Care Home: Sidney Gale House

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What the care home does well Prospective residents needs are fully assessed to make sure that they can be met before people move in. People are encouraged to visit the home and spend time there and given written information so that they can be sure that the home is the right place for them. Residents spoken to during the inspection and who completed our survey spoke very positively about the home, the manager and staff. Comments included` they do everything well and we are looked after excellently`, ` staff are always ready to help and are so kind` and thank you very much for the kindness from all the staff`. All residents have a care plan that is based on a comprehensive assessment, detailed and reviewed and updated whenever necessary. Residents are seen as individuals and treated accordingly by staff. Residents are involved in care planning and reviews and asked whenever possible to sign their agreement to the care provided. Comments made by visiting professionals included that the home paid ` personal attention to the needs and comfort` of residents and that` it provides a good caring home environment where additional individual needs can be met`. Risk assessments are in place and reviewed and updated whenever necessary. Residents have access to all medical and health care whenever necessary and the home has an effective and positive working relationships with health care professionals and other agencies. People are treated with respect and their right to privacy and dignity part of the care practice of the home. Training is planned for the senior staff and the manager relating to equality and diversity to make sure that individuals rights and lifestyle choices are respected and taken into account in the way the service is delivered. A wide range of activities are provided and people supported to join in if necessary. Residents are able to attend regular meetings to put forward their views on what should be available in relation to activities and food. The menu provides a range of nutritious, wholesome food with choices available at each meal time and staff familiar with individuals dietary needs and preferences. Visitors to the home are made welcome at any time and contact with residents families and friends encouraged and supported. one professional who visits the home said that the home created` a warm and welcoming atmosphere` while another commented that the home was a `very friendly, caring and happy environment`. Policies, procedures and systems are in place relating to the protection of people who live at the home to make sure the risk of abuse is reduced. The home provides contact details of external agencies including advocacy services so that people who live at the home and their families know who to contact if they need to. The home is clean, tidy and well maintained to provide a good standard ofaccommodation which is made as homely as possible by staff. Comments made by residents included that one way the home did well was its ` cleanliness` and that the home` always smells fresh and it`s clean`. Infection control measures are in place to reduce the risk of cross infection and keep people safe. The recruitment of staff is thorough to make sure that the appropriate checks are undertaken and to reduce the risk of unsuitable people working at the home. A training programme that covers induction, mandatory and foundation topics is in place to make sure that staff have the knowledge, skills and confidence to provide a good standard of care. Staff were confident that appropriate training was provided and believed that this meant that they were ` trained to a high standard to deliver a good standard of care`. Health and safety is taken seriously and policies and procedures are in place to make sure that people who live and work in the home are safe. The home is effectively managed by Mrs Manvell and the staff team and people who live and work in the home feel well supported and confident about the service. What has improved since the last inspection? The home has an ongoing maintenance programme to make sure that the standard of the environment is consistently good. All staff have undertaken person centred planning training and this is in place for half of the peopel living at the home. What the care home could do better: Daily record`s should reflect how people spend their time and reflect their well or ill being rather than a record of care tasks that have been carried out. New body maps should be used more frequently to make sure that they reflect individuals current circumstances and are clear. Consideration should be given to see if there could be more opportunities for residents to go out of the home. A clear, accessible complaints procedure should be displayed and also included in the homes information pack to make sure that people know how to complain and who to. Minor improvements are needed in relation to infection control practices to further reduce the risk of infection to staff and residents. Portable appliance tested should be undertaken yearly to make sure that electrical appliances are safe to use by staff and residents. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Sidney Gale House Flood Lane Bridport Dorset DT6 3QG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Susan Hale     Date: 3 0 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Sidney Gale House Flood Lane Bridport Dorset DT6 3QG 01308423782 01308423965 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Dorset County Council care home 44 Number of places (if applicable): Under 65 Over 65 14 30 dementia old age, not falling within any other category Additional conditions: 0 0 One named person (as known to the Commission for Social Care Inspection) may be accommodated in the category PD. Staffing levels must be those determined in accordance with guidance recommended by the Department of Health. Two named persons (as known to the Commission for Social Care Inspection) under the age of 65 with dementia may be accommodated at any one time. Date of last inspection Brief description of the care home Sidney Gale House is a purpose built home situated close to the town centre providing care and accommodation for older people. The home is owned and managed by Dorset County Council Social Services Directorate; Mrs Mairi Manvell is the manager and Mr Andrew Archibald the registered person. The manager has overall responsibility for the home which provides care for up to 44 residents within the categories of old age (OP), dementia over 65 years of age (DE (E)) and mental disorder over the age of 65 years of age (MD (E)), with 2 of these places available for respite care. The home Care Homes for Older People Page 4 of 30 Brief description of the care home accommodates residents in single bedrooms arranged over three floors in six units (two on each floor). Each unit has a communal room, kitchenette, bathrooms and toilets. There is a small smokers lounge on the ground floor. None of the bedrooms has en suite hygiene facilities, close to all bedrooms there are toilets and bathrooms suitable for residents with mobility difficulties. Ground floor rooms include offices, a hairdressing room, activities room, laundry, large commercial kitchen and a large lounge with toilets and a kitchen for residents use. The home is surrounded by gardens mainly laid to lawn with mature trees and a paved area at the side of the home. There is a car park and a nearby bus stop, for buses to and from the centre of Bridport. The current fees range from 108.10 pounds to 474 pounds per week. Care Homes for Older People Page 5 of 30 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 inspect relevant key standards and to focus on outcomes from residents. We measure the quality of the service under seven outcome groups and these are individually given a rating of excellent, good, adequate or poor.These ratings are collated to give an overall rating of the service provided by the home. The main part of the inspection was undertaken over the course of one day by two inspectors. There were 41 residents living in the home on the day of the visit. There was also a visit by a pharmacist inspector on a different day to look at how medicines are handled in the home. Care Homes for Older People Page 6 of 30 The registered manager, Mrs Manvell completed an Annual Quality Assurance Assessment (AQAA) and this is referred to within the body of this report. We spoke to the registered manager,twelve residents and four members of staff. We looked at selected residents care files, staff recruitment files and all of the documentation relevant to the running of the care home. We also undertook a tour of the premises. We sent out surveys at random to staff, residents and health and social care professionals. We received responses from nine residents, five members of staff and nine professionals who have contact with the home. The results have been collated and incorporated into this report. Nine residents completed our survey, some people chose not to complete some sections of the form. Seven people described themselves as British, six as Christian, one person as being non religious with some people describing themselves as having physical or sensory disabilities. What the care home does well: Prospective residents needs are fully assessed to make sure that they can be met before people move in. People are encouraged to visit the home and spend time there and given written information so that they can be sure that the home is the right place for them. Residents spoken to during the inspection and who completed our survey spoke very positively about the home, the manager and staff. Comments included they do everything well and we are looked after excellently, staff are always ready to help and are so kind and thank you very much for the kindness from all the staff. All residents have a care plan that is based on a comprehensive assessment, detailed and reviewed and updated whenever necessary. Residents are seen as individuals and treated accordingly by staff. Residents are involved in care planning and reviews and asked whenever possible to sign their agreement to the care provided. Comments made by visiting professionals included that the home paid personal attention to the needs and comfort of residents and that it provides a good caring home environment where additional individual needs can be met. Risk assessments are in place and reviewed and updated whenever necessary. Residents have access to all medical and health care whenever necessary and the home has an effective and positive working relationships with health care professionals and other agencies. People are treated with respect and their right to privacy and dignity part of the care practice of the home. Training is planned for the senior staff and the manager relating to equality and diversity to make sure that individuals rights and lifestyle choices are respected and taken into account in the way the service is delivered. A wide range of activities are provided and people supported to join in if necessary. Residents are able to attend regular meetings to put forward their views on what should be available in relation to activities and food. The menu provides a range of nutritious, wholesome food with choices available at each meal time and staff familiar with individuals dietary needs and preferences. Visitors to the home are made welcome at any time and contact with residents families and friends encouraged and supported. one professional who visits the home said that the home created a warm and welcoming atmosphere while another commented that the home was a very friendly, caring and happy environment. Policies, procedures and systems are in place relating to the protection of people who live at the home to make sure the risk of abuse is reduced. The home provides contact details of external agencies including advocacy services so that people who live at the home and their families know who to contact if they need to. The home is clean, tidy and well maintained to provide a good standard of Care Homes for Older People Page 8 of 30 accommodation which is made as homely as possible by staff. Comments made by residents included that one way the home did well was its cleanliness and that the home always smells fresh and its clean. Infection control measures are in place to reduce the risk of cross infection and keep people safe. The recruitment of staff is thorough to make sure that the appropriate checks are undertaken and to reduce the risk of unsuitable people working at the home. A training programme that covers induction, mandatory and foundation topics is in place to make sure that staff have the knowledge, skills and confidence to provide a good standard of care. Staff were confident that appropriate training was provided and believed that this meant that they were trained to a high standard to deliver a good standard of care. Health and safety is taken seriously and policies and procedures are in place to make sure that people who live and work in the home are safe. The home is effectively managed by Mrs Manvell and the staff team and people who