Care Home: Southway

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What the care home does well Southway is a well run home and residents say they are well looked after by caring staff. Relatives told us, "She is healthier now than when she went in"; and "Everyone is really well cared for". Staff find out a lot of detail about individual residents and the information is used to make sure that the right care and support is planned and delivered. The home has good links with family doctors, health professionals and others. Medicines at the home are well organised and staff who administer medicines are trained for this. Residents choose how they live at the home. A resident told us, "I`m just having breakfast because I slept late"; and another, "It`s home from home here". Visitors are made welcome and one told us, "I was told to make myself at home and I did." People like the food, "Meals are well presented and appetising". The manager encourages residents and relatives to raise concerns if they are worried about anything, and she listen to what people say. Staff at the home are recruited properly, new staff are supported, and residents say the staff are good: "The staff are caring and friendly". Staff like working at the home and receive training: "It`s friendly here"; "I get a lot of training". Staff are trained and supported to meet the needs of people with dementia in a methodical and helpful way. The home has a good manger who, with the company, checks that the home continues to run well and in residents` best interests. Staff find the manager helpful. "Our manager is very supportive" a staff member told us. What has improved since the last inspection? The home has addressed issues we raised in our last report: A fire risk assessment has been done and a fire inspection was due following our visit; the risk to residents regarding the use of kitchenettes has been assessed, and other risks have been considered too; staff supervision and much more thorough dementia training have been established; One unit has been redecorated and refurbished including the fitting of new floor coverings; records are now stored to better protect confidentiality; our most recent report and the home`s survey results are now kept in the reception area of the home. Other improvements over the last year include work done to enhance activities and meaningful occupation for residents. Dementia awareness now has a high profile within the staff team and an activities coordinator has been employed. What the care home could do better: Some areas of the home are in need of decorative attention. Work to refurbish the home is continuing in stages and decoration within Cherry Unit was due to start shortly after our visit. Refurbishment is to include replacement of some carpets which have seen better days. Some comments we received in our survey indicate that people could be better informed about the plans to refurbish specific areas together with time-scales for the work.In our opinion more could be done to make the home`s bathrooms more appealing and homely in character. The manager and staff spoken to agree with us and will consider with residents how to improve the bathrooms. Residents live in individual units within the home and this encourages a family atmosphere. Each unit is staffed separately with support from others including a "float". The manager agrees that she needs to continually think about working patterns and the role of the "float" to make sure that individual residents benefit in the best way. It is very important to focus on continued efforts to increase the number of staff with National Vocational Qualifications and to retain them on completion of this training. The manager indicated that the company is currently giving this issue the high priority it requires. Key inspection report Care homes for older people Name: Address: Southway 290 London Road Bedford Bedfordshire MK42 0PX     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Carol Mitchell     Date: 0 9 0 6 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 26 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 26 Information about the care home Name of care home: Address: Southway 290 London Road Bedford Bedfordshire MK42 0PX 01234345284 01234360340 fosterri@bupa.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: BUPA Care Homes (Bedfordshire) Ltd care home 42 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home Southway residential care home was purpose-built in 1975 and is operated by BUPA Care Homes (Bedfordshire) Ltd. The service is registered to provide care for 42 people over 65 years old, who may also have dementia and/or physical disabilities. Single room accommodation is provided. Accommodation is distributed over two floors and arranged in five units that each have a dining area, lounge and kitchenette facility. A large room for communal activities and a combined hairdressing room and shop are located on the ground floor. Bathroom and toilet facilities are distributed for convenient access throughout the building. There is a well laid out central quadrangle garden in addition to small gardens attached to each of the ground floor units. Parking for several vehicles is located close to the entrance of the building. Further information can be obtained by contacting the home direct. Weekly private fees are £650. Care Homes for Older People Page 4 of 26 0 0 0 Over 65 42 42 42 Brief description of the care home Additional charges are made for hairdressing, chiropody and aromatherapy. BUPA make a charge if a member of staff is required for an escort to hospital appointments unless a staff member is needed for clinical reasons or in an emergency (£25 first 4 hours, £50 for a full day). Care Homes for Older People Page 5 of 26 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: This report takes