Care Home: Silverdale

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What the care home does well The care home has a very welcoming atmosphere. Residents live in a homely environment. The person that we spoke with indicated (she/he has significant communication needs) that she/he was happy living in the home. The home is very well maintained. furnishings and fittings are of quality. People using the service are respected and their `well being` is promoted by the home. Caring, and competent staff demonstrate knowledge, and understanding of the varied needs of people living in the care home. The home liaises closely with health care professionals to ensure that the health and changing health care needs of people using the service are met by the home. We received positive feedback about the home from a health care professional. Records are in very good order, comprehensive, and up to date. Care plans, are `working tools` and are reviewed regularly to ensure that the needs (and changing needs) of the people using the service are met by Silverdale. Appropriate up to date policies and procedures are in place to ensure effective and efficient running of the care home, and for safeguarding residents and others. Meals meet the various religious, ethnic and vegetarian needs of people using the service. A resident told us that they liked the meals provided by the home. Residents` contact with relatives and others (as agreed by the residents) is fully supported and enabled by the care home. Feedback from a relative of a person using the service was very positive about Silverdale and comments included Silverdale is a `most wonderful place`, the home provides `superb care`, the manager/owners `care well above their duty`. The home has an attractive, well maintained enclosed garden. A resident spoke of enjoying this facility. What has improved since the last inspection? The manager and co-owner of Silverdale, have continued to be aware of the on-going improvements (such as re-decorating the home, and updating staff training) that should be made to a service providing care and support to residents. They ensure that action is always taken to continue to develop and improve the service that Silverdale provides to people. What the care home could do better: Silverdale continues to provide an excellent service to people. The format of some documentation of particular interest to people using the service (and prospective residents) such as the, service user guide, and complaints procedure could be further developed to improve their accessibility to residents who might have difficulty in reading, or who`s understanding of English might be limited. Key inspection report Care homes for older people Name: Address: Silverdale 13 Sudbury Court Road Harrow Middlesex HA1 3SD     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Judith Brindle     Date: 1 1 0 9 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: Silverdale 13 Sudbury Court Road Harrow Middlesex HA1 3SD 02083850841 02083851970 podonnell34@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr James O`Donnell,Mrs Pauline O`Donnell care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 4 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 Date of last inspection Brief description of the care home Silverdale is a care home providing personal care for up to 4 older people. The home is situated in a residential area within walking distance of local shops and bus and train public transport facilities. The home is very well maintained and furnished to a high standard. There are three single rooms on the first floor, and one bedroom located on the ground floor. Two bedrooms have en-suite facilities. The communal space consists of two large sitting rooms, and a kitchen/dining room. People using the service and owners dine together and share the communal space in the home, living together within a family environment. There is a well-kept enclosed garden at the rear of the Care Homes for Older People Page 4 of 27 Over 65 4 0 Brief description of the care home premises. The two owners (one is the registered manager), who live in the home, provide most of the care and support to people using the service. Details about the home and the fees are accessible from the manager and/or co-owner. 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: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The unannounced inspection took place throughout a day in September 2009. The last key inspection was completed on the 12th September 2006. There have been two annual service reviews of Silverdale home since then. These took place on the 3rd March 2008 and the 28th November 2008. There were two vacancies at the time of the inspection. We were pleased to meet and talk with one person using the service (the other resident was attending a hospital appointment at the time of this inspection) at the time of this inspection. The manager/owner and co-owner were working in the home during this key inspection. They supplied all the information and documentation which was requested by the us. The inspection focused on spending time talking with a person living in the care home and observing interaction between the resident and staff. We also looked at records which included, residents care plans, risk assessments, staff training records, and some policies and procedures. The inspection included a tour of the premises. We Care Homes for Older People Page 6 of 27 received one feedback survey from a health care professional, and we spoke with a relative of a person using the service. There were no requirements from the previous key inspection. 