live and work in the home feel well supported and confident about the service. What has improved since the last inspection? What they could do better: Daily records should reflect how people spend their time and reflect their well or ill being rather than a record of care tasks that have been carried out. New body maps should be used more frequently to make sure that they reflect individuals current circumstances and are clear. Consideration should be given to see if there could be more opportunities for residents to go out of the home. A clear, accessible complaints procedure should be displayed and also included in the homes information pack to make sure that people know how to complain and who to. Minor improvements are needed in relation to infection control practices to further reduce the risk of infection to staff and residents. Portable appliance tested should be undertaken yearly to make sure that electrical appliances are safe to use by staff and residents. Care Homes for Older People Page 9 of 30 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.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 10 of 30 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 11 of 30 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 do not move into the home until their needs have been assessed and the home is confident that they can be met. Prospective residents are given information and encouraged to spend time at the home before they make a decision on residency. Evidence: The home provides written information to prospective residents and encourages people to visit the home and spend time there so that they can make an informed decision about residency. Detailed pre admission assessments of prospective resident needs are undertaken to make sure that they can be met before they move into the home. It was positive to see that assessments are updated for people who come to the home for regular respite Care Homes for Older People Page 12 of 30 Evidence: care before every visit. Nine residents completed our survey, eight of whom said that they were given enough information before they moved in. Care Homes for Older People Page 13 of 30 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. All residents have a detailed care plan to record their needs and gives clear instruction to staff on how these will be met. Appropriate risk assessments are in place and are reviewed regularly. Residents health care needs are met and appropriate equipment provided whenever necessary. Residents are treated with respect their right to privacy and dignity is promoted. Medicines are handled safely in the home, and people receive their medicines as their doctor has prescribed for them. Evidence: We looked at the care plans of five residents in detail and also case tracked two others. Care plans were detailed and covered all the recommended topics. Residents Care Homes for Older People Page 14 of 30 Evidence: individual needs were clearly assessed and the plan gave clear guidance and instruction to staff and how these should be met. Life histories had been completed and staff were clearly familiar with people as individuals and treated them as such.All the plans looked at had been reviewed and updated whenever necessary to make sure they reflected peoples current circumstances. Residents and their relatives are clearly involved in care planning and reviews and are asked to sign their agreement to the care given. Nine residents completed our survey and they all said that they always received the care and support they needed. Seven said that staff always listened and acted on what they said and two people said that staff usually did. Mrs Manvell told us that all staff had been trained in person centred planning. One member of staff spoken to said they were looking forward to this and felt that it would improve the service offered to residents. We noted that body maps were used when people had sustained an injury, these had been used several times and could be unclear as to which issues were current. There was evidence of a very good understanding of the Mental Capacity Act and the Deprivation of Liberties and the implications for the home and how services are provided. Risk assessments were in place in relation to falls, moving and handling and pressure sores and these had also been reviewed and updated whenever necessary. Mrs Manvell told us that the home intended to introduce a recognised nutritional assessment tool and that staff will be given training on how to do this. It was clear from records and talking to residents that people have access to medical and health care professionals whenever necessary. Appropriate aids and adaptations including lifting equipment, pressure cushions and pressure mattresses were in place according to need. One professional surveyed said that the home was quick to respond to medical concerns and went on to say that the home had good liaison with residents, relatives and professionals . Nine residents completed our survey, all of whom said that they always or usually receive the medical care they needed.Nine professionals completed our survey, eight of whom said that residents social and health care needs were always properly monitored and met by the service, one of whom said that they usually were. Eight professionals said that the home always sought advice when necessary and acted upon it and one said they usually did. Staff were seen to treat people with courtesy and respect and to work in a way that respected peoples rights to privacy and dignity. Eight professionals said that the home always respected peoples privacy and dignity and one person said that they usually Care Homes for Older People Page 15 of 30 Evidence: did. We looked at arrangements for storing and giving medicines in the home. We checked the records that are held in the home for medicines given to people, and discussed how medicines are handled with the manager and other staff working in the home. Some people look after some of their own medicines if it is safe for them to do so. Medicines are stored safely in the home for the protection of residents. There are suitable arrangements for controlled drugs and any medicines requiring cold-storage. There is one medication recorded in the controlled drugs register where the balance did not match with the register by one tablet. This medication is no longer needed and is waiting to be returned to the pharmacy.The manager is checking to confirm the number of tablets received. This needs to be chased up as far as possible and amended in the register. Medicines are given to people using a safe