account of information we have received since the last key inspection in June 2008. This includes what the home and anyone else have told us since then. We also consider information given to us by the manager in a comprehensive self assessment document completed in May 2009. In addition we received 11 surveys giving us opinions about the home from residents, their relatives and staff. As part of this key inspection we visited the home on Tuesday 9th June for around five hours. During our visit we spent time with and spoke to some residents, family members, staff , and the manager. We checked a sample of care plans and other records relating to residents we met, and also looked around some parts of the building. We would like to thank everyone involved with the inspection visit. Care Homes for Older People Page 6 of 26 What the care home does well: What has improved since the last inspection? What they could do better: Some areas of the home are in need of decorative attention. Work to refurbish the home is continuing in stages and decoration within Cherry Unit was due to start shortly after our visit. Refurbishment is to include replacement of some carpets which have seen better days. Some comments we received in our survey indicate that people could be better informed about the plans to refurbish specific areas together with time-scales for the work. Care Homes for Older People Page 7 of 26 In our opinion more could be done to make the homes bathrooms more appealing and homely in character. The manager and staff spoken to agree with us and will consider with residents how to improve the bathrooms. Residents live in individual units within the home and this encourages a family atmosphere. Each unit is staffed separately with support from others including a float. The manager agrees that she needs to continually think about working patterns and the role of the float to make sure that individual residents benefit in the best way. It is very important to focus on continued efforts to increase the number of staff with National Vocational Qualifications and to retain them on completion of this training. The manager indicated that the company is currently giving this issue the high priority it requires. 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 8 of 26 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 9 of 26 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 manager makes sure that peoples needs and the homes ability to meet them are properly considered before anyone moves in. Therefore people living at the home can be sure that their needs will be met. Evidence: Prospective residents and their families receive information about the home which is both sufficient and relevant. Large print versions of the information are available. Comprehensive assessments are undertaken by the manager or her deputy before a person moves into the home, and the approach taken to assessment makes sure that the diversity of any individuals requirements are reflected. During our inspection visit we spoke to a resident who had recently moved into the home, and their relative. We also considered documentation completed regarding the residents needs. Meaningful information had been received and a comprehensive assessment had been completed by the manager and her deputy prior to admission. Care Homes for Older People Page 10 of 26 Evidence: The assessment had included discussions with the next of kin and with hospital staff. Personal care plans and risk assessments had been completed, and the use of a Life Map identified biographical details and diverse needs in an organised way. The relative confirmed that a contract had been issued, and expressed high levels of satisfaction with the care and support delivered at the home. Information from the homes surveys and our most recent report are now available in a file kept in the reception area of the home. The home does not provide intermediate care. Care Homes for Older People Page 11 of 26 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. Residents have up to date and individual care plans, and staff call on family doctors and others when they need to. Staff care about the residents and receive training and support to guide them. Therefore people living at the home can be sure that their health and personal care needs will be met. Evidence: During our visit we discussed how the home meets personal and health needs with residents and staff. We also asked relatives for their views. We considered the information in the care plans and other records kept regarding four residents in particular. Residents and relatives told us that they are very happy with the way they are cared for and supported. All the staff are very caring; She is healthier now than when she went into care; Everyone is really well cared for; The care regarding physical health is very good. The care plans are organised, reflect a person centred approach and are written in an individual and meaningful way. Assessments of risk are recorded and documents are kept up to date in line with changes. We checked that events we know about had been Care Homes for Older People Page 12 of 26 Evidence: recorded and that care plans had been updated accordingly. Staff readily update the documents and see this as part of their everyday role. In the event of an accident occurring appropriate action is taken and proper records are maintained. The incidence of accidents is monitored by the deputy manager. During our visit we saw that staff have a friendly, caring, and supportive manner with residents who they know well, and interact with often. The home is further developing its key worker approach to delivering care and support. Staff deal sensitively with people and in private. Since the last key inspection staff have received more in depth training about the needs of people with