29 National Minimum Standards for adults, including Key Standards, were inspected during this inspection. We thank the people living in the care home, staff, and people who provided us with feedback, for all their assistance in the inspection process. 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: Silverdale continues to provide an excellent service to people. The format of some documentation of particular interest to people using the service (and prospective residents) such as the, service user guide, and complaints procedure could be further developed to improve their accessibility to residents who might have difficulty in reading, or whos understanding of English might be limited. 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. People who may use the service and their representatives have the information needed to decide whether the home will meet their needs. People using the service have their needs assessed prior to moving into the care home, which makes certain that the home knows about the person, and the support that they need. Evidence: The home has information (statement of purpose and service user guide) about Silverdale and the service that it provides to people. We were told by the manager/owner that residents receive a copy of the service user guide and statement of purpose when moving into the home. The home could look at ways of developing the format of information about the care home, into different formats (i.e. pictorial or audio) to meet the needs of people using the service who might have difficulty in reading, or might have English as a second language. Care Homes for Older People Page 11 of 27 Evidence: Annual Quality Assurance Assessment (AQAA) told us that each resident is provided with their individual terms and conditions and contract setting out fees payable and their choice of accommodation (this information was seen recorded in the care plans). We were also told that people using the service also receive their residents rights, complaints and termination procedures, and residents and their representatives are given a copy of the homes inspection report. The home has an admissions policy/procedure, which we were told has been recently updated to include and address requirements from the Mental capacity Act 2005. There have been no recent admissions to the care home. The manager/told us that a comprehensive assessment of a prospective residents needs is always carried out (with the person and/or their relative depending on the persons needs) by her before they move into the care home. The Annual Quality Assurance assessment (AQAA) informed us that the manager when assessing and planning the way the service will be delivered, will make sure that the individual has every opportunity to state exactly how they wish their needs be met. The manager told us that she was aware that some residents will be able to give her information personally and that others will need an advocate who will support them and their expression of views. Care plans looked at by us included evidence of comprehensive assessment and risk assessment of the persons needs being understood and met. The manager/owner reported that there was an on-going assessment of each persons needs, during their settling in period, of living in the care home. AQAA told us the views of the other residents are taken into consideration when introducing a new client to the home. We were told by the manager that prospective residents are encouraged and supported to visit the home before moving in. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person using the service has a plan of care, in which residents health, personal, and social needs are set out. People using the service are respected and their right to privacy upheld. People using the service are protected by the homes policies and procedures for managing and administrating medication. Evidence: Each person using the service has a plan of care. Both care plans were looked at. The care plans were based upon the assessed needs of each individual person. It was evident that care plans are working tools (up dated regularly as the persons needs, wishes etc change), and they focus fully upon each individual person, and their wide range of needs. It was noted that the content of the care plans are developed from the initial assessment of the persons needs, including health, medication, nutritional, continence, social and mobility needs. The care plans are reviewed very regularly, on a daily and more fully on a monthly basis. Comprehensive records of each persons daily progress are recorded. It was evident that the people using the service are fully involved in the review of their plan of care (depending upon their needs and abilities) and that people using the service are verbally informed of any changes to their plan of Care Homes for Older People Page 13 of 27 Evidence: care. Care plans looked at by us included risk assessments, such as risk of falls, moving and handling assessment, and risk of pressure sores. AQAA told us each resident is supported to make their own decisions, with their agreement and the home will work with them and their representatives to provide the best support for them. It was evident that the privacy and dignity needs of people using the service are being met by the home. Records, staff, and a feedback survey told us that people using the service have access to care, and treatment from a variety of health professionals, and specialists. These include GP, optician, dentist and chiropodist. Feedback from a health care professional was very positive about the service. Comments included; health care needs are always promptly monitored, and Silverdale does very well in looking after our patients in all their