method, by trained staff. Records are kept of medicines received into the home, and of any unwanted medicines that are returned to the pharmacy, and clear records are kept of medicines that are given to people. These records help to show that people in the home receive their medication as their doctor has prescribed for them. The home has purchased a supply of a non-prescription remedy, and it is advised to draw up more detailed guidance for staff on when and how it could be given to people. This is to make sure it is used in appropriate circumstances, to protect peoples safety and welfare. Care Homes for Older People Page 16 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The routines of the home as flexible as possible to suit the choices and preferences of people who live there. A good range of in house activities are provided and enjoyed by people who live at the home. Residents are supported in maintaining contact with their friends and family and visitors made welcome to the home. A varied, nutritious and wholesome diet is provided that people at the home are generally satisfied with. Evidence: All the residents spoken to told us that they were consulted about the routines of daily living and they were able to get up and go to bed at times to suit themselves. Individual assessments of social needs had been recorded and a varied entertainment programme was in place and displayed the residents to see. Several residents spoken to during the inspection told us that they would welcome the opportunity to go out of Care Homes for Older People Page 17 of 30 Evidence: the home more although they enjoyed what was provided in house. Nine residents completed our survey, five of whom said there was always activities arranged that they could take part in, three said that there usually was and one said that there sometimes was. One member of staff who completed our survey said they would like to be able to take residents out more often. We saw evidence that a varied and wholesome menu was provided. The main meal of the day is served at lunchtime with three options including a vegetarian choice. A lighter meal is available at teatime with choices also available. Tables were laid with cloths, mats and condiments were freely available.Food & drink is available at any time for residents and all residents had a jug of fluid available in their private rooms and a choice of fluids in every communal lounges. It was positive to see that the breakfast menu at the weekends offer greater choice including kippers, croissants and bacon and egg. We observed that staff were available to offer assistance to residents discreetly during mealtimes. We saw that food was well presented and residents able to help themselves to vegetables from a serving dish. Comments about the food varied and included food very good , excellent food , reasonable and sometimes better than others but always edible . Nine residents completed our survey five of whom said they always like the meal served, three said they usually did and one said they sometimes did. Care Homes for Older People Page 18 of 30 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 at the home are confident that they can raise any concerns and that they will be listened to and taken seriously. Policies, procedures and staff training contribute to providing a safe environment for people who live at the home. Evidence: The home information pack given to prospective new residents includes the leaflet how to complain about adult and community services. Although it includes the contact details of the Commission it does not make clear that people are able to contact us at any stage of a complaint. Up to date information about how to complain was not on public display. The home had received one complaint since the last inspection and records showed this had been properly investigated and the outcome used to improve services. Nine residents completed our survey all of whom said they knew who to speak to if they were not happy. Four residents said they knew how to make a complaint and five said that they didnt. Five members of staff who completed a survey said that they knew what to do to raise any concerns. Eight professionals completed our survey, five of whom said the service had always responded appropriately when concerns have been raised, one said that they usually responded appropriately and two responses were blank. One resident commented that there are plenty of people to talk to if Im not happy. Care Homes for Older People Page 19 of 30 Evidence: The home has a whistle blowing policy for staff which contains the contact details of Public Concern at Work but not the Commission. It was positive to see that the home provides contact details of external agencies and local advocacy services. Appropriate policies and procedures were in place to make sure that people who lived at the home are protected from the risk of abuse. Care Homes for Older People Page 20 of 30 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. Residents live in a safe, clean and well maintained environment. Aids and adaptations and specialist equipment is provided to maximise residents independence. Infection control policies and procedures keep residents and staff safe. Evidence: The home was clean, tidy and free from unpleasant odours on the day of the visit. Access to the first and second floors of the home is via the main staircase, rear staircase or by use of a passenger lift. Residents are able to bring their personal belongings, including some items of furniture to personalise their private room to reflect their lifestyle and preferences. Residents are able to have a key to their private room to ensure their privacy is respected. Nine residents completed our survey, seven of whom said the home was always fresh and clean and two people said it usually was. Comments included everything is always so clean and that the home has a comfortable environment. One professional who visits the home commented the home is always clean and fresh smelling, and has a welcoming atmosphere. another professional commented that the home provides a safe environment with access to all facilities . Care Homes for Older People Page 21 of 30 Evidence: Radiators in corridors were not guarded or guaranteed low surface temperatures to reduce the risk. to redcue Appropriate Risk assessments were in place. Signage on communal bathrooms and toilets could be improved and could improve peoples independence and orientation. The patio and garden area are accessible to residents with garden furniture provided. Appropriate laundry facilities are