dementia and staff are now issued with a booklet aimed at raising awareness of dementia. When people move into the home they are able to keep their family doctors where this can be arranged. There are also strong links with a family doctor who visits the home regularly. The home works closely with district nurses and other professionals too. In addition the company has various regional and national specialists to whom the homes manager and staff can refer. A relative told us about the care his wife had received before she died at the home. He described very compassionate and caring staff and said that his wife had been treated as though part of the family. He and his family were made to feel welcome; we were told to make ourselves at home and we did. The family doctor had been called by staff on more than one occasion and in a timely manner. The relative was pleased that staff members had attended his wifes funeral. Medicines at the home are well organised and inspections are done every year by the providing chemist. The last inspection was in November 2008 when no recommendations were made. Staff who administer the medicines have received training. Residents told us that they receive their medicines as they should. We looked at a sample of medicine sheets and these were correctly completed. We also observed the safe administration of medicine and looked at where the medicines and controlled medicines are stored. The manager completes weekly and monthly checks to monitor continuously that medicines are well ordered and administered correctly. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager and staff are good at encouraging residents to make choices that suit them. Therefore people at the home feel sure that their expectations of living there will be met as far as possible. Evidence: During our visit we saw that residents enjoy frequent and friendly conversations with staff. Residents told us that they make choices in how they live at the home: Im just having breakfast because I slept late; Its home from home here. Residents described making everyday decisions and occupying themselves as they wish. A resident was playing the piano at the time of our visit, another singing along to music, another helping to tidy things away, someone else was enjoying doing some colouring, some residents were receiving hand massages and others watched children playing at the neighbouring school. Residents carry on with hobbies where possible and with their relatives are encouraged to complete life maps so that helpful information can be used to make lives more fulfilled. A residents cat quietly relaxed on a settee. When necessary the resident takes the cat to the vet. Personal items were observed in the bedrooms seen including cuddly toys for a resident who gains comfort from these. Care Homes for Older People Page 14 of 26 Evidence: Staff are actively involved in promoting meaningful activity on an individual basis. In addition an activities coordinator is employed to organise a structured events programme in consultation with residents. This area is being developed in the home and there are plans to increase activities and outings further. An art class was to take place during the afternoon of our visit. There is no pressure for residents to join in with group activities if they do not wish to. Monthly church services take place in the home, residents go out for meals, and trips to the local supermarket are organised. A resident told us, We have good entertainment in the club room. Another commented that although she would welcome more outings, the entertainment attended has been very good. Staff have recently nominated two residents for recognition of their services to the Land Army during the Second World War and were arranging a celebration at the time of our visit. Family members are involved with events such as summer fetes and Christmas parties. Relatives told us that they are made very welcome when they visit. One family member told us that he does not visit his mother during meal times having been advised that the distraction prevents her from eating well, and he agreed that this was the case. The deputy manager told us that although arrangements are made individually, the protected mealtime policy means that in general relatives are encouraged to take a meal with the resident if visiting at meal times, and they are most welcome to do this. Residents are given choice at mealtimes and snacks are available at flexible times. We asked residents about the food at the home and received very positive comments regarding it. We saw the lunch served on of the units. The meal looked and smelt appetising, was well presented, and was enjoyed by residents. The meal time was relaxed and residents and staff were not rushed. A relative wrote Meals are well presented and appetising. Attention to the needs of residents with dementia is given priority when decorating and considering the use of signs around the home. Care Homes for Older People Page 15 of 26 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. The manager makes sure that complaints are encouraged and dealt with properly. The right checks are made before people work at the home, and residents are able to speak freely to informed staff about any worries. Therefore people living at the home can be sure that they will be listened to and taken seriously. Evidence: The home has a complaints procedure on display in the reception area, and a copy is included in information given to residents and their families. There is a low level of complaints, one having been received during the last year. Any complaints are taken seriously and proper records are kept. The manager encourages people to express their feelings openly and makes sure that she is regularly available to talk. Views are requested during any relatives meetings held