`. What the care home could do better: When a new person is referred for a service then an assessment of their needs is attained from the referring agency. When appropriate an additional and more comprehensive assessment of needs should be carried out by a suitably experienced person. This is to ensure the sufficiently detailed information on the needs of the person has been attained. Some health and safety information was not up to date. This needs to be addressed and the required information must be forwarded to the Commission as confirmation that the checks are up to date. The manager should carry out a review of staff training and develop a staff training plan to ensure that all staff have appropriate and up to date training for their role. Staff are not being provided with regular and recorded supervision meetings. Such meetings provide staff with an opportunity to look at their pratice and to develop as workers. Key inspection report Care homes for older people Name: Address: Sedgemoor Care Home 41 Sedgemoor Road Norris Green Liverpool L11 3BR     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: Debbie Corcoran     Date: 2 3 0 2 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 29 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 29 Information about the care home Name of care home: Address: Sedgemoor Care Home 41 Sedgemoor Road Norris Green Liverpool L11 3BR 01512561810 01512268781 patricia.donnellan@liverpool.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Liverpool City Council care home 30 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC. To service users of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP. Dementia - Code DE. The maximum number of service users who can be accommodated is: 30. Date of last inspection Brief description of the care home Sedgemoor is registered to provide personal care for thirty people. Residents who require respite care, short-term care as well as permanent residential care are accommodated. Day care can also be provided for people from the local community. Sedgemoor is a purpose built single storey building, which opened in 1993. The home is owned and managed by Liverpool City Council and is located in the Norris Green area of Liverpool. Although the home is some distance from local shops and amenities, they are easily accessible via a bus service that stops directly outside the home. Care Homes for Older People Page 4 of 29 Over 65 0 30 30 0 0 2 1 1 2 0 0 9 Brief description of the care home There are three separate units and an administration block which all open out from a central atrium (large spacious communal area). Each unit has ten single ensuite bedrooms, a self-contained kitchen/dining area and two lounges. Residents have the use of a call bell with an alarm facility and moving and handling equipment to assist them. A spacious garden has patio areas. The weekly fee rate for accommodation is based on an individual financial assessment, which is completed by Liverpool City Council. The fee rate ranges from £108.10 to £375.00 per week. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: During the visit the majority of the people living at the home were met and a number were spoken with either on a one to one basis or a small group basis. A sample of records for people living at the home were looked at. We also looked at other records including, staff files, staff training records and health and safety records. These help to show us how peoples health and wellbeing are being promoted and whether staff have the skills and training needed to support people appropriately. A tour of the home was carried out which included all communal areas and a sample of bedrooms. Discussions also took place with the manager and a member of care staff. The manager returned a self assessment of the service prior to this visit. The self assessment enables the service provider to inform us of what they do well, where they have improved and where they can improve in the future. It also includes information Care Homes for Older People Page 6 of 29 on how they promote equality and diversity, how they seek the views of people living at the home and includes data on staffing and health and safety. The self assessment is referred to as an Annual Quality Assurance Assessment (AQAA). Some of the information in this has been used to inform the findings of the inspection. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: When a new person is referred for a service then an assessment of their needs is attained from the referring agency. When appropriate an additional and more Care Homes for Older People Page 8 of 29 comprehensive assessment of needs should be carried out by a suitably experienced person. This is to ensure the sufficiently detailed information on the needs of the person has been attained. Some health and safety information was not up to date. This needs to be addressed and the required information must be forwarded to the Commission as confirmation that the checks are up to date. The manager should carry out a review of staff training and develop a staff training plan to ensure that all staff have appropriate and up to date training for their role. Staff are not being provided with regular and recorded supervision meetings. Such meetings provide staff with an opportunity to look at their pratice and to develop as workers. 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 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with the information they need to make an informed choice as to whether or not to stay at the home. Evidence: We looked at the statement of purpose and service user guide for the home. These are documents which provide information on the services and facilities provided at Sedgemore. They include information on the location of the home, provision of care, the environment, supporting people with their health and medication, supporting people with their religious beliefs and needs, qualifications of the staff, arrangements for meals, social life / activities, gaining views and opinions, and making a complaint. People who are thinking of staying at Sedgemore can use these in order to aid their decision. There have been no long term people admitted to the home for sometime now. All new people to the service are for respite or for intermediate care purposes. Care Homes for Older People Page 11 of 29 Evidence: Prospective new people and their relatives or representatives are invited to visit the home and spend time there before deciding whether or not to stay at the home. This was confirmed during discussions with the people living at the home. We case tracked three people using the service. By this we mean that we looked in more detail at their needs, the type of support they were