provided and policies and procedures in relation to infection control are in place. We saw that toiletries and disposable razors were stored in communal bathrooms and toilets. This could present a risk of cross infection and were removed by the manager during the inspection. The home meet the requirements of Dorset Fire and Rescue Service and has received a five star rating from the Environmental Health department. Care Homes for Older People Page 22 of 30 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 employs enough staff to meet the needs of residents and they have confidence in how they are cared for. Recruitment procedures are robust and design to minimise the risk of unsuitable staff being employed. Staff have access to a wide range of appropriate training. Evidence: Staff rotas were in place and included the hours worked by the manager and domestic and housekeeping staff. We noted that the staffing levels were considered sufficient to meet the assessed needs of residents living in the home. Nine residents completed our survey, seven of whom said there was always staff available when they needed them and two said that there usually was. Five staff completed our survey, one said there was always enough staff to meet residents individual needs, three said that there usually was and one response was blank. Staff were described by residents as so kind and the friendly feeling is much appreciated. one resident commented that one thing the home did well related to staff smiles. Care Homes for Older People Page 23 of 30 Evidence: It was positive to see that the home also employs male carers one of whom was described by a male resident as fantastic. We looked at the recruitment records of three members of staff who had started work since the last inspection. All the necessary checks had taken place and files contained copies of all the documents required by regulation. The home has a staff training programme developed to ensure that staff are given the knowledge and skills to deliver a good standard of care. A formal induction programme based on the Skills for Care common induction standards was in place and was being undertaken by the new staff. Five members of staff completed our survey, one said they always felt they had enough support, experience and knowledge to meet residents needs and four said that they usually did. All the staff who completed surveys said they were given relevant up to date training and they all felt that the homes induction covered all aspects of their job very well. One member of staff commented that we are trained to a high standard to deliver a good standard of care another person commented that the home provided excellent training and went on to say that there was good support network between all staff. Training for the manager and all senior staff is planned relating to equality and diversity issues to make sure that individuals rights and lifestyles are acknowledged and respected and taken into account in the way the home is run. The AQAA told us that the majority (77 ) of staff have achieved qualifications to a least NVQ level 2. Care Homes for Older People Page 24 of 30 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 home benefits from clear leadership and effective management by Mrs Manvell. Management practices, records, policies and procedures are in place to promote and safeguard the health, safety and welfare of residents and staff. Evidence: The staff team is led by an experienced and competent manager, Mrs Mairi Manvell. All residents spoken to were positive about Mrs Manvells approachability and were confident they were well cared for.Mrs Manvell provides clear leadership and effective management supported by senior staff. Mrs Manvell provided the commission with a well completed Annual Quality Assurance Assessment within a timely manner as required by legislation. It was very positive to see copies of the last inspection reports freely available for residents and visitors on each floor of the home. Care Homes for Older People Page 25 of 30 Evidence: We looked at the way that residents personal finances are managed and found good records were kept and all records checked were correct. The home routinely undertakes quality assurance work to assess the quality of the service provided. This is done by using questionnaires and regular staff and residents meetings. Kitchen records were kept correctly and the kitchen was seen to be well maintained, clean and tidy. An accident book was in place and it recorded any treatment given and a record of action taken to reduce the risk of future accidents. All staff have undertaken mandatory training in health and safety, fire safety,manual handling and first aid. A wide range of risk assessments are being carried out in relation to individuals and aspects of the environment. Policies and procedures in relation to health and safety are in place and regularly reviewed to make sure they reflect current good practice advice. Care Homes for Older People Page 26 of 30 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 27 of 30 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 7 Serious consideration should be given to the information recorded on daily records so that it records how people have spent their time and their well or ill being. Serious consideration should be given to using a separate body map for each occasion so that information recorded is clear. All oxygen cylinders should be stored securely so there is no risk of them falling over. It is recommended that the non-prescription medicines policy is expanded to include more detailed guidance for staff on when and how they should be used. This is to make sure they are used in appropriate circumstances, to protect peoples safety and welfare. 2 8 3 9 4 5 12 16 Consideration should be given to see if there could be more opportunities for residents to go out of the home. Information about complaints should make clear that people are able to contact the Commission at any stage of a complaint. Serious consideration should be given to providing clear, accessible details about how to use the complaints policy Care Homes for Older People Page 28 of 30 and this should be displayed . 6 7 8 19 26 38 Serious consideration should be given to improving the signage on toilets and bathrooms. All waste bins in communal bathrooms, laundry and toilets should be foot operated and lidded. Portable appliance testing should be undertaken at least yearly. Care Homes for Older People Page 29 of 30 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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