Care Home: St Claires Care Home

What the care home does well Prospective residents have their needs properly assessed beforehand. The manager always goes out to meet with them and find out about the support that they will need and makes sure that the home is suitable for them. The assessment is recorded and information passed onto staff, so that they will be ready for the person when they move in. Each resident has a written plan of care that tells staff about them and the support that they need. The plans make sure that any risks are identified and they include guidance on how to keep the resident safe. Staff support residents in a respectful manner, making sure that their dignity is upheld. They provide well presented, varied and nutritious meals. There is a choice of food at all mealtimes and residents can choose where they eat their meals. The home is clean and well maintained, making it safe for residents to live in, with hygiene practices protecting them from the spread of infection within the home. The home has its own trainers and they have a comprehensive training programme that makes sure staff are suitably trained for their role. This includes dementia care and various safety courses to protect residents. There is a strong management team that makes sure that staff are supported. They encourage people`s views, which are listened to and acted upon to make changes for the benefit of the residents. What has improved since the last inspection? They have developed the activities they provide, which has resulted in more stimulation for residents. A team leader now coordinates activities to make sure that all residents have regular activities according to their wishes. There is a system to make sure that outside activities are shared around, so that individuals do not get left out. They have hired a minibus for outings in the summer months to provide residents with more opportunities. They have continued with the decorating and refurbishment of the home, which has enhanced the quality of the environment for residents. They have continued with their staff training programme to help staff develop their knowledge and skills. What the care home could do better: At our last inspection the home was providing a good service. This inspection has confirmed that they have maintained the standards evident at our last visit and no requirements or recommendations have been made. The only outstanding thing from our last inspection is the manager`s registration, which is now in hand.The providers and managers have shown that they have a development plan for the home and they have identified areas for future improvements. One thing that we discussed was for the care plans to be developed to make them more focused upon the needs of people with dementia. This should include personal profiles for each resident and things to build a memory bank for them. One of the bathrooms needs refurbishment and we were told that this would be added to the improvement plan. The providers have already identified the need for a proper sluice facility and they plan to create a larger laundry room, so that they can add another washing machine. Key inspection report Care homes for older people Name: Address: St Claires Care Home 18-24 Claremont Road Folkestone Kent CT20 1DQ     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: Christine Grafton     Date: 0 2 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 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: St Claires Care Home 18-24 Claremont Road Folkestone Kent CT20 1DQ 01303254897 01303220882 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Rosemere Care Home Ltd care home 39 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users to be accommodated is 39 The registered person may provide the following category 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 category: Dementia (DE) Date of last inspection Brief description of the care home St Claires is a detached premises situated in a residential area near to the town centre of Folkestone, within easy walking distance of facilities such as shops, health centres, churches, railway and bus stations. There are three floors incorporating four day rooms and 37 single bedrooms, six of which have en suite facilities and one double bedroom. Residents and visitors have access to all parts of the home via two shaft lifts. There is a small garden at the front of the premises, which is accessible to residents. Designated car parking is limited but there is off street parking. A copy of the inspection report is on display in the entrance hall. The current weekly fees range between £396.48 and £500.00. 39 Over 65 0 Care Homes for Older People Page 4 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 received since the last inspection of 5th June 2007 and included a visit to the home. We visited the home without telling anyone we were coming so that we could see what it is like for people living there on a usual day. We arrived at 09.10 hours and stayed for the day, leaving at 16.30 hours. We spoke to the manager, staff and residents. The manager showed us around the communal areas of the home and we saw a sample of bedrooms. We observed what was going on, the home routines, staff practices, and what activities were taking place. We looked at some of the homes records and saw the lunchtime meal being served. We also used the homes annual quality assurance assessment known as an AQAA for short. This is a document that all homes have to send us once a year to tell us how they think they are meeting the national standards, how they have improved in the Care Homes for Older People Page 5 of 27 previous year, what they aim to do and lets us know when they have completed important environmental safety checks. Information