Care Home: Shearwater

What the care home does well We observed staff interacting with service users and we saw that people are treated with respect and their right to dignity maintained. Those service users we spoke to told us that staff listen and act on what they say. The daily routines in the home are flexible and service users are able to make informed choices, there was good evidence in care plans to show that service users were able to make their own decisions wherever possible and this allows service users to be in control of their lives as much as possible. The visiting routines at the home are flexible and family and friends can visit at any time. Visitors we spoke with told us that they are made welcome at the home. The home has been purpose built and provides excellent accommodation for people who use the service. All of the people we spoke with were full of praise for the individual and communal accommodation provided. The home has comprehensive quality assurance systems in place, which takes into account the views of the people who live at the home and also the views of other relevant people. What has improved since the last inspection? This was the first visit to the agency since it was registered with the Care Quality Commission. What the care home could do better: No requirements or recommendations were made as a result of this inspection. However areas identified for improvement are contained in the main body of the report. General observations were; Although care plans are reviewed monthly, there is currently no evaluation of how the care plan is working for the individual. More information in the monthly review would provide evidence on how the care plan was working for each person and could also provide information on residents progress of lack of it as the case may be. We found whilst walking around the home ,that some individual rooms had been personalised. However there were no pictures on the walls in the lounges or in corridors and passageways to provide a more homely environment. Although there is an agreement in place that recruitment records for staff can be held centrally. The home did not have a list of the documents that are held for each person. The manager must contact the Portsmouth City Council Human Resource department to obtain confirmation that all of the documents required in schedule 2 off the Care Home Regulations are held centrally. And a list of documents held for each member of staff should be kept at the home. The homes completed AQAA also highlighted and identified the homes own areas for improvement. Key inspection report Care homes for older people Name: Address: Shearwater 18 Moorings Way Southsea Hants PO4 8QW     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: Mick Gough     Date: 0 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 27 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 27 Information about the care home Name of care home: Address: Shearwater 18 Moorings Way Southsea Hants PO4 8QW 0000 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Portsmouth City Council Name of registered manager (if applicable) Mrs Carol Kirk Type of registration: Number of places registered: care home 60 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: 1. The maximum number of service users to be accommodated is: 60 2. The registered person may provide the following category/ies of service only: Care Home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Dementia (DE) Date of last inspection Brief description of the care home Shearwater is a large care home for elderly people who have dementia. The home offers an excellent standard of accommodation and provides a purpose built environment that has taken into account the needs of the people who live there. The home is in the Milton area of Portsmouth and is close to local bus links to the city centre. Accommodation is on 3 floors and each floor has 20 ensuite bedrooms with shower and WC. Each floor has a medical room where medication is stored, a staff office, a sluice room, and there are also 2 bathrooms on each floor, which are fitted with assisted baths. Passageways are wide and have hand rails fitted. There is a Care Homes for Older People Page 4 of 27 Over 65 0 60 Brief description of the care home passenger lift and also stairs to all floors. Each floor is secure with a keypad system and fire exits are clearly marked. Doors are automatically unlocked if the fire alarm goes off. The ground and first floors are split into group living units with each unit having their own lounge/dining areas and each unit has its own kitchen where staff and residents can make drinks or snacks. The lounge areas are fitted with large wall mounted flat screen TVs and each unit has a DVD player and music system. In addition each unit has a small quiet room where residents can relax or meet visitors in private. The top floor has a large lounge dining area and this is also fitted with TV and DVD. The activities room is situated on the top floor and the first floor has a hairdressing salon and also houses the laundry. The ground floor has an office, reception area and main kitchen. All areas of the home have been finished to a high standard and the home provides excellent accommodation for residents. The home has a large rear garden which is landscaped and secure and provides a safe environment for service users. There is parking to the side of the building Care Homes for Older People Page 5 of 27 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 purpose of the visit was to assess the quality of service provided by Shearwater. This was the first visit to the home since it was registered with the Care Quality Commission in July 2009. The inspection took into account the