needs, and there is very homely, clean and loving atmosphere at Silverdale. Feedback also told us that staff always seek advice about residents health care needs, and people using the service are always supported with taking their medication. We were told that residents privacy and dignity is always respected; people are always supported to live the life they choose; staff and managers always have the right skills and experience to support people, and the service always responds to peoples diverse needs. A resident was attending a hospital appointment at the time of the key inspection. The home has a medication policy/procedure. Medication is stored securely. There were no gaps with regard to recording by staff when medication is administered to them. Medication of one resident was recorded on the medication administration record (MAR) as the amount of liquid medication to be given as opposed to the dosage prescribed (and recorded by the pharmacist on the bottles of medication). The importance of recording the dosage (ie milligrammes) of medication on the medication administration record was discussed with the manager/owner who amended the record with this information promptly during the inspection. It was noted that a resident (who has significant needs) was supported in a sensitive and respectful manner when being given their medication by the manager during the inspection. Care Homes for Older People Page 14 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have the opportunity to take part in a variety of preferred activities. The visiting arrangements are flexible and meet the needs of visitors and residents, so as to ensure that people using the service have the opportunity to develop and maintain important relationships. Meals provided are varied, and wholesome, and meet the cultural and specific dietary needs of people using the service. Evidence: We were told by the manager/owner, and records that residents have the opportunity to participate in a number preferred activities. It was evident that people using the service access community facilities, as well as enjoying indoor leisure pursuits of their choice. We were told that activities include; meals out at restaurants, pubs, picnics, shopping (including food shopping), and day trips. We were also informed that a resident has continued to participate in activities within his/her previous local area that he/she enjoyed prior to moving in the home. Records that we looked at confirmed this. A resident listened to music, looked at photographs, went for a walk, and went out for a drive (with staff), during the inspection. From talking to the manager/owner it was evident that she works hard at finding out what leisure pursuits people using the service enjoyed, before moving into the home and ensures that residents are Care Homes for Older People Page 15 of 27 Evidence: supported by the home to continue to participate in them if they wish. AQAA told us residents are involved in daily activities of their own choice and according to their interests and capability, and activities such as My Life Story Reminiscence and Stimulation and Motivation have proved very successful. We were told that people using the service are given the opportunity of taking part in leisure and recreational activities outside the home. The visitors record book indicated that people including relatives/friends, health care professionals visited people using the service. Records in the home told us that Silverdale has received a number of compliments from visitors/relatives (of residents) and others about the service. We received some very positive feedback from a relative of a person using the service who described the care and support provided by Silverdale as being superb. AQAA told us how the home takes residents to visit friends when the wish to see them, and that residents family and friends are encouraged to make regular visits and are always made to feel welcome, they can meet in private and there is no restriction on time imposed, however they do have a choice of who they wish to see. The home has a menu displayed in the kitchen, but we were told that it was flexible depending on the wishes and preferences of the residents. We were shown a folder which included numerous pictures of meals, that we were told was shown to a resident who with regard to her needs has difficulty reading, and the resident would indicate from looking at the pictures what she/he wished to eat. A person using the service had breakfast during the inspection. This meal was not rushed and the resident told us she/he chose and enjoyed the meal. Food eaten by people using the service is recorded. These records told us that residents receive varied, wholesome, meals which meet the preferences, specialist dietary, and cultural needs of residents. Drinks and snacks were regularly provided to the resident during the inspection. AQAA told us that residents and staff eat their meals together in the large and spacious kitchen, and that people using the service could choose if they wanted to eat elsewhere in the home. Care Homes for Older People Page 16 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. People using the service and others are confident that their complaints will be listened to, looked into and action be taken to put things right. Residents are protected from abuse, neglect and self-harm by the homes safeguarding policies. Evidence: Silverdale has a complaints procedure. This is included in the service user guide documentation. There were no complaints recorded. Several written compliments from visitors, relatives and others were seen. The manager told us of how she ensures that residents know and understand