from the last inspection is also referred to. The people who live in the home are referred to as residents throughout the report. At the time of our visit there were 37 residents, including one person staying for a period of respite care. The manager, Mary Coyne, has been managing the home for two years. She indicated that she would be submitting an application to become registered with us shortly. Care Homes for Older People Page 6 of 27 What the care home does well: What has improved since the last inspection? What they could do better: At our last inspection the home was providing a good service. This inspection has confirmed that they have maintained the standards evident at our last visit and no requirements or recommendations have been made. The only outstanding thing from our last inspection is the managers registration, which is now in hand. Care Homes for Older People Page 7 of 27 The providers and managers have shown that they have a development plan for the home and they have identified areas for future improvements. One thing that we discussed was for the care plans to be developed to make them more focused upon the needs of people with dementia. This should include personal profiles for each resident and things to build a memory bank for them. One of the bathrooms needs refurbishment and we were told that this would be added to the improvement plan. The providers have already identified the need for a proper sluice facility and they plan to create a larger laundry room, so that they can add another washing machine. 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 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Anyone considering moving into the home, or their representative, is given information about it and the facilities provided, to help them make the choice. Before a person moves into the home, they have an assessment that tells staff about them and the support they need. This makes sure that their needs can be met upon moving in. It is not the general policy of the home to admit residents for specialist intermediate care, so standard 6 was judged as not applicable at this inspection visit. Evidence: The AQAA indicates that a copy of the homes statement of purpose and service users guide is given to the relatives or representatives of a prospective resident. Since the last inspection, a new brochure has been introduced. As people admitted suffer from dementia, relatives, and, or, care managers, are fully involved with the admission Care Homes for Older People Page 10 of 27 Evidence: process and the decision about the suitability of the home. The person then moves in for a trial period where the assessment is continued and a care plan drawn up. We looked at a sample of care plans, including one for a person admitted in the past twelve months. A full assessment is carried out that includes obtaining a copy of the care management assessment, if the person is to be placed by care management arrangements. The manager and provider always go out to meet the prospective resident and their relative, or carers, in their own home, or hospital and carry out a pre admission assessment. The pre admission assessment provides an overview of the persons background, health and daily living needs, any difficulties they have and where assistance is needed. It covers risks and gives an indication of how these will be managed upon admission. The care plan is then devised as soon as possible following admission. The manager stated that the pre admission process is important to make sure the home can meet the needs of the person. She described a recent assessment where the decision was made not to admit the person, as it was evident that the home could not meet their needs. We spoke to a visiting relative of a resident staying for a period of respite care. They told us that the person had stayed at the home several times before and they were pleased with the way they had settled into the home on each occasion. They told us they were confident that the staff know how to care for people with dementia and that their relative was being well looked after. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from being given the personal support that ensures their physical and emotional needs are met. They are protected by the homes policies and procedures for dealing with medicines. Staff understand their needs and treat them with respect. Evidence: We looked at a sample of four care plans and discussed them with the team leader. They contain detailed information about the persons needs with guidance for staff on how to provide their individual care. The care plans are well ordered with sections covering a wide range of things, including, personal care, healthcare, nutritional needs, communication, mental state and cognition, mobility and dexterity, risk of falls, continence, personal safety and risk. Care plans are reviewed each month by the key worker and the team leader oversees the process. The reviews look at each individual need identified in the care plan and show where things have changed and what action has been taken. Records show where health professionals provide support, such as community nurses, doctors, Care Homes for Older People Page 12 of 27 Evidence: chiropodist and dentist. The AQAA states that involvement of the community psychiatric nurse (CPN) and the consultant psychiatrist is crucial for the well being of the residents. The CPN visits regularly to review all of the residents medication and reports back to the consultant psychiatrist. The manager described how one residents well being had improved following a change to their medication and this was confirmed when we checked the medication records and in discussion with the team leader. We discussed the needs of one