Care Home: Sonya Lodge Residential Home

Similar services:

• The Shelley
• Springfield House
• Sutton Lodge Nursing Home
• St Helier`s Residential Hotel
• St Joseph`s
• Ridgemount
• Wingham Court
• Old Hastings House

What the care home does well The staff have an excellent ability to assist residents in feeling relaxed, secure and at home, and in treating them as individuals. Pre-admission assessments and care plans contain suitably detailed information so that residents can be properly cared for. There is an excellent range of day to day activities as well as ongoing outings and visits to local places such as coffee shops and pubs. Residents and staff are well known in the local community. Food is well managed, providing sufficient choice and with frequent snacks available. The home is well designed, with spacious communal areas, and garden and patio areas for residents to enjoy. It is generally well maintained. Staff recruitment is thorough, and mandatory training is kept up to date. There are additional opportunities for staff to extend their studies. All staff receive dementia care training. The manager leads the way in providing person centred care, and ensuring that the home runs smoothly and efficiently. She makes it very clear that the residents` needs come first, and demonstrates this in her own manner towards the residents in her daily management. She has clear vision in regards to the development of the home; and residents, relatives and staff know that they are listened to, and valued. What has improved since the last inspection? The home has improved staff training and awareness of the importance of retaining residents` dignity, and there are now five "dignity champions" on the staff. Medication records have been developed to include clear guidelines and recording for administering "as necessary" medication. The manager has kept up to date with new legislation in regards to the Deprivation of Liberty, and is discussing and applying the implications of this with the staff. The home has become a member of NAPA (The National Association for the Providers of Activities). This is a voluntary organisation which promotes the understanding and awareness of the importance of relevant activities for older people. The activities organiser will be attending training sessions with this group. There has been ongoing refurbishment of the premises, which includes purchasing new dining chairs and armchairs; three new wheelchairs and a standing hoist; and complete upgrading of three bathrooms. What the care home could do better: The home is running well in all areas, and no requirements have been given as a result of this inspection. There are several areas for improvement which have already been identified by the management and which are being implemented. These include new carpeting in one area of corridor on the ground floor; adding photographs to staff files; and re-organising the staff files into indexed files. Key inspection report Care homes for older people Name: Address: Sonya Lodge Residential Home 10 High Road Wilmington Nr Dartford Kent DA2 7EG     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: Susan Hall     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 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) 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 29 Information about the care home Name of care home: Address: Sonya Lodge Residential Home 10 High Road Wilmington Nr Dartford Kent DA2 7EG 01322289768 01322289477 sonya.lodge@nellsar.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Nellsar Ltd Name of registered manager (if applicable) Mrs Jean Wright Type of registration: Number of places registered: care home 37 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 37. 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: Old age, not falling within any other category (OP) Dementia over 65 years of age (DE). Date of last inspection Brief description of the care home Sonya Lodge is owned and managed by Nellsar Limited, a company who currently have a total of thirteen care homes. It is situated in the village of Wilmington, which is near to Dartford, and all the local town amenities. Care Homes for Older People Page 4 of 29 Over 65 0 37 37 0 Brief description of the care home The premises are a large detached property, with an original old building, and large newer extensions. It is set in its own grounds, and there is a safe and well designed garden at the rear. There are parking spaces at the front, which staff and visitors can use; and additional on-road parking. The home provides residential care for up to 37 older people who have some form of dementia. The home is not registered for nursing care. Information and inspection reports are made available for residents and their representatives; and copies are available in the home. The fee levels currently range from £421.09 to £633.94 per week, depending on the assessed needs of individual residents, and the room available. There are additional charges for hairdressing and chiropody. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 home is assessed as having a rating of Excellent, 3 stars. This was a key inspection, which includes assessing all of the information obtained by the Commission since the previous inspection, as well as a visit to the home. Information is obtained from phone calls and letters about the service; legal notifications which the home is required to send in; any complaints or safeguarding issues in which we are involved; and an Annual Quality Assurance Assessment (AQAA) provided by the home. This is a comprehensive document which the home is required to complete each year, telling us about ongoing developments in the home, and any changes. We received the AQAA back within the specified timescale, and it was well completed. We sent out a number of survey forms to health professionals, staff and residents, and received six completed surveys which all included positive comments. The activities Care Homes for Older People Page 6 of 29 organiser had assisted some of the residents with their replies. The inspection visit took place over seven hours, commencing at 09:00a.m. The manager was present throughout the inspection, and the companys Operations Director was present in the home from approximately 