and as part of surveys sent out by the home. Verbal concerns are recorded and acted upon and a record is also kept of any thank yous received. In our surveys residents and relatives told us that they know how to raise issues if they need to. During our visit we noticed and were advised by residents that they feel confident to speak with staff freely. A resident told us If I need to complain I will just tell them straight! The home kept us properly informed about three incidents during the last year where the safety of residents might have been compromised in some way. Staff receive training about abuse which may be suffered by vulnerable adults, and the needs of people with dementia are emphasised during sessions. Care Homes for Older People Page 16 of 26 Evidence: The correct checks are made by the home before anyone is allowed to work there. No staff have been referred to the list of people not allowed to work with vulnerable adults during the last year. Residents used postal votes during the recent local and European elections. Care Homes for Older People Page 17 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Refurbishment of the home is underway. The company, manager and staff want to make improvements and there is a plan of works to be done. Safety checks to do with for example fire and hot water are undertaken regularly. Therefore people at the home can be sure they are living in a safe and improving environment. Evidence: Residents, relatives and a visitor to the home remarked to us that the atmosphere there is warm, welcoming and homely. The individual sections in the home mean that people come to feel included in something of a family unit, getting to know fellow residents and staff well. Residents we spoke to were happy in their environment and we noticed that personal items were displayed in bedrooms. They told us that they use the courtyard gardens in good weather. In our survey a relative said The environment is well cared for making the building a safe and pleasant place to be. There is an ongoing programme of redecoration and refurbishment. Residents views and the needs of people with dementia are taken into account regarding colour schemes and any signage used. Work has been done to Aspen unit and is next scheduled for Cherry unit. Unfortunately following completion of some works in Aspen there was some flood damage. Since then two old toilets have been replaced and additional work to make good was awaited at the time of our visit. This may delay the start of proposed work to Cherry unit. The refurbishment being undertaken Care Homes for Older People Page 18 of 26 Evidence: includes replacement of some carpets and floor coverings. Two relatives in our survey commented that work to replace some carpets is required and this was confirmed when we looked around some parts of the home. A relative in the homes own survey commented that work talked about had not yet come to light. The home could consider how it can better communicate the intention to do works and the time frames for such work to be done. We thought that the bathrooms we saw were functional in nature, but were not very appealing and did not feel very homely in character. Staff we were with and the manager agreed with this and started thinking about how the bathrooms could be improved for the benefit of residents. A maintenance man is employed, and he helps with some health and safety issues at the home. We confirmed that hot water checks and fire checks are done. Information regarding chemicals is posted in the laundry, and the risks to residents in case of a lift breakdown have been assessed as requested during our last visit. The risks regarding the use of the kitchenettes have also been assessed since our last visit. Staff and residents we spoke to were familiar with the hazards. A detailed fire risk assessment has been completed and a fire inspection was due two days after our visit. The most recent environmental health inspection took place in January 2009 where systems were judged satisfactory. Care Homes for Older People Page 19 of 26 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 care staff at the home are well liked and know the residents. The manager makes sure that staff are able to meet the individual needs of residents and continues with the company to increase the numbers of staff with National Vocational Qualifications. No one is able to work at the home unless the proper checks have been done first. This means that people living at the home can be sure they are in safe hands. Evidence: During our visit residents and relatives told us that there is a good staff team at the home. We noticed that staff have an easy, kind and attentive manner with residents, and that staff engage with them often. When questioned staff were able to speak confidently about their role and they were knowledgeable about the needs of individual residents. In our survey people told us The staff are caring and friendly; The general staff care standard is very high; I have never sensed any impatience from the staff. Staff enjoy working at the home and there is a core of staff who have worked at the home for some time. Staff turnover has reduced and four male care assistants have been employed since the time of our last visit. There is currently one vacancy which had just been filled when we visited, and recruitment is ongoing due to scheduled maternity leave. Staff told us Its friendly here, we all get on well. Everyone has time to create a family and relaxed atmosphere. Staff said they feel well supported, they Care Homes for Older People Page 20 of 26 Evidence: have hand overs, meetings and supervision sessions. Staff at the home are pleased with the amount, range and breadth of training they receive. Since our last visit dementia training and awareness at the home has been improved