homes Annual Quality Assurance Assessment (AQAA), which was sent to us when we asked for it. The AQAA is a self assessment tool that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. As part of the inspection process an unannounced visit to the home was carried out on the 7 December 2009. For this visit we involved 6 members of staff. Also the manager of the service and her deputy assisted us throughout the visit. Other evidence for this report was obtained from reading and inspecting records; Care Homes for Older People Page 6 of 27 including pre admission assessments, plans of care, risk assessments, recruitment and training records, medication records and some of the homes policies and procedures. We sent out surveys to staff, care managers, health care professionals and also to people who use the service. Surveys were returned by 9 members of staff and these were all positive about the service provided at Shearwater. When asked what the home does well comments from staff included; shearwater provides a homely atmosphere for residents I have noticed whilst only working a short time at shearwater, all staff take the residents needs very seriously and they go above and beyond the call of duty to make sure that those they care for are comfortable and happy residents are well cared for and the staff are very patient and understanding and the home provides excellent care for all its vulnerable older people. 8 people who use the service returned surveys and again these were all positive and comments included; I did not want to move but now I am here I am very happy everyone is friendly the staff are marvellous and they can not do enough for you and I love my new room it has everything I need. We were also able to observe staff supporting service users in the home and to see the interaction between staff and users of the service. The home is registered to provide support for 60 residents and at the time of the inspection there were 39 people living at the home. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: No requirements or recommendations were made as a result of this inspection. However areas identified for improvement are contained in the main body of the report. General observations were; Although care plans are reviewed monthly, there is currently no evaluation of how the care plan is working for the individual. More information in the monthly review would provide evidence on how the care plan was working for each person and could also provide information on residents progress of lack of it as the case may be. We found whilst walking around the home ,that some individual rooms had been personalised. However there were no pictures on the walls in the lounges or in corridors and passageways to provide a more homely environment. Although there is an agreement in place that recruitment records for staff can be held centrally. The home did not have a list of the documents that are held for each person. The manager must contact the Portsmouth City Council Human Resource department to obtain confirmation that all of the documents required in schedule 2 off the Care Home Regulations are held centrally. And a list of documents held for each member of staff should be kept at the home. The homes completed AQAA also highlighted and identified the homes own areas for improvement. Care Homes for Older People Page 8 of 27 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 27 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 27 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. Potential new residents have a needs assessment undertaken prior to moving into the home and this allows the home, the resident and their relatives to see if the home can meet the residents needs. The home does not provide intermediate care. Evidence: The home carries out an individual needs assessment prior to residents moving into the home and there is a clear admission process. Assessments were on file at the home and were looked at for the 4 residents case tracked. Initial referral is made through Portsmouth City Council Social Service Department. Social service assessments are then carried out and once this information is forwarded to the home the manager and her deputy carry out their own pre admission assessment to ensure that the home can meet the persons assessed needs. Assessments are made using a needs assessment form and therefore covered the same issues for everyone, with a Care Homes for Older People Page 11 of 27 Evidence: separate section for any additional information. The assessment covers diagnosis, behaviour, communication,sleep patterns, memory, medication, likes and dislikes, hobbies and interests and orientation. Once the home decides that it can meet a persons needs they are invited to the home to look around and meet the staff and other residents before they make a decision whether to move into the home or not. The admission process is thorough and this was confirmed by a residents relative who we spoke to on the day of the inspection. Intermediate care is not provided at the home. Care Homes for Older People Page 12 of 27 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 health, personal and social care needs of residents are contained in an individual plan of care, which gives information on what care is needed, however the recording of monthly reviews could be improved to provide clear evidence of care delivery. The health care needs of residents are met by the home and there are medication policies and procedures in place to help protect residents. Evidence: Care plans were inspected for 4 residents and those seen had information on physical needs, mental health, behaviour, social and emotional needs, nutrition, spiritual needs, night care needs and