Care Home: Springkell House

What the care home does well People who may wish to use the service have a full needs assessment prior to using the service in order to ensure that the homes staff have the skills and abilities to meet the individuals assessed needs. People are involved in decisions about their lives and have an active role in planning the care and support they receive. Peoples health care is promoted and the care people recieve is reviewed and changes recorded. The medication processes in the home are robust to protect individuals from harm and the control of the spread of infection and cleanliness of the home is generally well managed. Peoples rights to protection, dignity and respect are promoted at all times and people are protected by the homes complaints and safeguarding adults procedures. Peoples rights of choice about their daily routines and the range of activities offered is promoted. Visitors are welcomed to the home to maintain contact with their family members and friends. The home provides a healthy and balanced diet in spacious and pleasant surroundings. The physical design and layout supports individuals to live in a safe, well maitained and comfortable environment. Staff in the home are in sufficient numbers to support the people who use the service. Safe recruitment and vetting of staff protect the welfare and safety of individuals and staff receive training to ensure peopels needs are appropriatly met. The management and administration of the home is robust and continues to be run in the best interests of the people living in the home. Peoples views and opinions and those of others associated with the home are sought and acted upon and peoples welfare is promoted through the monitoring of health and safety in the home. What has improved since the last inspection? The three requirements made during the last inspection have been met. Individuals care plans have been further developed to include an improved person centred approach. The menus have been reviewed, the quality and type of activities provided in the homehave improved, redecorataion of parts of the home have been completed, the home have introduced a suggesstion box for individuals to make suggestions and give feedback about the home. Staff have attended equality and diversity training and have an increased awareness through training of the Mental Capacity Act. A proactive approach has been taken by the homes management regarding the Mental Capacity Act and the Deprivation of Liberty Act in order to ensure all individuals living at the home are safeguarded. The home have begun to apply the Gold Standards Framework for Palliative Care to support individuals with end of life care. What the care home could do better: No requirements have been made as a result of this inspection. The AQAA outlines that as a result of listenning to what people say about the service they will continue to improve the service based on the requests and suggestions from individuals living at the home. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Springkell House Wood Road Hindhead Surrey GU26 6PT     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Suzanne Magnier     Date: 0 7 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Springkell House Wood Road Hindhead Surrey GU26 6PT 01428605509 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : karen_springkell@tiscali.co.uk www.springkellcare.co.uk Madeprice Ltd care home 34 Number of places (if applicable): Under 65 Over 65 0 34 dementia old age, not falling within any other category Additional conditions: 34 0 The maximum number of service users to be accommodated is 34. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) Old age, not falling within any other category (OP). Date of last inspection Brief description of the care home Springkell House is a large Victorian detached property set in its own grounds in a residential part of Hindhead. The service provides twenty-four hour care for up to 34 older people, some of whom have dementia. All bedrooms are single accommodation and several benefit from en-suite facilities. Two passenger lifts are available to upper floors and signage is evident in the home to support individuals to orientate themselves in the home. Care Homes for Older People Page 4 of 29 Brief description of the care home There are large homely communal areas which include a lounge and a dining area and several other areas within the home where individuals can receive visitors in private or enjoy the quiet space. The service provides a range of activities and events for individuals to attend, both inhouse and within the local community. The home has a large enclosed garden for individuals to use if they choose to. The employer offers staff accommodation close by to the home. There is ample parking in the grounds. 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 Quality rating for this service is 3 stars. This means the people who use this service experience excellent quality outcomes. The last key inspection on this service was completed on the 8th May 2007. This key inspection was conducted by Ms S Magnier Regulation Inspector and lasted for seven hours commencing at 07.00 hours and concluded at 14.00. The registered manager represented the service with the inclusion of the deputy manager. The inspector looked at and assessed how well the service was meeting all the National Minimum Standards for Care Homes for Older People and has in this report made judgements about the standard of the service. Care Homes for Older People Page 6 of 29 The service had completed a well documented Annual Quality Assurance Assessment AQAA which includes information from a variety of sources. This initially helps us to prioritise the order of the inspection and identify areas that require more attention during the inspection process. This document was received by the commission and is referred to within the report. The