11.00a.m. for the rest of the inspection visit. During the inspection, we (i.e. the Commission) chatted with 2 residents in their own rooms, and 11 residents in the lounges, and met many others briefly. We also carried out a Short Observational Framework Inspection (SOFI), which is a method of written observations regarding a set number of residents over a given period of time. The SOFI took place in one of the lounge areas, and lasted for 45 minutes. It helped to confirm previous findings, in that staff interact very well with the residents and with each other, and are aware of the residents individual preferences, moods and behaviours. We also chatted with 3 relatives and a pastoral visitor, and 10 staff. It was very clear throughout the visit that staff know the residents very well, and put them first in regards to their wishes and choices on a daily basis. We were impressed with the caring and friendly manner shown by all the staff, and their ability to make each resident feel cared for and important to them. The inspection included viewing all areas of the home; inspecting medication; and reading documentation such as care plans, maintenance records, staff recruitment and training files, and minutes of meetings. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: The home is running well in all areas, and no requirements have been given as a result of this inspection. There are several areas for improvement which have already been identified by the management and which are being implemented. These include new Care Homes for Older People Page 8 of 29 carpeting in one area of corridor on the ground floor; adding photographs to staff files; and re-organising the staff files into indexed files. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The provision of detailed information, and a comprehensive assessment process, assist people in making a decision about moving into the home. Evidence: The statement of purpose and service users guide are kept available for prospective enquirers to view. The statement of purpose includes all the required information, such as details of the registered provider and manager, an overview of the staffing available, and the accommodation and facilities provided by the home. The homes philosophy is people first, and this value was evident throughout the visit. The home also has a colour brochure, and this is sent out to enquirers who are in the initial stages of looking for a care home. The service users guide is produced in a large font for easy reading, and can also be made available as a CD guide on request. It includes details of the running of the home, and facilities such as visiting arrangements, meal times, use of telephone, the Care Homes for Older People Page 11 of 29 Evidence: call bell system and care planning. The complaints procedure is included. All prospective residents have a comprehensive pre-admission assessment carried out by the manager or a senior member of staff. This ensures that the home will be able to meet the persons individual needs, and gives the person the opportunity to find out more about the home and to discuss questions with the manager. As this is a home for residents with dementia, the persons relatives or representatives are invited to take part in the assessment processes and discussions, as applicable. All residents are provided with a contract. These contain clear details of the terms and conditions of residency, the cost of accommodation and the services provided, and who is responsible for paying the fees. Additional charges for items such as hairdressing and chiropody are clearly stated. Residents are admitted for a trial period of thirty days, after which a review is carried out to decide whether or not to make the placement permanent. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The evidence obtained shows that residents are given excellent individual personal and health care; and are treated with the respect and dignity that they deserve. Evidence: Care plans are initially set up using the pre-admission assessment as a basis, and are then developed according to additional information which becomes apparent. All care plans have a monthly review, and the manager has a monthly care plan auditing system in place. Residents and relatives are involved in care planning as much as possible. The relatives input is much appreciated, as this enables staff to become acquainted with residents likes and dislikes, and to help them to settle into life in the home more quickly. We viewed three care plans, and found that they contained good individual information about the residents and their care needs. Care plans are neatly typed, and include all aspects of care, such as personal hygiene care, skin integrity, communication, eating and drinking, mobility and continence. These show details such as if the person prefers a bath or shower, (and how often); if they require assistance Care Homes for Older People Page 13 of 29 Evidence: with eating and drinking, and the type of diet needed; and if they are independently mobile or need assistance from one or two staff. Care plans show the residents ability to understand and communicate information, and details of their dementia. They might show that someone is able to make decisions about joining in with social activities, or the clothes they wish to wear, but are unable to manage their personal money or to go out of the home unsupervised. There are separate care plans for sleeping, with specific details for items such as if the resident would like the light on or off, curtains or window open, drink before bedtime etc. This enables staff to follow residents previous routines, so that they feel secure and cared for in the home. The care plans contain comprehensive risk assessments, which include a mental health assessment, falls risks, continence assessment, nutritional assessment and moving and handling risk assessments. There is also an assessment to show the residents ability to understand and use the call bells. Some care plans have specific instructions such as ensure the call bell is placed on the pillow at night. Risks associated with environmental hazards show if residents are safe to use the stairs, and if they can walk around the home unsupervised. Each resident is assigned a key worker, who