the complaints procedure. The format of this procedure could possibly be developed to make it more accessible to people using the service who might have difficulty in reading. AQAA told us that the home holds daily briefings where staff, residents and visiting representatives are invited to raise any issues, concerns or complaints that they may have, in the knowledge that they will be resolved to their satisfaction, and the home adopts the opinion that each resident has the capacity to make their own decisions unless proved otherwise however the staff are aware that residents capacity may change daily and they act upon this. The manager/owner told us that she, her husband (joint owner), have received safeguarding adults training given by the Local Authority, and that another staff member had also had safeguarding training. The lead Local Authoritys safeguarding procedures was available in the home. There have been no safeguarding referrals since the previous key inspection. The manager told us that she had awareness and Care Homes for Older People Page 17 of 27 Evidence: understanding of the Mental Capacity Act 2005 (this Act governs decision-making on behalf of adults who may not be able to make their own decisions)and Deprivation of Liberty safeguards, and has training with regard to this, planned. It was noted that a resident had had a recent assessment of their capacity to make decisions. 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. The environment of the home is safe, warm, clean and comfortable. The premises are suitable for the care homes stated purpose. Residents bedrooms are individually personalised and meet their individual needs. Evidence: Silverdale is located in Sudbury, close to Harrow and to Wembley, near shops and to a park. The house is in keeping with other houses in the residential area. The house is well maintained, very clean, and attractively decorated. There are flowering plants in both the front and rear gardens of the home, and parking for two to three vehicles. The interior of the home is homely with furnishings and fittings of quality. It was evident that residents are very much included into the family environment. There are two large sitting rooms, which are accessible to people using the service. We were told that residents could use these rooms to spend time with their visitors in private. The rear garden is well maintained and very attractive. It has a number of flowering shrubs and plants, and seating available for residents and visitors. We were told that the care home has a continuous programme of refurbishment and decoration. Within the last twelve months the home has been decorated throughout, had a new kitchen, all new electrical appliances, and been rewired. AQAA told us that the home has installed a carbon monoxide alarm and heat sensors in the kitchen and has painted the outside of the building, replaced two windows with double glazed Care Homes for Older People Page 19 of 27 Evidence: windows and painted all external woodwork. The manager told us that all the walking areas at the back of the home had been re-surfaced with non-slip resin. There are hand rails located within the home. We were told by the manager that aids and equipment are provided to people using the service as and when they need them. The bedrooms looked at during the inspection were very clean and individually personalised in accordance with the needs and preferences of people using the service. There are accessible call bells in the bedrooms. Two bedrooms have en-suite facilities. A resident told me that she/he liked her/his bedroom. AQAA told us that the home takes cleanliness very seriously both internally and externally, under the umbrella of infection control procedures and safe cleaning methods. We were told that the home has cleaning schedules and a daily routines planner which underpins the cleaning programme in the home. AQAA and records told us that Silverdale has been awarded the excellence 5 Star rating in hygiene and food safety management Scores on the doors from the Food Standards Agency and Brent Council. This is positive. The manager/owner told us that staff have had training with regard to infection control. 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. Staff in the home are trained, skilled and competent to support people who use the service, and to ensure the smooth running of the service. People using the service are supported and protected by the care homes recruitment policy and procedure. Evidence: The owners of the home are presently carrying out most of the care working duties. There is one other staff member who generally carries out domestic duties within the home. A staff rota was looked at. This recorded the hours worked by staff. The manager told us that the number of staff on duty was flexible and changed in accordance with meeting the needs, and changing needs of people using the service. AQAA told us that the home ensures that all staff operate in a manner which promotes liberty, and yet enables residents to feel safe and secure whilst promoting independence. We noted during the inspection that interaction between the manager and a resident was very positive, respectful and particularly sensitive with regard to this persons significant needs. The staff records were looked at. These included evidence that the home has an appropriate recruitment and selection process, which includes carrying out of required checks, including an enhanced Criminal Record Bureau (CRB) check (a check carried out to gain information as to whether potential staff have a criminal record). AQAA Care Homes for Older People Page 21 of 27 Evidence: told us that the home undertakes