resident where there had been a change following a hospital admission. We saw that pressure relieving equipment had been obtained and the care plan updated to clearly show the higher level of care now required. Fluid and food intake and turning records are kept, weight is regularly monitored and risk assessments updated. Daily records show what the person has been like during the day and night. We learnt a lot more about the residents case tracked from talking with the manager and a staff member that was not recorded in the care plans. We discussed with the manager about developing the care plans to make them more person centred and to show how they consider equality and diversity. Although we were seeing that residents diverse needs are known and taken into account, the care plans do not include some of the things seen and discussed that would evidence good practice. For example introducing a more person centred model of dementia care and use of well being and ill being indicators. The manager and provider were very receptive and the provider had already identified this as an area for future development. We looked at the way medications are managed and found that things are in order. Staff that give out the medications have undergone training. Two team leaders are responsible for ordering and auditing of medication and two carers have also been trained in this. Their auditing includes the close monitoring of the medication administration records and we checked a sample of these and found that they were in order. Medication is securely stored. A British National Formulary (BNF) has been obtained since the last inspection as an up to date drug reference for staff to refer to. We met residents in the various lounges and other parts of the home and observed that staff interacted with them in a respectful, calm and friendly manner. We observed staff giving due consideration for dignity. Care Homes for Older People Page 13 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from having opportunities to take part in activities that suit their needs and from being able to keep in contact with families and friends. Residents benefit from having a varied menu with choices at each mealtime. They also have a choice of where to have their meals. Evidence: Activities are coordinated by a team leader who arranges indoor activities around residents wishes. Outdoor activities include monthly visits to the Salvation Army hall for the Silver Song Club. The coordinator monitors activities and makes sure that residents take it in turns going to this so that no one that enjoys this activity is left out. They have listened to feedback from relatives and have booked some outings for the summer months. A special minibus is hired for two days each month and separate morning and afternoon trips out take place with four residents and two carers going on each trip. This enables a total of sixteen residents to be taken on these outings each month. We saw staff doing activities with residents. A staff member is allocated to each of the Care Homes for Older People Page 14 of 27 Evidence: lounges and we saw a soft ball game being played in one lounge, residents listening to music and singing along in another lounge, some doing jig saw puzzle making and one resident playing a selection of musical instruments in another. Staff were seen sitting and talking with residents and encouraging them to interact. Staff keep a record of what activities residents have participated in. The manager obtains as much background information about the person as possible at the pre admission assessment and from the care management assessment. Care plans include a section for a personal profile to be recorded, but three out of the four that we looked at had not been completed. Some brief details about past interests and lifestyle are recorded in various parts of the care plan. We discussed with the manager that it would benefit residents if this information could be coordinated and recorded in a meaningful way. For example, the manager and team leader that we spoke with told us about the backgrounds of residents case tracked, things that they know about and clearly use to inform the way that they support those residents. However, a lot of the things discussed had not been recorded, so might be missed by other staff. We discussed that a personal profile should be completed for all residents wherever possible. This is important for people with dementia, as it can help staff to know and understand them, especially as they might not be able to tell staff about themselves, due to lack of memory. Relatives and friends are encouraged to visit and cordless phones are used to enable residents to talk to relatives in the privacy of their own room. A visiting relative said that they are always made to feel welcome whenever they visit. We talked to the cook and saw the menu plan, which she is currently reviewing. The menus indicate a varied nutritious diet with two choices at each meal time. Meals are home cooked, with fresh meat and vegetables and a variety of fruit. Special diets are catered for, including vegetarian, pureed, diabetic and dairy free. The cook indicated she knows residents food tastes and that staff tell her about the likes and dislikes of new residents, which she records. Residents can choose to have their meals in the dining room in the basement, in any of the three lounges on the first floor, or in their bedroom. Staff are allocated to supervise in each area and help with feeding as required. A lunch time meal was observed and seen to be unhurried, with discreet prompting, encouragement and assistance given. Care Homes for Older People Page 15 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents relatives and representatives can be