takes details of their life history, and who can relate to the resident and their family members about their progress. This includes the residents ability and preferences in regards to joining in with social activities; if they prefer one to one time; and if they like to chat with others at meal times or prefer to be alone. A daily record is completed for morning, afternoon and night shifts. These are good records, which include relevant details of personal care given, diet taken and social interaction. The records are signed and dated, but did not include the time of entry. The manager said that the time would be included from the day of the inspection, so as to add further clarity to these records. Nellsar are in the process of completing a new care plan format for all of their homes to use, and we viewed the proposed templates. We could see that these would remind staff to include even more information, and would put the information into a more accessible format. The staff ensure that referrals are made to health professionals as appropriate, such as GP, district nurse, and community psychiatric nurses. Details of these visits are clearly recorded. Medication is suitably stored in a clinical room which is fitted with sufficient cupboard Care Homes for Older People Page 14 of 29 Evidence: space. The storage cupboards are neat and tidy, and there is no overstocking. There is a new drugs fridge, and the room and drugs fridge temperatures are recorded every day. Controlled drugs are correctly stored in a controlled drugs cupboard which meets the required specifications. However, one of the screws and bolts attaching it to the wall appeared to be loose, and the manager immediately asked the maintenance man to check the safety of the cupboard. The controlled drugs register is well maintained. Most medication is administered using a monitored dosage system. There are two administration trolleys and these were seen to be in good order. No out of date medication was found. We examined all of the Medication Administration Records (MAR charts), and these are very well completed. No signature gaps were found, and all hand written entries are correctly signed by two appropriately trained staff. There are separate records to show when as necessary medication is indicated, and when this has been given. Medication is administered by senior care staff who have completed an ASET 12 -15 week medication training course, and who have been assessed for competency. Staff also have updates for this training. We were impressed throughout the visit by the way in which the staff treat the residents with gentle courtesy and respect, as well as with affection and humour. The residents privacy is carefully protected; and their dignity is promoted by the staffs ability to listen carefully to them, and to take them seriously, however confused they may be. Residents are very well groomed, and attention is paid to individual preferences such as being shaved, wearing jewellery, matching clothes, and manicures. Residents sometimes answer the phone or go to greet visitors when they arrive, and staff ensure that relatives understand that this is a natural part of residents recognising that this is their home now. The care plans show that the staff ask about individual wishes in the case of residents being suddenly taken ill, or dying. This enables them to liaise with relatives according to residents wishes; and to arrange for any specific support or religious observances required. Documentation is in place to show the mental capacity of residents, and where decisions need to be made on their behalf. Some of the senior staff are carrying out specific training in regards to giving palliative care. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent 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 wide variety of activities and social events for residents to enjoy. The food is well prepared and provides a nourishing diet. Evidence: The home has an activities organiser who ensures that there is an ongoing programme of structured activities in place on a day to day basis. These are further backed up by spontaneous activities throughout the day, which are flexible according to residents moods and wishes. Structured activities include puzzles and games, music sessions and singing, a sewing club, opportunity to take part in gardening; and films, crafts and pampering sessions. We carried out a Short Observational Framework Inspection (known as SOFI) in one of the lounges during the afternoon. This is a method of observing the care and attention paid to a specific number of residents over a given period of time. During this time, we observed spontaneous games and competitions organised by care staff, singing, and dancing; and nail care in the adjoining dining room. Residents were mostly very relaxed, able to wander, rest, or join in as they wished; and showed by their smiles and laughter that they feel secure and comfortable with the staff. There are frequent opportunities throughout the week for residents to go out of the Care Homes for Older People Page 16 of 29 Evidence: home. This includes regular visits to a local church coffee morning; visits to the local pub for meals or drinks; and visits to a local coffee shop and a luncheon club. The staff and residents are well known in the local community, and this enhances the residents sense of wellbeing. Residents also enjoy regular visits from local school children; and regular church services held in the home. The activities organiser visits the home at weekends as well as during the week, and will take residents out to church if they wish to go. Relatives and friends are able to visit at any time, and are made aware of the security arrangements in the home for residents safety. Relatives spoke highly of the staff and their commitment to providing the residents with a good quality of life. We chatted with many residents, who, in spite of different levels of confusion, were able to express their contentment in living in the home. These included phrases such as the home is always nice and clean; the food is lovely; and I am lucky to be here. Residents rooms are personalised according to choice, and they can have their own soft furnishings if they want to. Rooms vary from having many