receiving and their care plans. The quality of information in the assessments for the people we case tracked was variable. The assessment information had been attained from the referring agency. We talked to the manager about introducing an assessment tool for use by the home so that where the information received is not particularly detailed then the home can demonstrate that they have carried out a comprehensive assessment of the persons needs and are then confident in being able to meet these. The manager told us that staff from the home do visit prospective service users to attain information for their care plan. Ensuring comprehensive assessments are carried out is fundamental to ensuring staff are provided with the information they need to know to meet the persons needs and to ensure good care planning based upon the persons assessed needs. Sedgemore provides intermediate care for up to five people. The home also provides respite to older people and people who have dementia care needs. We met with some of the people on the intermediate care section of the home. We could see that people were being encouraged to utilize their skills and keep active. Staff told us that each of the people who stays at the home for intermediate care has a specific plan with regards to their rehabilitation which has been drawn up by an Occupational Therapist. Staff also told us that weekly multi disciplinary meetings are held to look at the needs and progress of people. Assessments are then carried out to determine the most appropriate support package required when the person moves on from the home. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are well supported with their health and personal care needs and feel that their privacy and dignity is protected. Evidence: Each of the people living at the home has a care plan. We looked at the care plans for three people in some detail. The level of information in care plans was good. Care plans included information on how to meet the needs of the person in areas such as their health, communication, mobility, diet and nutrition, routines and personal care. We found the care plans to be a straight forward document which explained the needs of the person in a good level of detail. We did note that one person living at the home had a wound which required intervention and this was being provided by visiting district nurses. There was no reference to this in the persons care plan. It is important that information on wound care or pressure are care is clearly documented as part of a persons care plan and risk assessment. Care Homes for Older People Page 13 of 29 Evidence: Care plans were found to have been reviewed and updated on a monthly basis. The manager has informed us in the providers self assessment (AQAA) that Staff review care plans on a monthly basis which enable us to maintain relevancy for each individual all visits from health professionals are recorded. All service users get annual visits from an optician, a chiropodist visits on a six weekly cycle, a district nurse visits on a weekly basis as well as a G.P who also does a weekly visit. Feedback from people living at the home about how they are supported with their personal care was good. People told us that they felt respected by staff and that their privacy was upheld when they were being supported with personal care. Risk assessments are carried out where a person living at the home is thought to be at risk of harm. These include risks such as falling. Where a risk had been identified then there was information in the persons care plan as to how to manage or reduce the risk. We noted that care plans included a health action plan which described the health needs of the person and what staff needed to do to support the person with these. Records showed that people are well supported with their health care needs and are regularly supported to see their GP, nurse, optician etc. A visiting healthcare professional was asked to comment on the home and they gave very positive feedback on the care of the people living at the home and on the competence of the staff team in supporting people with their health. Since our last key inspection visit the home has been the subject of investigations with regards to the management of medication. We have carried out a random inspection to look at medication practices since the last key inspection of the home and we found at that time that medication practices were poor and we served an enforcement notice to the provider to address the issues we found. We visited the home again to make sure that action had been taken to make medication practices safe and we found that they had. As part of the inspection a pharmacist inspector visited the home on 8th February 2010 to make sure medicines were handled safely. This involved checking some medicines stock, medicines records and speaking with two senior carers. Overall we found continued improvements in the way medicines were handled and gave some further advice about how to improve the recording of external medicines such as creams. Care Homes for Older People Page 14 of 29 Evidence: Records of medicines received into the home, given to people and disposed of were usually signed and up to date. Regular recorded checks were carried out by senior staff to make sure medicines were being given to people correctly and when any mistakes were found action was taken to help prevent them happening again. All staff had been trained to handle medicines and their competency had been formally assessed. Regular training, competency checks on staff and detailed audits help make sure care staff have the necessary skills to handle medicines safely. We carried out detailed checks of the records and some stocks and found that medicines were being given to people correctly and at the right time. Medicines that were prescribed as when required were given properly and we saw some detailed information in peoples care plans about how to use them. We looked at how external medicines such as creams were given and recorded and found the records were not always completed correctly. Care staff were not always remembering to sign for the creams because the records were not kept with the medicines. Senior staff said they were planning to improve this by having the records kept in peoples rooms and we gave some further advice about how this could be managed. All medicines should be signed for at the time of giving them so that an accurate record is made. We looked at how several people were being supported to look after their own medicines. We saw some detailed paperwork that showed senior staff were checking and supporting people to manage their own medicines safely. Care plans were usually detailed and up to date and good risk assessments had been carried out to make sure the right amount of support was being given. A formal review was made every week and this was clearly recorded to show that people were continuing to manage their medicines properly. Supporting people to look after their own medicines helps them retain some of their independence. People have their meals in small groups on different areas of the building and this lends itself to a more personalised and relaxing experience of mealtimes. We asked people if they were enjoying their meals and all comments were positive. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have good opportunities to get involved in activities and to remain independent and exercise choice. People are provided with a choice of good quality food and catering arrangements are well organised. Evidence: In order to assess the level and variety of activities available to people we spoke with people living at the home and with staff and we viewed records which contained details of what activities had taken place. People gave good feedback on their opportunities to get involved in activites. This feedback, along with observations and looking at the weekly activities plan indicated that people are supported to be involved in regular activities such as listening to music, sing alongs, reminiscence, carpet bowels, chat about the news, bingo, reading, exercise, going to the park, going shopping, manicure, reading newspapers, games, puzzles, ten pin bowling, skittles, music evenings, bingo and quiz afternoons. People are encouraged to join in activities and people are awarded for certain activities where competition has been involved. We were told of people using some local community respurces and occassinal day trips out. Entertainers are also brought into the home occassionally. A number people will choose not be included in group activities and Care Homes for Older People Page 16 of 29 Evidence: their choice to do this is respected. The home has a number of quiet lounges were people can go and spend time on their own or with a small group or with their visitors. In the intermediate care area people are encouraged to do chair exercises and people are involved in household type activities to retain and develop their skills. Activities in the intermediate care area are also based on individualised programmes of rehabilitation. A monthly newsletter is provided to people living at the home which informs people of up and coming activities and other pieces of important or good to know information. A newsletter hasnt been produced for a number of months as a result of staff absence but it is intended that these will be started up again. The providers self assessment (AQAA) details Through the monthly service user meetings a new and varied activity programme has been set up which encompasses service users ideas to suit their age and abilities. People are encouraged to make choices at the home. Many people are able to express their needs and preferences and to contribute to changes at the home. People are given their post directly and are supported to manage their own medication when they wish to and are able to. During discussions with people living at the home they stated that they are free to make their own choices about things such as where to spend the day and their own routine. Resident meetings take place. These are chaired by one of the people who lives at the home. If well implemented these meetings should empower residents to have a greater say about the running of the home and to contribute to the development of the service. People living at the home gave good feedback on the quality and quantity of meals and food provided. Comments included the food is lovely and I can make a choice of what I like. We were told that people are consulted with on the development of the menu. Staff ask people each day what they want from the choice of menu for the day. People have a choice of two meals at mealtimes everyday. The kitchen was found to be clean, well organized, well stocked and meals are cooked from fresh ingredients. We asked the catering staff how they ensure people who have special dietary requirements are catered for and they were aware of the peoples dietary needs and how to accommodate these. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are safeguarded through appropriate policies, procedures and practices being in place for dealing with complaints and for protecting people from abuse or neglect. Evidence: The home has a complaints policy and procedure which is time scaled appropriately and includes contact details for the Commission, although the latter needs to be updated. People living at the home who were asked about complaints said that they would let staff know if they were not happy about something and that staff would then address their concerns. Information on how to make a complaint is provided to people in the service user guide. A log of complaints is maintained. This was looked at and showed that complaints have been documented, investigated and responded to. The complaints did not raise any particular issues of concern with regards to the practices at the home. An adult protection policy and procedure is in place. This outlines responsibilities for responding to an allegation of abuse and any subsequent investigations. It was reported that all staff have been provided with adult protection training. During discussions with staff they were able to explain what course of action they would take Care Homes for Older People Page 18 of 29 Evidence: in the event of an abusive incident taking place. We asked the manager for information on safeguarding as we are aware of a number of safeguarding investigations. The manager did not have this information but he agreed to forward this to us. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with a clean and comfortable home environment which is presented to a satisfactory standard. Evidence: The home was purpose built and it meets required standards in relation to size, facilities, and accessibility. It is a one storey building situated in accessible grounds. The home is divided into three separate areas. Two of these areas accommodate people on a long term basis and a respite basis. The third area accommodates people who have dementia care needs and require either respite care or intermediate care. There are a total of seven lounges, two on each of the three designated areas and there is also a large main lounge to which all areas have access. This is not a particularly homely area as it is large and is a thorough fare to numerous parts of the building. But we were told that people living at the home choose to congregate there as opposed to the smaller more homely lounges located throughout the home. Each of the three areas of the home also has a dinning room and kitchen facilities. There is also a main kitchen and laundry room. We looked at a sample of bedrooms and these were seen to be furnished and presented to a suitable standard. Care Homes for Older People Page 20 of 29 Evidence: There is a hairdressing salon for use of people living at the home. There were numerous domestic staff on duty at the time of the visit ensuring that the home was clean. The home is fitted with aids and adaptations such as hoists, handrails and bath chairs so as to assist people to move and transfer safely. Records showed that these are regularly serviced. The manager has told us in the self assessment of the service We offer both the space and privacy for all our service users and their family and friends. The building continues to maintain compliancy with DDA standards and there remains an ongoing repair and maintenance programme Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels at the home are good and this means that people receive the support they need when they need it. Evidence: There is a manager or deputy and senior staff on duty at all times. Staff roles and lines of accountability are clear. This means that staff know their responsibilities and know when to refer to a senior person for advice or support. Staff were observed to interact with residents with warmth and familiarity. People living at the home gave good feedback on the staff team. One person commented nothing is too much trouble for them and another person said the staff seem very nice. Staffing levels were good at the time of the visit and this allows staff to spend some quality time interacting with the people living at the home. The turnover of staff is low and there have been no new recruits since the last inspection visit. Therefore we could not assess staff selection and recruitment practices on this occasion. We looked at a sample of training records. These showed us that staff have been Care Homes for Older People Page 22 of 29 Evidence: provided with training in topics such as emergency first aid, adult protection, moving and handling, excercise therapy, dementia care, fire safety, health and safety, food hygiene and infection control. The manager should carry out a review of staff training and develop a training plan to ensure all staff have appropriate and up to date training for their role. The manager told us in the self assessment of the service (AQAA) that twenty seven out of the thirty care staff have attained a National Vocational Qualification (N.V.Q) in Health and Social Care or equivalent. The minimum ratio of 50 trained staff has therefore been achieved and exceeded. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home which is run in their best interests. Evidence: The manager of the home has been absent for a number of months and a temporary manager has been brought in to oversee the management of the home. We were told that the home is visited by a representative of the organisation to check on quality of the service on a monthly basis and a report of the findings of these visits is made. However, these reports were not availale at the time of the visit and therefore a copy of recent reports should be forwarded to the Commission. The manager told us in the self assessment of the service (AQAA) We have our own internal questionnaire which is completed anonymously by service users on a quarterly basis which indicates satisfaction levels on a variety of issues related to the service provided. We looked at how people living at the home are supported to manage their money. Care Homes for Older People Page 24 of 29 Evidence: People manage their own money when possible or the staff can care take peoples money and this is signed in and out for safekeeping accordingly. Staff team meetings take place and minutes of these were available for us to look at. Staff files showed us that staff are not being provided with regular supervision. This has not been identified and addressed as part of the quality assurance checks of the home. It is important that staff are provided with regular and recorded supervision as this aids the development of the person as a worker and gives them the opportunity to explore their practice and better ways of working. Health and safety policies and procedures are in place to safeguard the well being of people living at the home, staff and visitors. However, we noted some areas for improvement, for example fire alarm checks were being carried out but the documentation of these was not appropriate. We found that a fire drill was overdue and the manager could not locate information to confirm that fire equipment had been tested and was in good order. We also found that the electricity safety certificate and gas safety certificate were out of date. The manager agreed to look into these and must forward information on safety checks which could not be located on the day to the Commission. A safe working practice risk assessment has been carried out. This identifies potential areas of risk and includes information on how these are being managed. Information provided to us in the self assessment of the service (AQAA) informs us that a review of policies and procedures may be needed to ensure they are up to date with changes in legislation and current good practice. Care Homes for Older People Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 3 A comprehensive assessment of needs of should be carried for new people referred to the service when this is appropriate. Care plans should include information on how to meet the needs of the person in all aspects of their health and wellbeing so as to promote the persons health and wellbeing and ensure staff are aware of what actions they need to take to meet the persons needs. The manager should carry out a review of staff training so as to ensure all staff have been provided with up to date training relevant to their role. A plan for how and when training will be provided to staff should then be devised. The system for quality assurance should be reviewed to ensure that it is fit for purpose. Staff should be provided with regular and recorded supervision meetings. The registered provider should ensure health and safety checks are up to date and forward a copy of outstanding documents as identified in the report to the Commission. Page 27 of 29 2 7 3 30 4 5 6 33 36 38 Care Homes for Older People 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 7 38 Policies and procedures should be reviewed and updated accordingly so as to ensure they are in line with current best practice. Care Homes for Older People Page 28 of 29 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. 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