information contained in this report was gathered from observation by the inspector, speaking with a number of individuals living at the home and their relatives who were visiting and some of the the care staff. Further information was gathered from records kept at the home. The commission received a variety of written comments from people associated with the home which included twelve comment cards from individuals living at the home, two comment cards from health care professionals and ten comment cards from staff. The information contained within the comment cards has been added within the report. A full tour of the premises was undertaken and documents sampled during the inspection included peoples care plans, daily records and risk assessments, medication procedures, health and safety records, staff training and recruitment records, and some of the homes policies and procedures. The final part of the inspection was spent giving feedback to the registered manager about the findings of the visit. The commission have not received or been made aware of any notifications of complaints or safeguarding vulnerable adults referrals since the last inspection. From the evidence seen by the inspector it is considered that the home would be able to provide a service to meet the needs of individuals who have diverse religious, racial or cultural needs. What the care home does well: What has improved since the last inspection? The three requirements made during the last inspection have been met. Individuals care plans have been further developed to include an improved person centred approach. The menus have been reviewed, the quality and type of activities provided in the home Care Homes for Older People Page 8 of 29 have improved, redecorataion of parts of the home have been completed, the home have introduced a suggesstion box for individuals to make suggestions and give feedback about the home. Staff have attended equality and diversity training and have an increased awareness through training of the Mental Capacity Act. A proactive approach has been taken by the homes management regarding the Mental Capacity Act and the Deprivation of Liberty Act in order to ensure all individuals living at the home are safeguarded. The home have begun to apply the Gold Standards Framework for Palliative Care to support individuals with end of life care. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 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. People who may wish to use the service have a full needs assessment prior to using the service in order to ensure that the homes staff have the skills and abilities to meet the individuals assessed needs. Evidence: The homes management team evidenced through the three care plans sampled, that they understood the importance of having sufficient information through the completion of a full needs assessment for all people considering admission to the home. There was evidence to support that the care needs assessments had been completed with the individual or their representative prior to admission to the home. Admissions to the home only take place if the management team are confident that the homes staff have the skills and experience to support the individuals assessed needs. Care Homes for Older People Page 11 of 29 Evidence: Written comments received from a healthcare professional stated that occasionally placements are found to be wrong and efforts are made to find a more suitable home in such circumstances. The home does not offer intermediate care. 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. People are involved in decisions about their lives and have an active role in planning the care and support they receive. Peoples health care is promoted and the care people recieve is reviewed and changes recorded. The medication processes in the home are robust to protect individuals from harm. Peoples rights to protection, dignity and respect are promoted at all times. Evidence: The principles of the home are that people remain in control of their daily lives and this was evidenced by observing individuals moving around the home freely and having choices about where to be during the day which included staying in their room, being in the main lounge area, walking in the garden or being in the numerous quiet places in the home. The three care plans sampled evidenced that individuals and their representatives had been involved in the development of the care plans. The care plans demonstrated sound evidence of individuals equality and diversity. Care Homes for Older People Page 13 of 29 Evidence: The care plans sampled were person centred and included a range of information about the individual for example their life experiences and social history, how they like to communicate, their skills and abilities, and how they like to make choices in their lives and how the individuals health care needs are met. Written comments about the care people receive at the home included They are a great caring team of girls who always listen and act on what I say. They are available when you need them and also offer great support. My sister and I are very pleased with the care our mother has been given by a great team of staff. Friends and work colleagues have been pleased with the care their relatives are receiving or have received and individuals care is assessed and reviewed regularly. Case reviews involving the service user and family with the manager promptly resolves any concerns. The home are excellent in reporting any changes in medical conditions. There was evidence to support that the home has mainitained links with the local general practitioner who visits the home regularly, district nurse visits are arranged for individuals who require specfic interventions and referrals to other health care professionals are made in order to maintain the health and welfare of all individuals at the home. The home have documented