confident that any complaints will be listened to and sorted out. They can be assured that staff practices in the home will safeguard residents from harm. Evidence: The service users guide contains a copy of the complaints procedure and it is displayed in the foyer. The manager has an open door policy for all relatives and staff and makes herself freely available on a daily basis to listen and talk over any concerns that relatives may have. In this way any issues are dealt with straight away. Regular feedback is also encouraged via satisfaction surveys and relatives meetings. The AQAA states that they offer a vast range of training for staff to improve all aspects of the service provided for residents. The providers and manager are qualified trainers. All staff are trained in dementia awareness, Mental Capacity Act, person centred care and challenging behaviour. This enables them to have a sympathetic and professional approach to residents needs. The staff training matrix indicates that nineteen staff have completed adult protection training. Some staff completed this training in 2006 so refresher courses are due. One of the providers is the adult protection trainer and we saw the training programme for September to November 2009 that indicates planned sessions for this and the Mental Capacity Act training. Care Homes for Older People Page 16 of 27 Evidence: The team leader that we spoke with confirmed she had done this training and indicated good understanding of residents rights. She described how to react to certain behaviours and how to make sure that residents are protected. The manager and providers are aware of the new deprivation of liberties safeguards (DOLS) guidance. Stair gates and keypads have been fitted to the top and bottom of stairways for safety reasons. Due to the nature of residents dementias, it has been deemed as the only option to provide a safe environment for them. They have kept the use of these under review and are currently looking at the implications of the DOLS guidance as part of their management plans and forthcoming staff training programme. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a comfortable environment and benefit from the recent investment to renew some of the fabric and decoration of the building. This has enhanced the quality of the environment for residents. The home provides a range of specialist equipment and adaptations to enhance residents safety. Safe practices are in place to maintain hygiene and prevent the spread of infection within the home. Evidence: Since the last inspection a number of improvements have been made to the environment. These include a new roof and redecoration of the outside of the building. Internally, decoration is ongoing, with several bedrooms having been redecorated with new carpets fitted. The three lounges were decorated in 2008 and a new fifty inch television provided, which the AQAA indicates has been a huge success. Decoration of the first floor hallway has been completed with new carpet fitted. Some replacement windows have been fitted and the kitchen has a new double drainer stainless steel sink with tiled backing. We looked at the communal areas of the home and a sample of bedrooms. Those that we visited looked comfortable and well furnished. Equipment has been provided where needed, such as special hospital type beds and moving and handling equipment. New Care Homes for Older People Page 18 of 27 Evidence: bed linen has been provided throughout the home. One bathroom that we looked at is in need of refurbishment. The flooring is worn and stained around the bath hoist and there is a wooden toilet base, which is unhygienic, as spillages may seep into the wood and create odours. Also the wooden base is not easily cleanable. The manager indicated that the provider has a development plan for the home and is working through the refurbishment programme, which will include this bathroom, but she was not sure when. There were two cleaners and one laundry assistant on duty during the morning of our visit until 14.00 hours. A rotowash carpet cleaner was being used to maintain the freshness of the carpets. All areas of the home seen were clean and odour free. All bathrooms, toilets and bedrooms have supplies of liquid soap and paper towels for hand washing, to prevent the spread of infection. Staff wear disposable protective clothing when assisting residents with their personal care. There are two laundry assistants who cover seven days a week. We spoke to the laundry assistant who described procedures for dealing with soiled items and for maintaining infection control. The industrial washing machine has a special cycle that disinfects and kills germs. The AQAA indicates that twenty one staff are trained in infection control. The staff training matrix confirms this and shows that this includes kitchen and domestic staff. There is a separate sluicing sink for the cleaning of commode pans in a toilet that is also used by residents. There is an additional washbasin in this room for hand washing. The manager stated that the providers have plans to enlarge another bathroom and create a separate sluicing area. They also have plans to create a larger laundry room so that they can fit in a second washing machine that would be of benefit in the event of this one breaking down. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit because there are enough staff on duty with the right skills to meet their needs. Recruitment practices are sufficiently robust to protect them. Evidence: The AQAA states that they allocate six care staff during the day, which works out at an average ratio of six residents to one care assistant. At night there are four waking staff on duty. This was confirmed by the rotas seen and numbers of carers on duty during our visit. Care staff are supported by cleaners, catering staff, a laundry assistant and maintenance person. There is also an administrator that works two days a week. The AQAA also states that one member of staff starts at 07.00 hours to ensure that residents have been provided with an early morning drink and discussion with the manager and the rotas seen confirmed this. Staff training is encouraged and staff are supported to achieve their National Vocational Qualifications (NVQ) in care. Most of the training is done in house, as the providers and manager are trained trainers. There is also a training manager for the group of three homes under the same ownership and a separate training room on the top floor. Training is designated in staff rotas and the training programme and rotas show that courses are put on at suitable times for the staff and are arranged in advance, so that shifts can be covered. Care Homes for Older People Page 20 of 27 Evidence: The AQAA indicates that eight staff have completed, or are in the process of completing, their NVQ level 2 in care. Three senior carers have completed their NVQ level 3 and one senior has completed the NVQ level 2 Team Leader course, with three others in the process of doing this course. As well as this, the training matrix indicates that staff have completed a wide range of other courses relevant to their role. We looked at two staff files and saw that all the necessary security checks had been completed before they started work at the home. These include two written references, verbal references, criminal records bureau (CRB) and protection of vulnerable adults (POVA) checks. This helps to make sure that they are trustworthy to be around residents. All new staff undergo induction training with mandatory training included in the early stages of employment, with regular updating as necessary. The team leader spoke positively about the training provided at the home and confirmed that it has helped to develop her skills. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience 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 managed in a way that safeguards residents best interests, promoting and protecting their health, safety and welfare. Evidence: The manager was in post at our last inspection, two years ago, and at that time, stated that she was in the process of applying to become registered with the commission. Her application has not yet been submitted, but at the time of our visit we saw that arrangements were being made to start this process. This is important to comply with the law. The manager and provider both made a commitment to ensure that this is completed without delay. The manager has completed her NVQ level 4 in Health and Social Care and has worked at the home over six and a half years. She has undertaken a wide variety of training courses to equip her in her role, including being the trainer for moving and handling and challenging behaviour. Care Homes for Older People Page 22 of 27 Evidence: The management structure includes two team leaders and three senior carers, who are currently training to become team leaders. The two providers are both actively involved in the running of the home and support the manager in her role. Therefore there is a strong management team. An administrator also provides two days support at the home. Staff, residents and relatives are able to speak with the manager about any matters. We spoke to three staff members and one relative, who all confirmed that the manager has an open approach and always listens to them and residents. We saw her relating to residents in an empathetic way. The homes quality monitoring processes include holding regular staff meetings and relatives meetings. Prior to the relatives meetings, questionnaires are sent to them in good time so, that their responses can be collated and recorded. These are then incorporated into the agenda for the relatives meeting and we saw how decisions have been made as a result of their input. For example, the hiring of a minibus during summer months to take residents on outings. We were told that the CPN and consultant psychiatrist had attended one relatives meeting that had been a great success, as relatives were able to ask questions. Regular audits take place and since the last inspection, an audit of accident forms is regularly undertaken, with action plans devised and acted upon. The manager stated that this has been a success. We saw the monthly accident and falls analysis, and action included discussion with relatives of one resident, regarding the use of hip protectors. The provider does monthly visits and writes a report on the conduct of the home. The home does not deal with residents personal finances and instead invoices relatives for any additional items such as hairdressing and chiropody. The manager and both providers are moving and handling trainers. The manager said she makes sure that all new staff have this training as soon as possible. The home has its own stand aid hoist and mobile hoists are obtained via the loan store for specific residents use, as needed. One provider is the trainer for the majority of the mandatory training and the training matrix and current training programme indicate that these courses are held regularly. These include, fire safety, health and safety, infection control and food hygiene. The AQAA indicates that the homes equipment is maintained and services are up to date. They have regular visits from a health and safety consultancy as an advisory Care Homes for Older People Page 23 of 27 Evidence: service. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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 27 of 27 - 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!