photographs, ornaments, plants or small pieces of furniture, to rooms which have plain, bare walls, because the resident may not want anything on the walls. Care plans include property lists, and records of residents activities and social outings. The home has a chef who works from Monday to Fridays, and a separate cook for weekends. There is no set breakfast time, as each resident can get up when they want to, and breakfast is given out individually from early to late morning. Breakfast can be served on a tray in their bedroom if they wish, or in the dining room. Cooked breakfasts are available as well as a range of cereals and toast etc. There are two choices of main meals at lunch times, and the chef will also make other dishes if residents change their minds. Each resident is asked for their choice of menu during the morning, which means that some residents are able to remember what they have asked for. There is always a hot choice of meal at tea time, as well as sandwiches, soup and salads available. The chef has a good understanding of the needs of residents with dementia, and knows that they are often hungry, or forget if they have eaten. Snacks such as sandwiches, cakes and biscuits are available throughout the day, and are also offered at supper time in the evenings. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. All concerns and complaints are taken seriously and are followed up appropriately. There are good policies and procedures in place to protect residents from abuse. Evidence: The complaints procedure is on display in the entrance hall, and is also included in the service users guide. There are clear directions to encourage people to go first to the senior person on duty, or to the manager. There are additional directions for contacting the companys Operational Director, Social Services, and the Care Quality Commission. The procedure states that complaints will be investigated and responded to in seven days, unless a more detailed investigation is needed; in which case the response will be within twenty-eight days. We viewed the complaints log, and this contained one complaint for the last year. The documentation showed that the complaint was properly investigated, and that action was taken as a result of this. The home has good recruitment procedures in place, which helps to protect residents from abuse. All staff are trained in the recognition and prevention of abuse, and the home follows the agreed Kent and Medway policies and procedures for safeguarding vulnerable adults. The home has a whistleblowing policy in place, and staff know that they can raise issues in private with the manager. Most residents are unable to manage their own finances, and the home will only look after small amounts of pocket money for residents, so as to safeguard their private Care Homes for Older People Page 18 of 29 Evidence: finances. These accounts are individually maintained, and audited every month to ensure their accuracy. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The premises provide a comfortable and well maintained home for the residents. Evidence: The premises include an original old building, and large newer extensions which have been completed some years ago. The premises are generally well maintained, and kept in a good state of decoration. All the bedrooms have new furniture, which is of good quality. There are five lounges, one of which is a small quiet room which is completely separate. The other four lounges are adjacent to each other, and to the dining space. These communal rooms have been very well designed, so that while there are separate areas, they all run off from each other, enabling the staff to oversee many residents at the same time, and without intruding on them if they are happily chatting together. There are different television areas, and these are spaced far enough apart for residents to have the benefit of different programmes on at the same time, so they can choose which they wish to watch. It also enables the staff to put on film shows, without interrupting other programmes. The lounges and dining room are light and spacious, and provide large areas for residents to walk in or move around. The home has a good sized garden at the rear, and this is a secure area. There is a permanent gazebo and barbecue area, and other seating areas, including tables and chairs for meals or drinks outside. Care Homes for Older People Page 20 of 29 Evidence: The bedrooms are all for single use, and most have en-suite toilet and washbasins. However, seven bedrooms in the old building do not have en-suite facilities, but have toilets and bathrooms near to them. There are also commodes for use at night. Accommodation is provided on three floors, the ground floor, the first floor, and the lower ground floor. The home has a suitable number of toilets, assisted baths and showers, and there is appropriate signage to help residents to find their way around. Toilets on the ground floor all have colour coded red seats. Most bedrooms doors have a picture of the resident, as well as their name, but some residents do not want their name or photograph on their doors, and this is respected. The home is equipped with a sluice room and a sluice disinfector, which promotes good infection control. There are hoisting facilities and wheelchairs available, and any additional equipment (such as pressure-relieving mattresses) is obtained as needed. Some carpets have been replaced during the past year, and carpets are cleaned as needed on a daily basis. One area of corridor on the ground floor has stained carpeting, and the manager said that she had already requested for this area to be replaced in the near future. Arrangements are made to hire in an industrial carpet cleaner as the need arises. All radiators are covered for safety, and hot water outlets have individual thermostatic valves. The hot water temperatures are checked on a regular basis to ensure that there is no risk of scalding for the residents. There are also window restrictors fitted for safety. The home employs a maintenance man, and he is carries out routine checks for items such as emergency lighting, fire alarm and automatic door closures, wheelchair checks and and checks for any bed rails. (There were no bed rails in use at the time of the inspection). The