significantly. Training is supported by additional material such as a booklet and DVD, and an awareness group gathers each month so that information can be shared and outside speakers can be heard. A member from The Alzheimers Society was due to speak at the home in late June, and a local college has been approached to deliver workshops at the home. Staff confirmed I get a lot of training here; We are given a lot of training to help us keep up with the individual needs of clients. The home continues to actively support National Vocational Qualification training. It was nearing the requirement for 50 percent of staff to have achieved a certain level of training but unfortunately two staff left and so this standard is still not quite achieved. Two staff members were starting the training at the time of our visit and other nominations had been made. The company knows that this issue is a priority and is currently considering how best to give staff incentives to enhance the retention of staff with the qualifications. The home employs housekeeping, laundry, administrative, and catering staff as well as a handyman and someone to coordinate activities. The home is organised into separate units which are individually staffed. The small units enhance the friendly and homely atmosphere, and can support the key worker method of working being developed at the home. Efforts are made to reduce deficits in staffing and the isolation which may be felt by staff working in separate units. Staff can call on floats and the manager and deputy manager are often available. Staff told us they find that this works well although one spoken to observed that the role of float could be further developed and structured for the increased benefit of residents in each unit. Residents may need support for one on one occupation in addition to the meeting of their physical needs. The manager agreed with this and is currently considering the issue. A sample of staff files and discussion confirmed that the proper checks are made before anyone is employed by the home. New staff members are supported and are given induction training. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is well supported by the company to make improvements when necessary and tries hard to address any problems. She listens carefully to what residents and their relatives say, and makes every effort to ensure that residents individual needs are identified and met. The manager and the company check that the home is run safely and properly. Therefore people living at the home can be sure that it is run with their best interests at heart. Evidence: The manager works with us well, and keeps us informed about important aspects of life at the home. Attention has been given to the requirements we made at our last key inspection: A fire risk assessment has been done; regular staff supervision is now established; the risk to residents regarding the use of kitchenettes is being managed; decoration and refurbishment at the home is ongoing; the storage of records has due regard for confidentiality; the dementia training given to staff has significantly improved. We made additional recommendations at our last visit, and other improvements include the following: work has been and is being done to enhance Care Homes for Older People Page 22 of 26 Evidence: activities for residents at the home; the company places a high priority on the need to train and retain staff with National Vocational Qualifications; a training plan and a method of keeping track of staff training have been developed. The manager of the home is supported by a deputy, and an administrative assistant is employed. The manager also benefits from company resources such as finance, human resources and health and safety departments. In addition, the company employs regional and national specialists in a variety of roles to support the needs of residents and staff in care homes throughout the country. Recent training received by the manager and her deputy includes the detailed dementia care training undertaken by other staff at the home. During our visit we noticed that the manager is very approachable, and has a friendly and open demeanour with residents, family members, visitors and staff. In our survey residents told us that they are listened to. The manager tries to have an open door policy as much as possible and uses initiatives such as the recording of verbal concerns and issuing surveys to actively encourage communication. Results of surveys and our most recent report are kept within a file held in the reception area of the home. Residents have life plans so that detailed knowledge is sought and can be used to make sure that every individuals views and needs count. Staff like the manager and find her helpful: Our manager is very supportive and is always available for a one to one should this be needed. The company has a quality and compliance section which supports the manager in the area of quality assurance. Checks are for example made concerning care planning, medicines, human resources and finance in addition to the local home based checks done by the manager. Monitoring visits are done every month by a company manager in line with the regulation requiring this. The manager completed a detailed self assessment document before we visited the home. Information in the self assessment confirms that the home has policies and procedures in place, and that the required safety checks are made. During our visit we checked that the fire log is maintained recording fire alarm and lighting checks, and fire training for staff. Care Homes for Older People Page 23 of 26 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 24 of 26 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 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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