plans for assessing individuals nutrition and the management of individuals body weight and where necessary pressure relieveing equipment is used to promote good tissue viability. The care plans were up to date and reviewed regularly to reflect the changing needs of the individual. The care plans contained comprehensive risk assessments which were reviewed and sampled as current to reflect the hazards being presented in the persons life and the measures in place to reduce the hazards as far as reasonably practicable. The homes management have sought additional information relating to peoples human rights with regard to limitations on freedom, mental capacity and choice to promote the best interests of people living at the home. There was evidence to support that peoples rights to citizenship were supported through access to visiting polling stations or postal voting. The home has a medication policy and procedure in place and continues to use a monitored dosage system. Medication records were well documented and all controlled medication checks were accurate. The procedures for ordering, delivery and disposal of medicines were robust. Training records evidenced that senior staff who administer medicines have received appropriate training. Written comments received by the commission from a health care professional stated With most of the residents administration of their medication is an organised and documented way which is key to Care Homes for Older People Page 14 of 29 Evidence: their wellbeing. When residents have mental capacity to organise their medication and wish to do so this is organised. I like to be kept informed of any difficulties. It was confirmed that some people like to continue to take their own medication without the help of staff and risk assessments were documented to support people to maintain this opportunity and independence. Whilst speaking with staff it was confirmed that people have a right to refuse to take medication and if the refusal continued external advise would be sought in order to ensure the well being of the individual. Throughout the day the inspector observed that people were addressed in a polite and courteous way by all staff and there was evidence of meaningful professional relationships between staff and individuals at the home. 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. Peoples rights of choice about their daily routines and the range of activities offered is promoted. Visitors are welcomed to the home to maintain contact with their family members and friends. The home provides a healthy and balanced diet in spacious and pleasant surroundings. Evidence: During the inspection it was observed that peoples rights to live an ordinary and meaningful life were promoted and where people chose to get up late, stay in their room or wander around the home these activities were accepted by staff in order to promote the persons autonomy and respect their choices. It was confirmed that the home is visited by the Christian clery and people can take part in a holy communion service if they choose to. The staff confirmed that if individuals from differing religious or faith backgrounds sought spiritual care these arrangements would be organised by the home to support the persons needs. Some people were observed to enjoy and particpate in the morning activities of a singalong with staff which was of amusement and particpation for some individuals Care Homes for Older People Page 16 of 29 Evidence: whilst other people preferred to observe. Staff were encouraging and participated in the activities and there was photographic evidence that individuals had been supported to social events outside of the homes environment. Handicrafts which individuals had made with staff were found in various areas in the home and individuals were interested in telling the inspector what they had been doing. The manager explained that a shop is available for people in the home and it was observed that the garden was well maintained and accessible to all individuals with some people being involved in the gardenning and pottering about. There was evidence that individuals are helped to maintain their interests and skills and have a daily nwespaper or talking newspaper and a computer has been provided with internet access for individuals or their families and freinds to use if they wish. Written comments received by the commission about the activities provided by the home included the activities are varied.I take part in the communion service. Music is used as an activity and the staff interact with the residents. Staff are patient and attempt to involve residents in social activities. Regular social activities and clients are encouraged to take part in activities outside the home. Springkell House provides good entertainment. It would be good to have more variety of entertainment and some residents should have more physical exercise as they spend too much time in their chair. Several vistors were in the home during the inspection and all spoke highly of the care, support and openess in the home by the manager and staff. Several visitors said they were delighted with the care their loved ones received and they felt they did not have to worry about them being in the care home as they were in good hands and the staff kept in contact with them. The registered manager showed evidence to support that people had been asked about their views about the meals provided at the home and several of the suggestions had been implemented and menus were available throughout the home in a variety of formats to inform people about the food offered by the homes chefs. Written comments received by the commission about the food provided by the home were varied and stated The food is excellent. More variation with the evening meals is required, sometimes overcooked vegetables especially potatos. Broccoli and carrots always nearly raw. Custard sometimes cold. No