medication. All care plans also had assessments on falls, pressure areas, behaviour, mobility and risks. Care plans were clear and they provided information for staff on the support that residents needed and also gave staff information on how residents would like their care to be given. Staff members spoken with said that the care plans provided them with the information they needed to enable them to give the right type of support at the right time. Residents said that staff were always very helpful and one commented Care Homes for Older People Page 13 of 27 Evidence: I am well looked after here and another said they look after all of us very well and if we need anything all we have to do is ask. We spoke to 2 visitors who said that they felt that their relatives care needs were met by the home. Daily recording in care plans took place at the end of each shift and there was a good handover to oncoming staff. Care plans were reviewed monthly, but the recording space was mainly a small box, which indicated if there had been any change to the plan. If there was a change there was insufficient space where this change could be clearly recorded. We pointed out to the manager the need to expand on the recording of reviews to provide some evaluation on how the care plan was working for the individual and this would also give information on residents progress of lack of it as the case may be. The fact that care plans were hand written also meant that any changes to a particular section of the care plan could result in the whole of the plan having to be re written, which was time consuming. Residents are registered with a number of different GPs, and they are able to keep their own GP if they wish. Community nurse visits are arranged though the residents GP surgery. A continence nurse provides advice and support and a chiropodist calls every 4 to 6 weeks. Dental checks are carried out in the local community and a visiting optician calls at the home. GP surgeries provide residents with access to all relevant health care professionals. The home has a policy for the receipt, storage, return and administration of medication and all staff at the home who are authorised to administer medication have undertaken training. The home uses a monitored dose system from a local pharmacy and the medication administration records sheets (MARS) were inspected and found to be up to date. When inspecting MARS it was found that staff were signing for when required (PRN) medication even if it had not been given and this made it difficult to establish on what days medication had actually been administered. We spoke with the manager and staff that administer medication and it was clear that there was some confusion on what needed to be recorded. We stated that the MARS should only be signed when medication had been given and if it was not required the MARS should be blank. In order to ensure that staff has clear information, the manager needs to produce a clear in house policy with regard to medication administration at Shearwater. Currently the home does not hold any controlled drugs, however should they be required there were suitable storage arrangements in place. Staff were seen to behave appropriately with residents and we observed staff interacting with residents and using their preferred form of address. It was clear that residents and staff got on well together and staff were seen to spend time chatting Care Homes for Older People Page 14 of 27 Evidence: with residents and they were laughing and joking together. Staff were seen to knock on residents doors before entering and residents spoken to confirmed that staff treat them with dignity and respect. Care Homes for Older People Page 15 of 27 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. The home provides a range of activities for residents, which meet their expectations and their religious and recreational needs are met. Residents are able to maintain contact with family and friends and visitors are welcome at any time. Residents are supported to exercise choice and control over their lives as much as possible and they are provided with a balanced diet in pleasant surroundings at time convenient to them. Evidence: The homes completed AQAA told us that on admission the social activities and interests of residents are recorded and that suitable activities are arranged for individuals. The home has a dedicated activities room and there were a range of board games and equipment available. Activities at the home are normally arranged by staff and any activities are recorded for each individual at the end of each shift. The home does not have a dedicated activities co ordinator but staff spoken with told us that they enjoy arranging activities for residents. Residents spoken with said that they were happy with the activities provided, however one resident who completed a survey told us that the home could organise more structured activities. The home has a clear visitors policy and there are no set times, visitors are asked to Care Homes for Older People Page 16 of 27 Evidence: sign in at the home and the visitors book is kept in the reception area. Residents spoken to told us that their visitors were always made welcome. We had the opportunity to speak with 2 visitor to the home who confirmed that visiting times were flexible and they said that they had never experienced any restrictions. We observed staff supporting residents and they were consulted about life in the home, those spoken to confirmed that they are able to make informed choices and are able to control their own lives as much as possible. Residents told us that they were consulted regularly and that staff at the home respected their views and that if they wanted anything all