a robust recruitment process. AQAA also informed us that Silverdale likes to introduce the prospective candidate (staff member) to our residents to gage their reaction to the person before the home offers them the position and we were told that all staff receive a job description and have induction and foundation training within six weeks of employment. Records told us that staff receive varied appropriate training to ensure that they have knowledge and understanding of their role and responsibilities in meeting the needs of people using the service. AQAA told us that within the last twelve months staff have completed infection control and contamination training and have undergone refresher training on fire safety, medication, health and safety in the workplace, and the manager has also completed training in working with dementia, and the swine flu pandemic. We were also informed that in the next twelve months training/refresher courses will be completed by our staff Food Hygiene, Mental Capacity Act Training, Manual Handling, First Aid at Work, Deprivation of Liberty Safeguards, and any other training courses that will become available which we feel will be of benefit, and that staff will continue to receive regular formal supervision. We were told that the manager and deputy manager have an National Vocational Qualification (NVQ) in care or Health and Social Care. The manager told us that she had NVQ level 4 in management. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home is based on openness and respect, and has effective quality assurance systems to monitor and improve the quality of the service provided to people using the service. So far as reasonably practicable the health, safety, and welfare of people using the service is promoted and protected, and their financial interests are safeguarded. Evidence: The manager is very competent and manages the running of the home well in conjunction with the co-owner. The manager/co owner has managed and run the home for a significant number of years and is very experienced in caring and supporting older people who have a wide range of needs. It was evident from information recorded in the AQAA that the manager is fully aware of her role and responsibilities, and ensures that these are carried out to a very high standard. The manager and the deputy manager/co-owner work hard to ensure that people using the service lead a quality, lifestyle, that each person enjoys. It is evident that the well being of people using the service is seen to be of paramount importance, and the Care Homes for Older People Page 23 of 27 Evidence: home has a very caring atmosphere, where residents are supported to lead the life that they want. Records and that manager told us that she keeps her skills updated and accesses a variety of relevant/appropriate training to develop her knowledge and understanding of meeting the needs of people using the service and in managing Silverdale. AQAA told us that the home has annual business plan, and there are systems in place to monitor, improve and develop the quality of the service provided to residents. Policies and procedures needed for the safe running of the home are in place, and are up to date. AQAA told us that Silverdales inspection reports are openly available to all. We were told that staff are requested to read and understand all the policies and procedures of the home, and these and any new policies are discussed with staff. All documentation that was looked at was well recorded and up to date. Records told us that staff receive one to one supervision and appraisal. Records told us that views of the service, from people using the service, relatives/significant others, are regularly requested by the home. We were told by the manager that residents (or their relatives) manage their own finances. AQAA told us that safeguards are in place to protect the financial interests of the residents, and that secure facilities are provided for the safe keeping of money and valuables and written records for these transactions are maintained. We saw that appropriate finance records of residents monies are in place and up to date. Records told us that required health and safety checks are carried out and that systems such as the electrical and gas systems are checked by a competent person as required. The home has a recorded emergency plan, which was displayed. This includes information about what to do if there is a gas, electric or infection emergency. The manager told us that following the inspection she had up dated the emergency plan to include up to date information with regard to swine flu. Required fire safety checks and fire drills are carried out, and the home has a fire risk assessment. The home lets us know about things that have happened and they have shown us that they have managed significant issues/incidents appropriately. The home has an accident policy/procedure. Incidents and accidents are recorded as required. The home has an up to date employers liability insurance certificate. 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 1 1 The home could look at ways of developing the format of information about the care home, into different formats (ie pictorial or audio) to meet the needs of people using the service (including prospective residents) who might have difficulty in reading, or might have English as a second language. The format of the complaints procedure could have its format further developed to make it more accessible to people using the service (and prospective residents) who might have difficulty in reading. 2 16 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. 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