servicing and maintenance records are excellently maintained. The laundry room is situated on the lower ground floor. There are separate areas for dirty linen and clean linen, and there are two washing machines and two tumble dryers. All clothing is properly ironed so that residents feel well presented. There are currently two staff on duty each day to carry out cleaning and laundry, but the manager has just completed recruitment for a third staff member as this is necessary to maintain the cleaning schedule to a good standard. There is an ongoing programme of redecoration, and additional maintenance staff are Care Homes for Older People Page 21 of 29 Evidence: available in the company when the need arises. Care Homes for Older People Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents benefit from being cared for by a team of well trained, competent, and caring staff. Evidence: There are five care staff on duty throughout the day, and three care staff for night duties. They are supported by the Head of Care (who is also the deputy manager), who works alongside staff throughout the week. She usually has three days per week as supernumerary, enabling her to update care plans, and carry out one to one supervision and competency checks with other care staff. The home also has a chef or cook on duty, an activities co-ordinator, two housekeeping and laundry staff, and a maintenance man. Care staff are encouraged to study for NVQ levels 2 and 3 in Health and Social care, and the home currently has over 50 per cent trained in NVQ 2, and five other staff currently studying for this. The high standards of staff competency and care reflect these good levels of training. The home has good recruitment procedures in place. We viewed three staff files, and found that all required checks and information are in place. This includes a POVA first and CRB (Criminal Record Bureau) checks; proof of identity; a full employment Care Homes for Older People Page 23 of 29 Evidence: history; two satisfactory written references; and previous training records. The files viewed did not include photographs. The manager stated that the company had already noted that staff photographs were not on file and were in the process of addressing this. Staff photographs have mostly now been taken and are being added to the files. The manager also said that she is starting to index all of the staff files, and put them into a specific order, so that information can be obtained more easily. New staff go through a detailed induction programme, and the manager and deputy manager work together with senior staff to ensure that all aspects are covered, and signed to confirm the persons understanding. Staff are trained first in dementia care, prior to carrying out mandatory training in subjects such as moving and handling and first aid. This enables them to start interacting with residents in a meaningful way, with an awareness of the difficulties caused by dementia in regards to communication, memory and confusion. The training matrix confirmed that mandatory training is kept up to date, and that staff have updates on a regular basis. Other training includes palliative care, and application of the Mental Capacity Act and the Deprivation of Liberty. Senior care staff administer medication, and they have just completed a comprehensive course to update them in medication management. Care Homes for Older People Page 24 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run well by a competent and experienced manager. Evidence: The registered manager has been working at this home for fifteen years, and has been the manager for the last three years. She said that the company are extremely supportive, and enable her to run the home in a way which benefits the residents. She meets regularly with other home managers, and has monthly visits from the homes Operations Director; who also phones the home at least twice per week to keep updated with any changes or developments. The manager is suitably trained and experienced, and keeps her own training up to date. This includes NVQ level 3, and ASET courses in infection control, medication, palliative care, and dementia. She is currently completing the Registered Managers Award. The manager demonstrates empathy and genuine concern for the residents, and leads Care Homes for Older People Page 25 of 29 Evidence: the way for the staff in caring for these vulnerable adults. There is an excellent sense of team work, and a clear message that the residents are always considered first. There are staff meetings every two months, and individual staff supervision at least six times per year. This provides the staff with the opportunity for input into the life of the home; and also provides them with opportunity for their own personal development. Residents are encouraged to make their feelings known, and although most have high levels of confusion, the staff spend time listening to them and trying to understand what they are really saying. There are regular residents meetings, which are chaired by the the activities co-ordinator. The topics most frequently discussed are menu changes, and different ideas for activities and outings. There are also relatives meetings; and weekly joint opportunities for residents, relatives and staff to share together over a cream tea, or cheese and wine. The residents really enjoy these occasions. The home uses yearly questionnaires to provide residents and relatives with the chance of sharing their views on all aspects of the running of the home. These can be completed anonymously if wished. All comments are taken on board, and action is taken to address specific issues raised. Small amounts of pocket money can be stored for residents in a safe place, and individual accounts are maintained. All debits are clearly itemised, and all receipts are retained. There are monthly audits for these accounts. Records for maintenance and servicing are generally well maintained, and kept up to date. The homes policies and procedures are revised as needed, and are reviewed annually. Accidents and incidents are properly recorded, in line with other legislation. There are ongoing building checks to ensure the health and safety of the residents and staff. Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!