they had to do was ask. The majority of residents had bought some of their own possessions into the home and rooms had been personalised. The home operates a four week rolling menu and residents spoken with were happy with the choice of food provided. Comments received were; the food is very good I always have enough to eat and there is nothing to complain about. The main kitchen is situated on the ground floor and each floor has its own small kitchen area. There is a service lift to transport food between the main kitchen and the other floors and each floor has a heated trolley so that food can be served hot to all areas of the home. There is a choice of meals available each day and the staff go round and speak to all residents so that they can choose what they would like to eat the following day. The cook told us that if anyone does not want one of the choices on offer an alternative meal can be provided. We observed residents having their lunchtime meal and this was unhurried and staff provided suitable support for those residents who required it. Residents are able to eat their meals in the dining areas or elsewhere if they prefer. Care Homes for Older People Page 17 of 27 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 simple, clear and accessible complaints procedure, which includes timescales for the process and any complaints are logged and responded to appropriately. The homes policies and procedures help to protect service users from any form of abuse. Evidence: The home has a clear complaints procedure, which contains all of the required information and residents spoken to said if they had any complaints they would speak to a member of staff. Staff members spoken to were aware of the complaints procedure and said that they would support any service user to make a complaint if they wished to do so. The home keeps a record of all complaints and there have been no complaints to the home since it opened. The manager said that there had been some relatively minor issues raised and that they had been appropriately recorded and responded to. Staff have received training on adult protection and the home has a whistle blowing policy and also a copy of the Hampshire Adult Protection procedure. Staff spoken to were aware of their responsibilities in this area. The manager told us that there had been one adult protection issue that had been appropriately reported by using the adult protection procedure. We spoke with the manager about this issues and she told us that the issue had highlighted a training need for staff and that everyone had learnt a valuable lesson. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a safe and well-maintained environment and have access to comfortable indoor and outdoor facilities. Residents have the specialist equipment they require to maximise their independence and the home was clean, pleasant and hygienic and free from offensive odours. Evidence: The home is a new purpose built care home, set over 3 floors. Each floor has 20 ensuite bedrooms with shower and WC and all rooms have profile beds. Each floor has a medical room where medication is stored, a staff office, a sluice room, and there are also 2 bathrooms on each floor, which are fitted with assisted baths. Passageways are wide and have hand rails fitted. There is a passenger lift and also stairs to all floors. Each floor is secure with a keypad system and fire exits are clearly marked and doors are automatically unlocked if the fire alarm goes off. The ground and first floors are split into 10 person group living units with their own lounge/dining areas and each unit has its own kitchen where staff and residents can make drinks or snacks. The lounge areas are fitted with large wall mounted flat screen TVs and each unit has a DVD player and music system. In addition each unit has a small quiet room were residents can relax or meet visitors in private. The top floor has a large lounge dining area and this is also fitted with TV and DVD. The activities room is situated on the top floor and the first floor has a hairdressing salon and also houses Care Homes for Older People Page 19 of 27 Evidence: the laundry. The ground floor has an office, reception area and main kitchen. All areas of the home have been finished to a high standard and the home provides excellent accommodation for residents. Although some individual rooms had been personalised we noticed that there were no pictures on the walls in the lounges or passageways. We spoke with the manager who told us that she will be consulting residents and staff about what pictures to put on the walls and she was planning to go out to purchase some Christmas decorations for the home. She told us that she had a budget to purchase items to provide a more homely environment. The home has a large enclosed rear garden which is secure and provides suitable outside space for residents. The garden has raised flower beds and there are benches for residents to sit and relax in warmer weather. The home has a maintenance contract for the upkeep of the garden and it is planned to purchase some more garden furniture for the spring and summer months. To the side of the building there is parking for approximately 16 cars. The home has a laundry, which is situated on the first floor and provides a full laundry service for residents. The laundry is equipped with industrial washing machines and tumble driers. The home employs dedicated staff to carry out laundry duties and there are housekeepers who keep the home clean and tidy and all areas of the home were clean and there were no offensive odours. Care Homes for Older People Page 20 of 27 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. The home have a mix of staff that has a range of