consistency. We have recently changed the breakfast menu and I consider the residents have more variety now and they enjoy it. The registered manager advised that the home had recently had an environmental health visit which did not highlight any shortfalls. Care Homes for Older People Page 17 of 29 Evidence: Breakfast and the midday meals were served in a efficient manner and evidenced a choice including a cooked or continental breakfast. . The dining area was viewed and contained small tables which had been set with appropriate condiments, crockery, cutlery, tablecloths and napkins. People were observed during the midday meal and staff were on hand to support anyone who needed assistance. Care Homes for Older People Page 18 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. People are protected by the homes complaints and safeguarding adults procedures. Evidence: The home has an established complaints procedure which was evidenced as an up to date document and was available throughout the home. It was confirmed whilst speaking with the registered manager that no complaints have been received since the last key inspection. Written comments received by the commission from individuals at the home regarding how to make a complaint included I talk to one of the older staff members who are very kind to me.My daughter would help me to make a complaint if I needed to. Various people told the inspector that they would make a complaint to staff or their relatives if they were not happy or had concerns about the home. It was observed that the managers and staff were aware of individuals anxieties at particular times of the day or night and staff were prompt to recognise these and assist the individual by offering reassurance and support. The security of the home was robust and incorporated a key pad system. People entering the home signed the visitors book and the homes garden was fully enclosed to offer security for individuals. Care Homes for Older People Page 19 of 29 Evidence: Three staff files sampled evidenced that Criminal Record Bureaux checks and Protection of Vulnerable Adult checks are carried out on all new staff. The home has a copy of the current Surrey County Council Multi-agency Procedures for Safeguarding Vulnerable Adults. The homes policy regarding the safeguarding of vulnerable adults was sampled and it was evidenced that the policy was complex and did not comply with the local authorities protocols. The registered manager agreed that the policy was complex and verbally advised the inspector of the homes process in reporting safeguarding concerns which was compliant with the local authority protocols. Assurances were given that the homes policy would be updated as a matter of urgency and all staff would be made aware and receive an updated copy of the policy and procedure. It was confirmed that no safeguarding referrals have been made since the last key inspection. Records sampled evidenced that all staff had received safeguarding vulnerable adults training and where staff were due to attend the training this had been booked. The home has a whistle blowing procedure in order that staff are aware of their duty of care to report any safeguarding incidents. The manager has been procative in seeking additional information and assessing situations regarding the Mental Capacity Act and the Derprivation of Liberty Act for some individuals who may lack capacity in order to ensure the protection of the individuals. Care Homes for Older People Page 20 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 physical design and layout supports individuals to live in a safe, well maitained and comfortable environment. The control of the spread of infection and cleanliness is generally well managed. Evidence: The location and layout of the home remains suitable for its stated purpose and the home continues to provide pleasant surroundings for individuals with suitable furniture and soft furnishings throughout the home for people to use. The home was well maintained and where a shortfall was identified during the inspection regarding the closure of the laundry door this was promptly rectified by the home maintenance person. Written comments received by the commission about the homes environment were varied and stated The bedrooms could be hoovered and dusted a bit more often and the ensuites, especially the basins could be washed a bit more than they seem to be. Window cleaning inside and outside would be nice.My room has not always been dust free. There have been frequent problems getting the staff for cleaning duties. The service looks after elderly people in an environment they can cope with and the recent refurbishment makes Springkell House much more comfortable. Care Homes for Older People Page 21 of 29 Evidence: Generally the home was clean and one housekeeping staff member was spoken with during the inspection. The home have two passenger lifts providing access to all floors. During the tour of the premises the hairdressing suite was seen and it was suggested that the room be arranged in a more creative way that helps people to have a sense that they are visiting a hairdresser as the room was void of any resemblence to a hairdressing suite. All bathroom and toilet doors are painted red and signage is available to assist individuals to find their way around the home. There are quiet areas where individuals can choose to meet their friends and family if they do not want to have visitors in their bedrooms. The inspector noted that the general standard of cleanliness and hygiene throughout the communal areas of the home was good yet the comments from individuals living in the home regarding the cleaning of their private rooms needs to be taken into account following receipt of the report. The control of infection in the home was well managed and staff were seen to wear protective clothing for all tasks undertaken in the home, disposal of clinical and domestic waste was well managed and handwashing facilities including hand gels were available to all people throughout the home. 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. Staff in the home are in sufficient numbers to support the people who use the service. Safe recruitment and vetting of staff protect the welfare and safety of individuals and staff receive training to ensure peopels needs are appropriatley met. Evidence: During the inspection it was observed that the home was adequatley staffed at all times and staff were at hand to meet the needs of individuals. The home employs fourteen carers, nine of whom have achieved their National Vocational Qualifications in level 2 or above. The deputy and registered manager advised that they work hands on in the home and this was evidenced during the day of the inspection. The general atmosphere was quiet and orderly and staff were observed to undertake their duties in an efficient and professional manner. Staff relationships with individuals were professional and the use of terms of endearment supported trusting relationships between the individual and the staff member. Peoples preferences on how they like to be addressed were documented in peoples care plans. Written comments received by the commission about the staff at the home included The patience and understanding of most of the carers utterly amazes me. Senior staff keep me informed of relatives concerns or aspirations.Regular training is Care Homes for Older People Page 23 of 29 Evidence: attended. Staff written comments included We provide a good quality care to the service users and there is good training for staff. The people you work with help each other and the manager takes care of any problem and is there when you need help. We offer a clean and happy house with a stable staff who are fully trained. A busy house with plenty for service users to do in a safe environment.Our manager always sees to it that there is supervision every 2 months. The home has a recruitment and selection policy, which incorporates equal opportunities. The inspector sampled two care staff files which were well recorded and evidenced the vetting practices concerning the recruitment of staff were robust in order to ensure the safety and protection of people in the home. The files contained application forms, with two references, evidence that face to face interviews had taken place and the job description in order that the staff member was clear about their roles and responsibilities. There was documented evidence that a CRB clearance had been obtained. The managers affirmed that the home is committed to the ongoing training and development of staff and the staff files and training matrix detailed that staff attended induction, statutory training and specialist training which supports them to care for individuals with specfic needs for example dementia or dementia type illness. 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 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 robust and continues to be run in the best interests of the people living in the home. Peoples views and opinions and those of others associated with the home are sought and acted upon and peoples welfare is promoted through the monitoring of health and safety in the home. Evidence: The management of the home is robust and based on openess and respect. The registered manager demonstrated throughout the inspection a knowledge and understanding of the day to day running of the service for the benefit of the people living at the home. It was evident during the inspection that the homes staff have open and professional relationships with individuals living in the home and their visitors and their views about the care and support their friends and relatives receive is listenned to and acted upon by the homes managers. Written comments received by the commission about the running of the home included Care Homes for Older People Page 25 of 29 Evidence: The home appears to be run efficiently. Staff and residents appear content and there is always a pleasant atmosphere in the home. The home are very welcoming to visitors. The home has an internal Quality Assurance process and there was evidence to support that the views from people living in the home had been instrumental in changing some of the aspects in the home which have included changes in the menu choices, more exciting recipes, an increased number and type of activities, and the introduction of a suggestion box. Regulation 26 records of an unannounced visits by the organisations area manager noted that the record was thorough in assessing the quality of the service and any issues identified would be noted by the owners in order that appropriate action would be taken to rectify the shortfalls. The storage of chemicals in the home were appropriate to ensure the safety and welfare of all people in the home. The fridge, freezer and pantry were well stocked. Fresh fruit and vegetables were available for individuals. Records of food temperatures, storage of food in the fridge and pantry was in compliance with food hygiene standards to ensure peoples health and safety. The homes fire procedures sampled confirmed that records were kept of fire tests and equipment checks and signage was available within the home to show people fire exits. Three individuals finance records were sampled all of which were an accurate account to ensure peoples finances are safeguarded. The home have a current certificate of registration and insurance and the recording of accident and incidents has been maintained with the commission continuing to be informed promptly of events which affect the well being and welfare living in the home. 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 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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. 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