skills and there were sufficient numbers of staff on duty to meet the needs of residents. The homes recruitment policy and practice supports and protects residents, however clear information regarding the recruitment documents held for staff needs to be held at the home. Service users benefit from a staff team that has had sufficient training to meet their needs. Evidence: The homes completed AQAA told us that at present the home employs a total of 26 permanent care staff and of these 24 have a minimum of NVQ2. The home also employs 12 domestic staff, 2 laundry assistants, 1 chef, 2 cooks, 2 kitchen assistants, 2 administrative staff a deputy manager and the homes registered manager. Staffing arrangements were discussed with the manager who told us when the home is full it is intended to have 3 care staff, 1 shift leader and 2 domestic staff members on duty on each floor. However, the home needs to ensure that staffing levels are kept under review due to the changing needs of residents. The home has policies and procedures in place with regard to recruitment and staff recruitment records were inspected for 3 staff members. Recruitment takes place with Care Homes for Older People Page 21 of 27 Evidence: assistance from Portsmouth City Councils human resources department and staff records are held centrally, however the manager keeps copies of 2 references for each staff member and also keeps information on the persons Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks. However there was no information held at the home, which confirmed that all of the documents required in Schedule 2 of the care home regulations were held centrally. The manager must contact the Portsmouth City Council Human Resource department to obtain confirmation that the required documents are held centrally and that they are available for inspection on request. The manager must also ensure that a list of all the recruitment documents that are held centrally for each staff member is kept at the home. Portsmouth City Council has its own training department and there is a rolling programme of training circulated to staff. The manager informed us that training needs are identified at supervision and staff are booked on training courses as they become available. Staff training records showed that staff have completed training in, fire, medication, moving and handling, first aid, adult protection, food hygiene, infection control, dementia care, equality and diversity. care practises and health & safety and COSHH. Staff spoken to confirmed that they receive regular training and they were confident that they could meet the needs of service users. The home has a good induction procedure which is NVQ based and includes skills for care induction and foundation standards. There is also an in house induction to cover procedures within the home. When staff were asked on the surveys did your induction cover everything you needed to know to do the job when you started staff who completed questionnaires answered very well or mostly. Care Homes for Older People Page 22 of 27 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 provides effective management of the home and it is run in the residents best interests. The financial interests of residents are protected by the homes policies and procedures and the health, safety and welfare of residents and staff are promoted and protected. Evidence: The homes manager transferred from another Portsmouth City Council home and has previously been registered with the Care Quality Commission. During the recent registration process at Shearwater the manager has demonstrated her fitness to manage the home. During the visit we were able to look at the homes quality assurance systems and Portsmouth City Council undertake their own audit of the home by carrying out visits as required by Regulation 26 of the Care Home Regulations. These are unannounced visits to establish how the home is meeting its aims and objectives. The person Care Homes for Older People Page 23 of 27 Evidence: carrying out the visit provides a written report on their findings and copies of reports were on file at the home. Staff at the home have regular meetings where they are able to express their views and there are also regular key worker and shift leader meetings. The manager told us that she intends to send out anonymous questionnaires to its staff. Additionally questionnaires will be sent out to service users, relatives and stake holders. There is a comments book, which is kept in the entrance hall to the home where visitors can comment on how they found the home. The manager also told us that she intends to set up a relatives support group who will be able to represent service users interests. The home has good systems in place for residents finances and this is well documented, each resident has an individual account set up by Portsmouth City Council and there is a clear audit trail of monies received in and paid out. The home has only been operating for 6 months and all of the certificates for the safe operation of the home were inspected as part of the registration process. The majority of equipment in the home is still under gaurantee and there is a maintenance contract for servicing all equipment in the home. The manager informed us that weekly health and safety audits are carried out and results of these audits are kept in the office at the home. All staff completes health and safety training as part of their induction. Care Homes for Older People Page 24 of 27 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 25 of 27 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 26 of 27 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). 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